Biomedical waste management has recently emerged as an issue of major concern not only to hospitals, primary health-care centres and nursing home authorities but also to the environment [1,2]. Advances in medical facilities and the introduction of more sophisticated instruments have increased the waste generation per patient in health-care units worldwide [3]. According to the World Health Organization (WHO), high-income countries generate on average up to 0.5 kg of hazardous waste per hospital bed per day. Although the figure for low-income countries is only 0.2 kg per hospital bed per day, health- care waste is often not separated into hazardous or non-hazardous wastes, making the real quantity of hazardous waste potentially much higher [4]. Clinical solid waste is a particular chal- lenge in most health-care facilities of the developing world. Poor handling practices and inappropriate disposal of hospital waste is an increasing health hazard in these countries [5–7]. For example, hazardous and medical wastes may be handled and disposed of to- gether with domestic wastes, thus creat- ing a health risk to municipal workers, the general public and the environment [8]. In countries where efforts have been made to tackle the problem, waste disposal options are limited, and small- scale incinerators have been used as an interim solution.
Like many developing countries, Egypt struggles to enhance its hospital waste management practices. Although the Environmental Law No. 4 of 1994 was issued in order to systematize in- tegrated hospital waste management implementation, authorities are failing to install efficient systems with respect to segregation, collection, transfer or treatment, due to weak legislative enforcement. Health-care workers in Egypt are often unaware of this legislation due to the absence of writ- ten policies and protocols. The most
frequent methods of final waste disposal are incineration or autoclaving. Most general hospitals in Egypt use incinera- tion while the majority of teaching and university hospitals use autoclaving. To our knowledge there has been only one published Egyptian study that assessed the knowledge and practice related to waste management among doctors, nurses and housekeepers in the surgical departments, at Al-Mansoura Univer- sity Hospital [9]. The objective of this study therefore was to assess the knowl- edge, attitudes and practices (KAP) of health-care providers towards waste management at Ain Shams University Hospitals, Cairo.