Iligan Medical Center College

San Miguel Village, Pala-o, Iligan City

College of Nursing, Midwifery and Health Aide

Impact of Waste Management Practices

on Health Awareness and Perception Of Healthcare
Personnel
and Neighboring Communities In Selected Hospitals in
Iligan City
 An Undergraduate Thesis
Presented to the Faculty of
College of Nursing, Midwifery, and Health Aide Department
Iligan Medical Center College

In Partial Fulfillment
Of the Requirement for the
Degree Bachelor of Science in Nursing

Presented by

Anticamara, Ian Dave Moscoso, Renante

Celdran, Carlos Miguel Ong, Eleonor
Dasmarinas, Ronald Padayogdog, Marivic
Devocion, Elrence Sabayle, Maila Angela
Limpao, Jamillah Tanudra, Elmer
Macataman, Settie Naillah Unabia, Louella Jo
 Introduction

All activities of living things on earth produce waste in some

form or the other. both biodegradable and non-
biodegradable hardly had any impact on the environment
until the invention of plastics by the modern man. Solid
waste management is a major problem in most developing
countries of the world due to its ever growing and endless
generation coupled with poor management. The air, the
water and the land are today becoming disposal sinks for
the waste (S. Saini, et al, 2005).
Hospital waste management is one of the biggest challenges
our country is facing today. Public concern over the past
years has been growing with regards to the disposal of
wastes produced by health care facilities in the Philippines
(Morones, 2009).The concern regarding the medical waste is
mainly due to the presence of pathogenic organisms and
organic substances in hospital solid wastes in significantly
high concentrations.
 The intent of this paper is to raise the awareness
regarding the importance of proper health care waste
management so as to enhance the quality of the health
care environment. This, along with the lack of local data
creates the need for the assessment of the hazardous
waste management of hospitals in Iligan City.
Theoretical Framework

Florence Nightingale and subsequent nurse scholars have written

about the impact of the environment on human health. Nightingale
described, and staked out, the nurse´s role in optimizing
environments for healing. The environment was the main emphasis
on Nightingales nursing beliefs. She clearly emphasized that clean
environment, fresh air, warmth, noise control and management of
wastes and odors were ways that the "environment could be
altered in such a way as to improve conditions so that nature could
act to cure the patient." (Selanders, 1993). She realized that
internal and external environment controls were both important to
the progress of the patient's health.
Theoretical Framework

There is a direct connection between nursing actions and

the health of the environment in health care agencies.
However, in daily practice nurses, whether administering
a medication, changing a dressing, or starting an IV, do
not usually consider the environmental impact of such
activities. To do an adequate assessment of the impact
of nursing care on the environment, one must consider
everything in the environment including the lighting, air
conditioning or heating, electrical equipment and pumps,
elevators, computers, electronic medication dispensing
machines, monitors, and more.
Conceptual Framework
The Independent variable Hospital waste management
practices encompasses three major factors.

 Hospitals must have an appropriate waste disposal that ensures

proper segregation, treatment, collection and transportation of the
generated waste by the healthcare facility.

Hospitals must also allocate sufficient safety precautions to

ensure efficient operation such as provision of personal protective
equipment for handling wastes and proper storage area and
equipments.

Hospital programs. These programs must be designed to reach

out to the entire staff, tap existing channels of education, to provide
education on a continuing basis especially for new staff.
Conceptual Framework
Every employee and manager should be made aware of the
existing government policies, laws and regulations related to
health care waste management. The overall aim of the training
is to develop awareness on the health, safety and environmental
issues relating to health care waste.
It also helps to create awareness and foster responsibility among
hospital patients and visitors to health care establishments
regarding hygiene and health care waste management. Public
education also plays an important role in health care waste
management.
The Dependent variables of this study are the health awareness
and perception of health care personnel and neighboring
community regarding Hospital waste management.
. SCHEMATIC DIAGRAM

Independent Variable Dependent Variable

Hospital Waste Management Health Awareness and Perception

Practices of respondents on hospital waste
management:
Hospital waste disposal
 Segregation  Health care personnel
 Treatment  Neighboring Community
 Collection and
Transportation
Safety precautions
 Storage area and
equipments
 Personal protective
equipments/measures
Hospital programs
 Educational and training
programs on healthcare
personnel
 Public education

Intervening Variable

Healthcare personnel profile

 Age
 Length of service

Community Profile
 Age
 Educational attainment
 Length of residency

Figure 1.1: The Conceptual Framework of the Study

Statement of the Problem

This research attempts to determine the Impact of

Waste Management Practices on Health
Awareness and Perception of Healthcare
Personnel and Neighboring Communities in
Selected Hospitals in Iligan City.
Hypothesis
This sector presents an assumption of the relationships
between the variables being studied. A null hypothesis
is being utilized and is to be tested and, if found to be
true, accepted. If not, it is rejected.

Ho1. There is no significant relationship between
hospital waste management practices to the health
awareness and perception of the health workers.

Ho2. There is no significant relationship between
health workers and community respondents profile to
their health awareness and perception.

Ho3. There is no significant relationship between the
health workers profile to the hospital waste
management practices.
The investigator will utilize the null hypothesis of 0.05
level of significance.
Significance of the Study
This study attempts to look into the Impact of
Waste Management Practices on Health
Awareness and Perception of Healthcare
Personnel and Neighboring Communities in
Selected Hospitals in Iligan City. Thus, the result
of this study will be helpful to concerned
institutions and individuals – Hospital
Administrators and Staff, to the Nursing
Students, to the Community and Future
Researchers.
 Hospital Administrators

This study could:

 Serve as an evaluative report that the
respective hospital could use in assessment
and identifying venues for future improvement.
 Encourage them to formulate effective and
sound policies to improve regulatory
compliance for the benefit of their agencies and
to all personnel working in their hospital
 Provide relevant recommendations to hospitals
and medical centers on possible ways of
managing medical waste disposal.
 Chief Nurses
This study would:

Help identify a number of personal health, environmental
safety, and patient care issues.

Serve as an evaluative report that the chief nurses of the
respective hospital could use in assessment and identifying
venues for future improvement of his/her division.
Staff Nurses
This study would:

Help raise awareness regarding the importance of proper

health care waste management so as to enhance the quality
of the health care environment.
As nurses will be able to advocate more effectively for
environmental conditions that promote health.
 Colleges of Nursing
This study would:
 Help promote the importance of the environmental issues in
nursing actions in health care agencies.
 That the colleges be a venue for training the future nurses to
becoming effective nurses despite the rigors of the chosen
career.

Nursing students
This study:

Becomes an inevitable concern as soon as they begin their

nursing career.

Would help develop awareness on the health, safety and

environmental issues relating to health care waste.
 Hospital workers

This study would :

 Help in identifying problems that needs improvement
in proper disposal of healthcare waste to protect the
health of workers and prevent spread of nosocomial
infections.
It creates: To the Community
 Public awareness for protection of human health by
reducing the exposure of employees, patients,
watchers, and entire community to hazardous health
care waste
 Enhance community relations by demonstrating a
commitment to environmental protection.
 Future Researchers

The document could also contribute to the already

existing body of academic knowledge. In that, it
serves as a source of information for
subsequent research in this area. Hopefully, this
will encourage future researchers to explore
solutions that will be of assistance to the
improvement of quality health care.
Scope and Limitation of the Study
 Among the selected are the two tertiary
hospitals in the city, Gregorio T. Lluch Memorial
Hospital (GTLMH) a government subsidized
medical institution, and St. Mary’s Maternity and
Children’s Hospital a private medical institution.
 There are two types of respondents included in
the study.
 hospital personnel
 households in the neighboring community.
 Definition of Terms
To facilitate and to give a better understanding of this
study, there are specific terms, which are defined
operationally, or they are given meaning according on
how they are used in this study.
 Age. In this study, this term was used to denote the
total number of years a person has lived.
 Awareness. In this study, this term shall refer to the
knowledge of the respondents about healthcare waste.

Collection/Transportation. In this study, this term
shall refer to the act of removing health care waste
from the source or from a communal storage point.

Disposal. In this study, this term shall refer to the
discharge, deposit, dumping, placing or release of any
health care waste into or on any air, land, or water.

Educational Attainment. In this study, this refers to
the highest educational level attained by the
respondent.

Hospital programs. In this study, this refers to the
educational and training programs the hospital offers
to their personnel and to the public.

Length of Service. In this study, this term was used
to refer to the length of time, years, or duration of an
occupation within a particular job in a hospital.

Length of residency. In this study, this term was used
to refer to the length of time, years, or duration of stay
within the neighboring community.

Perception. In this study, this term refers to the level
of satisfaction of the respondents on the hospitals
waste management.

Personal protective equipments/measures. In this
study this term refers to the available equipments and
measures the hospital provides to protect healthcare
personnel from healthcare waste.

Segregation. In this study, this shall refer to a health
care waste management practice of separating
different waste materials found in health care
establishment in order to promote recycling and re-use
of resources and to reduce the volume of waste for
collection and disposal.

Storage. In this study, this shall refer to the interim
containment of health care waste after generation and
prior to collection for ultimate recovery or disposal.

Treatment. In this study, this term refers to treating of
health care waste to change the biological and
chemical character of the waste to minimize its
potential to cause harm.
 Chapter II

REVIEW OF RELATED LITERATURE AND STUDIES

Medical or healthcare wastes are in the form of solid and
liquid wastes generated in the diagnosis, treatment or
immunization of human beings or animals; in medical
research; or in production of vaccines or other substances
produced from living organisms. They are commonly
generated by hospitals, medical or research laboratories,
clinics, offices of physicians and dentists, veterinarians,long
term-care facilities for example, nursing homes and funeral
homes.
 IMPACTS OF HEALTH CARE WASTE

A framework for health care waste management should

always consider health and occupational safety. There
are many potential hazards associated when dealing or
handling health care waste such as physical, chemical
and biological hazards as well as ergonomic factors.
Health care facilities should identify all these specific
environmental and occupational hazards during handling,
storing, treating, and disposing of health care waste.
Exposure to hazardous health care waste can result to
disease or injury. The hazardous nature of health care waste
maybe due to one or more of the following characteristics:

 Contains infectious agents

 Genotoxic
 Contains toxic or hazardous chemicals or
pharmaceuticals
 Radioactive
 Contains sharps (DOH manual, 2004).
Persons at Risk

The main groups of people who are at risk of exposure to health

hazards associated with health care waste are the following:


Staff of the health care establishments such as physicians, nurses, health care

Auxiliaries, and hospital maintenance personnel;

Patients in the health care establishments or receiving home care;

Visitors, comforters, and caregivers to health care establishment;

Personnel and workers providing support services and allied to health care

Establishments, such as laundries, waste handling and transportation;

Persons transporting hazardous health care waste;
Workers and operators of waste treatment and disposal facilities, i.e. sanitary
landfill including scavengers;
Persons at Risk

• Workers in mortuaries, funeral parlors and autopsy centers;

and

General public (DOH manual, 2004).

Establishments, such as laundries, waste handling and
transportation;

Persons transporting hazardous health care waste;

Workers and operators of waste treatment and disposal
facilities, i.e. sanitary landfill including scavengers;

Workers in mortuaries, funeral parlors and autopsy centers;
and

General public (DOH manual, 2004).
 Impacts of Health Care Waste to Public Health and the
Environment

Apart from the risk to the patients and health care personnel, consideration
must be given to the impact of health care waste to:

• The general public

• The environment

In particular, attention should be paid to the possible pollution of the air, water
and soil including the aesthetic aspects.

Minimizing the risk to public health and the environment will require actions to
deal with health care waste within the health care establishment such as proper
waste segregation and minimization so that it does not enter the waste
stream requiring disposal.
 Categories of Health Care Waste

1. General Waste - Comparable to domestic waste, this type of waste does not
pose special handling problem or hazard to human health or to the environment.

2. Infectious Waste – This type of waste is suspected to contain pathogens

(bacteria, viruses, parasites, or fungi) in sufficient concentration or quantity to
cause disease in susceptible hosts.

3. Pathological Waste - Pathological waste consists of tissues, organs, body

parts, human fetus and animal carcasses, blood and body fluids. Within this
category, recognizable human or animal body parts are also called anatomical
waste. This category should be considered as a subcategory of infectious waste,
even though it may also include healthy body parts.
4. Sharps - Include needles, syringes, scalpels, saws, blades, broken glass,
infusion sets, knives, nails and any other items that can cause a cut or puncture
wounds. Whether or not they are infected, such items are usually considered as
highly hazardous health care waste.

5.Pharmaceutical waste - Includes expired, unused, spilt, and contaminated

pharmaceutical products, drugs, vaccines, and sera that are no longer required
and need to be disposed of appropriately.

6.Geotaxis Waste - Geotaxis waste may include certain gyrostatic drugs, vomit,
urine, or feces from patients treated with gyrostatic drugs, chemicals, and
radioactive materials.
Related Studies
Several studies have been done to assess the management of
hazardous wastes in the Philippines and abroad. Soncuya et al, (1997)

Majority of the hospitals is not practicing treatment

procedures prior to the disposal of their infectious waste
and does not adhere to color-coding system required by
MMDA Ordinance No. 16. These practices pose
significant risks to humans, including direct contact and
contamination of surface water or groundwater.
Another study on waste management practices of
hospitals in Metro Manila conducted for the Department
of Health (DOH) revealed that although most of the
hospitals perform waste segregation, less than 50% of
the 144 hospitals studied did not have the proper
mechanisms for proper waste handling and
segregation.
Related Studies

In Sylhet, a study entitled “Hospital Waste Management

in Sylhet City”; it was observed that:
•Existing hospital waste collection, and handling and
disposal practices of all the hospitals in Sylhet involved
transport of wastes by ward boys, maid nurses and other
employees from the point of generation to initial storage.
In a similar study done in Dhaka City on Solid Waste
Management, it was found out that there were over 500
clinics and hospitals in Dhaka City and majority of the
hospitals were not practicing safe disposal of wastes.
Waste is collected from small bowls or plastic bins
provided for each bed and emptied into larger containers.
Related Studies
Bhatia (2003) did a study in Mumbai on “Biomedical
Waste Management: Understanding our civic
issues”, health care institutions dump their infectious
waste, along with the rest of the non-infectious waste,
in the municipal garbage systems, posing a serious
risk to public health as well as a risk of
scavenging(Bhatia, 2003 ).

Thus, poor management of healthcare waste poses a

severe threat to public health and may also damage
the environment.
 Chapter III

RESEARCH METHODOLOGY

Research Design

Descriptive Correlational type of research will be used,

since this study aims to determine the Impact of Waste
Management Practices on Health Awareness and
Perception of Healthcare Personnel and Neighboring
Communities in Selected Hospitals in Iligan City.

The main purpose is to describe events, phenomena,

situations, practices and trends developing through the
use of measurement or quantification of events or
variables under the study and the relationships that
occur naturally between and among them.
Research Design

An observation of hospitals in Iligan City will be

done regarding waste management practices
performed by the different departments of the
hospital at the same time survey questionnaires
and informal interview will be utilized to gather
the necessary information needed for the study.
The information to be gathered from this study
will be those which exist at the time of the
survey.
Research Locale
The City of Iligan, dubbed as the
Industrial City of the South, is a
highly urbanized city in the province
of Lanao del Norte, Philippines, and
the province's former capital.

Serving the medical needs of its

populace are the two hospitals,
among others, that have been home
to teams of doctors, nurses and
aides Gregorio T. Lluch Memorial
Hospital and St. Mary’s Maternity
and Children’s Hospital are the
venues for gathering data on this
Respondents of the Study
There are two types of respondents included in
the study. First, are the hospital personnel and
second are the households in the neighboring
community of selected hospitals in Iligan City.
1. Hospital personnel of the following positions:
Hospital Waste Manager
Nurses
Orderlies/waste handlers
2. Head of the households of the neighboring
community
Sampling Design
Purposive sampling will be used in the selection
of hospital personnel and household of the
neighboring community based on the inclusion
criteria.
Purposive sampling is based in the belief that
researcher’s knowledge about the population
can be used to hand pick the cases to be
included in the sample.
This study will purposely select the widest possible variety of
respondents and choose subjects who are judged to be
typical of the population in question or particularly involved
and knowledgeable about the issue under study.
Research Instrument
The study will make use of a self made form
of questionnaires as means of collecting
data for hospital waste managers, nurses,
orderlies and household of the neighboring
community.

Observations will be recorded during

personal interviews with subjects.
Similarly, all items in the checklists are
based on the guidelines set on healthcare
waste management by the DOH Manual.
Statistical Treatment of Data
The data that will be obtained from the respondents will be
tabulated systematically in order to obtain accurate information
related to each element of the target population. In analyzing the
data gathered from respondents, the descriptive statistical
technique like the percentage distribution and mean for the
different variables in the study will be used. This reveals the
overall average of responses or perceptions of the respondents.
Percentage formula will be used for the profile of the respondents
in problems 1 and 2.
% = number of respondents in a group x100%
Total number of respondents
Mean formula will also be utilized for the other problems 3, 4 and 5
of the study.
Where:
n = refers to the number of subjects
xi = i th observation in a data set
= summation of observation from 1st (i=1) up to the last
respondent (n)
For relationship between variables on problems 6,
7, 8, and 9 Pearson’s product will be used.
Pearson’s Formula:
Pearson’s Formula or Correlation Coefficient:  Used to define
the strength and direction of a relationship between 2 variables (ex.
Age vs. salary) – often presented as a scatter diagram. 
 

Where r is the number of samples

X is the observed value of the first variables
Y is the observed value of second variables
N is the number of sample or respondents used in the
analysis
 Chapter IV

PRESENTATION, DISCUSSION AND ANALYSIS OF DATA

This chapter presents the data collected in the order stated
in the statement of the problem, in the frequency distributions
includes the descriptive statistics for each variable.

A total of 18 nurses, 2 waste handlers, and 30 households

of the neighboring community were made respondents of the
survey. This is composed of 35 respondents from Gregorio T.
Lluch Memorial Hospital and 15 from St. Mary’s Maternity and
Children’s hospital.

Problem I: What is the profile of the healthcare personnel in

terms of the following:
1.1 Age
1.2 Length of Service
 Table 1.1 Percentage Distribution According to Age

Profile Frequency Percentage

Age
21 – 23 7 35 %
24 - 26 8 40%
27 - 29 3 15%
30 and above 2 10 %
Total 20 100 %

Table 1.1 Presents the Percentage Distribution According to Age. The table shows
that majority or 40% (8 nurses) of the total respondents were within the age range
of 24-26 years old. On the other hand, 35% (7 nurses) where within the age range
of 21 – 23 years old, 15% (3 nurses) belongs to the age range of 27 – 29 and 10%
(2 waste handlers) belongs to the age range of 30 and above. This result can be
attributed to the increasing trend of new nurses belonging to ages 21-29 most of
them just join the healthcare workforce upon graduation from nursing courses.
 Table 1.2 Percentage Distributions According to Length of Service
Profile Frequency Percentage

Length of Service
3 years and below 18 90 %
4 years and above 2 10 %
Total 20 100 %

Table 1.2 Presents the Percentage Distribution of the Respondent According to

Length of Service Rendered. It shows that majority or 90% of the total
respondents have been in service for 3 years and below, but not less than 2
months, and 10 % of them from 4 years and above, but not more than 15 years
in service. This result essentially means that nurses working are generally new
in this field and can be related to the result in Table 1.1 regarding the age
distribution where it has been found out that most nurses are from ages ranging
from 21-29 years old. Again, this is attributable to the increasing trend of new
nurses and the fact that most nurses in the institutions today are generally
young.
Problem II: What is the profile of the community
respondents in terms of the following:
2.1 Age
2.2 Educational attainment
2.3 Length of residency
 Table 2.1 Percentage Distribution According to Age

Profile Frequency Percentage

Age
21 – 29 3 10 %
30 - 38 3 10 %
39 - 47 10 33.33 %
48 - 70 14 46.67 %
Total 30 100 %

Table 2.1 Presents the Percentage Distribution According

to Age. It shows that majority or 46.67% of the total
community respondents belong to the age bracket of 48-
70. Out of 30 community respondents, 33.33% belongs
to ages 39-47, 10 percent belongs to ages 30-38 and
another 10% belongs to 21 – 29 age bracket.
 Table 2.2 Percentage Distribution According to Educational attainment

Profile Frequency Percentage

Educational
attainment
Primary level 2 6.67 %
Secondary level 6 20 %
Tertiary level 22 73.33 %
Total 30 100 %

Table 2.2 Presents the Percentage Distribution

According to Educational attainment. It shows that
majority or 73.33% of the total population of
community respondents are college graduates, 20%
have finished high school level, and 6.67% have only
reached grade school level.
 Table 2.3 Percentage Distributions According to Length of residency

Profile Frequency Percentage

Length of
Residency 11 36.67 %
0-7 years 7 23.33 %
8-14 years 7 23.33 %
15-21 years 5 16.67 %
22-35 years 30 100 %
Total

Table 2.3 Presents the Percentage Distribution According to

Length of residency. It shows that majority or 36.67% of the total
population have been a resident in the neighborhood for 7 years
and below but not less than 1 year, 23.33 % of them from 8 years
to 14 years, another 23.33 % from 15-21 years and 16.67% has
been a resident there for more than 22 years but not more than 35
years.
Problem II: What is the profile of the community
respondents in terms of the following:
2.1 Age
2.2 Educational attainment
2.3 Length of residency
 Table 2.1 Percentage Distribution According to Age

Profile Frequency Percentage

Age
21 – 29 3 10 %
30 - 38 3 10 %
39 - 47 10 33.33 %
48 - 70 14 46.67 %
Total 30 100 %

Table 2.1 Presents the Percentage Distribution According to Age. It

shows that majority or 46.67% of the total community respondents
belong to the age bracket of 48-70. Out of 30 community
respondents, 33.33% belongs to ages 39-47, 10 percent belongs
to ages 30-38 and another 10% belongs to 21 – 29 age bracket.
 Table 2.2 Percentage Distribution According to
Educational attainment

Profile Frequency Percentage

Educational
attainment 2 6.67 %
Primary level 6 20 %
Secondary level 22 73.33 %
Tertiary level 30 100 %
Total
Table 2.2 Presents the Percentage Distribution According to Educational
attainment. It shows that majority or 73.33% of the total population of community
respondents are college graduates, 20% have finished high school level, and
6.67% have only reached grade school level.
 Table 2.3 Percentage Distributions According to Length of residency

Profile Frequency Percentage

Length of
Residency 11 36.67 %
0-7 years 7 23.33 %
8-14 years 7 23.33 %
15-21 years 5 16.67 %
22-35 years 30 100 %
Total
Table 2.3 Presents the Percentage Distribution According to
Length of residency. It shows that majority or 36.67% of the total
population have been a resident in the neighborhood for 7 years
and below but not less than 1 year, 23.33 % of them from 8 years
to 14 years, another 23.33 % from 15-21 years and 16.67% has
been a resident there for more than 22 years but not more than 35
years.
Problem III: What is the status of the waste
management practices of the selected hospitals in
Iligan City as to the following:

•Waste segregation
•Treatment done to the waste before disposal
•Collection and transportation of waste
•Waste storage area and equipments
•Personal protective equipments/measures
•Hospital educational programs
 Table 3.1 Mean Distribution According to Waste Segregation
Waste Segregation Mean Interpretation

1. I observe proper segregation of wastes. 4.1 Highly Effective

2. Waste from infected patients in isolation wards 4.1 Highly Effective

e.g. dressings from wounds are properly separated
from general wastes.

3. Terminated IVF, blood and body fluids are properly 4.2 Highly Effective
separated from general wastes.

4. I always make sure that sharps are never mixed 4.7 Highly Effective
with non sharps.

5. I never find needles and syringes and other sharp 4.65 Highly Effective
waste mixed with infectious or general waste.

6. Proper color coding system in the vicinity is 4.05 Highly Effective

followed.

7. Bags and containers for infectious waste are 4.3 Highly Effective
properly marked with the international infectious
substance symbol.

8. I separate contaminated sharps such as needles 4.4 Highly Effective

and syringes from uncontaminated sharps such as
broken glass and nails.

9. I practice waste minimization. 4.3 Highly Effective

Over all Mean 4.31 Highly Effective

Legend: 0 - 1.25= Poor 1.26-2.5= Less Effective 2.6-3.75= Effective 3.76-5.0= Highly
Effective
These results would mean that the respondents apply
waste minimization on their respective departments and
recycling is their main measure to achieve waste
minimization. Waste minimization is centered on the
elimination or reduction of the healthcare waste stream.
Recycling is collecting waste and processing it into
something new. Many items in the hospital can be
recycled. Items such as organics, plastic, paper, glass
and metal can be recycled easily (DOH Manual). An
effective healthcare waste management considers the
basic element of waste minimization therefore it is
beneficial for all hospitals in Iligan City to implement such
measures.
 Table 3.2 Mean Distribution According to Treatment of waste
Treatment of waste Mean Interpretation
10. Proper on-site treatment is done prior to the 4.2 Highly Effective
disposal of infectious waste.
11. Proper sterilization prior to the disposal of 4.2 Highly Effective
pathological wastes such as blood and body fluids is
done.
12. Proper encapsulation is done prior to disposal of 4.1 Highly Effective
sharps.
Over all Mean 4.16 Highly Effective

Legend: 0 - 1.25= Poor 1.26-2.5= Less Effective 2.6-3.75= Effective 3.76-5.0= Highly Effective

It shows that the respondents of this study concur that they able to
treat infectious waste prior to disposal. The purpose of treating
healthcare waste is to change the biological character of the waste to
minimize its potential to cause harm. In an interview with the waste
manager they make use of chemical substance as means of treatment.
• These results would mean that the respondents do perform
sterilization of pathological waste prior to disposal.
• The subjects concur that proper encapsulation is done prior to
disposal of sharps are done.
 Table 3.3 Mean Distribution According to Collection and
Transportation of waste
Collection and Transportation of waste Mean Interpretation
13. The establishment utilized wheeled trolleys, 4.15 Highly Effective
containers, or carts in the transportation of healthcare
wastes.
14. Waste are collected daily (or as frequently as 4.35 Highly Effective
required) and transported to the designated central
storage site.
Over all Mean 4.25 Highly Effective

Legend: 0 - 1.25= Poor 1.26-2.5= Less Effective 2.6-3.75= Effective 3.76-5.0= Highly Effective

Table 3.3 shows the Mean Distribution according to

collection and transportation of waste.The table shows that
garbage collection per daily basis is properly implemented
and designated to central storage site.
Table 3.4 Mean Distribution According to Storage area and
Equipments

Storage Area and Equipments Mean Interpretation

15. Containers of sharps are puncture-proof and fitted 4.45 Highly Effective
with covers.
16. Wastes are stored according to specific rules. 4.3 Highly Effective

17. Appropriate containers or bag holder in all locations 4.1 Highly Effective
where particular categories of waste may be generated
are in place.
18. There is a storage area for healthcare waste which 4.5 Highly Effective
is properly enclosed and is located within the
establishment.
19. Colored garbage bags are immediately replaced 3.55 Effective
with new ones of the same type after disposal of
waste.
Over all Mean 4.18 Highly Effective
 Table 3.5 Mean Distribution According to Personal Protective
Equipment/ Measures
Personal protective equipment/measures Mean Interpretation
20. Appropriate personal protective equipment in 3.3 Effective
handling waste such as heavy-duty gloves, boots, etc is
made available.
21. Protective measurements are available such as 3.6 Effective
soap and warm water, and immunization against
hepatitis b and tetanus infection.
Over all Mean 3.45 Effective

Legend: 0 - 1.25= Poor 1.26-2.5= Less Effective 2.6-3.75= Effective 3.76-5.0= Highly
Effective

•It has an overall mean of 3.3 and interpreted as effective. These results would mean that
majority of the respondents find the availability of appropriate personal protective equipment to
be adequate. However, as observed waste handlers lack the use of protective gears which is
clearly given less importance. Among staffs who routinely handle health care waste, awareness
of the need for safety may decrease with time, which will increase the risk of injury. Periodic
refresher course is therefore recommended (DOH manual).

• It has an overall mean of 3.6 and interpreted as effective. Again these results would mean
that majority of the respondents find the availability of protective measures to be just adequate.
 Table 3.6 Mean Distribution According to Hospital educational
programs
Hospital educational programs Mean Interpretation
22. I have undergone training program on hospital 3.45 Effective
waste management.
23. The hospital provides annual education on waste 3.5 Effective
management for employee.
24. I am taught about the color coding for waste 4.1 Highly Effective
segregation.
25. There is training on how to deal with injuries and 3.85 Highly Effective
exposure in handling healthcare wastes.
26. There are billboards and other propaganda 3.85 Highly Effective
materials on environmental sanitation to motivate
cleanliness
Over all Mean 3.75 Effective

Legend: 0 - 1.25= Poor 1.26-2.5= Less Effective 2.6-3.75= Effective 3.76-5.0= Highly Effective

• In an interview with their hospital waste manager, it was discovered during an interview that
they only train and educate newly hired employees. In developed countries, training programs and
educational classes are instituted repeatedly for all personnel and the content of these programs
is specifically designed to different personnel (Hospital waste management in Dhaka City, 2005).
•Based on the color coding for waste segregation lecture, The table shows that respondents
clearly understand the color coding system in waste segregation.
•The result shows that billboards and other propaganda materials are being utilized in
promoting proper waste disposal.
Problem IV: What is the status of the
healthcare personnel’s health awareness
and perception on hospital waste
management:
4.1 Health awareness
4.2 Perception
 Table 4.1 Health awareness on
Hospital Waste Management Mean Interpretation
1. I have the knowledge of the definition of clinical 4.85 Strongly Agree
waste.
2. I am aware of danger exposed to myself by the 4.8 Strongly Agree
clinical wastes
3. I am aware of the danger exposed to others by the 4.75 Strongly Agree
clinical wastes
4. I am aware of the effects of the clinical wastes to the 4.75 Strongly Agree
environment
5. I am familiar with the waste management policy and 4.65 Strongly Agree
procedures for healthcare waste management.
6. I am familiar with the clinical waste management plan 4.65 Strongly Agree
by the hospital.
7. I am aware of my duties and responsibilities in 4.75 Strongly Agree
maintaining proper waste management
8. I am able to identify various type of clinical wastes 4.65 Strongly Agree

9. I know how to segregate, contain and label the 4.6 Strongly Agree
clinical wastes properly
10. I know how to deal with any accident with clinical 4.3 Strongly Agree
spills, injury or exposure in handling healthcare wastes.
Over all Mean 4.67 Highly Effective

Legend: 0 - 1.25= Poor 1.26-2.5= Less Effective 2.6-3.75= Effective 3.76-5.0= Highly Effec
 Table 4.2 Perception on Hospital Waste Management
Mean Interpretation

1. Sufficient funds are allocated to healthcare waste 3.7 Agree

management.
2. Sufficient human resources are allocated to 4 Strongly Agree
healthcare waste management.
3. The storage area access is secured (only accessible 4.4 Strongly Agree
for authorized persons).
4. Current practices on healthcare waste collection & 4.05 Strongly Agree
on-site transport offer sufficient security.
5. Off-site healthcare waste treatment option is 3.65 Agree
satisfactorily offered by the organization.
6. The healthcare waste final disposal site area is 3.9 Strongly Agree
secured.
7. The facility has a proper waste management 4.15 Strongly Agree
committee who develops a waste management plan for
the facility.
8. There are proper written guidelines or a written 4.25 Strongly Agree
facility plan on healthcare waste management.
9. The hospital provides enough trash bins in every 4.35 Strongly Agree
area of the hospital that provides instructions on waste
segregation.
10. Proper safety measures are being followed. 4.3 Strongly Agree
11. Appropriate attention is given to waste 4.3 Strongly Agree
management.
12. Proper record keeping of the clinical wastes is done. 4 Strongly Agree
13. Clinical waste management follows the standard 4.2 Strongly Agree
procedure.
14. Policies regarding waste segregation are properly 4.1 Strongly Agree
disseminated or clear instructions are given to visitors
and patients.
Over all Mean 4.09 Highly Effective
Legend: 0 - 1.25= Poor 1.26-2.5= Less Effective 2.6-3.75= Effective 3.76-5.0= Highly Effec
Problem V: What is the status of the
neighboring community’s health awareness
and perception on hospital waste
management:
5.1 Health awareness
5.2 Perception
 Table 5.1 Awareness on Hospital Waste Management
Mean Interpretation
1. I have the knowledge of the definition of clinical 4.96 Strongly Agree
waste.
2. I have sufficient knowledge about the health risk of 4.93 Strongly Agree
the clinical wastes to the environment.
3. I have sufficient knowledge about the health risk 4.96 Strongly Agree
exposed to myself by the clinical wastes.
4. I have sufficient knowledge about the health risk 4.96 Strongly Agree
exposed to others by the clinical wastes
5. I have sufficient knowledge about the protective 4.83 Strongly Agree
measures against healthcare wastes.
6. I am aware of the possible transmission routes of 4.8 Strongly Agree
diseases from clinical wastes.
7. I am aware that proper disposal of waste is important. 4.86 Strongly Agree

8. I am aware that proper rules and regulations should 4.83 Strongly Agree
be implemented regarding waste management.
Over all Mean 4.89 Highly Effective

Legend: 0 - 1.25= Poor 1.26-2.5= Less Effective 2.6-3.75= Effective 3.76-5.0= Highly Effec
 Table 5.2 Perception on Hospital Waste Management
Mean Interpretation
1. I am satisfied with how the hospital manages their 4.8 Strongly Agree
waste over the past years.
2. The hospital waste are properly stored or covered. 4.76 Strongly Agree
3. The hospital’s final disposal site area is secured. 4.76 Strongly Agree
4. The hospital conducts proper awareness about 4.66 Strongly Agree
healthcare waste to the community.
5. Staff of the health care establishment is able to 4.53 Strongly Agree
explain to incoming patients and visitors the health care
waste management policy.
6. Hospital wastes are properly contained which 4.7 Strongly Agree
prevents environmental odors from affecting the
neighboring community.
7. Community concerns are properly addressed by the 4.56 Strongly Agree
hospital about healthcare waste management.
Over all Mean 4.68 Highly Effective

Legend: 0 - 1.25= Poor 1.26-2.5= Less Effective 2.6-3.75= Effective 3.76-5.0= Highly Effective
Problem VI: Is there a significant relationship
between health awareness and waste
management practices of health workers.
 Table 6.1 Correlation of the Health awareness of health workers and waste

management practices
Variables R Interpretation Hypothesis
Segregation = .306 Not significant Accepted

Treatment = .006 Not significant Accepted

Collection and transportation = .116 Not significant Accepted

Storage area and equipment = .472 Significant Rejected

Personal protective equipment = .086 Not significant Accepted

Hospital educational programs = .107 Not significant Accepted

This means health workers gives much awareness on the storage area and
equipment they use. The better is their waste storage practice means that they have
higher awareness on the safety protective measures. Health workers have high level
of awareness on the impact of medical waste on occupational health as well as
environmental issues. To minimize the risk to public health and the environment it is
imperative to have a proper storage area and equipments so that injury and infection
can be prevented (WHO, 1999).
Problem VII: Is there a significant relationship
between perception and waste management
practices of health workers.
 Table 7.1 Correlation of the perception of health workers and
waste management practices

Variables R Interpretation Hypothesis

Segregation = .052 Not significant Accepted

Treatment = .332 Not significant Accepted

Collection and transportation = .630 Significant Rejected

Storage area and equipment = .421 Significant Rejected

Personal protective equipment = .624 Significant Rejected

Hospital programs = .676 Significant Rejected

It means that the better is the waste management practices namely collection and
transportation, storage area and equipment, personal protective equipment, and
hospital educational programs the greater is their perception on hospital waste
management. Similarly, good practices are more likely adhered if hospital
management support is well provided. Collection and transportation, and storage area
and equipment are perceived by them because it is visible and they can observe the
actual activity of waste disposal and storage of waste. Personal protective equipment
and measures is related to their perception as they easily observe the supplies that
exist and the one’s lacking. Hospital educational program is also related to their
perception because they understand the importance of continuous educational and
training programs.
Problem VIII: Is there a significant relationship
between the profile variables of both health
workers and community respondents to their
health awareness and perception:
8.1 Health awareness of health workers
8.2 Perception health workers
8.3 Health awareness of community respondents
8.4 Perception of community respondents
 Tables 8.1 Correlation of the Health workers profile
variables to their Health awareness.

Variables R Interpretation Hypothesis

Age = .047 Not significant Accepted

Length of Service = .168 Not significant Accepted

It shows that respondents profile does not make a difference to their

health awareness. Regardless of age and length of service their health
awareness stays the same as most of the respondents are nursing
graduates and the rest are waste handlers so both have a background
on the risk involved with improper waste disposal.
 Tables 8.2 Correlation of the Health workers profile
variables to their Perception.

Variables R Interpretation Hypothesis

Age = .122 Not significant Accepted

Length of Services = .028 Not significant Accepted

Regardless of age and length of service their perception stays the

same as most of the respondents are nursing graduates and the
rest are waste handlers so both have a background on the risk
involved with improper waste disposal.
Tables 8.3 Correlation of the neighboring community
profile variables to their Health awareness.

Variables R Interpretation Hypothesis

Age = .357 Significant Rejected

Educational attainment = .105 Not significant Accepted

Length of residency = .448 Significant Rejected

The impression is that the longer their stay in the community and
the higher their age, the greater is their awareness of the need for
proper waste disposal to promote and maintain a healthy
environment in the community. It is highly noted that with increasing
age and length of stay comes with knowledge and experience.
 Tables 8.4 Correlation of the neighboring community profile
variables to their perception.

Variables R Interpretation Hypothesis

Age = .381 Significant Rejected

Educational attainment = .278 Not significant Accepted

Length of residency = .567 Significant Rejected

This finding shows that the longer their stay in the community and the higher
their age makes their perception on hospital waste management greater. It is highly
noted that with increasing age and length of stay comes with knowledge and
experience.
Problem IX: Is there a significant relationship
between the profile of health workers and
their waste management practices:
9.1 Age
9.2 Length of services
 Table 9.1 Correlation of the Waste Management Practices to
their Age.
Variables R Interpretation Hypothesis
Segregation = .107 Not significant Accepted

Treatment = .274 Not significant Accepted

Collection and transportation = .156 Not significant Accepted

Storage area and equipment = .111 Not significant Accepted

Personal protective equipment = .152 Not significant Accepted

Hospital programs = .226 Not significant Accepted

It also shows that the hypotheses of these items are accepted since it
stated that both variables have no significance. Respondents age does
not make a difference to the waste management practices, since majority
of the respondents are generally young.
 Table 9.2 Correlation of the Waste Management Practices to
their Length of service.
Variables R Interpretation Hypothesis
Segregation = .125 Not significant Accepted

Treatment = .204 Not significant Accepted

Collection/transportation = .212 Not significant Accepted

Storage area and equipment = .241 Not significant Accepted

Personal protective equipment = .096 Not significant Accepted

Hospital programs = .327 Not significant Accepted

Length of service does not make a difference to the waste

management practices, since majority of the respondents are young
their length of service and experience are also not that long.
 Chapter V
SUMMARY, CONCLUSION AND
RECOMMENDATIONS
Summary

This study was conducted within Iligan City which aims to seek
out the Impact of Waste Management Practices on Health
Awareness and Perception of Healthcare Personnel and
Neighboring Communities in Selected Hospitals in Iligan City. It
aims to explore the different factors of Healthcare personnel profile
namely Age, and Length of service with regards to their relationship
to their health awareness and perception and to the Hospital waste
management practices. It also aims to explore the different factors
of Community respondents profile namely Age, Educational
attainment, and Length of residency with regards to their
relationship to their Health awareness and perception on hospital
waste management.
 Also, to correlate the relationship of dependent variables
Health awareness and perception of health workers with
the independent variables Hospital waste management
practices namely Waste Segregation, Treatment done to
Waste before Disposal, Collection and Transportation of
Waste, Waste Storage Area and Equipments, Personal
Protective Equipments and Measures, and Hospital
Educational Programs.

The study was conducted in the Month of March 2010,

employed 18 nurses, 2 waste handlers, and 30 neighboring
community respondents from the selected Tertiary
Hospitals in Iligan City Namely Gregorio T Lluch Memorial
Hospital and St. Mary’s Maternity and Children’s Hospital.
A purposive criterion sampling was made on the number of
respondents.
 A Descriptive-Correlational type of research
was used wherein a self report data are
obtained from the study sample in order to
describe respondents on the variables of
interest. A self-made questionnaire was
produced and utilized. The content of the self-
made questionnaire were brought to the
statistician for interpretation and analysis.
 Findings of the Study

The following are the Major Findings of this Study:

1. Profile of the healthcare personnel respondents:
1.1 Majority of the participants belongs to the 21 – 29 years old age
bracket.
1.2 Majority of the participants have 0-3 years of experience.
2. Profile of the Community respondents:
2.1 Majority of the participants belongs to the 48-70 years old age
bracket.
2.2 Majority of the total population of community respondents are
college graduates.
2.3 Majority of the of the total population of community respondents
have been a resident in the neighborhood for 7 years and below
 Findings of the Study

Waste management practices of the selected hospitals in Iligan

City in accordance to their Waste segregation, Treatment done
to waste, Collection and transportation of waste, Waste storage
area and equipments, Personal protective equipments and
measures, and Hospital educational programs:

3.1 The respondents have comparable insight towards waste

segregation. It shows that the respondents have over-all mean
percentage of 4.31 translated as highly effective which means
that proper waste segregation among hospitals is being
practiced. It was discovered during an interview with their
hospital waste manager that they practice the color-coding
system but is not sufficient enough to sustain it due to lack of
budget and supplies. However, they were able to develop
means on how to manage their healthcare waste through
separation of infectious waste from non- infectious waste.
 Findings of the Study
3.2 The respondent’s insight towards treatment done to the waste
before disposal has an over-all mean percentage of 4.16 translated
as highly effective which means that they are able to treat infectious
waste prior to disposal.

3.3 In the collection and transportation of waste the respondents has

an over-all mean percentage of 4.25 translated as highly effective
which means that garbage collection per daily basis is properly
implemented and designated to central storage site with the use of
appropriate trolleys and carts.

3.4 The respondent’s insight towards waste storage area and

equipments has an over-all mean percentage of 4.18 translated as
highly effective. 4 out of 5 items are rated with scales of 3.76-5.0,
which means that proper waste storage materials are disseminated
in different areas in the hospital. Containers for sharps are all
puncture-proof and properly fitted with covers. However, most of the
hospital can’t provide enough funds for the container bags. For this
reason, containers for waste are not immediately replaced.
 Findings of the Study
3.5 The respondent’s insight towards personal protective
equipments/measures has an over-all mean percentage of 3.45
translated as effective which means that the respondents find
the availability of appropriate personal protective equipment to
be adequate. However, as observed waste handlers lack the
use of protective gears which is clearly given less importance.

3.6 On hospital educational programs, it shows that the

respondents have over-all mean percentage of 3.75 translated
as effective which means that the respondent’s have undergone
training regarding hospital waste management. The subjects
claimed that annual education on employee is satisfactorily met.
However, in an interview with their hospital waste manager, it
was discovered during an interview that they only train and
educate newly hired employees.
 Findings of the Study

4. The status of the healthcare personnel’s health awareness and

perception on hospital waste management.
4.1 The respondent’s health awareness on hospital waste
management has an over-all mean percentage of 4.675 and is
interpreted as highly effective.
4.2 The respondent’s perception on hospital waste management
has an over-all mean percentage of 4.09 and is interpreted as
highly effective.
5. The status of the neighboring community’s health awareness
and perception on hospital waste management.
5.1 The respondent’s health awareness on hospital waste
management has an over-all mean percentage of 4.89 and is
interpreted as highly effective.
5.2 The respondent’s perception on hospital waste management
has an over-all mean percentage of 4.89 and is interpreted as
highly effective.
 Findings of the Study
6. Significant relationship between health awareness and waste
management practices of health workers.

6.1 Health awareness in relation to waste management practices:

1 item from the independent variable, Waste storage area and
equipments is known to have significant relationship to health
awareness. On the other hand, 5 items which are Waste segregation,
Treatment done to waste, Collection and transportation of waste,
Personal protective equipments and measures, and Hospital
educational programs do not show any significance.

7. Significant relationship between perception and waste

management practices of health workers.

7.1 Health workers perception in relation to waste management practices:

4 items from the independent variable, Collection and transportation of
waste, Waste storage area and equipments, Personal protective
equipments and measures, and Hospital educational programs are
known to have significant relationship to health workers perception. On
the other hand, 2 items which are Waste segregation and Treatment
done to waste do not show any significance.
 Findings of the Study
8. Significant relationship between both health workers and
community respondents profile variables to their health
awareness and perception.
8.1 All items under health workers profile variables have no significant
relationship to their health awareness.
8.2. All items under health workers profile variables have no significant
relationship to their perception on hospital waste management.
8.3 Neighboring community profile variables namely age and length of service
are known to have a significant relationship with the dependent variable,
health awareness. The remaining item educational attainment has no
significant relationship to their health awareness.
8.4 Neighboring community profile variables namely age and length of service
are known to have a significant relationship with the dependent variable,
perception on hospital waste management. The remaining item educational
attainment has no significant relationship to their perception on hospital
waste management.
 Findings of the Study

Significant relationship between the profile of

health workers and their waste management
practices.
9.1 All items under waste management practices
have no significant relationship to the health
workers age.
9.2 All items under waste management practices
have no significant relationship to the health
workers length of service.
 CONCLUSION
From the data collected, the researchers had summed up the following findings:

1. It was discovered during an interview with their hospital waste manager that
they practice the color-coding system but is not sufficient enough to sustain it
due to lack of budget and supplies. However, they were able to develop
means on how to manage their healthcare waste through separation of
infectious waste from non- infectious waste.
2. It is observed that waste handlers lack the use of protective gears which is
clearly given less importance. Appropriate personal protective equipment in
handling waste such as heavy-duty gloves, and boots are not made
available. These findings suggest that readily available personal protective
equipments are crucial to ensure their use. Protective measures such as
soap are provided but not regularly, and immunization against hepatitis b and
tetanus infection are not provided.
3. Garbage bags are not immediately replaced with new ones of the same type
after disposal of waste because there are not enough funds for the container
bags.
 CONCLUSION
4. Respondent’s have undergone training regarding hospital waste
management. However, in an interview with their hospital waste manager,
it was discovered that they only train and educate newly hired employees.
5. Although wastes are properly sorted in the hospital, the local government
garbage collectors do not follow proper segregation and disposes it in the
city dump site - a practice that defeats the purpose of waste segregation
in hospitals.
6. Waste storage area and equipments is known to have a significant
relationship to the health awareness of health workers.
7. Collection and transportation of waste, Waste storage area and
equipments, Personal protective equipments and measures, and Hospital
educational programs are known to have significant relationship to health
workers perception.
8. Neighboring community profile variables namely age and length of
residence are known to have a significant relationship with their health
awareness.
9. Neighboring community profile variables namely age and length of
residence are known to have a significant relationship with their
perception on hospital waste management.
 Recommendations
Considering the results and conclusions made, the
researchers offer the following recommendations:
1. Hospitals should conduct regular orientation on
the hospitals waste segregation and waste
management policies to patients and new staff.
2. Ensure worker safety through education, training
and proper personal protective equipments.
3. Reactivate committees and hold monthly
meetings to discuss and address issues related
to updates on waste management and
environmental health awareness.
 Recommendations
4. Ensure proper dissemination of information through
supervisors/managers of each department and
discussed to their members. Hold event such as Waste
Management Week or an Infection Control Week once a
year.
5. Consider training for all garbage collectors by the DOH,
because there is a need for education as to the hazards
of improper disposal of healthcare waste.
6. The city government should propose a separate
dumpsite for all healthcare wastes and set limit to public
access to decrease the risk of epidemics of infectious
diseases. Other recommendation for future research
would be to determine the waste generation rate of
hospitals in Iligan City.
Gregorio T. Lluch Hospital Waste Management
Gregorio T. Lluch Hospital Waste Management
Gregorio T. Lluch Hospital Waste Management
Gregorio T. Lluch Hospital Waste Management
St. Mary’s Maternity and Children’s Hospital