20.500.12556/RUL-158655 Varno ravnanje z odpadki iz zdravstva v laboratoriju 3. stopnje biološke varnosti magistrsko delo Safe management of medical waste in a biosafety level 3 laboratory master thesis Uvod: Pravilno ravnanje z odpadki iz zdravstva je izziv za vsako državo. Redni nadzori nad obravnavo odpadkov iz zdravstva, nad njihovim zbiranjem, prevozom in uničenjem kot tudi nad vplivi na zdravje ljudi in okolje so izrednega pomena, saj se količine odpadkov povečujejo. Z ustreznim ravnanjem z odpadki iz zdravstva že pri delu zmanjšujemo in preprečujemo tveganja zaradi izpostavljenosti biološkim dejavnikom. Statistično zbrani in urejeni podatki prikazujejo trend povečanja količine odpadkov iz zdravstva po svetu in doma. Države Evropske unije imajo zaradi zakonodajnih okvirjev, ki smo jih članice dolžne upoštevati, področja ravnanja z odpadki urejena zelo podobno. Kljub poenotenemu in predpisanemu ravnanju pa je potrebno, tudi zaradi povečevanja količine zdravstvenih odpadkov, obvladovanje zdravstvenega tveganja ves čas preverjati in izboljševati. Namen: Namen magistrskega dela je bil pregled in optimizacija obstoječih protokolov, procesov dela in dekontaminacije trdnih odpadkov in tekstila, ki nastajajo v laboratoriju 3. stopnje biološke varnosti. Metode dela: Z natančnim opisom vrst, količin, razmerja in tokov trdnih odpadkov in tekstila (bombažna oblačila in bombažne brisače) smo preverili učinkovitost dekontaminacije s parno sterilizacijo, v odvisnosti od spremembe programa avtoklava, teže trdnih odpadkov in tekstila ter časa avtoklaviranja. Učinkovitost smo preverjali na podlagi pridobljenih rezultatov fizikalnih parametrov – temperature, časa in tlaka – ter s pomočjo dveh bioloških in enega kemičnega indikatorja. Rezultati: Na uspešnost dekontaminacije trdnih odpadkov in tekstila so vplivali naslednji dejavniki: število uporabljenih avtoklavirnih vreč, način zapiranja avtoklavirnih vreč, teža trdnih odpadkov in tekstila ter čas, temperatura in tlak pri parni sterilizaciji. Dekontaminacija trdnih odpadkov, ki se avtoklavirajo v dveh avtoklavirnih vrečah, ni bila uspešna v primeru vreče, tesno zaprte s plastično vezico. Prav tako ni bila uspešna pri krajših časih avtoklaviranja. Dekontaminacija tekstila ni bila uspešna pri večji količini in krajšem času avtoklaviranja. Razprava in zaključek: V raziskavi smo ugotovili, da tovarniške nastavitve programov avtoklava niso ustrezne za vse vrste in količine trdnih odpadkov, ki nastajajo v laboratoriju 3. stopnje biološke varnosti na Inštitutu za mikrobiologijo in imunologijo Medicinske fakultete v Ljubljani. Dokazali smo, da je postopek dekontaminacije trdnih odpadkov mogoče prilagoditi tako, da zvišamo temperaturo parne sterilizacije na 134 °C in skrajšamo čas na 10 min. Za dekontaminacijo tekstila smo potrdili, da je trenutni protokol avtoklaviranja pri temperaturi 121 °C in s časom 30 min ustrezen. Introduction: Proper management of healthcare waste is a challenge for every country. Regular controls on the treatment of healthcare waste, its collection, transport and destruction, as well as on the impacts on human health and the environment, are of paramount importance as the volumes of waste increase. By properly handling healthcare waste, we reduce and prevent risks from exposure to biological agents at work. Statistically collected and organized data show the trend of increasing amount of waste from healthcare around the world and at home. Due to the legislative frameworks that Member States are obliged to follow, the areas of waste management are regulated very similarly in the countries of the European Union. Despite uniform and prescribed practices, health risk management needs to be constantly reviewed and improved, not least because of the increase in the amount of medical waste. Aim: The purpose of the master’s thesis was to review and optimise existing protocols, work processes and decontamination of solid waste and textiles generated in the Biosafety Level 3 laboratory. Methods: By accurately describing the types, quantities, proportions and flows of solid waste and textiles (cotton clothes and cotton towels), we verified the effectiveness of decontamination by steam sterilization, depending on the change in the autoclave programme, the weight of solid waste and textiles and the time of autoclaving. The effectiveness was verified on the basis of the obtained results of physical parameters – temperature, time and pressure – and with the help of two biological and one chemical indicator. Results: The success of decontamination of solid waste and textiles was influenced by the following factors: the number of autoclaving bags used, the method of sealing the autoclaving bags, the weight of solid waste and textiles, and the time, temperature and pressure of steam sterilisation. Decontamination of solid waste autoclaved in two autoclaving bags was unsuccessful in the case of a bag more tight closed with a plastic strap. It was also unsuccessful with shorter autoclaving times. Decontamination of textiles was unsuccessful with higher volumes and shorter autoclaving times. Discussion and conclusion: In our research, we found that factory settings of autoclave programs are not suitable for all types and quantities of solid waste generated in the Biosafety Level 3 laboratory at the Institute of Microbiology and Immunology of the Faculty of Medicine in Ljubljana. We have shown that the solid waste decontamination process can be adapted by increasing the steam sterilization temperature to 134°C and reducing the time to 10 minutes. For decontamination of textiles, we have confirmed that the current autoclaving protocol at 121 °C with a time of 30 minutes is adequate. magistrska dela sanitarno inženirstvo odpadki iz zdravstva SARS-CoV-2 laboratorij 3. stopnje biološke varnosti parna sterilizacija master's theses sanitary engineering medical waste SARS-CoV-2 biosafety laboratory level 3 steam sterilization true false false [T. Elezović] Slovenski jezik Angleški jezik Magistrsko delo/naloga 2024-06-19 07:45:58 2024-06-19 07:46:03 2024-07-02 03:42:56 0000-00-00 00:00:00 2024 0 Ljubljana 0 Ljubljana 66, [1] str. 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 614 132575 199312643 38400.pdf 38400.pdf 1 0E11C905E779AEE79DB60C28536CC69B e51605c7b7d17e1f404f55b85be8be3d4e8bf35ac87502a1cf1d2c602db30332 37372221-2dff-11ef-aa1b-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=186364 Zdravstvena fakulteta 0 0 0