Regulations on medical waste management in Vietnam

Regulations on medical waste management in Vietnam (Illustration)

First, in Clause 1, Article 49 of Vietnam's Decree 38/2015/ND-CP, waste from medical activities (except wastewater put into the wastewater treatment system of medical facility) must be classified at source as follows:

- Hazardous medical wastes shall include: infectious wastes; hazardous waste not infectious (classified separately according to the list and provisions on hazardous waste management in Chapter II of this Decree); radioactive waste (managed under the provisions on radioactivity);

- Ordinary medical waste shall include: conventional solid wastes (including daily-life solid waste); non-hazardous liquid waste.

The classification of medical waste is carried out according to the principles in Clause 1, Article 6 of Vietnam's Joint Circular 58/2015/TTLT-BYT-BTNMT.

Specifically, infection waste must be strictly managed with the highest level in medical facilities, ensuring no spread of pathogens affecting the environment and human health. Where infectious wastes are put together with daily-life solid waste, ordinary solid waste, that waste mixture must be managed in accordance with regulations on hazardous waste. (Clause 2 and 3, Article 49 of Decree 38).

Second, the collection of medical waste is also specified in Article 7 of Joint Circular 58. Specifically:

- Infectious waste must be separately collected at source and moved to the waste storage area in the medical establishment precincts. Highly infectious waste must be preliminarily treated before it is collected and transported to the waste storage and treatment area in the medical establishment precincts. (Clause 1 of Article 7)

- Non-infectious hazardous waste must be separately collected and stored at the waste storage area in the medical establishment precincts. Mercury-containing waste shall be separately collected and stored in plastic boxes or boxes made out of other suitable materials, ensuring that mercury vapor cannot be leaked or emitted to surrounding environment. (Clause 2 of Article 7)

- The non-hazardous biomedical waste for recycling shall be collected separately from the non-hazardous biomedical waste that is not used for recycling. (Clause 3 of Article 7)

Third, in Article 8 of the Joint Circular 58 regulating Biomedical waste storage as follows:

- The medical establishment in charge of performing the treatment of hazardous biomedical waste for a cluster of medical establishments and hospitals must have a hazardous biomedical waste storage area which meets technical requirements as prescribed in Annex No. 03 (A) enclosed to Joint Circular 58;

- The medical establishment that is not a subject governed by Point a of this Clause must have a hazardous biomedical waste storage area which meets technical requirements as prescribed in Annex No. 03 (B) enclosed to Joint Circular 58.

Note: Hazardous and non-hazardous biomedical waste must be separated stored in the waste storage area in the medical establishment precincts. In addition, the infectious waste must be stored separately from the non-infectious hazardous waste, except for cases where these types of waste apply the same treatment method.

Besides, in Clause 6, Article 8 of Joint Circular 58, infectious waste storage period: is as follows:

- With regard to the infectious waste generated in medical establishments, period for storing infectious waste in medical establishments shall not exceed 02 days in normal conditions. If the infectious waste is stored in cold storage equipment with temperature of below 8°C, the storage period may reach 07 days. As for medical establishments where the amount of infectious waste generated is less than 05 kg/day, the storage period shall not exceed 03 days in normal conditions and waste storage packing must be closely tied up or waste storage equipment must be covered with lids.

- The infectious waste which is transported from other medical establishments for treatment under the model of medical establishments cluster or concentrated model must be treated in day. If such waste cannot be immediately treated in day, it must be stored in temperature of below 20°C and the storage period shall not exceed 02 days.

Fourth, regarding transportation, Clause 1, Article 11 of Circular 58 allows health care facilities in the cluster to hire an outside unit or deliver by themselves but must meet the following conditions:

- Dry van or refrigerator truck or other means of transportation for transporting hazardous biomedical waste from medical equipments to the cluster’s waste treatment facility provided that all requirements. (Clause 2 of Article 11)

- Instruments and equipment for storing hazardous medical waste must have walls, bottoms, tight-fitting lids, rigid structures, resistant to impact, unbreakable, etc., which are fixed or removable on transport vehicles to ensure safety during the transportation process; There is a symbol of the type of waste stored according to Appendix 02, issued with Circular 58, printed clearly and legibly (Clause 3, Article 11).

- Before being transported, the infectious waste must be carefully packaged in bottles, boxes or bags, ensuring that they shall not be cracked or broken, and stored waste shall not be leaked out during the transportation.

Note: During the transportation of biomedical waste from medical establishments to the cluster’s biomedical waste treatment facility, if the transported biomedical waste is overflowed, burned or exploded, or any other incidents occur, measures against environmental incidents must apply immediately as regulated by the law.

Finally, health facilities based on planning, economic conditions, ... to choose to apply one of the hazardous medical waste treatment options according to Clause 4, Article 49 of Vietnam's Decree 38/2015/ND-CP and Article 13 of Circular 58, including:

- Concentrated treatment (at treatment facilities that meet the conditions, ensure thorough treatment, do not cause environmental pollution).

- Treatment according to the cluster model (this form is widely applied, whereby, the medical waste at some nearby health facilities around the cluster will be collected and treated at the central health station).

- Treatment at the facility (this form is often applied in difficult areas, where there is no centralized treatment facility or it is not possible to apply the cluster method)

Each form of treatment of medical waste will comply with the law, for example, for the form of concentrated treatment, "waste treatment enterprises must carry out the procedures in Circular No. 36/2015/TT-BTNMT to be licensed by MONRE", or "must be approved by the Provincial People’s Committee" (for cluster treatment) or permitted by DONRE (in case of on-site treatment).

Bao Ngoc

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