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RESUMO - O quadro legislativo de um país, no que concerne aos resíduos
hospitalares (RH), contém a sua designação, definição
e classificação.
É essa a matriz de referência para a separação efectuada
na origem e todo o circuito que, a partir desse momento,
um determinado resíduo toma até ao seu tratamento.
Assim, faz-se o estudo comparativo das definições e tipos
de classificação de RH em quatro países da União Europeia:
Alemanha, Reino Unido, Espanha (Região Autónoma
da Catalunha) e Portugal.
Reconhecem-se as diferentes designações deste tipo de resíduos
e discute-se o seu significado e as suas implicações na
percepção de risco por parte dos profissionais e do público.
Identificam-se duas estratégias subjacentes à elaboração
das definições: a contaminação de materiais com microrganismos
patogénicos bem definidos, as suas fontes e as actividades
que os produzem.
Apresentam-se as classificações de RH propostas pelos
organismos internacionais de referência e analisa-se comparativamente
a evolução do enquadramento legal português
e da Região Autónoma da Catalunha, evidenciando-se
a variabilidade temporal e justificando-se a necessidade de
se efectuar o estudo da variabilidade geográfica.
Utilizam-se três critérios para a análise das classificações
consideradas: a concordância definição-classificação, o
número e tipo de grupos das classificações e os tipos de
resíduos por grupos.
Identificam-se os denominadores comuns às classificações
analisadas, assim como as suas principais diferenças.
Conclui-se que a definição de RH adoptada por cada país
condiciona o tipo de classificação de RH nesse mesmo país.
Verifica-se ainda que a inexistência de critérios claros de
avaliação da contaminação pode dificultar a tarefa da triagem
dos RH por parte dos profissionais de saúde.
ABSTRACT - A country’s legislation governing current hospital waste management includes its designation, definition and classification. That is the framework for a right separation in production and for all the circuit that, from that moment on, a specific waste takes until its treatment. Therefore, a study that compares the definition and classification patterns of hospital wastes in four European Union countries: Germany, United Kingdom, Spain (Generalitat de Catalunya) and Portugal, was carried out. The large range of these waste designations, as well as their meanings and implications on professionals and public’s risk perceptions, are discussed. Two strategies underlying the working out of the definitions are identified — the material contamination by pathogenic micro-organisms and, on the other hand, the locations and activities that produce them. The different hospital waste classification proposed by the most important international organisms are outlined. A comparison of the evolutions of the regulations that have been governing hospital waste in Portugal and Generalitat de Catalunya shows time variability and justifies the need for a study on geographical variability. Three criteria concerning the study of the classification are used: the agreement definition-classification, the number and type of groups and the assortment of waste by groups. We found the common denominator and the differences among the analysed classification. In conclusion, the hospital waste definition adopted by each country dictates the terms of hospital waste classification. On the whole, the absence of clear criteria for contamination values complicates waste assortment by health professionals.
ABSTRACT - A country’s legislation governing current hospital waste management includes its designation, definition and classification. That is the framework for a right separation in production and for all the circuit that, from that moment on, a specific waste takes until its treatment. Therefore, a study that compares the definition and classification patterns of hospital wastes in four European Union countries: Germany, United Kingdom, Spain (Generalitat de Catalunya) and Portugal, was carried out. The large range of these waste designations, as well as their meanings and implications on professionals and public’s risk perceptions, are discussed. Two strategies underlying the working out of the definitions are identified — the material contamination by pathogenic micro-organisms and, on the other hand, the locations and activities that produce them. The different hospital waste classification proposed by the most important international organisms are outlined. A comparison of the evolutions of the regulations that have been governing hospital waste in Portugal and Generalitat de Catalunya shows time variability and justifies the need for a study on geographical variability. Three criteria concerning the study of the classification are used: the agreement definition-classification, the number and type of groups and the assortment of waste by groups. We found the common denominator and the differences among the analysed classification. In conclusion, the hospital waste definition adopted by each country dictates the terms of hospital waste classification. On the whole, the absence of clear criteria for contamination values complicates waste assortment by health professionals.
Descrição
Palavras-chave
Gestão de resíduos hospitalares Resíduos hospitalares Legislação Hospital waste management Hospital waste Regulation
Contexto Educativo
Citação
Editora
Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa
