skip to main content

Pengelolaan Limbah Medis Rumah Sakit yang Berkelanjutan: Eksplorasi Strategi Ekonomis dan Ramah Lingkungan

1Program Doktor Ilmu Teknik, Universitas Udayana, Jl.PB Sudirman, Denpasar, Bali 80234, Indonesia, Indonesia

2Prodi Ilmu Kesehatan Masyarakat, Fakultas Kedokteran, Universitas Udayana, Jl.PB Sudirman, Denpasar 80234, Indonesia

3Prodi Teknik Sipil, Fakultas Teknik, Universitas Udayana, Kampus Bukit Jimbaran, Badung, Bali 80361, Indonesia

Received: 7 Feb 2023; Revised: 12 Sep 2023; Accepted: 8 Nov 2023; Available online: 4 Feb 2024; Published: 15 Feb 2024.
Editor(s): Budi Warsito

Citation Format:
Abstract

Limbah medis rumah sakit sangat berbahaya bagi manusia dan lingkungan dan berkontribusi besar pada pengeluaran rumah sakit. Apalagi pada masa pandemi covid-19, jumlah limbah medis meningkat. Sementara itu belum semua fasilitas pelayanan kesehatan mempunyai fasilitas pengolahan limbah medis yang memadai dan masih mengandalkan pihak ke tiga untuk memusnahkan limbah medis. Banyak sumber masalah dalam pengelolaan limbah medis rumah sakit, mulai dari kurangnya personil terlatih sampai pada besarnya resistensi untuk perubahan. Padahal volume limbah medis rumah sakit sebenarnya hanya 10-50% limbah yang dihasilkan rumah sakit. Tulisan ini bertujuan untuk membahas cara mereduksi jumlah limbah medis sehingga pengeluaran rumah sakit untuk pengelolaan limbah medis dapat ditekan sebesar mungkin, dengan membahas pengelolaan limbah rumah sakit secara umum dan menelaah beberapa alternatif pengelolaan dan pengolahan. Metode yang digunakan adalah studi literatur dari Pubmed-Medline, Research Gate, dan Google Scholar. Pemilahan di sumber dengan pengolahan sederhana dengan autoklaf untuk beberapa jenis limbah infeksius merupakan alternatif yang relatif mudah, murah, dan ramah lingkungan. Selain itu, komitmen dari seluruh stakeholder rumah sakit untuk melaksanakan secara konsisten pemilahan limbah di sumber mutlak diperlukan.

Note: This article has supplementary file(s).

Fulltext View|Download |  Cover Letter
Mengatasi Timbulan Limbah Medis Rumah Sakit di Sumber
Subject Limbah B3 medis; Rumah sakit; Timbulan Limbah; Pengelolaan Limbah Padat; Pemilahan di Sumber.
Type Cover Letter
  Download (377KB)    Indexing metadata
 Transcripts
Mengatasi Timbulan Limbah Medis Rumah Sakit di Sumber
Subject Limbah B3 medis; Rumah sakit; Timbulan Limbah; Pengelolaan Limbah Padat; Pemilahan di Sumber.
Type Transcripts
  Download (496KB)    Indexing metadata
 Transcripts
Mengatasi Timbulan Limbah Medis Rumah Sakit di Sumber
Subject
Type Transcripts
  Download (3MB)    Indexing metadata
Keywords: Limbah B3 medis; Rumah sakit; Timbulan Limbah; Pengelolaan Limbah Padat; Pemilahan di Sumber.
Funding: -

Article Metrics:

  1. Abd El-Salam, M. M. 2010. Hospital waste management in El-Beheira Governorate, Egypt. Journal of Environmental Management, 91(3): 618–629
  2. Al Huraimel, K., M. Alhosani, S, Kunhabdulla, M.H. Stietiya. 2020. SARS-CoV-2 in the environment: Modes of transmission, early detection and potential role of pollutions. Science of The Total Environment, 744: 140946
  3. Ali, M., W. Wang, N. Chaudhry. 2016. Application of life cycle assessment for hospital solid waste management: A case study. Journal of the Air & Waste Management Association, 66(10): 1012–1018
  4. Ali, M., W. Wang, N. Chaudhry, Y. Geng. 2017. Hospital waste management in developing countries: A mini review. Waste Management & Research: The Journal for a Sustainable Circular Economy, 35(6): 581–592
  5. Al-Khatib, I.A., D. Eleyan, J. Garfield. 2016. A system dynamics approach for hospital waste management in a city in a developing country: The case of Nablus, Palestine. Environmental Monitoring and Assessment, 188(9): 503
  6. Al-Khatib, I.A., A.-S. Khalaf, M.I. Al-Sari, F. Anayah. 2020. Medical waste management at three hospitals in Jenin district, Palestine. Environmental Monitoring and Assessment, 192(1): 10
  7. Awad, A.R., M. Obeidat, M. Al-Shareef. 2004. Mathematical-Statistical Models of Generated Hazardous Hospital Solid Waste. Journal of Environmental Science and Health, Part A, 39(2): 315–327
  8. Bahri, M., R. Belkhadir, M. Benzakour, L. Idrissi, A. Khadri. 2006. Hospital Solid Waste: Quantification. Bacteriological Analyses-Case of Hospital Ibn Sina. La Tunisie Medicale, 84(1): 34–39
  9. Baker, N., R. Bromley-Dulfano, J. Chan, A. Gupta, L. Herman, et al. 2020. COVID-19 Solutions Are Climate Solutions: Lessons From Reusable Gowns. Frontiers in Public Health, 8: 590275
  10. BBC News. 2020, October 24. Virus corona: Limbah infeksius Covid-19 masih ditemukan di TPA, “ada kelonggaran, pengabaian, dan tidak ada pengawasan.” https://www.bbc.com/indonesia/majalah-54640725
  11. Bellizzi, S., S.A. Kamal, A.E. Newir, G. Pichierri, P. Salaris., et al. 2020. Simple technology for COVID-19 medical solid waste treatment in low-resourced settings. Journal of Global Health, 10(2): 020373
  12. Biomedical Waste Services (BWS). 2016, March 15. Key Methods of Medical Waste Treatment and Disposal. https://bwaste.com/resources/the-knowledge-center/articles-insights-and-updates/key-methods-medical-waste-treatment
  13. Blatchley, E.R., W.-L. Gong, J. E. Alleman, J. B. Rose, D. E. Huffman, et al. 2007. Effects of Wastewater Disinfection on Waterborne Bacteria and Viruses. Water Environment Research, 79(1): 81–92
  14. Candra, S.A., R. Puspita. 2021, July 28. KLHK Soroti Temuan Limbah Medis yang Dibuang Sembarangan. Republika. https://www.republika.co.id/berita/qwy1q7428/klhk-soroti-temuan-limbah-medis-yang-dibuang-sembarangan
  15. Capoor, M.R., A. Parida. 2021. Current Perspectives of Biomedical Waste Management in Context of Covid-19. Indian Journal of Medical Microbiology, 39(2): 171–178
  16. Chaerul, M., M. Tanaka, A.V. Shekdar. 2008. A system dynamics approach for hospital waste management. Waste Management, 28(2): 442–449
  17. Damghani, A.M., G. Savarypour, E. Zand, R. Deihimfard. 2008. Municipal solid waste management in Tehran: Current practices, opportunities and challenges. Waste Management, 28(5): 929–934
  18. Dang, H. T. T., H.V. Dang, T.Q Tran. 2021. Insights of healthcare waste management practices in Vietnam. Environmental Science and Pollution Research, 28(10): 12131–12143
  19. Di Maria, F., E. Beccaloni, L. Bonadonna, C. Cini, E. Confalonieri, et al. 2020. Minimization of spreading of SARS-CoV-2 via household waste produced by subjects affected by COVID-19 or in quarantine. Science of The Total Environment, 743: 140803
  20. Doi, K.M., G.M.S.S. de Moura. 2011. Resíduos sólidos de serviços de saúde: Uma fotografia do comprometimento da equipe de enfermagem. Revista Gaúcha de Enfermagem, 32(2): 338–344
  21. Duong, D. 2023. Improper disposal of medical waste costs health systems and the environment. Canadian Medical Association Journal, 195(14): E518–E519
  22. Eleyan, D., I.A. Al-Khatib, J. Garfield. 2013. System dynamics model for hospital waste characterization and generation in developing countries. Waste Management & Research: The Journal for a Sustainable Circular Economy, 31(10): 986–995
  23. Farzadkia, M., A. Moradi, S.M. Mojtaba, S. Jorfi. 2009. Hospital waste management status in Iran: A case study in the teaching hospitals of Iran University of Medical Sciences. Waste Management & Research: The Journal for a Sustainable Circular Economy, 27(4): 384–389
  24. Gielar, A., E. Helios-Rybicka. 2013. Enviromental impact of a hospital waste incineration plant in Krakow (Poland). Waste Management & Research: The Journal for a Sustainable Circular Economy, 31(7): 722–728
  25. Girsang, V.E., W. Herumrti. 2013. Pengelolaan Limbah Padat B3 Hasil Insinerasi di RSUD Dr Soetomo Surabaya. Jurnal Teknik ITS, 2(2): D45–D50
  26. Gupta, S., R. Boojh. 2006. Report: Biomedical waste management practices at Balrampur Hospital, Lucknow, India. Waste Management & Research: The Journal for a Sustainable Circular Economy, 24(6): 584–591
  27. Hanako, A., Y. Trihadiningrum. 2021. Kajian Pengelolaan Limbah Padat B3 di Rumah Sakit X Surabaya. Jurnal Teknik ITS, 9(2): C133–C138
  28. Harte, J.A., C.H. Miller. 2004. Sterilization update 2003. Compendium of Continuing Education in Dentistry (Jamesburg, N.J.: 1995), 25(1 Suppl): 24–29
  29. Humas LIPI/LPTB. 2021, June 29. LIPI Tawarkan Solusi Timbulan Limbah Masker. http://lipi.go.id/siaranpress/LIPI-Tawarkan-Solusi-Timbulan-Limbah-Masker/22432
  30. Humas UGM. 2019, August 16. Pengelolaan Limbah Medis di Indonesia Belum Maksimal. https://ugm.ac.id/id/berita/18264-pengelolaan-limbah-medis-di-indonesia-belum-maksimal
  31. Jang, Y.-C., C. Lee, O.-S. Yoon, H. Kim. 2006. Medical waste management in Korea. Journal of Environmental Management, 80(2): 107–115
  32. Kalogiannidou, K., E. Nikolakopoulou, D. Komilis. 2018. Generation and composition of waste from medical histopathology laboratories. Waste Management, 79: 435–442
  33. Karamouz, M., B. Zahraie, R. Kerachian, N. Jaafarzadeh, N. Mahjouri. 2007. Developing a master plan for hospital solid waste management: A case study. Waste Management, 27(5): 626–638
  34. Kemenkes RI. 2020. Pedoman Pengelolaan Limbah Rumah Sakit Rujukan, Rumah Sakit Darurat dan Puskesmas Yang Menangani Pasien Covid-19. Kementerian Kesehatan RI. https://kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Pedoman-Pengelolaan-Limbah-Fasyankes-Covid-19_1571.pdf
  35. Keterangan Pers Menteri LHK usai Ratas Pengelolaan Limbah Bahan Berbahaya dan Beracun Medis COVID-19. 2021, July 28. . https://www.youtube.com/watch?v=c2OtwbKDz_8
  36. Khan, B.A., L. Cheng, A.A. Khan, H. Ahmed. 2019. Healthcare waste management in Asian developing countries: A mini review. Waste Management & Research, 37(9): 863–875
  37. Kulkarni, B.N., V. Anantharama. 2020. Repercussions of Covid-19 pandemic on municipal solid waste management: Challenges and opportunities. Science of The Total Environment, 743: 140693
  38. Latief, A.S. 2012. Manfaat dan Dampak Penggunaan Insinerator Terhadap Lingkungan. Jurnal Teknis, 5: 20–22
  39. Lee, S.M., D. Lee. 2022. Effective Medical Waste Management for Sustainable Green Healthcare. International Journal of Environmental Research and Public Health, 19(22): 14820
  40. Liu, Yangsheng, Z. Zhan, F. Du, S. Kong, Y. Liu. 2009. Indoor air concentrations of mercury species in incineration plants for municipal solid waste (MSW) and hospital waste (HW). Chemosphere, 75(2): 266–271
  41. Ma, Y., X. Lin, A. Wu, Q. Huang, X. Li, et al. 2020. Suggested guidelines for emergency treatment of medical waste during COVID-19: Chinese experience. Waste Disposal & Sustainable Energy, 2(2): 81–84
  42. Madden, A.A., L.B. Crowe, E.E. Logee, P.T.B. Starks. 2021. Growsafe: A Chemical Method to Deactivate Cultivated Microorganisms Using Low-Cost Kitchen Supplies. Journal of Microbiology & Biology Education, 22(1): ev22i1.2577
  43. Mazzucco, W., C. Costantino, V. Restivo, D. Alba, C. Marotta, et al. 2020. The Management of Health Hazards Related to Municipal Solid Waste on Fire in Europe: An Environmental Justice Issue? International Journal of Environmental Research and Public Health, 17(18): 6617
  44. McDermott-Levy, R., C. Fazzini. 2010. Identifying the Key Personnel in a Nurse-Initiated Hospital Waste Reduction Program. Nursing Administration Quarterly, 34(4): 306–310
  45. Medical Expo. n.d. Microwave wastetreatment systems. Medical Expo, VirtualExpoGroup. https://www.medicalexpo.com/medical-manufacturer/microwave-waste-treatment-system-41611.html, July 20, 2021
  46. Melaku, H.S., M.A. Tiruneh. 2020. Occupational Health Conditions and Associated Factors Among Municipal Solid Waste Collectors in Addis Ababa, Ethiopia. Risk Management and Healthcare Policy, Volume 13: 2415–2423
  47. Motta, O., I. Zarrella, R. Cucciniello, M. Capunzo, F. De Caro. 2018. A new strategy to control the proliferation of microorganisms in solid hospital waste and the diffusion of nosocomial infections. Le Infezioni in Medicina, 26(3): 210–215
  48. Narayana, V., S. Rudraswamy, N. Doggalli. 2014. Hazards and Public Health Impacts of Hospital Waste. Indian Journal of Applied Research, 4(6): 384–386
  49. Neveu, C.A., C.P. Matus. 2007. Residuos hospitalarios peligrosos en un centro de alta complejidad. Revista Médica de Chile, 135(7). https://doi.org/10.4067/S0034-98872007000700009
  50. N.N. 1984. Using a pressure cooker as an autoclave. EPI Newsletter, 6(6): 5–8
  51. Nosheen, F., N. Malik, Z. Mehmood, F. Jabeen, A. Mahmood, et al. 2022. Biomedical waste management associated with infectious diseases among health care professionals in apex hospitals of a typical south asian city. Environmental Research, 215: 114240
  52. Nurwahyuni, N.T., L. Fitria, O. Umboh, D. Katiandagho. 2020. Pengolahan Limbah Medis Covid-19 Pada Rumah Sakit. Jurnal Kesehatan Lingkungan, 10(2): 52–59
  53. Pan, X., J. Yan, Z. Xie. 2013. Detoxifying PCDD/Fs and heavy metals in fly ash from medical waste incinerators with a DC double arc plasma torch. Journal of Environmental Sciences, 25(7): 1362–1367
  54. Pandey, A. 2016. Bio-Medical Waste Managment in a Tertiary Care Hospital: An Overview. Journal of Clinical and Diagnostic Research. https://doi.org/10.7860/JCDR/2016/22595.8822
  55. Parida, A., M.R. Capoor, K.T. Bhowmik. 2019. Knowledge, attitude, and practices of Bio-medical Waste Management rules, 2016; Bio-medical Waste Management (amendment) rules, 2018; and Solid Waste Rules, 2016, among health-care workers in a tertiary care setup. Journal of Laboratory Physicians, 11(04): 292–296
  56. Patil, G.V., K. Pokhrel. 2005. Biomedical solid waste management in an Indian hospital: A case study. Waste Management, 25(6): 592–599
  57. Peng, J., X. Wu, R. Wang, C. Li, Q, Zhang, et al. 2020. Medical waste management practice during the 2019-2020 novel coronavirus pandemic: Experience in a general hospital. American Journal of Infection Control, 48(8): 918–921
  58. Pertiwi, V., T. Joko, H.L. Dangiran. 2017. Evaluasi Pengelolaan Limbah Bahan Berbahaya dan Beracun (B3) di Rumah Sakit Roemani Muhammadiyah, Semarang. Jurnal Kesehatan Masyarakat, 5(3): 420–430
  59. Prihartanto. 2020. Prediction of Medical Hazardous Waste Generation from Covid-19 Patient Handling Hospitals. Jurnal Sains dan Teknologi Mitigasi Bencana, 15(1): 12–18
  60. Rafiee, A., K. Yaghmaeian, M. Hoseini, S. Parmy, A. Mahvi, et al. 2016. Assessment and selection of the best treatment alternative for infectious waste by modified Sustainability Assessment of Technologies methodology. Journal of Environmental Health Science and Engineering, 14(1): 10
  61. Rikin, A.S. 2020. 83. Rikin, A.S.(2020). Selama Pandemi, Indonesia hasilkan 1600 ton limbah medis. https://www.beritasatu.com/nasional/698379/selama-pandemi-indonesia-hasilkan-1600-ton-limbah-medis
  62. Rizal, A.M., I. Nurhayati. 2017. Pengolahan Limbah Bahan Berbahaya dan Beracun (B3) dengan Insinerator Tipe Reciprocating Grate. Waktu: Jurnal Teknik Unipa, 15(2): 21–27
  63. Rupani, P.F., R.M. Delarestaghi, M. Abbaspour, M.M. Rupani, H.S. EL-Mesery, et al. 2019. Current status and future perspectives of solid waste management in Iran: A critical overview of Iranian metropolitan cities. Environmental Science and Pollution Research, 26(32): 32777–32789
  64. Saad, S.A.G. 2013. Management of hospitals solid waste in Khartoum State. Environmental Monitoring and Assessment, 185(10): 8567–8582
  65. Salman, N., D. Aryanti, F.M.L. Taqwa. 2021. Evaluasi Pengelolaan Limbah Rumah Sakit (Studi Kasus: Rumah Sakit X di Kab. Tasikmalaya). Jurnal Komposit, 5(1): 7–16
  66. Sangkham, S. 2020. Face mask and medical waste disposal during the novel COVID-19 pandemic in Asia. Case Studies in Chemical and Environmental Engineering, 2: 100052
  67. Santos, E. de S., K.M. dos S. Gonçalves, M. P. G. Mol. 2019. Healthcare waste management in a Brazilian university public hospital. Waste Management & Research: The Journal for a Sustainable Circular Economy, 37(3): 278–286
  68. Saragih, J.L., W. Herumurti. 2013. Evaluasi Fungsi Insinerator dalam Memusnahkan Limbah B3 di Rumah Sakit TNI Dr. Ramelan Surabaya. Jurnal Teknik ITS, 2(2): 138–144
  69. Sarmin, Y. Sabilu, Nurmaladewi. 2020. Pengelolaan Limbah Medis Padat Di Masa Pandemi Covid-19 Di Rumah Sakit Umum (rsu) Bahteramas Provinsi Sulawesi Tenggara. Preventif Journal, 5(2). https://doi.org/DOI :
  70. Sholihah, E.M., A.C. Sjaaf, A. Djunawan. 2021. Evalusi Pengelolaan Limbah Medis Sebelum dan Saat Pandemi Covid19 di Rumah Sakit Sentra Medika Cikarang. Jurnal Manajemen Kesehatan Yayasan RS.Dr. Soetomo, 7(1): 105
  71. Sitepu, N. A. 2020. Upaya Memutus Rantai Infeksi Pada Limbah Padat Medis B3 (Bahan Berbahaya dan Beracun) di Rumah Sakit. Preprint, Open Science Framework. https://doi.org/10.31219/osf.io/ynfzs
  72. Sobia, M., S.A. Batool, M.N. Chaudhry. 2014. Characterization of hospital waste in Lahore, Pakistan. Chinese Medical Journal, 127(9): 1732–1736
  73. Sutrisno, H., F. Meilasari. 2020. Review: Medical Waste Management for Covid-19. Jurnal Kesehatan Lingkungan, 12(1si): 104
  74. Taghipour, H., M. Alizadeh, R. Dehghanzadeh, M.R. Farshchian, M. Ganbari, et al. 2016. Performance of on-site Medical waste disinfection equipment in hospitals of Tabriz, Iran. Health Promotion Perspectives, 6(4): 202–206
  75. Utami, R.D., D.G. Okayadnya, M. Mirwan. 2018. Meningkatkan Kinerja Insinerator pada Pemusnahan Limbah Medis RSUD Dr. Soetomo Surabaya. Jurnal Ilmiah Teknik Lingkungan, 7(2): 115–123
  76. Wei, G., H. Liu, R. Zhang, Y. Zhu, X. Xu, et al. 2017. Application of microwave energy in the destruction of dioxins in the froth product after flotation of hospital solid waste incinerator fly ash. Journal of Hazardous Materials, 325: 230–238
  77. Wyssusek, K.H., M.T. Keys, A.A.J. van Zundert. 2018. Operating room greening initiatives—The old, the new, and the way forward: A narrative review. Waste Manag. Res., 37(1): 3–19
  78. Zimmermann, K. 2017. Microwave as an emerging technology for the treatment of biohazardous waste: A mini-review. Waste Management & Research: The Journal for a Sustainable Circular Economy, 35(5): 471–479
  79. Zorko, D.J.,S. Gertsman, S., K. O’Hearn, N. Timmerman, N. Ambu-Ali, et al. 2020. Decontamination interventions for the reuse of surgical mask personal protective equipment: A systematic review. Journal of Hospital Infection, 106(2): 283–294

Last update:

No citation recorded.

Last update: 2024-11-20 05:53:31

No citation recorded.