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Knowledge of health workers at Riyadh Medical Complex of Health Care Waste management, 2004


Healthcare activities are inevitably followed by the generation of waste. About 15% of health care waste (HCW) is hazardous and may be infectious, toxic or radioactive, thus creating a variety of health risks. Appropriate management of HCW requires certain steps: segregation at site of production, collection, transportation, storage, treatment and final disposal. The continuously progressing medical system in Saudi Arabia has dictated an increase in use of disposable needles, syringes, and other similar items. Adequate knowledge of health care workers of the steps of waste management is crucial for the success of any HCW management program. The present study investigates the knowledge of health workers at Riyadh Medical Complex (RMC) of the components of HCW management and factors influencing knowledge.


A descriptive cross-sectional study was conducted among health care workers at RMC. A standard questionnaire was distributed inquiring on basic demographic data, the different types of medical waste, their segregation, storage, transport inside and outside the hospital, and final disposal, and whether the participant health care worker had received previous training on HCW management. For assessment of knowledge, a composite score based on 44 knowledge questions was developed and used for further analysis. The median of the composite score was used as a cut off point to split the workers into two categories: high knowledge group and low knowledge group.


The study population included 73 (23.4%) doctors and 239 (76.6%) nurses, working in the medicine department 118 (44.7%), surgery 64 (24.2), emergency (4.9%), other (26.1%). There were 66 (22.8%) Saudis and 223 (77.2%) non-Saudis. Deficiencies in knowledge of health workers were apparent in almost all aspects of HCW management, such as the classification of the types of medical waste, types of waste produced in their departments, segregation of waste, collection, storage, transport and disposal of HCW. Of the total study population, only 73 (22.7%) had received previous training on HCW management. The median score of knowledge based on the composite score was used to divide health workers into two groups; low knowledge group (139 health care workers, 43.3%), and high knowledge group (182, 56.7%). Statistically significant factors influencing knowledge were gender, the proportion of high knowledge being greater among female health workers (62.5%), (p-value=0.002); occupation, the proportion of high knowledge being greater among nurses (62.8%), (p-value=0.000); and nationality, the largest proportion of high knowledge workers were among non-Saudis (63.7%), (p-value=0.000). Health workers who had received previous training had a greater proportion of high knowledge (69.9%), and this was statistically significant (p-value = 0.01).


Our study showed that knowledge of health care workers of HCW management has still not achieved the desired standards. The awareness of healthcare providers on the generation of hazardous waste in the course of providing healthcare is fundamental for the planning of its effective management. Increasing the knowledge as well as the sense of responsibility of staff members can improve attitude and practice habits. Extensive training and re-training programmes will surely help in changing the risk behavior of health care workers for the effective implementation of HCW management. Teaching and demonstration sessions for the nursing domestic and portering staff are also required.