Despite the institutional regulations, a regrettable reality is that the case of illegal reselling of medical waste in Nanjing is not uncommon in recent years. The illegal recycling of medical waste seems to have been circulating in the cycle of “reflection-accidentâ€.
Plastic tableware and children's toys used in daily life may be derived from medical wastes such as infusion bottles and infusion bags used in hospitals! The Qixia District Bureau of Nanjing Municipal Public Security Bureau of Jiangsu Province (hereinafter referred to as Qixia Branch), the first case of environmental pollution caused by medical waste in Nanjing, which was detected more than three months ago, shocked the public.
According to the Qixia Branch, the author disclosed that 13.5 tons of medical waste were seized at the scene, and the suspects acquired and resold more than 3,000 tons of medical waste. These medical wastes were transferred into layers and processed into disposable plastic plates and inferior children. toy.
The illegal sale of medical waste is not a new topic. In the interview with the author, Zhuo Xiaoqin, an expert in health law, stressed that the emergence of this chaos is mainly driven by interests, and how to avoid the frequent “missing†of medical waste, the relevant departments are needed. Comprehensively strengthen supervision and completely “cut off†the chain of interests behind the resale of medical waste.
"Fatal killer" being resold at will
Unusual smell, the needles, syringes, infusion tubes, and blood swabs that are scattered on the spot still have residual potions or blood...
This is the scene that Qixia Branch saw at the waste collection station in Gujiacun during the investigation and rectification of the Yanziji area in the jurisdiction at the end of August this year. These findings immediately caught the attention of the police. After the situation was notified to the Nanjing Environmental Protection Bureau and the Qixia District Environmental Protection Bureau, the Qixia Branch established a task force to investigate.
From August 30 to 31, the police of the task force collected the medical equipment for needles, infusion tubes, etc. in the car of the legal representative of Nanjing Kangshiyuan Environmental Protection Technology Co., Ltd. registered at the acquisition station and the waste collection station after two days of inventory. About 8.5 tons of waste and about 5 tons of antibiotic small glass bottles, a total of about 13.5 tons. From the photos posted by the Qixia Branch, we can see that the snake skin bags and black plastic bags used to wrap medical waste have been piled up into mountains. Each bag is mixed with a large number of disposable infusion tubes, disposable syringes, needles, etc. Hazardous Waste.
According to the surrounding people, the police said that the waste collection station often emits a disgusting smell, and the frequently disturbing noise also affects the normal work of the surrounding people. After the investigation, the police also found that the recovery of medical waste at the acquisition station was not a "small crime", but an "underground industry chain" had already formed.
From the beginning of 2012, Zhang began to recover medical waste mixed with needles and infusion tubes from several hospitals in Nanjing at prices ranging from 800 yuan to 1,000 yuan per month. These medical wastes are classified by disposable workers in accordance with disposable plastic infusion soft bags, disposable plastic infusion bottles and disposable infusion glass bottles. Disposable plastic infusion soft bags are mechanically compressed and packaged, and disposable plastic infusion bottles are used. The pulverizer is pulverized into plastic granules and sold to Suqian, Zhejiang and other places for further processing. Finally, the plastic granules produced by the processing plant are sold to plastic products manufacturers all over the country through the plastics market and network. Some even become the raw materials used by some black-hearted manufacturers to produce counterfeit brand plastic toys and tableware.
According to police investigations, since 2012, Zhang has illegally acquired and sold more than 3,000 tons of medical waste, involving more than 40 million yuan. Behind such a shocking amount of crime, Dr. Mao Da, the environmental history doctor of Beijing Normal University and Beijing zero-abandon initiator, is more worried about the huge health risks that this kind of behavior will bring to the people. He is well aware of the work of waste sorting research all the year round. The harmfulness of medical waste is “fatal†compared to ordinary household waste.
In many countries, medical waste is known as a “fatal killerâ€. This is not only because the wastes, infusion tubes, infusion bottles and other wastes produced in these medical treatments contain harmful pathogens and are more than hundreds or even thousands of ordinary household waste. Double bacteria, more importantly, many medical wastes are directly in contact with the patient's body. If they are improperly disposed, they will be highly infectious, become a source of environmental pollution and a source of disease, and breed double pollution.
According to some data, in the 1970s, there were incidents in which the spread of medical waste was caused by improper disposal of medical waste. To this end, in addition to being listed as “the number one hazardous waste†in the National Hazardous Waste List in China, after the SARS in 2003, the State Council also promulgated the “Regulations on the Management of Medical Wastesâ€, requiring local governments to implement a special person responsibility system. Strictly supervise the whole process of collection, storage, transportation and disposal, and construct a centralized disposal center for harmless disposal. It is strictly forbidden for any unit or individual to buy or sell medical waste.
Despite the institutional regulations, a regrettable reality is that the case of illegal reselling of medical waste in Nanjing is not uncommon in recent years. The illegal recycling of medical waste seems to have been circulating in the cycle of “reflection-accidentâ€. "This is definitely a problem that cannot be ignored, and it is a problem that needs to be solved and regulated from the source." Mao Da stressed.
Containing the source is the key
The three suspects involved in the case have been prosecuted. Severe punishment for illegal trading and processing of medical waste will definitely help regulate medical waste management. However, in Maoda’s view, this is not the “seven inch†that really solves this problem, because if there is no hospital violation, the hospital will be produced. The sale of medical waste to lawless elements will naturally not lead to the subsequent resale, production, sales and re-circulation. "Regulation and supervision of the treatment of medical waste in hospitals, from the source to contain the entire black industrial chain." The essential".
How does the hospital dispose of medical waste? With this question, the Qinhuangdao City Entrepreneur Association of Hebei Province conducted a three-month investigation in 68 community hospitals and private clinics in the main city and harbor areas in 2008.
Zhou Jian, the president of the association, revealed to the author that the choice of private clinics and small hospitals was due to the fact that these medical institutions may expose more problems than large hospitals, and the final result is indeed not satisfactory.
Almost none of the small medical institutions surveyed were responsible for the disposal of medical waste. More than half of the medical institutions disposed of medical waste simply mixed the medical waste with household waste and discarded it in the community waste bin.
“This obviously does not meet the state's requirements for the standardized disposal of medical waste.†Zhou Jian said in an interview with the author that although the investigation was conducted earlier, the results may be affected by the awareness and level of overall medical waste disposal at that time, but with Compared with large hospitals, private clinics and small hospitals are more likely to become “disaster areas†for the illegal outflow of medical waste.
Zhuo Xiaoqin agreed with this. He believes that in addition to the lack of relevant awareness and the lack of supervision, the core is to be driven by interests.
According to the relevant national regulations, medical waste must be treated centrally by the “incineration method†to ensure sterilization and avoid environmental pollution. It is now common practice for major hospitals to sign contracts with units with nationally recognized medical waste centralized disposal qualifications. The company handles the medical waste generated by the hospital.
“The cost of processing medical waste should be borne by the hospitals themselves. This is not a small expense.†Tang Jin, a staff member of a top three hospital in Chaoyang District, Beijing, introduced to the author that various fees have been set up everywhere. Beijing requires a standard of not more than 3,000 yuan per ton of medical waste. The specific cost is determined by the medical waste disposal unit and the hospital. “In general, the cost of medical waste disposal and the necessary materials for collecting medical waste in a large general hospital for one year will be more than several hundred thousand yuan.â€
Compared with large hospitals, although the medical waste generated by small hospitals or private clinics is not too large, it is inevitable that additional expenses will be incurred in the processing of medical wastes by specialized agencies, and it is not necessary to pay for reselling privately with some illegal medical waste purchasers. This fee, on the other hand, can still be paid back. "It is this kind of 'one reduction and one increase' that has driven individual medical institutions to do an article on medical waste." Zhuo Xiaoqin bluntly said.
Regulatory registration is imperative
Compared with some small medical institutions, large medical institutions are currently more standardized in the treatment of medical waste. Zhuo Xiaoqin believes that this aspect is related to the large-scale medical institutions themselves focusing on standardized development and more easily regulated, and at the same time compared to the reputation of large hospitals. And the profits that can be created each year, there is no need to take risks in the treatment of medical waste.
However, having a standardized procedure does not mean completely “invulnerableâ€. In this case of Nanjing’s reselling of medical waste, according to the suspect Zhang, some recovered disposable infusion bags, infusion bottles and other medical wastes come from individual top three. hospital.
Tang Jin also frankly said that some hospital staff had previously heard about the behavior of “self-stealingâ€. It is difficult for doctors or nurses to have some opportunity to relocate some medical waste for work reasons. These “inner ghosts†tend to focus on medical waste. Department of hospital property and logistics cleaning.
According to Tang Jin, because the departments that produce medical waste in large hospitals are more dispersed, the currently widely used model is collected by each department, and then collected by hospitals who specialize in medical waste in the hospital for centralized collection and centralized storage. In the special storage area of ​​the hospital, it is taken away by the cooperative processing agency every night or regularly.
At present, many hospitals have established corresponding departments responsible for medical waste treatment or are responsible for them. However, for the sake of manpower and other reasons, the actual operation of medical waste inventory and storage is mostly the cleaning company or property company personnel hired by the hospital. It is difficult to ensure that some people will have private reselling behavior at work because of their interests or weak legal awareness.
However, with Tang Jin’s understanding of major hospitals in Beijing, it is still difficult to “hands-on†on medical waste.
In order to regulate the treatment of medical waste, and in order to facilitate management and liquidation, many hospitals currently have rigid requirements for the registration of medical waste.
Take the hospital where Tang Jin is located as an example. Every day at a fixed time, relevant personnel will go to various departments to collect medical waste. How many bags of medical waste, what types and weights are used in each department today, there will be specific labels and Record, these data not only require the relevant responsible person to sign and confirm, but also to stay in the hospital. When a specialized agency comes to collect medical waste, the hospital will check with them again to ensure that there is not much deviation in the overall quantity and weight.
Zhuo Xiaoqin is extremely recognized by this system. He believes that the registration of hospital-regulated medical waste not only helps to standardize medical waste management, but also enables hospital medical waste to be traced and helps to find out in time. And stop the problem.
Strict supervision
Zhuo Xiaoqin stressed that it is far from enough to improve the source of the hospital if it is only based on the hospital's own system. The local health administrative departments must also increase the supervision of various hospitals. In the actual practice of hospital supervision, there are indeed many problems such as many points, wide areas, and long lines. This requires that the supervision work should be normalized and targeted, especially for medical wastes such as primary medical institutions and private clinics. More attention should be paid to the treatment of non-standard medical institutions.
The illegal reselling process of medical waste has to go through many links. Therefore, in addition to increasing the source of governance, strengthening the supervision of all links and implementing a comprehensive and complete supervision system can effectively combat such behavior.
“Currently, all departments have put more emphasis on the supervision of medical waste in hospitals, but in practice, the illegal outflow of medical waste may also occur in transportation and disposal.†Zhuo Xiaoqin believes that those qualified medical wastes The supervision of professional disposal agencies cannot be relaxed. At the same time, the system of medical waste disposal, flow registration, and reporting should be further promoted. Once problems arise, it is helpful to trace the source and clarify responsibilities.
At present, many regions are already experimenting with such systems. It is understood that the environmental protection department of Nanyang City, Henan Province has formulated a “unit-to-single transfer systemâ€, which is a unitary four-part, and each of the medical waste generating units, transport units, disposal units, and environmental protection bureaus maintains one. The environmental protection department will ensure the standardized disposal of medical waste by regularly checking the implementation of the transfer of joint orders and conducting on-site inspections on the spot.
As an illegal acquisition party that resells medical waste, these collected medical wastes will be reprocessed and profited by selling materials or making products. Many cases are actually seized at this stage.
In view of the fact that the resale of medical waste has formed a complete chain of interests, Zhuo Xiaoqin believes that a multi-sector linkage mechanism should be formed for its supervision. The health, environmental protection and public security departments should strengthen linkages and carry out various forms of joint law enforcement activities to form mutual support. We must pay close attention to the supervision situation of the co-management and increase the intensity of the crackdown.
In the actual research, Zhuo Xiaoqin found that a major reason why some medical institutions are “disapproving†for illegal treatment of medical waste is that the illegal cost is too low. At present, the relevant punishment is based on the “Regulations on the Management of Medical Wastesâ€, but the penalties imposed on the competent departments, hospitals, and illegal operators are relatively minor. For example, the general medical waste disposal violations are only fined 1,000 yuan to 30,000 yuan, only serious pollution occurs. It is only possible for an accident to be held criminally liable.
"For some medical institutions that have long resold medical waste, such fines are far lower than the gains from reselling." Zhuo Xiaoqin believes that punitive measures should be applied to illegally reselling medical waste, which may seriously violate the rights and interests of the general public. The principle of compensation and the increase of illegal costs can also force medical institutions to actively strengthen internal supervision, and at the same time, they can establish an accountability mechanism for the regulatory authorities and strengthen external supervision.
Violation of medical waste should be severely cracked, and formal processing needs to be more standardized. In the actual investigation, Maoda found a problem, that is, some hospitals lacked in the classification of medical waste.
“The classification of medical waste is an important pre-work.†Mauda explained that for reasons of energy conservation and environmental protection, according to the regulations, in addition to needles and other sharp or infectious medical wastes need to be completely burned, for one-time infusion Non-infectious medical waste such as bags and infusion tubes can be recycled and used after scientific processing.
Many large hospitals are also currently requesting the classification of medical waste. For example, the recyclable medical waste is placed in a double-layered yellow plastic bag, and the discarded needles are placed in the sharps box. However, there are still some medical institutions that do not pay enough attention to and regulate the use of needles and other recyclable medical waste, resulting in waste of recyclable resources.
In addition, Maoda suggested that China's medical waste disposal technology can draw more experience from Western countries. For example, in addition to concentrated incineration, it can also adopt more economical and environmentally friendly methods such as high-temperature cooking, which can reduce the cost of medical waste disposal. Avoid environmental pollution caused by burning medical waste. At the same time, this technology can be handled within the hospital itself, and it can also solve the practical difficulties of some medical waste disposal institutions in relatively scarce areas.
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