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Abstract
The hospital environmental services are usually considered secondary in importance to the care for patients, because such services are neither diagnostic nor curative. However, the hospital environment can present an important risk of infection to employees, patients, visitors and the community. That’s why maintaining a hygienic internal and external hospital environment is a must in order to avoid the hospital acquired infection (nosocomial infection).
Examples of the assessment of environmental services that ensure the prevention and control of infection include the adequacy of water supply for both quality and quantity, the propriety of the sanitary disposal of wastewater, and the proper disposal of solid waste.
The Medical Research Institute Hospital (MRIH) is a sector of the University of Alexandria. It includes a number of diagnostic, treatment, and research units. In general, few studies have been carried out with the aim of assessing the sanitation services in hospitals, and none were done in the MRIH. In the present study, a full investigation of the environmental sanitation services in the MRIH has been conducted to shed light on the existing environmental conditions.
To attain this goal, the study took place over the period of one year, starting in autumn 2002 and ending in summer 2003.
The main site characteristics of the MRIH were studied, along with the possible sources of nuisance, through an observation sheet (Appendix I). The observation technique was also applied for the assessment of the plumbing systems for both drinking water and wastewater.
Water sampling was done in October, January, April, and June that were considered as representatives of the four seasons of the year. The water samples were taken randomly from the tap water of the thirty-three different units of the MEIH. The process included taking five samples from each unit in each season of the year, with a total number of 660 (33 x5x4) samples. The samples were subjected to examination, such as estimation of residual chlorine using the choloroscope, and microbiological examination using the plate count procedure for the detection of colonies and the multiple tube technique for total coliforms according to procedures in Standard Methods for examination of water and wastewater.(50)
The solid waste management at the MRIH was also assessed. This included the determination of unit generation rate in terms of kg/day and kg/patient/day for each unit of the hospital, taking into account the domestic and clinical categories (infectious, pathological, sharps, pharmaceutical, genotoxic, chemical, radioactive, and pressurized containers) of waste. The physical components of solid waste were also checked and classified into plastic, textile, rubber, metal, and glass, in accordance with the WHO classification. (20)