Impact of COVID-19 pandemic on healthcare waste management: A pre experimental study from a Tunisian hospital

Introduction: Worldwide, healthcare waste management (HCWM) is a high priority public health and environmental concern issue. During the Corona Virus Disease 2019 (COVID-19) pandemic, hygiene measures were more strictly applied in hospital setting. Objectives: The aim of this study was to assess HCWM before and during the COVID 19 pandemic in Sahloul University Hospital (2019-2021). Methods: A pre experimental study, based on two audits of HCWM, was carried out at Sahloul University Hospital (2019-2021). The intervention consisted on repeated training sessions on standard hygiene precautions among all healthcare workers. The data was collected by trained auditors using a pre established observation grid based on the manual of good HCWM techniques and practices (ANGED). Results: Between 2019 and 2021 the overall compliance with the sorting of HCWs has increased from 44.7% to 68.9%: it passed from 75% to 87.2% for needle containers, from 23.9%to 48.8% for yellow bags reserved for infectious risk waste and from X to 70.9% for black bags reserved for ordinary waste. For the intra-service collection step the overall score passed from 28.51% to 58.2%;The most improved dimensions were “The filling level of the yellow bags is respected” (passed from 28.6% to 76.6%) and “Absence of HCWs outside containers or waste bags” 19.9% to 90.9%). Nevertheless, a lack of improvement in labeling practice was noted, such as the labeling of bags containing infectious risk wastes, which went from 0 to 0.9%;labeling of needle containersfrom6% to 3.2% and the traceability of the waste disposal time from 0 to 7.3%. Conclusion: The pandemic may present a unique chance to improve compliance with recommendations regarding HCWsM on the long term, therefore, we should focus on how to maintain high adherence to recommendations and improve deficiencies during and after the COVID-19 pandemic.