# Domestic Medical Waste Management: An Assessment of Knowledge and Disposal Practices in the City of Tshwane Metropolitan Municipality

## TL;DR

This study examines how residents in Tshwane improperly dispose of medical waste, highlighting risks to public health and the environment, and proposes better waste management solutions.

## Contribution

The paper introduces a proposed model for integrated domestic medical waste management tailored to Tshwane, emphasizing education and policy changes.

## Key findings

- 78.3% of residents dispose of medical waste in general waste bins.
- Only 5.2% return unused medications to pharmacies.
- The study identifies significant gaps in awareness and infrastructure for proper medical waste disposal.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Domestic Medical Waste Management needs attention to prevent the spread of communicable diseases that could significantly impact the public health system in the City of Tshwane Metropolitan Municipality and in South Africa.Domestic medical waste is as infectious and hazardous as any other medical waste from a healthcare facility and needs to be managed properly. Failure to do so could lead to improper disposal thereof and could also lead to pollution of natural water resources, easy access of used needles and syringes by drug users, and sustained injuries (needle pricks) by waste pickers.

Domestic Medical Waste Management needs attention to prevent the spread of communicable diseases that could significantly impact the public health system in the City of Tshwane Metropolitan Municipality and in South Africa.

Domestic medical waste is as infectious and hazardous as any other medical waste from a healthcare facility and needs to be managed properly. Failure to do so could lead to improper disposal thereof and could also lead to pollution of natural water resources, easy access of used needles and syringes by drug users, and sustained injuries (needle pricks) by waste pickers.

Public health significance—Why is this work of significance to public health?
Provision of Domestic Medical Waste Management services by the City of Tshwane Metropolitan Municipality would ensure regular collection and proper disposal of DMW within the City of Tshwane Metropolitan Municipality, thus reducing and eliminating bad practices of DMW disposal such as dumping of DMW, pouring and flushing medicine in the toilet and putting DMW in the general municipal waste bin, with it thereby ending up at General Landfill sites.The proposed DMW Management Model would ensure integrated hazardous waste management within the City of Tshwane Metropolitan Municipality that will divert DMW from reaching General Landfills and reduce disease transmission, as well as educating residents in the City of Tshwane Metropolitan Municipality about proper management of DMW, thus saving the Municipality money that could have been spent on medical treatment.

Provision of Domestic Medical Waste Management services by the City of Tshwane Metropolitan Municipality would ensure regular collection and proper disposal of DMW within the City of Tshwane Metropolitan Municipality, thus reducing and eliminating bad practices of DMW disposal such as dumping of DMW, pouring and flushing medicine in the toilet and putting DMW in the general municipal waste bin, with it thereby ending up at General Landfill sites.

The proposed DMW Management Model would ensure integrated hazardous waste management within the City of Tshwane Metropolitan Municipality that will divert DMW from reaching General Landfills and reduce disease transmission, as well as educating residents in the City of Tshwane Metropolitan Municipality about proper management of DMW, thus saving the Municipality money that could have been spent on medical treatment.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Domestic Medical Waste Management service must be an integral part of integrated waste management within the City of Tshwane Metropolitan Municipality.The Waste Management By-laws and the Integrated Development Plan (IDP) of the City of Tshwane Metropolitan Municipality must be reviewed to include DMWM service so that it can be budget for and be rendered accordingly.

Domestic Medical Waste Management service must be an integral part of integrated waste management within the City of Tshwane Metropolitan Municipality.

The Waste Management By-laws and the Integrated Development Plan (IDP) of the City of Tshwane Metropolitan Municipality must be reviewed to include DMWM service so that it can be budget for and be rendered accordingly.

The improper disposal of domestic medical waste (DMW) constitutes a significant public health and environmental concern; however, limited studies exist concerning DMW disposal practices in South Africa. This study evaluated the knowledge and practices involving the disposal of domestic medical waste (DMW) in the City of Tshwane Metropolitan Municipality. The study investigated common disposal methods, levels of awareness of appropriate techniques, and associated health risks. Data were collected using structured questionnaires (Annexure A) with closed-ended questions, administered both physically at shopping complexes and electronically via LinkedIn, WhatsApp, and email to eligible participants. Data analysis was conducted using the Statistical Package for the Social Sciences (SPSS) Version 29 and Microsoft Excel, with results presented in graphical form. Findings revealed that 78.3% of residents disposed of DMW in general waste bins, while 85.8% reported discarding medicine bottles in the same manner, and only 5.2% returned unused medications to pharmacies. The findings highlight gaps in awareness, infrastructure, and policy, necessitating comprehensive education programs, improved waste management services, and policy revisions to include DMW. A proposed model emphasizes education, community involvement, infrastructure enhancement, and ongoing policy evaluation to address these challenges. These efforts aim to reduce health risks, mitigate environmental impacts, and promote safe DMW disposal practices, safeguarding public health and creating a sustainable environment.