Assessment of Waste Management System and Sterilization Procedure of the Equipment in the Dental Section of Khwaja Yunus Ali Medical College and Hospital, Sirajganj

Md. Nahidul Islam^1*, Md. Shahidul Islam², Mohammad Rakibul Islam Babu³, Mst. Amina Khatun⁴, Raihana Nahar⁵, S. M. Shahinul Islam⁶, Parvez Hassan⁶

¹Dental Unit, Khwaja Yunus Ali Medical College & Hospital, Sirajganj, Bangladesh

²Department Of Prosthodontics, Dental Unit, Khwaja Yunus Ali Medical College & Hospital, Sirajganj, Bangladesh

³Department of Orthodontics & Dentofacial Orthopedics, City Dental College & Hospital, Dhaka, Bangladesh

⁴Depatment Of Conservative Dentistry & Endodontics, Kumudini Women’s Medical College & Hospital, Tangail, Bangladesh

⁵Department of Conservative Dentistry and Endodontics, Dhaka Dental College, Dhaka, Bangladesh

⁶Institute of Biological Sciences, University of Rajshahi, Bangladesh

^*Corresponding Author: Md. Nahidul Islam, Lecturer, Dental Unit, Khwaja Yunus Ali Medical College & Hospital, Sirajganj, Bangladesh.

Received: 08 June 2026; Accepted: 10 June 2026; Published: 22 June 2026

Introduction

Biomedical waste refers to all waste generated during the diagnosis, treatment, immunization, or research activities involving human beings and animals [1]. Healthcare facilities produce a wide range of waste materials, including both non-hazardous and hazardous waste [2]. Dental healthcare settings contribute significantly to biomedical waste generation using needles, dressings, extracted teeth, disposable materials, disinfectants, chemicals, and dental amalgam [3]. In addition, reusable dental instruments require proper cleaning, disinfection, and sterilization to prevent the transmission of infectious diseases [4]. According to the World Health Organization (WHO), healthcare waste is broadly classified as general waste and hazardous waste [5]. While general waste resembles household waste, hazardous waste includes infectious waste, pathological waste, sharps, pharmaceutical waste, chemical waste, heavy metals, pressurized containers, and radioactive materials [6,7]. Improper handling and disposal of these wastes pose significant risks to healthcare workers, patients, waste handlers, and the surrounding environment [8]. Medical waste management remains a major public health concern worldwide. Studies have shown that a substantial proportion of healthcare facilities in developing countries fail to implement appropriate waste management practices [9]. Inadequate segregation of waste at the source often results in hazardous waste being mixed with general waste, increasing the risk of infection, injury, and environmental contamination. Occupational exposure to improperly managed healthcare waste may lead to the transmission of serious infections such as hepatitis B, hepatitis C, and human immunodeficiency virus (HIV) [10]. In Bangladesh, rapid urbanization, increasing healthcare demands, and limited waste management infrastructure have intensified the challenges associated with biomedical waste disposal [11]. Previous studies have reported deficiencies in waste management policies, inadequate supervision, insufficient resources, and poor compliance with standard guidelines in many healthcare institutions. These shortcomings contribute to unsafe waste handling practices and increase the risk of healthcare-associated infections and environmental pollution [12].

Infection prevention and control (IPC) is a fundamental component of quality healthcare services. Effective waste segregation, safe disposal methods, and proper sterilization procedures are essential elements of IPC programs. Among healthcare disciplines, dentistry requires particular attention because dental procedures frequently involve direct contact with blood, saliva, and oral tissues. Consequently, contaminated instruments can serve as potential sources of cross-infection if sterilization procedures are not properly followed [13]. Sterilization of dental instruments is crucial for eliminating microorganisms and ensuring patient safety. International organizations such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have established guidelines for instrument processing, sterilization, and infection control in dental settings [14]. However, adherence to these guidelines may vary among healthcare facilities, especially in resource-limited environments. Assessing existing waste management systems and sterilization practices is essential to identify strengths, deficiencies, and areas requiring improvement [15]. Such assessments can contribute to the development of safer working environments, better infection control measures, and improved quality of patient care. The aim of this study was to assess the waste management system and sterilization procedures in the Dental Section of Khwaja Yunus Ali Medical College and Hospital, Sirajganj, and to identify areas for improvement in infection prevention and control practices.

Methodology

This study was taken at Khwaja Yunus Ali Medical College and Hospital in Sirajganj district, which is in the northern part of Bangladesh. Research was conducted over a one-year period, starting from June 2024 to May 2025. The research population consisted of 125 purposively selected respondents. The research employed the descriptive cross-sectional method. A survey technique was applied for collecting data from hospital employees, which included doctors, nurses, medical technicians, ward boys, cleaners, and ayas. Data collection was achieved through face-to-face formal interviews following the structured method. There were several variables in the study. The socio-demographic variable involved age, sex, religion, occupation, length of service, and waste segregation practices within the hospital. Hospital waste management systems were based on waste segregation, methods of storage, disposal following color code guidelines, shredding or mutilating used plastic syringes, waste collection from departments, means of transportation of the waste, mixing the waste with the rest of garbage, and availability of designated storage areas. Records on hospital waste management systems referred to the presence of injury reports in connection with hospital waste management system implementation. The disposition of hospital waste system was determined based on how blood-stained material (cotton and gauze), papers, and kitchen wastes, sharp and hazardous liquid waste were disposed of. Sterilization practices involved wearing PPEs during waste handling and hand washing. The presence of injuries, needlestick injuries, and adequacy of treatment for injuries were evaluated. In addition, the vaccination status of the respondents was noted especially regarding immunizations against tetanus and hepatitis. Finally, the presence of training in the hospital waste management process was assessed. Prior to statistical analysis, collected data underwent scrutiny to eliminate inconsistencies, omissions, and errors before proceeding with coding and classification of the data. The Statistical Package for Social Science (SPSS) software version 22.0, running on windows operating system, was utilized to analyze data collected. Findings from this study were presented using tables, figures, and descriptive analyses. Socio-demographic information of the subjects was given along with analysis of the relationship between dependent and independent variables.

Results

A total of 125 healthcare personnel participated in this study. The sociodemographic characteristics of the respondents are presented in Table 1. Most of the respondents were aged 25–29 years (39.2%), followed by 30–34 years (28.8%), while 20.0% were aged 35 years or above and 12.0% were aged 21–24 years. Female respondents constituted 64.0% (n=80) of the study population, whereas males accounted for 36.0% (n=45). Most participants were Muslim (91.2%), followed by Hindu (8.0%) and Christian (0.8%). Regarding occupation, more than half of the respondents were doctors (53.6%), while nurses, medical technicians, and other support staff constituted 30.4%, 12.8%, and 3.2%, respectively. In terms of work experience, 68.0% of the respondents had worked for less than five years, whereas 32.0% had five years or more of service experience.

Table 1: Sociodemographic Characteristics of the Respondents (n=125).

Table 2 presents the waste segregation, collection, and transportation practices among the respondents. A total of 76.0% (n=95) reported practicing hospital waste segregation, while 24.0% were unaware of the practice. Most respondents (75.2%) reported storing waste in plastic dustbins with lids, whereas 23.2% used plastic dustbins without lids and only 1.6% used color-coded containers. Regarding waste disposal according to color-coding guidelines, 79.2% reported following the color-coded system, while 19.2% did not and 1.6% were unaware of the procedure. Proper mutilation or shredding of used syringes before disposal was reported by 92.8% of respondents. The majority (94.4%) indicated that hospital waste was collected once daily, while 5.6% reported collection twice daily. For waste transportation, 83.2% used wheeled carts or trolleys, whereas 16.8% used covered bins.

Table 2: Waste Segregation, Collection and Transportation Practices (n=125).

The waste disposal practices of the respondents are summarized in Table 3. A notable finding was that 80.0% (n=100) of respondents reported that different categories of waste were mixed with general garbage, while only 20.0% reported proper segregation. For disposal of blood-contaminated cotton, gauze, and related materials, 79.2% used red plastic bags and 20.8% used yellow plastic bags. Regarding paper and kitchen waste disposal, 48.8% used yellow plastic bags, 45.6% used red plastic bags, and 5.6% used blue plastic bags. Disposal of sharp waste was most performed using red bins (53.6%), followed by yellow bins (40.0%), while 6.4% used other disposal methods. Concerning hazardous liquid waste, nearly half of the respondents (48.8%) reported disposal with general garbage, 19.2% disposed of it through drains, 1.6% used chemical treatment before discharge, and 30.4% were unaware of the appropriate disposal method.

Table 3: Waste Disposal Practices in the Hospital (n=125).

Table 4 describes occupational safety, record-keeping, and infection prevention practices among the respondents. Waste management records were maintained by 67.2% of respondents, while 32.8% reported no record maintenance. Injury records related to healthcare waste management were available according to 64.0% of respondents, whereas 32.8% reported their absence and 3.2% were uncertain. The use of personal protective equipment (PPE) during waste handling was reported by 68.0% of respondents. Hand washing after handling hospital waste was practiced by 96.0%, indicating a high level of compliance with basic infection prevention measures. More than half of the respondents (56.0%) reported a history of needle-stick injury, while 44.0% had never experienced such injuries. Among all respondents, only 41.6% reported receiving adequate treatment following a needle-stick injury, whereas 58.4% did not receive appropriate post-exposure management. Regarding immunization status and training, 94.4% of respondents had received tetanus vaccination and 76.8% had been vaccinated against hepatitis B. In addition, 52.0% reported receiving training on hospital waste management, while 48.0% had never received such training. These findings indicate good vaccination coverage among healthcare personnel; however, training on hospital waste management and post-exposure care remains inadequate for a considerable proportion of respondents.

Table 4: Occupational Safety, Record Keeping and Infection Control Practices (n=125).

Discussion

Most respondents reported practicing waste segregation (76.0%) and disposal according to color-coded guidelines (79.2%). In addition, most respondents indicated that used syringes were mutilated or shredded before disposal (92.8%), suggesting a relatively good level of compliance with recommended biomedical waste management practices. Proper segregation and safe disposal of sharps are essential for preventing accidental injuries and reducing the risk of disease transmission among healthcare workers and waste handlers [16]. Appropriate waste storage and collection practices were also observed in the study. Most respondents reported using plastic dustbins with lids (75.2%), while hospital waste was generally collected once daily (94.4%). Furthermore, waste transportation was mainly carried out using wheeled carts or trolleys (83.2%). These findings indicate the presence of an organized waste handling system within the institution. Proper storage, collection, and transportation of healthcare waste are important components of infection prevention and environmental safety [17]. Despite these positive findings, several gaps in waste management practices were identified. A notable proportion of respondents (80.0%) reported that different categories of waste were mixed with general garbage. This finding is concerning because improper segregation increases the risk of environmental contamination and exposure to infectious materials. Similarly, only a small proportion of respondents reported the use of color-coded containers for waste storage, suggesting that although staff may be aware of color-coding principles, practical implementation may not always be adequate [18,19]. The study also revealed variations in waste disposal practices. Most respondents disposed of blood-contaminated materials in red plastic bags; however, practices regarding paper, kitchen waste, sharp waste, and hazardous liquid waste were inconsistent [19]. Nearly half of the respondents reported disposing of hazardous liquid waste with general garbage, while a substantial proportion were unaware of the appropriate disposal method. These findings suggest deficiencies in knowledge and implementation of standard biomedical waste disposal procedures [20]. Occupational safety and infection prevention measures showed mixed results. The majority of respondents reported using personal protective equipment during waste handling (68.0%) and practicing hand washing after waste handling (96.0%). The high rate of hand hygiene reflects a positive awareness of infection prevention measures. However, the PPE utilization rate indicates that a considerable proportion of healthcare personnel remain unprotected during waste handling activities, increasing their risk of occupational exposure [21].

Needle-stick injury remains an important concern in the study setting. More than half of the respondents (56.0%) reported experiencing a needle-stick injury during their professional activities. Moreover, only 41.6% reported receiving adequate treatment following such incidents. These findings indicate weaknesses in occupational health and post-exposure management systems and emphasize the need for stronger reporting mechanisms, immediate medical evaluation, and appropriate post-exposure prophylaxis protocols [22]. Record-keeping practices were moderately satisfactory. Approximately two-thirds of respondents reported maintaining waste management records (67.2%) and injury-related records (64.0%). Although these findings indicate some level of institutional monitoring, the absence of complete documentation may limit effective supervision, evaluation, and quality improvement efforts. The study further demonstrated encouraging vaccination coverage among healthcare personnel. Most respondents had received tetanus vaccination (94.4%), while more than three-quarters had been vaccinated against hepatitis B (76.8%). Vaccination plays a critical role in protecting healthcare workers from occupationally acquired infections and contributes to a safer healthcare environment [23]. Training is a key factor influencing effective healthcare waste management. In the present study, only 52.0% of respondents reported receiving formal training on hospital waste management. The relatively low training coverage may explain some of the inconsistencies observed in waste segregation, disposal practices, and occupational safety measures. Regular training programs, refresher courses, and continuous supervision are therefore necessary to improve compliance with standard waste management guidelines.

Conclusion

Generally, the hospital demonstrated acceptable behaviour concerning the segregation, collection, and transport of its waste. Nevertheless, one should raise concerns about the security of temporary storage places and containers, which are poorly protected from being accessed by anyone unauthorized. For the proper conduct of hospital waste management practices, it is crucial to provide hospitals with enough of all needed equipment and supplies in all departments. Moreover, hospitals should post safety posters and instructions, policy statements, and other guidelines that would promote the implementation of HWM guidelines. Finally, it is important to develop an appropriate plan and allocate funds for the establishment of waste management facilities. With these measures, it is possible to promote the creation of effective HWM systems in hospitals by providing them with the right number of employees, materials, and equipment.

Limitations of the Study

This study had several limitations. First, it was conducted in a single hospital, which may limit the generalizability of the findings to other healthcare settings in Bangladesh. Second, participants were selected using convenience sampling, introducing the possibility of selection bias. Third, no formal statistical method was used to calculate the sample size, which may have affected the representativeness of the study population. Finally, the relatively short study period may have limited the scope and depth of data collection.

Recommendations

Based on the analysis of 125 randomly selected samples, the current study revealed some aspects related to hospital waste management practices and the behaviour of workers. It also allowed considering different categories of healthcare workers, including doctors, nurses, and other supporting staff members. Still, there are certain issues and problems that should be taken into account. The cross-sectional design limits the possibilities to establish any causal relationship. Convenience sampling may produce selection bias that influences the generalization process. The data is collected through self-reports; thus, it may produce response and recall biases among respondents. The research is limited to a single hospital of a particular region. The determination of the required sample size is performed only once, and no consideration of variability is provided.

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