The fault tree analysis of infectious medical waste management

Providing an efficient and reliable system of medical waste management is one of the key environmental issues not only for health-care institutions but for a wider range of organizations and communities. Medical waste produced in health care is a special kind of waste, which, if inadequately treated, can cause numerous possible health and safety hazards for people and the environment. In this paper the authors introduce an application for risk assessment of infectious medical waste management in the biggest health institution of South-East Europe the Clinical Centre of Serbia. The fault tree analysis (FTA) method was used in the assessment regarding its three aspects functional, qualitative and quantitative. The qualitative analysis provided the structural function of the system and minimal cut sets, whilst the quantitative analysis based on experts' evaluations defined the probability of both basic and top events (spreading of infection with medical waste). Finally, according to Birbaim's, RAW (Risk achievement worth), RRW (Risk reduction worth) and Fussell-Vesely's importance measures, the events have been ranked regarding their effect on the undesired event related to infectious medical waste management. In this paper, we have chosen the FTA approach because it enables the analysis of the individual risks (like the most of the risk assessment methods used in medical waste management FMEA, HACCP, PHA, CREA) but it also provides the analysis of risk relationships and interdependences. Based on the obtained results we identified the basic failures in the medical waste management systems whose prevention or mitigation have the biggest influence on the observed system improvement. Furthermore, the research presented in this paper has clearly pointed out that the FTA method and importance measures can be used in the risk assessment of the medical waste and should be taken into consideration in appropriate medical waste management systems. (C) 2015 Elsevier Ltd. All rights reserved.