Descarte de medicamentos e os impactos ambientais: uma revisão integrativa da literatura / Disposal of drugs and the ensuing environmental impacts: an integrative review of the literature

Resumo O objetivo deste artigo é investigar as evidências nacionais e internacionais disponíveis sobre o descarte de medicamentos e os impactos em matrizes ambientais. Trata-se de uma revisão integrativa da literatura realizada nas bases de dados PubMed, SciELO e Biblioteca Virtual em Saúde (BVS) e que incluiu artigos em inglês, espanhol e português publicados entre 2010 e 2020. Foram selecionados 26 artigos, que evidenciaram o descarte incorreto de medicamentos por profissionais e consumidores devido, principalmente, à falta de conhecimentos sobre os impactos ambientais que esses podem ocasionar. Estudos apontaram a contaminação de água, esgoto e sedimentos por fármacos descartados de forma incorreta. Além disso, observou-se que seres vivos aquáticos podem ser impactados pela presença de medicamentos em matrizes ambientais. O descarte de medicamentos incorreto ainda é uma realidade nas evidências avaliadas, que promove a contaminação de matrizes ambientais e muitas vezes não é removido por estações de tratamento de águas residuárias e interfere no equilíbrio da vida ambiental.

Abstract The scope of this article is to investigate the national and international evidence available on the forms of drug disposal and the presence of drugs in environmental matrices. It involved an integrative review of the literature conducted in the PubMed, SciELO and Virtual Health Library (VHL) databases, which included articles in English, Spanish and Portuguese published between 2010 and 2020. Twenty-six articles were selected, which revealed the incorrect disposal of medicines by professionals and consumers due mainly to the lack of knowledge about the environmental impacts that they may cause. Studies have highlighted the contamination of water, sewage and sediments by incorrectly discarded drugs. Furthermore, it was observed that aquatic living creatures can be impacted by the presence of drugs in environmental matrices. The incorrect disposal of drugs continues to be a reality in the evidence assessed, which leads to the contamination of environmental matrices and is often not removed by wastewater treatment plants and interferes with the equilibrium of environmental life.

Fate and emission behavior of heavy metals during hazardous chemical waste incineration.

The fate and emission behavior of heavy metals (As, Cd, Co, Cr, Cu, Ni, Pb, Se, and Zn) from a hazardous chemical waste incinerator were systematically explored. The results show that the main components of incineration fly ashes and slags contain minerals such as salt, plagioclase, pyroxene, gypsum, calcite, and slaked lime. The elements As, Cd, Pb, and Se are enriched in the fly ash particles during flue gas condensation. Co and Ni are more likely to be deposited in the rotary kiln slag and cooling tower slag owing to their lower volatility. Zn, Cr, and Cu are usually volatilized into the flue gas as oxides or chlorides are condensed and enriched in the slag of the cooling tower during the flue gas cooling process. The content of As, Cd, Pb, Ni, Cr, and Se increase with decreasing fly ash particle size. After the flue gas purification equipment was employed, the concentration of particulate metals significantly reduced. In the exhaust flue gas, the concentrations of Cu and Zn are 29.85 and 28.47 µg/m3, those of As, Cr, Ni, Pb, and Se range from 2.54 to 9.25 µg/m3, and those of Co and Cd are 0.42 and 0.13 µg/m3, respectively.

Untapped potentials of hazardous nanoarchitectural biopolymers.

The First Industrial Revolution began when manual labour transitioned to machines. Fossil fuels and steam eventually replaced wood and water as an energy source used predominantly for the mechanized production of textiles and iron. The emergence of the required numerous enormous factories gave rise to smoke pollution due to the immense growth in coal consumption. The manufactured gas industry produced highly toxic effluent that was released into sewers and rivers polluting the water. Many pieces of legislation were introduced to overcome this issue, but with varying degrees of effectiveness. Alongside our growth in world population, the problems that we had with waste remained, but together with our increase in number the waste produced has also increased additionally. The immense volume of waste materials generated from human activity and the potentially detrimental effects on the environment and on public health have awakened in ourselves a critical need to embrace current scientific methods for the safe disposal of wastes. We are informed daily that our food waste must be better utilized to ensure enough food is available to feed the world's growing population in a sustainable way (Thyberg and Tonjes, 2016). Some things are easy, like waste food and cellulose products can be turned into compost, but how do we recycle sheep's wool? Or shrimp shells? Despite the fact that both these substances are hazardous, and have caused environmental and economic impact from being incinerated; but we anticipate that those substances may have the potential to convert into added value applications.We have been working in this area for over 15 years, working towards managing them and seeking their added value applications. We take the biological products, process (reconstitute) and engineer them into added value products such as functional and nanostructure materials including edible films, foams and composites including medical devices useful in the human body. Anything that we can ingest, should not cause an immune response in the human system. Natural biomacromolecules display the inherent ability to perform very specific chemical, mechanical or structural roles. Specifically, protein- and polysaccharide-based biomaterials have come to light as the most promising candidates for many biomedical applications due their biomimetic and nanostructured arrangements, their multi-functional features, and their capability to function as matrices that are capable of facilitating cell-cell and cell-matrix interactions.

Laboratory chemical waste: hazard classification by GHS and transport risk / Resíduos químicos laboratoriais: classificação de perigo pelo GHS e risco no transporte

ABSTRACT OBJECTIVES: To identify and evaluate, based on the Globally Harmonized System of Classification and Labelling of Chemicals (GHS) and the legislation of the Agência Nacional de Transportes Terrestres (ANTT - National Agency for Terrestrial Transport), the hazards arising from chemical waste generated in research laboratories in the health area. METHODS: Chemical residues generated in two medical research laboratories of the Faculdade de Medicina da Universidade de São Paulo were inventoried, from November 2017 to April 2019, and classified according to the GHS (hazard statements) and the ANTT transport legislation (risk classes), to determine the dangers coming from the respective substances and mixtures. RESULTS: In total, we identified 40 substances or mixtures with classification by the GHS indicating 36 hazard statements, 27 of which related to human health. According to the legislation established by ANTT, we found 16 cases of hazard associated with flammability, 15 cases related to toxicity and 12 cases related to corrosivity. CONCLUSIONS: Chemical residues generated in the laboratories studied are diversified in terms of their hazard characteristics, implying the possibility of exposure to severe risks to workers, students and the environment. The correct identification of these residues is a primary factor for reducing exposure to risks.

RESUMO OBJETIVOS: Identificar e avaliar, com base no Sistema Globalmente Harmonizado de Classificação e Rotulagem de Produtos Químicos (GHS) e na legislação da Agência Nacional de Transportes Terrestres (ANTT), os perigos provenientes dos resíduos químicos gerados em laboratórios de pesquisa na área de saúde. MÉTODOS: Resíduos químicos gerados em dois Laboratórios de Investigação Médica da Faculdade de Medicina da Universidade de São Paulo foram inventariados, no período de novembro de 2017 a abril de 2019, e classificados conforme o GHS (frases de perigo) e a legislação de transportes da ANTT (classes de risco), para determinação dos perigos provenientes das respectivas substâncias e misturas. RESULTADOS: No total, foram identificadas 40 substâncias ou misturas, cuja classificação pelo GHS indicou 36 frases de perigo, sendo 27 relacionadas à saúde humana. De acordo com a legislação estabelecida pela ANTT, foram encontrados 16 casos de periculosidade associada à inflamabilidade, 15 casos relacionados à toxicidade e 12 casos relativos à corrosividade. CONCLUSÕES: Resíduos químicos gerados nos laboratórios estudados são diversificados quanto a suas características de periculosidade, implicando a possibilidade de exposição a riscos severos aos trabalhadores, aos estudantes e ao ambiente. A correta identificação desses resíduos é fator primordial para diminuição da exposição aos riscos.

Redistributing deaths by ill-defined and unspecified causes on cancer mortality in Brazil

ABSTRACT OBJECTIVE to discuss the impact four different redistribution strategies have on the quantitative and temporal trends of cancer mortality assessment in Brazil. METHODOLOGY This study used anonymized and georeferenced data provided by the Brazilian Ministry of Health (BMoH). Four different approaches were used to conduct the redistribution of ill-defined deaths and garbage codes. Age-standardized mortality rates used the world population as reference. Prais-Winsten autoregression allowed the calculation of region, sex, and cancer type trends. RESULTS Death rates increased considerably in all regions after redistribution. Overall, Elisabeth B. França's and the World Health Organization methods had a milder impact on trends and rate magnitudes when compared to the Global Burden of Disease (GBD) 2010 method. This study also observed that, when the BMoH dealt with the problem of redistributing ill-defined deaths, results were similar to those obtained by the GBD method. The redistribution methods also influenced the assessment of trends; however, differences were less pronounced. CONCLUSIONS Since developing a comparative gold standard is impossible, matching global techniques to local realities may be an alternative for methodological selection. In our study, the compatibility of the findings suggests how valid the GBD method is to the Brazilian context. However, caution is needed. Future studies should assess the impact of these methods as applied to the redistribution of deaths to type-specific neoplasms.

Minimizing laboratory waste and improving material reuse through chemical waste exchange: Case of a Brazilian institution.

Concern over the management of chemical wastes from laboratories has been gaining importance since the 1990s. For a good management of chemical wastes generated from laboratories, it is recommended that managers encourage an environment of cooperation and exchange, thus reusing chemical reagents. The institution under study implemented the Chemical Waste Exchange, whose objective is to capture reagents past their expiry dates that would be discarded and make them available internally to other areas or even to other institutions. A total of 1075 reagents were reused internally and 4382 items were donated for external institutions. As for financial data, between 2011 and 2018, the internal economy was US$16,700.70 and for external institutions it was US$62,633.11. When comparing the waste reuse according to the destination, an internal address showed a significant difference when compared with the external use. Some categories of reagents have greater added value and provide even greater benefits when reused. The strategy of capturing and making available expired reagents through the Chemical Waste Exchange is positive; it helps the management of the waste generated; the economic benefit will depend on the market value of the material; the adopted strategy avoids the need to remove raw material from nature for the production of new reagents and reduces the costs related to treatment and environmentally appropriate final destination.

SUSTAINABILITY INDICATORS FOR END-OF-LIFE CHEMICAL RELEASES AND POTENTIAL EXPOSURE.

Understanding the chemical risk to environment and human health is an important issue when a waste management strategy and a control risk system is analyzed and selected. This is even more important at the end-of-life (recycling, recovery and disposal) scenario for a chemical due to the uncertainty in respect of the most susceptible receptors (e.g., workers), pathways (e.g., groundwater), routes (e.g., inhalation) and hazard (e.g., cancer) associated to a chemical exposure. Hence, selecting a group of sustainability performance indicators for estimating the chemical risk when evaluating end-of-life scenarios is a crucial task. Therefore, this manuscript focuses on a critical analysis of the sustainability indicators taxonomy which are used to assess chemical risk to the environment and human health during end-of-life scenarios. The insights from performing an extensive literature search in the largest database of peer-reviewed literature provide that chemical intake, hazard quotient, hazard index, and carcinogenic risk have been the most commonly used for human health chemical risk. In addition, previous research has been less focused on environment chemical risk, with ecological risk index being the most widely used indicator for. The most employed human health chemical risk sustainability indicators are part of a methodology suggested by U.S. Environmental Protection Agency for chemical risk assessment.

Gerenciamento intra-hospitalar dos resíduos químicos perigosos manuseados pela enfermagem / Intra-hospital management of hazardous chemical waste handled by nurses / Gestión intrahospitalaria de los residuos químicos peligrosos manejados por la enfermería

Objetivo: avaliar as etapas de gerenciamento dos resíduos químicos perigosos - formaldeído e ortoftaldeído, manuseados pela enfermagem. Método: pesquisa descritiva e coleta de dados realizada de setembro a dezembro de 2012, no Hospital Universitário da Universidade de São Paulo, por meio da aplicação da Ficha de Informação de Gerenciamento de Resíduo Químico Perigoso dos resíduos formaldeído e ortoftaldeído gerados, respectivamente, no centro obstétrico e endoscopia. Projeto aprovado por Comitê de Ética em Pesquisa. Resultados: a análise estatística dos dados evidenciou que foram atendidas 3 (13%) especificações do total de 23 (100%) necessárias, com prevalência da identificação, seguida da segregação e nenhuma do transporte interno dos resíduos. Há necessidade de a instituição cumprir as especificações de identificações gerais em relação ao número total de avaliações nos recipientes de resíduos de formaldeído e ortoftaldeído. Conclusão: esta pesquisa proporcionou importantes diretrizes para a elaboração do Plano de Gerenciamento de Resíduos Químicos Perigosos da atenção hospitalar.

Objective: to evaluate the stages in management of hazardous chemical waste handled by nursing staff. Method: in this descriptive study, data was collected from September to December 2012 at São Paulo University Hospital, by applying the Hazardous Chemical Waste Management Information Sheet for formaldehyde and ortho-phthalaldehyde waste in the obstetric center and endoscopy, respectively. The study was approved by the research ethics committee. Results: data analysis showed that 3 (13%) of the 23 (100%) required specifications were met, predominantly identification, followed by segregation, and that none on internal waste transportation were met. The institution needs to comply with general identification specifications regarding the total number of evaluations of formaldehyde and orthophthaldehyde waste containers. Conclusion: this study also yielded important guidelines for preparation of the hospital care Hazardous Chemical Waste Management Plan.

Objetivo: evaluar las etapas de la gestión de los residuos químicos peligrosos - formaldehído y ortoftaldehído, manejados por la enfermería. Métodos: investigación descriptiva y recolección de datos realizada, de septiembre a diciembre de 2012, en el Hospital Universitario de la Universidad de São Paulo, por medio de la aplicación de la Ficha de Información de Gestión de Residuo Químico Peligroso de los residuos de formaldehído y ortoftaldehído generados, respectivamente, en el Centro de Obstetricia y Endoscopía. Proyecto aprobado por el Comité de Ética en Investigación. Resultados: el análisis estadístico de los datos mostró que fueron atendidas 3 (13%) especificaciones del total de 23 (100%) requeridas, con prevalencia de la identificación, seguida por la segregación y ninguna relacionada al transporte interno de los residuos. Es necesario que la institución cumpla con las especificaciones de identificaciones generales en relación al número total de evaluaciones en los recipientes de residuos de formaldehído y ortoftaldehído. Conclusión: la investigación proporcionó importantes directrices para la elaboración del Plan de Gestión de Residuos Químicos Peligrosos de la atención hospitalaria.

Utilização de hormônios e antibióticos em produtos alimentícios de origem animal: aspectos gerais e toxicológicos / Use of hormones and antibiotics in animal food products: general and toxicological aspects

OBJECTIVE: To approach the use of hormones and antibiotics in the production of animal origin food, mechanisms of action, toxicity, regulations in Brazil and worldwide and methods for residues detection in food. Data source: For this review, articles were searched using databases indexed in MEDLINE, LILACS, PUBMED and SciELO, using the key words: residues, antibiotics, hormones, meat, milk, eggs, in addition to their translations in Portuguese and Spanish. Data synthesis: We considered publications in the last 10 years, including 28 articles. CONCLUSIONS: The consumption of foods containing antibiotics and hormones residues is a problem to be considered, therefore, it is necessary to develop better methods of compounds detection and invest in food inspection

OBJETIVO: Abordar o uso de hormônios e antibióticos na produção de alimentos de origem animal, mecanismos de ação, toxicidade, regulamentação no Brasil e no mundo e os métodos para detecção dos resíduos nos alimentos. FONTE DE DADOS: Para essa revisão, artigos foram pesquisados usando bancos de dados indexados no MEDLINE, LILACS, PubMed e SciELO, utilizando as palavras-chave: resíduos, antibióticos, hormônios, carne, leite, ovos, além das respectivas traduções em inglês e espanhol. SÍNTESE DOS DADOS: Foram consideradas publicações dos últimos 10 anos, sendo incluídos 28 artigos. CONCLUSÕES: O consumo de alimentos contendo resíduos de hormônios e antibióticos constitui um problema a ser considerado, entretanto há necessidade de desenvolver melhores metodologias de detecção dos compostos e investir em fiscalização de alimentos

Influence of mixture ratio and pH to solidification/stabilization process of hospital solid waste incineration ash in Portland cement.

Solidification/stabilization (S/S) is an established utilization technology to treat hazardous wastes. This research explored the influence of pH (3-12) on the immobilization of heavy metals present in five mixtures of hospital solid waste incinerator ash and Portland cement, following two different processes of waste solidification/stabilization (cement hydration and granulation). In general, cement hydration process resulted in more stable products than granulation process. A high ash content in the mixture with Portland cement (60wt%) resulted in the highest immobilization of Pb(2+) and Cu(2+), while a low ash content in the mixture (10wt%) resulted in the lowest leachability of Zn(2+). When ash and Portland cement was mixed in equal proportions (50wt%) the highest encapsulation was observed for Ni(2+), Cd(2+) and Cr(3+). Neutral and weak alkaline pH values within the range pH=7-8 resulted in the lowest leachability of the monitored heavy metals.

Atitudes de usuários de medicamentos do Sistema Único de Saúde, estudantes de farmácia e farmacêuticos frente ao armazenamento e descarte de medicamentos / Attitudes of Brazilian Public Health System users, pharmacy students and pharmacists regarding the storage and disposal of medicines

O acúmulo desnecessário de medicamentos ocasiona um aumento de produtos com o prazo de validade vencido para serem descartados, podendo causar impactos ambientais e risco à saúde humana. Este trabalho analisou como é realizado o descarte de medicamentos pelos farmacêuticos de farmácias e drogarias, o armazenamento e descarte de medicamentos pelos acadêmicos de farmácia e por uma amostra dos usuários de medicamentos do Sistema Único de Saúde (SUS). Foram aplicados formulários estruturados para entrevista dos usuários do SUS, questionários aos acadêmicos de três diferentes períodos da Faculdade de Ciências Farmacêuticas da UNIFAL-MG e questionários aos farmacêuticos ou responsáveis por estes estabelecimentos durante o período de abril a junho de 2012. Os resultados demonstraram que 56% dos acadêmicos descartam os medicamentos no lixo residencial, dado semelhante ao dos usuários de medicamentos do SUS que foi de 57%. O perfil de armazenamento também demonstrou semelhança entre usuários do SUS e acadêmicos, sendo que 40,4% dos usuários do SUS armazenam seus medicamentos em armários fechados, comparados com 43,7% dos acadêmicos avaliados. Cerca de 85% dos responsáveis pelos estabelecimentos de saúde afirmaram que a prática de devolução de medicamentos é inexistente. Não houve grande diferença em termos de conhecimento dos acadêmicos comparativamente à população sobre a forma apropriada de descarte dos medicamentos; ambos possuem menos informações sobre o descarte do que sobre o armazenamento, e por isso praticam essa ação de forma incorreta. Também foi constatado que farmácias e drogarias não eram uma opção de destino final dos medicamentos adquiridos pela população

The unnecessary accumulation of unused medicinesgenerates large quantities of expired products to bediscarded, which may represent an environmental andhuman health hazard. This study was an analysis of howmedicines are disposed of by professionals responsiblefor pharmacies and drugstores and how the storageand disposal of medicines is carried out by pharmacystudents and a sample population of users of thepublic health system (SUS ? Sistema Unico de Saude).Structured interview forms were given to the users ofSUS, questionnaires to students from three differentperiods of the School of Pharmaceutical Sciencesof UNIFAL-MG and questionnaires to pharmacistsor other professionals responsible for commercialestablishments during the period of April to June,2012. It was found that 56% of the students disposedof the medicines in the household trash, similarly toSUS users, 57% of whom did the same. The storageprofile also demonstrated a similarity between the SUSusers and the students, 40.4% of SUS users storingtheir medications in a locked cupboard, while 43.7% ofthe students interviewed did the same. About 85% ofprofessionals responsible for establishments stated thatthe practice of returning medicines was nonexistent.There was no great difference in terms of knowledgeabout the proper way to dispose of medicines, betweenstudents and the population; both had less informationabout disposal than storage and therefore practiced itinappropriately. It was also noted that pharmacies anddrugstores were not the preferred final destination ofmedicines acquired by the population.

Dental solid waste characterization and management in Iran: a case study of Sistan and Baluchestan Province.

The management of dental solid waste continues to be a major challenge, particularly in most healthcare facilities of the developing world. In Iran, few studies on management of dental solid waste and its composition are available. An effort has been made through this study to evaluate the hazardous and infectious status of dental solid waste, keeping in mind its possible role in cross-infection chain. For this study, 123 private dental centres and 36 public dental centres were selected and the composition and generation rate of dental solid waste produced were measured. Dental solid waste was classified to four main categories: (i) domestic-type; (ii) potentially infectious; (iii) chemical and pharmaceutical; and (iv) toxic, which constituted 11.7, 80.3, 6.3, and 1.7%, respectively, of the total. Also, the results indicated that the dental solid waste per patient per day generation rate for total, domestic-type, potentially infectious, chemical and pharmaceutical, and toxic wastes were 169.9, 8.6, 153.3, 11.2, and 3.3 g/patient/d, respectively. Furthermore, the per day generation rates for total, domestic-type, potentially infectious, chemical and pharmaceutical, and toxic wastes were 194.5, 22.6, 156.1, 12.3, and 3.4 kg/d, respectively. According to findings of this study, for best management of dental waste it is suggested that source reduction, separation, reuse, and recycling programmes be implemented and each section of dental waste be collected and disposed of separately and in accordance with related criteria.

Mathematical modelling of peristaltic propulsion of viscoplastic bio-fluids.

This article studies theoretically the transportation of rheological viscoplastic fluids through physiological vessels by continuous muscle contraction and relaxation, that is, peristalsis. Both cases of planar and cylindrical physiological vessels are considered. A mathematical model is developed under long wavelength and low Reynolds number approximations. Expressions for axial velocity in core region, axial velocity in plug flow region, volume flow rate and pressure gradient in non-dimensional form are obtained. A comparative study of velocity profiles, pressure distribution, friction force and mechanical efficiency for different viscoplastic liquids is conducted. The influence of width of plug flow region, shear rate strain index and yield stress index on the pressure distribution, friction force and mechanical efficiency is elaborated. The study is relevant to gastric fluid mechanics and also non-Newtonian biomimetic pump hazardous waste systems exploiting peristaltic mechanisms.

Caracterização dos produtos geradores de resíduos químicos perigosos: estudo em um hospital público universitário / Characterization of products which create dangerous chemical waste: a study in a public university hospital / Caracterización de los productos generadores de residuos químicos peligrosos: estudio en un hospital público universitario

Estudo descritivo com o objetivo de identificar nas áreas de farmácia e almoxarifado de um Hospital Universitário os grupos de produtos caracterizados como geradores de Resíduos Químicos Perigosos segundo a classificação dos dispositivos legais. Para coleta de dados, realizada em 2008, foi utilizado um formulário para identificação destes produtos. A análise dos dados revelou a existência de 138 itens classificados em 12 Grupos de produtos que, uma vez utilizados ou vencidos, geram resíduos com características de periculosidade de acordo com a Agência Nacional de Vigilância Sanitária brasileira. O princípio ativo desses produtos apresentam riscos à saúde, como toxicidade aos diversos órgãos e sistemas do corpo humano, assim como potencial de inflamabilidade, corrosividade e reatividade de algumas substâncias. Essas características são de grande relevância, uma vez que os resíduos químicos poderão, em algum momento, causar impacto negativo para a saúde do trabalhador, saúde pública e meio ambiente.

This descriptive study aimed to identify, in the areas of Pharmacy and the stockroom of a Public University Hospital, the groups of products characterized as creating Dangerous Chemical Waste, according to the legal classification. A form for identifying these products was used for data collection, which took place in 2008. Analysis of the data revealed the existence of 138 items classified in 12 Groups of products which, once used or out of date, create waste with dangerous characteristics, according to the Brazilian National Health Surveillance Agency. These products' active ingredients present risks to health, such as toxicity to various organs or systems in the human body, as well as the potential for inflammability, corrosiveness and reactivity of some substances. These characteristics are highly relevant, as the chemical wastes can, at some point, impact negatively on the worker's health, on public health, or on the environment.

Estudio descriptivo cuyo objetivo fue identificar en las áreas de farmacia y depósito de un Hospital Universitario los grupos de productos caracterizados como generadores de Residuos Químicos Peligrosos de acuerdo a la clasificación de los dispositivos legales. Para recoger los datos, lo que se dio en 2008, fue utilizado un formulario que identificaba eses productos. El análisis de los datos reveló la existencia de 138 ítenes clasificados en 12 Grupos de productos que, una vez utilizados o vencidos, generan residuos con características de peligrosidad de acuerdo con la Agencia Nacional de Vigilancia Sanitaria brasileña. El principio activo de eses productos presenta riesgos a la salud, como si es tóxico a los diversos órganos y sistemas del cuerpo humano, así como potencial de inflamabilidad, corrosividad y reactividad de algunas substancias. Esas características son de grande relevancia, una vez que los residuos químicos podrán, en algun momento, causar impacto negativo a la salud del trabajador, salud pública y medio ambiente.

A percepção dos trabalhadores de enfermagem sobre o manejo dos resíduos químicos perigosos / Nursing workers' perceptions regarding the handling of hazardous chemical waste / Percepción de los trabajadores de enfermería sobre el manejo de residuos químicos peligrosos

Este estudo objetivou identificar a percepção dos trabalhadores de enfermagem sobre o manejo dos resíduos químicos perigosos no Hospital Universitário da Universidade de São Paulo e elaborar uma proposta para o manejo desses resíduos. Trata-se de pesquisa de abordagem qualitativa, cuja amostra foi intencional, composta por dezoito trabalhadores de enfermagem. A coleta de dados foi realizada por meio da técnica de grupo focal. Com a análise temática foram identificadas quatro categorias que evidenciaram a deficiência de treinamento nas etapas do manejo, como a primeira dificuldade expressa, tendo aparecido ainda o desconhecimento da exposição e impactos, assim como o uso dos equipamentos de proteção individual em detrimento da proteção coletiva, seguidos das sugestões quanto às medidas de competência institucional e dos trabalhadores para o manejo seguro dos resíduos químicos perigosos. Esses dados permitiram recomendar propostas para o manejo adequado dos resíduos químicos perigosos pela enfermagem.

The objectives of this study were to identify the perceptions of nursing workers regarding the handling of hazardous chemical waste at the University of São Paulo University Hospital (HU-USP), and develop a proposal to improve safety measures. This study used a qualitative approach and a convenience sample consisting of eighteen nursing workers. Data collection was performed through focal groups. Thematic analysis revealed four categories that gave evidence of training deficiencies in terms of the stages of handling waste. Difficulties that emerged included a lack of knowledge regarding exposure and its impact, the utilization of personal protective equipment versus collective protection, and suggestions regarding measures to be taken by the institution and workers for the safe handling of hazardous chemical waste. The present data allowed for recommending proposals regarding the safe management of hazardous chemical waste by the nursing staff.

Se objetivó identificar la percepción de trabajadores de enfermería sobre el manejo de residuos químicos peligrosos en el Hospital Universitario de la Universidad de São Paulo y elaborar una propuesta para manejar dichos residuos. Investigación cualitativa, muestra intencional, constituida por 18 trabajadores de enfermería. Datos fueran recolectados por técnica de grupo focal. En el análisis temático se identificaron cuatro categorías que evidenciaron la deficiencia de capacitación en las etapas del manejo, como la primera dificultad expresada, habiendo aparecido incluso el desconocimiento sobre la exposición y sus impactos, así como el uso de equipamientos de protección individual en detrimento de la protección colectiva, seguidos de sugerencias respecto de las medidas de competencia institucional y de los trabajadores para el manejo seguro de residuos químicos peligrosos. Dichos datos permitirán recomendar propuestas para el manejo adecuado de residuos químicos peligrosos para la enfermería.

Periculosidade dos produtos e resíduos químicos da atenção hospitalar / Dangerousness of chemical products and waste from hospital care / Peligrosidad de los productos y residuos químicos de la atención hospitalar

O presente estudo descritivo teve por objetivo identificar a periculosidade atribuível aos produtos e resíduos químicos da atenção hospitalar. A instituição campo de estudo foi o Hospital Universitário da Universidade de São Paulo; as informações foram coletados em documentos dos almoxarifados e farmácia da instituição. A análise dos dados evidenciou 23 compostos químicos com potencial inflamável, corrosivo, reativo e tóxico, tanto para produtos quanto para resíduos, sendo esses os ácidos acético, peracético, tricloroacético, além de acetona, álcool etílico, benzina, benzocaina, ciclofosfamida, éter, formol, ganciclovir, halotano, hidróxido de potássio, hipoclorito de sódio, isoflurano, glutaraldeído, óleo mineral, óxido nítrico, permanganato de potássio, peróxido de hidrogênio, sevoflurano, tintura de benjoim e xilol. As características de periculosidade dos produtos e seus respectivos resíduos devem ser identificadas, analisadas e contempladas no Plano de Gerenciamento de Resíduos Químicos Perigosos, evitando riscos para saúde do trabalhador, saúde pública e meio ambiente.

This descriptive study aimed to identify the dangerousness attributable to chemical products and waste resulting from hospital care. The institution serving as field of study was the University Hospital of the University of São Paulo; information was collected from documents from the institution's storerooms and pharmacy. Analysis of the data found evidence for 23 chemical compounds with flammable, corrosive, reactive or toxic potential, both for products or waste; these were acetic acid, peracetic acid and trichloroacetic acid, as well as acetone, ethyl alcohol, benzene, benzocaine, cyclophosphamide, ether, formalin, ganciclovir, halothane, potassium hydroxide, sodium hypochlorite, isoflurane, glutaraldehyde, mineral oil, nitric oxide, potassium permanganate, hydrogen peroxide, sevoflurane, tincture of benzoin and xylol. The dangerousness characteristics of the products and their respective wastes, must be identified, analyzed and considered in the Management Plan for Dangerous Chemical Wastes, so avoiding risks to workers' health, public health and the environment.

Este estudio descriptivo tuvo por objetivo identificar la peligrosidad de los productos y residuos químicos de la atención hospitalar. La institución campo de estudio fue el Hospital Universitario de la Universidad de São Paulo; las informaciones fueron recogidas en documentos de los depósitos y farmacia de la institución. El análisis de los datos mostró 23 compuestos químicos con potencial inflamable, corrosivo, reactivo y tóxico, tanto para productos como para residuos, siendo eses los ácidos acético, peracético, tricloroacético, además de acetona, álcohol etílico, benzina, benzocaína, ciclofosfamida, éter, formol, ganciclovir, halotano, hidróxido de potásio, hipoclorito de sodio, isoflurano, glutaraldeído, óleo mineral, óxido nítrico, permanganato de potasio, peróxido de hidrogenio, sevoflurano, tintura de benjoim y xilol. Las características de peligrosidad de los productos y sus respectivos residuos deben ser identificadas, analizadas y contempladas en el Plan de Gerenciamento de Residuos Químicos Peligrosos, evitando riesgos para la salud del trabajador, salud pública y medio ambiente.

Chemical waste risk reduction and environmental impact generated by laboratory activities in research and teaching institutions

The environmental impact caused by teaching and research with regard to chemical waste is of increasing concern, and attempts to solve the issue are being made. Education and research-related institutions, in most laboratory and non-laboratory activities, contribute to the generation of small quantities of waste, many of them highly toxic. Of this waste, some is listed by government agencies who are concerned about environmental pollution: disposal of acids, metals, solvents, chemicals and toxicity of selected products of synthesis, whose toxicity is often unknown. This article presents an assessment of the problem and identifies possible solutions, indicating pertinent laws, directives and guidelines; examples of institutions that have implemented protocols in order to minimize the generation of waste; harmonization of procedures for waste management and waste minimization procedures such as reduction, reuse and recycling of chemicals.

O impacto ambiental acarretado por atividades de pesquisa e ensino no que se refere aos resíduos químicos vem sendo cada vez mais discutido e tentativas de solucionar a questão vêm sendo apresentadas. As instituições de ensino e pesquisa, em quase todas as atividades e não somente as laboratoriais, contribuem para a geração de pequenas quantidades de resíduos, muitos deles altamente tóxicos. Destes, alguns constam em listas de agências governamentais que se preocupam com a qualidade do meio ambiente: descartes de ácidos, metais, solventes, agentes químicos de elevada toxicidade e ainda os produtos de síntese, cuja toxicidade é frequentemente desconhecida. Este artigo apresenta uma avaliação do problema identificando possíveis soluções, a partir da apresentação de legislações pertinentes, exemplos de instituições que vêm implantando protocolos que minimizam a geração de resíduos, sistemas de harmonização de processos de gerenciamento de resíduos e procedimentos de minimização de resíduos, como a redução, reutilização e reciclagem dos produtos químicos.