Resíduos domiciliares com características de resíduos de serviços de saúde: novo paradigma de categorização e manejo

Abstract

In Brazil the PNRS no 12.305/2010 and the RDC no 222/2018 aim to standardize the management of health care waste (HCW) at the national level but with limitations to include household waste with characteristics of health care waste (HHW) still without legal visibility in the categorization of risk groups and which, on the contrary, gained notoriety with COVID-19. OBJECTIVE. The general objective of this empirical research was to analyze the management of the HCW based on the current legislation and to propose a bill, which contemplates the HCW as a new categorization of waste. METHODOLOGY. In the theoretical contribution a bibliographical and documentary research was carried out with primary legislative sources and publications with empirical data of solid urban waste (SUW) and HCW to substantiate the accurate relationship between theory and technical-scientific practice of waste. The empirical research on HHW considered assumptions and requirements for on-the-job work, applying a questionnaire, in an online form, addressing aspects such as: production, management, disposal and disposal of HHW in normal and pandemic situations, legitimized with data from specific jurisprudence and results in publications in the area, for the adequacy of legal and scientific instruments. RESULTS AND DISCUSSIONS. The empirical research had a sample consisting of 230 interviewed; involved 15 of the 27 brazilian federative units; covered 50 cities and had representatives of respondents in all geopolitical regions of Brazil. For 52.17% (n=120) of individuals the HHW started to be generated in their homes by the pandemic, while 47.83% (n=110) reported that they were already responsible for the generation of this waste. In the management of the HCW, 56.54% of the participants indicated the pandemic as the main responsible for the generation of waste; 41.30% (n=95) of the individuals reported knowing and adopting the referred HCW security protocols; 26.09% (n=60) reported having heard about it; 16.52% said they knew it but did not execute it and 16.09% (n=37) never heard of it. In the packaging and disposal of the HHW, 43.48% (n=100) claimed to dispose of the HHW together with the common garbage in the bathroom and/or general household garbage without treatment/disinfection and 23.48% (n=54) in bags separate garbage, but without any identification; 47.83% (n=110) of the interviewees claimed to dispose of the HHW together with ordinary garbage, in the same bag/packaging and only 5.65% (n=13) reported delivering this waste to health facilities. The results showed a significant number of individuals who claimed to know the HCW management protocols, but, on the contrary, perform the final disposal without treatment, along with the other waste for the public collection service. CONCLUSION. It is possible to infer the population's unpreparedness in understanding and conceptions about waste management at home, compromising the innocuous characteristic of SUW, with the aggregate contingent of waste similar to that produced in health services, being necessary the recognition of the various origins of the generation of household waste, with its HSW characteristics, giving legal visibility to the Brazilian legal regulation. As a product of this field research, a new categorization of solid residues was proposed the Home Health Waste - HHW, with an emphasis on the inclusion of the regulation within the PNRS no 12.305/2010 and the RDC no 222/2018 by for proposing a Law’s project.