Decision No. 43/2007/QD-BYT promulgating the Regulation on management of medical wastes

24 THE MINISTRY OF HEALTH OFFICIAL. GAZETTE Issue nos OH4IDecember2007 (Cong Bao nos 829-832/December 22,2007) Decision theRegulation onManagement of Medical Wastes. Article 2-lIDs Decision takes effect 15 days after its publication in "CONGBAG." To annul Decision No. 257511999/QD-BYT of August 27, 1999, of the Minister of Health, promulgating the Regulation on Management of Medical Wastes. Article3.-Thedirectors oftheOffice, Departments andInspectorate of the HealthMinistry; directors of provincial/municipal Health Services; directors of hospitals and institutes of the Health Ministry, principals ofmedical workers-training schools; heads of health sections of branches, managers of private establishments. and heads ofconeemed units shall implement thisDecision. DECISION No. 43/2007/QD-BYT OF NOVEMBER30,2007,PROMULGATING TIlE REGULATION ON MANAGEMENT OF MEDICAL WASTES TIlE MINISTER OFHEAT,TH Pursuao: to the Government's Decree No. 49/ 2fX8IND CPofMay 15,2003, defining thejunctions, tasks. and organizational structure of the Health Ministry; Pursuant to the November 29, 2()()5 Law on ETwimmnental Protection; At the proposal of the Director of the Therapy Deparrmenr, The Director uJ Vietnam Preventive Medicine Department and the Directorofthe Legal Department oftheHealth Ministry. DECIDES: Article 1.- To promulgate together with this Minid"r ofHealth. NGUYEN QUOC TRIEU REGULATION ON MANAGEMENT OF MEDICAL WASTES (Promulgated togetherwith Decision No. 4:3/20071 QD-BIT ofNovember 30,2007, of the Minister of Health) ChapterI GENERALPROVISIONS Article 1.- Governing scope 1. This Regulation provides for the management of medicalwastes,the rights and responsibilities of organizations and individuals in the management of medical wastes. © \JIETNA.M lA.W s lEGA.l FORUM Issuo nOB 03 O"JDecembor 2007 (GOng BaD nos829-832/December22. 2007) OFFICIAL GAZETTE os 2. Medical establishments and organizations as wellas individuals participating in the treatment and destruction of medical wastes shall, apart from implementing this Regulation. implement current state regulations onmanagement of wastes. Altkle 2.-Subjects of application This Regulation applies to medical examination and treatmentestablishments, maternity homes. health stations, establishments engaged in medical and pharmaceutical research, preventive medicine, training of heath workers, production of and trading in pharmaceutical products, vaccines, medical biologicals (collectively referred to as medical establishments) and organizations as well as individuals involved in the transportation, treatment or destruction of medical wastes. Article 3.- Interpretation of terms In this Regulation, the terms below are construed as follows: 1.Medical wastes means materials in solid, liquid or gaseous form, discharged from medical establishments, including hazardous medical wastes andordinary medical wastes. 2. Hazardous medical wastes means medical wastes containing elements hazardous to human health and environment such as contagiousness, intoxication, radiation, flammability, explosiveness, corrosiveness or other hazardous characters if these wastes are not safely destroyed. 3. Management of medical wastes means activities ofmanaging the classification, preliminary treatment, r.nllprtion, transportation, storage, rninirnizatirm, re use, recycle, treatment and destruction of medical wastes, and inspecting as well as overseeing the implementation. 4. Minimizationofmedical wastes means activities of restricting to theutmost thedischarge of medical wastes, including reduction ofmedical waste volumes at their sources, use of recyclable or re-usable products, good management and strict control of the process of accurate classification of wastes. 5. Re-use means the use of a product for many times until the end of its lifetimeor the use of products [UI a III::W fUIlt:UUII UI a 1I1::W l'llIpUst:. 6. Recycle means the re-production of diSCllr'ded materials into new products. 7. Collection ofwastes at their sources means the process of classifying, gathering. packing and temporarily storing wastes at places where wasres are generated inmedical establishments. 8. Transportation of wastes means theprocess of U"aIISPUI Liug wastes [rum Ult:IT sources '10 places of preliminary treatment, storage or destruction. 9. Preliminary treatment means the~s of disinfecting or sterilizing highly contagious wastes at their sources before the transportation 'thereof to places of storage or destruction. 10. Waste treatment and destruction means !be process of using technologies to deprive the wades of their hazard to human health and envlrcnmenl. Article 4.- Prohibited acts 1 Discharging hazardous Tll/""nl('.lll w~~. which are not yet treated or destroyed up to prescribed standards, into the envirorunent. 2. Treating and destroying hazardous rucUi.cal wastes not according to the prescribed technical process and not at the prescribed place. 3. Delivering medical wastes to organizations or individuals having nolegal person status foropemtion in the domain of waste management. 4. Trading in hazardous wastes. 5.Recycling hazardous medical wastes. © VIETNAM LAW & LEGAL FORUM OFFICIAL GAZETTE leeue nO! 03-04lDocemb!r 2007 (06ng Bao nos 82g-832AJecember22, 2007) Chapter II IDENTIFICATION OF MEDICALWASTES Article 5.- Groups of medical wastes Based on their physical, chemical and biological properties and hazards. wastes in medical establishments are classified into the following 5 gmllpS: 1. Conmgioue wastes 2.Hazardous chemical wastes 3. Rad tcective wastes 4.Pressure containers 5. General wastes. AJfick 6 "Types of medical wastes 1. Contagious wastes: at Sharp and pointed wastes (Type A) are those which can cause cuts or punctures and may be mrecsec; Including injection needles, sharp ana pail dtid ends oftransfusion tubes, scalpels, nails and saws, injection ampoules, broken glass pieces and uti. sharp and pointed instruments used in medical activities. hi Non-sharp andnon-pointed contagious wastes (Type-B) are those stained with blood or body biological fluids and wastes fromisolation wards. cI Highly contagious wastes (Type C) are those .;;oru::ndicd at Iubomtoriee such as swabs and containers SlJlined with swabs, dISurgery wastes (Type D),which include human tissues, organs, body parts; placentas, fetuses and tested animal carcasses. 2. Hazardous chemical wastes: atExpired orpoor-quahty phannaoeuticals which no longer usable. blHazardous chemicals used in medical activities (Appendix 1 to this Regulation). d TIssue intoxicants, including drug bottles and pots, instruments stained with tissue intoxicants or substances secreted from patients treated with chemicals (Appendix 2 to this Regulation). d1Wastes containingheavymetals:mercury (from broken thermometers, blood pressure meters, wastes from dental treatment), cadimi (Cd (frombatteries, accumulatedbatteries), lead (from lead-coatedhoards nr materials used to prevent Xvrays from image diagnosis or X-ray treatment rooms). 3. Radioactive wastes: Radioactive wastes include solid, liquid and gaseous ones, which aregenerated fromdiagnostic, therapeutic, research and production activities. The list or radioactive drugs and marked compounds used in diagnosis and therapy was promulgated together with Decision No. 33120061 QD-BYT of October 24, 2006, uf til", Minister of Health. 4.Pressure containers, which includeoxygen, CO, or gas cylinders, prone to cause fires and explosion when puton thefire. 5.General wastes are those which do not contain contagious elements, hazardous chemicals, radioactive substances, inflammable or explosive elements, including: aJ Garbage from patients' rooms (excluding isolation wards). hi Wastes generated from medical activities such as glass bottles and pots, serum bottles, plastic materials, assorted plasters for broken bone cast, which are not stained with blood, biological fluids and hazardous chemicals. cIWastesgeneratedfromadministrativeactivities: papers, newspapers, documents, packing materials, cardboard boxes, plastic bags andfilm hags. d/ External wastes: leaves and garbage from external areas. © VIETNAM LAW & LEGAL FORUM ISGUO noe 03'04IDecember 211107 (COng Bao nos 829-832/December22,2007) OFFICIAL GAZETIE 11 ClwpterlII STANDARDS OF INSTRUMENTSAND BAGSFOR CONTAININGAND TKANSPORTINGSOLID WASTES IN MEDICALESTABLISHMENTS Article 'I.- Color coding 1. Yellow for contagious wastes. 2. Black for hazardous chemical and radioactive wastes. 3. Green for ordinary wastes and small pressure cylinders. 4. White for recycled wastes. Article R.- Waste h~es 1. Yellow and blackbags mustbe madeof PE or PP, not PVCplastic. 2. Medical waste bags must be at least 0.1 mm thick andhavesizessuitableto wastevolumeandthe maximum volume of0.1rn3. 3. The bag outside must be printed with a line at the 3/4 height of the bag and the phrase "KHONG DUOC DUNG QUA VACH NAY" (NOT CONIAINEDABOVE THISLINE). 4. Waste bagsmustcomplywiththecolorsystem specifiedin Article 7 of this Regulation and be used for properpurposes. ArtU:le 9.- Sharp andpointedwaste containers 1. Sharp and pointed waste containers must suit the final destructionmethods. 2.Sharpandpointedwastecontainersmustsatisfy the tollowmg standards: aJ Their walls and bottoms are hard enoughso as not to be punctured. bl They can resist infiltration. c/ They have proper sizes. d1They have lidswhichareeasy to openandclose. cI TIlde mouths an: big enough fur puffingsharp and pointed objects withoutpush. f/ Theyareprinted withthephrase"CHIDUNG CHAT TIW SAC NHOW (FOR SHARP AND POINTED WASTES ONLY) and a line at the 3/4 height andthephrase "KHONG DUOC DUNGQUA VACH NAY" (NOT CONTAINED ABOVE THIS LINE). gj They are in yellow. h/They have handles or are anached witb lI'f".xed system. ilThe contained sharp andpointedobjectsdo IIOl fall uu~ilk: uVUH «aesporrauon. 3. For medical establishments using injection needle-destroying machinesor injectionsyringe and needle......uucrs, shall' and pointed waste containers mustbe made of metalor hardplastic, wbichgn be usable and must constitute a part of tile injection needle- and syringe--destroying machine, or cutters. 4. For re-usable sharp and pointed wJ'Iiteplastic containers, before their-re-use, theymustbe cleansed and disinfected under the medical iJ1strt.1l'nent disinfectingprocess.Thedisinfectedplasticcot1llin<lll for re-use must retain all their original PiOpe:rtie8. Article10.-Waste bins aJ To be made of high-density plasticwith thit:k and hard bottoms or made of metal with pedal lids. Collection bins of 50 liters or larger tho~ld be wheeled. b1Yellow binsare usedfor gathering yellowwaste bagsand boxes. d Black bins are used for gathering black waste bags. For radioactive wastes, bins must be madeof metal. dI Green bins are used for gatheringgreen waste bags. eIWhite bins are used for gathering white waste bags. fl Rio capar-ity rlp:~ nd<;: on generated W~H:tp: © VIETNAM LAW & LEGAL FORUM 38 OFFICIAL GAZETTE I!K!UC nCIG Dt.!wpeoembcr 2007 (GOng 83.0 nos 829-8321December22, 2(07) volumes, ranging from 10 liters to 250 liters. glThe bin'soutside mustbe printedwitha signal line at the3/4height and with the phrase"KHONO DUDC DUNG QUA VACII NAY" (NOT CONTAINED ABOVE TIllS LINE). A1tide 11.w Waste typesymbols The outside of bags and bins storing assorted hazardous wastes andto-be-recycled wastes mustbear symbols indicating proper waste types (Appendix 3 to thisRe~tation, notprintedherein): alYelk.w bagsand binsstoringcontagious wastes display the symbol of biological hazard. b/Blacl< bagsandbinsstoring tissue-intoxicating wastes~y the symbol of tissue intoxicants and the phrase, CHAT GAY DOCTE BAD" (TISSUE INTOXICANTS). cI BIad bagsandbinsstoring radioactive wastes display the iil.ymhol of radioactive substance and the phrase H' CHAT THAI PHONG XA" (RADIOACTIVE WASTES). dI Whitg hags and bins storing to-he-recycled wastes display the symbol of recyclable wastes. A11icle12.-Waste-carrying vehicles Vehicla;tarryingwastes mustmeetthestandards of having walls, lids and tight bottoms, being convenient for loading and unloading wastes, for cleaning, cleansing anddrying. Chapter IV CLASSIFICATION, COLLECTION, TRANSPORTATION AND STORAGE OF SOLID WASTES AT MEDICAL ESTABLISHMENTS Amell" 11.- Classification of solid wastes 1.Waste generators mustclassify wastes right at their sources. 2. Wastes must be stored in bags and bins with prescribed colorcodesandsymbols. Article14.-Collection of solidwastes in medical establishments 1. Waste bin locations aJ Departments andsections mustclearly identify places tor bins to storeeach type ot medical waste; waste sources must have corresponding collection bins. bI Waste bin Locations musthaveclassiticationand collection instructions. c/ Waste binsmustbe up to prescribed standards and cleaned daily. dICleanbagsforwaste collection mustbe always available at places where wastes are generated for replacement of bags of the same kinds, already transported to temporary waste storage places of medical establishments. 2. Each type of waste must be gathered. into collection tools according totheprescribed colorcode andaffixed with labels or inscriptions onthe outside of waste bags. 3. Hazardous medical wastes mustnot be stored together with general wastes. If hazardous medical wastes are accidentally stored together with general wastes, such waste mixtures must be treated and destroyed likehazardous medical wastes. 4. The waste volume in each bag is only 3/4 full, then the bagsmustbe tiedup. 5. Collection frequency: Nurses or assigned employees shullcollcct hazardous medicalwastes and general wastes fromtheirsources totheconcentrated waste places of departments at leastoncea day and when necessary. 6. Highly contagious wastes, before being collected to theconcentrated waste places ofmedical establishments, mustbe preliminarily treated at their sources. Article 15.- Transportation of solid wastes in © VIETNAM LAW & LEGAL FORUM Issue "015 O:1..Q.4/Dec.ember 2007 (C6ng BaD nos 829-8321Decomber22. 2001) medical establishments OFFICIAL GAZETIE wastes in cold houses. 1. Hazardous wastesandgeneral wastes generated atdepartments/sections mustbe separately transported to thewastestorageplacesofmedical establishments at leastonce a dayand when necessary. 2.Medical establishments mustprescribe thewaste transport routesandtime. Thetransportation ofwastes through patients' areas and other clean zones must be avoided. 3. Waste bags must be closely tied up and transported by special vehicles; wastes and waste liquid must not be dropped en route.and their strong smells must not be dispersed in the course of transportation. Article 16.- Solid waste storage in medical establishments 1.Hazardous medical wastesand general wastes mnsr hP. stored in .<>p-par~t~ chambers. 2.Re-usable andrecyclable wastes mustbestored separately. 3. Waste storage places in medical establishments must satisfy the following conditions: a/Being atleast10meters awayfromdining halls, patients' rooms, public passages, crowded places. b/ Being accessible to waste-carrying vehicles from theoutside. cl Waste storage houses must have roofs, protection fences, doors and locks andmust not be intruded freely by animals, rodents or unconcerned persons. d/Their areassuit thevolumeof wastes generated at medical establishments. eI Having hand-washing facilities and protection devices for personnel, having cleansing tools and chemicals. fl Havingculvertsystems,wallsandanti-seepage floors, being well ventilated. g/Medicalestablishments areencouraged tostore 4. Duration for hazardous medical waste storage in medical establishments a/ 'I 'he duration forstorage of hazardous wastes in medicalestablishments must notexceed 48 hours. hi The duration for waste storage in cold houses or boxes may reach 72 hours. cl Surgery wastes must be transported for daily burial ordestruction. d/ For medical establishments with a volume of lessthan 5 kg ofmedical waste a day,~col1ection frequency mustbe at least twice a week ChopterV TRANSPORTATION OF SOLID MernCAT. WASTES FROM MEDICAL. ESTABLISHMENTS Article 17.- Transportation I. Medical establishments shall sign contracts with establishments having the legal person status for transportation anddestruction ofwastes."Nttere there areno establishments withthe legalpersonstatusfor transportation and destruction of medical wastes in localities. medical establishments shall '"port mrlJ to localadministrations for solution. 2.Hazardous medical wastes mustbe transported by specialvehicles meetingthe reqairerrents stated in CircularNo. 12I20061IT-BlNMT of December 26,2006, of the Ministry of Natural Resources and Environment, guiding conditions for professional practice and procedures for making dossiers, registration, grantof practicelicenses and hazardous wastemanagement codes, 3. Hazardous medical wastes, before being transported to destruction places,must be packed in bins 10 avotc cracksor breaks en roure. 4. Surgery wastes must be stored in two yellow bags,packedseparately in binsor boxescloselytied © VIETNAM LAW & LEGAL FORUM OFFICIAL GAZETTE ISliU1t nos 03=04/DeCiember 2007 (C6ng Bao nos 829-832/December22,2007) up and displaying the )IJlllase ''CHATTHAI GIAI PRAU" (SURGERY WASTES) before being transported for destruction. Ankle 18.- Dossiers on waste monitoring and transportation Each medical establishment must establish a systemof booksto monitor the daily waste volume; keeprecords ofhazardous medical wastes andgeneral wastescarried for destruction, made according to a set [(I'm jf\. Circular No. 1212006fIT-BTNMT of December 26, 2006, of the Ministry of Natural ResOtJl'C(8 and Environment, guidingconditions for professional practice and procedures for making dossiers, registration, grant of practice licenses, hazardout. wastemanagement codes, ChapterVI SOLIDMEDICALWASTE TREATMENT AND DESTRUCTION MODELSAND TECHNOLOGIES Amcle 19.- Hazardous solid medical waste treatment-and destruction models andtheapplication thereof I. Hazardous solidmedical waste treatment and deslructiM models include: alMoOOll;Concentratedhazardous uK::dical waste treatment md destruction centers. hi Model 2: Hazardous medical wastetreatment and desrrucnon facilities fur clusters of medical establishments. f;/ Model 3:On-spottreatment and destruction of hazardous solidmedical WWiU:S. 2. Medical establishments shall base themselves on ptmnings, geological elements, economic and environmental conditions toapplyoneofthemedical waste treatment anddestruction models specified in C1au8e 1of thisArticle. Article 20.- Hazardous medical waste lTeaU1~IlL anddestruction technologies 1. The selection of hazardous medical waste treatment technologies must ensure environmental standards and satisfy the requirements of treaties to which Vietnam is a contracting party. 2. Hazardous medical waste treatment technologies includeincineration infurnaces reaching environmental standards: hot-steam disinfection; microwave and other treatment technologies. The application of environment-friendly technologies is encouraged. Article 21.- Methods of preliminary treatment of highlycontagious wastes 1. Highly contagious wastes mustbe safely treated near their sources. 2. Highly contagious wastes can be preliminarily treatedby oneof the following methods: a/ Chemical disinfection: Highly contagious wastes aresoakedin 1-2% cloramin B or 1-2% javel water for at least 30 minutes or other disinfectant chemicals undertheuseinstructions ofproducers and regulations of 1111;; Health Ministry. bl Hot-steam disinfection: Highly contagious wastes are put into disinfection steamers which are operated underproducers> instructions. cINon-stop boiling for at least 15 minutes. 3. Highly contagious wastes, after be irrg preliminarily treated, can be buried or wrapped in yellow plastic bags for mixture with contagious wastes. If these wastes are preliminarily treated by autoclave or microwave methods or other modem technologies up to prescribed standards, theycan be latertreatedlikegeneral wastes andbe recycled. Article 22.- Contagious waste treatment and destruction methods © VIETNAM LAW & LEGAL FORUM IGGue: 093 03-04JDeoe:mbc;r 2007 (Cang Bao nos 829-8321December22,2007) OFFICIAL GAZETTE 1. Contcgiouc Wtl3tC3 curt be trcutcd and destroyed byoneof the following methods: aIAutoclave disinfection hI Microwavedisinfection d Incineration d/Hygienic burial: Beingonlytemporarily applied to medical establishments in mountainand midland areas where local standardhazardous medicalwaste treatment facilities are not yet available. The burial sites are designated by local administrations and approvedby localenvironment managementbodies. Burial pits must meet the requirements: being surroundedbyfences, at least 100m awaytromwater wellsandresidential houses; theirbottoms are atleast 15m belowthe surfacewater level,theirmouthsare abovc the ground and temporarily roofs against rain water,each waste layermust be coveredby anearth layer of 10-25 emthick andthefinal earth layer must lw.O 5 m thick. Contagions wastes must not be buried together withgeneral wastes. Contagious wastesmust be disinfected before being buried. cl Where contugious wastes arc treated by autoclave, microwave method or other modern technologies up to theprescribed standards, they can he later treated. recycled or destroyed like general wastes. 2. Sharp and pointedwastes: One ot the following destruction methodscan be applied: aI Incineration in special furnaces together with other contagious wastes. bI Direct burial in cementholesexclusively used for burial of sharpand pointedobjects: The holesare built with concretebottoms, wallsand lids. 3. Surgery wastes: One of the following methods can apply: alThe contagious wastetreatment anddestruction methods mentioned inClause 1ofArticle 22. bl They arc wrapped in two yellow bags, ~lI.t:U in casesand buriedin cemeteries. d Burial in concretepits with tight bottomsand lids. Article 23.- Chemical waste treatment and destruction methods I. General methodsfor treatmentand destruction of hazardous chemical wastes: a/ Keturnmg them to suppliersundercontracts. b/ Incinerating them in high blastfurnaces. cI Destroying them by method of alkali neutralization or hydrolysis. dI Pre-burial inertization: Mixing W4SteS with cement and a number of other materials in order to fasten hazardous substances in wastes. Themixture ratios will be as follows: 65% pharmaceutical, chemical wastes, 15%lime, 15%cement,5% water. After an uniqueblock is created,it is tranrported for burial. 2.Oneofthefollowing methods canbe applied to the treatment and destruction of pharmaceutical wastes: aI Incinerating them in furnaces, if aT1:.~, together withcontagious wastes. bIBurying themat hazardous waste luial Jiles. c/ Inertization. dI Liquid pharmaceutical wastes are <lI1Uled and discharged into waste water treatment iYsterns of medical establishments. 3.Oneof thefollowing methods canapply to !he treatmentanddestruction oftissue-intoxicating 'WeStes: a/ Returning them to suppliersundercontracts. hi Incinerating themin high-temperature fix:naces (Appendix 2: A numberof tissue-intoxicating drugs frequently used in medical acnvmes anathe minimum temperature for destruction of tissue intoxicanl8). cI Using a number of oxides such as KMn02• © VIETNAM lAW & lEGAL FORUM OFFICIAL GAZEnE I"ue nos OJ.<!4I!J6<emoer2007 (COng Bao nos 829-8321December22.2007) ~SU4' etc., degradmg tissue mtoxrcants mto non hazardouscompounds. dJ Inertization then burial at concentrated waste burial sites. 4.Treatmentanddestruction of wastes containing heavy metals: aIRetuming them to producers for recovery of heavy metals. b/ Destroying them at places for safe destruction of industri-al wastes. c1lf tl1<se two methods cannot be applied, the method cf packing wastes tight in metal or high density polyethylene cans or boxes, then adding I'asleIling '"bstances (cement, lime,sand), letting them illy and packing them tight, then discharging them to waste dumping sites. Artlcle 24.- Radioactive waste treatment and destruction. MediC-31 establishments using radioactive substances and radioactive substance- related instruments or equipment mustcomply with current legal provisions on radiation safety. Article 25.- Preoeurc cylinder treatment and destructiQ(\. One of the following methods canapply: aIReturning themto producers. b/Re-using them. e! Burying them like pressure cylindersof small capacity. ATtkIe26.- General solid waste treatment and destruction 1.Recycling, re-use "A/The list of general wastesto be recycledor re used complies withAppendix 4 to thisRegulation. h'To-be- recycled general wastes mustnotcontain contagious elements and hazardous chemicals attectmghumanhealth. dWastes allowedforrecycling andreuse areonly supplied to organizations or individuals licensedfor such operation and having thefunctionof recycling wastes. dI Medical establishments assign one unit to organize, inspectand strictly supervise the treatment of general wastes according to regulations for recycling andre-use. 2.Treatment anddestruction: Burialat localwaste burial sites. ChapUrIX TREATMENTOFWASlEWAlERAND GASEOUS WASlE Article 27.- General provisions on treatment of waste water 1. Each hospital must have a synchronous waste watercollection and treatment system. 2.Thosehospitals, whichdonothavewastewater treatment systems, must build complete waste water treatment systems. 3. Those hospitals already having waste water treatment systems which are, however, out of order orhaveoperatedinefficiently, mustrepairand upgrade them for operation up to envlrunmental standards. 4. Newly built hospitals must include waste water treatment systemsinto construction items approved by competentagencies. 5. Hospital waste water treatment technologies must satisfy environmental standards andconform to topographical conditione, investment, transportation and maintenance costs. 6. Waste water treatment must be qualitatively examined periodically and waste water treatment dossiers mustbe kept. ArtiCle 28.- Waste watercollection © VIETNAM LAW & LEGAL FORUM lnue nos 03-o41D mbe( 2007 (Gong Baa nos 829-832iDecember22,2007) OFFICIAL GAZETTE 1. Ilospitals must have separate systems fUl collecting surface water andwaste waterfrom various departments, rooms. Waste water culvert systems must run underground or be covered with lids. 2.Wastewatertreatment systems musthavemud gathering tanks. Arucle29.-Requirements onhospital waste water treatmentsystems 1. They are structured with an appropriate technological process for treatment of waste water up to environmental standards; 2. Their capacities suit the volume of hospitals' wastewater; 3.Waste waterdischarge gatesmustbe convenient CUI inspection and supervision, 4. Mud discharged from waste water treatment systemsmustbemanagedlikesolidmedical wastes. 5. Waste water treatment must be qualitatively inspected periodically. There must be books on management of operation and results of relevant qualityinspection. Article30.- Treatment of gaseous wastes 1. Laboratories, chemicals or pharmaceuticals storehouses mustbeconstructed withairventilation systems and toxic gas-gathering cabinets up to the prescribed standards. 2.Equipment usingtoxicchemical gasmusthave systems for treating gas up to prescribed standards before it is discharged into environment. 3. Gas discharged from solid medical waste incinerators must be treated up to Vietnam's environmental standards. Chapter X ORGANIZATION OF IMPLEMENTATION Article 31.- Responsibilities for management of 1.Headsof medical establishments: a/ To manage medical wastes from the time. they are generated to the time they are finally destroyed. bl To possibly contract the transportation, treatment and destruction of medical wastes to organizations or individuals havingthe legalperson status. clTo formulate plans on managementcf medical wastes and workout schemes for investment in and upgrading of infrastructure for managemro't oftheir units' medical wastes andsubmitthemtocompetent authorities for approval. Investment project! on construction of infrastructure for medical waste treatment and destruction must comply wirb CA.I rT"&IIt regulations on management of capital ccrrstrucaon investment. dJ Topurchase andsupply adequate special means up to standards for the classification, collection, transportation andtreatment of wastes; tocoordinate with localenvironment bodies and waste treatment establishments in treating and destroying medical wastes according to regulations. eITo apply measures to reducethe vchsre of to be- destroyed medical wastes through rninimizaUon. collection, recycling and re-use activities .-ter they are treated according to regulations. 2. Directors uf provincial/rnunicipe] Health Services shall manage and formulate> plans on treatment of medical wastes in their respective localities and submit them to provinr.i~lImllni~ip..'l.l People's Committee presidents for consideration, approval andimplementation organization. 1 Hf':lCI!':.ofmedica1esrahlishmentsundertheHealth Ministry andheads of branches' health sections shall manage, drawupplanson disposal ofmedical~ of theirestablishments andattached units, andsubmit them to the minister of the managing ministry for consideration, approval and implementation organization. © VIETNAM LAW & LEGAL FORUM OFFICIAL GAZETIE Issue nos 03-t14lPeCfmbtr 2007 (GOng BaD nos 829-8321Derember 22, 2007) 4 Bureaus. departments and the Inspectorate ofthe Health Ministry shall manage medical wastes according to their respective functions and tasks prescribed by the Minister of Health. Article 32.- Trainiog and research I. The Health Ministry shall formulate programs. and documents for training on medical waste management for uniform application to medical establishments; incorporate medical waste management into training programs in medical and pharmaceutical schools; research into and apply modem technologies suitable to the treatment and dcIaucrion of medical wastes. 2. Medical establishments shall guide the imp","",ntllion of theRegulation on management nf me<liCal wastes to their starr memoers and concerned subjects, guide patients and their families in classification of medical wastes acco-rding to regulatiOIlS • Jtrticle33.-Registration ofowners ofwaste sources and wastetreatment Medicalestablishments shallregisterto be owners of waste sources and waste treatment under the guidance in Circular No. lmOO6fIT-BTNMf of December 26, 2006, of the Ministry of Natural ~ and Environment, guiding conditions for professional practice and procedures for making IX 'C, registration, grant of practice licenses and hazardous wastemanagement codes. Adirle .14.- Fund 1.Medical establishments shall arrange funds for medical wastemanagement 2. Funds invested in the construction of infrastrocture, operation andmanagementof medical wastescome fromthe following sources: . aJ State budget: Healthnon-business budget. Environmental protection non .bceirees budget. hi Capital sources of international organizations, foreign governments, non-governmental organizations. d Other lawfulcapitalsources. Minisf£r ofHealth NGUYEN QUOC TRIEU Appendix! HAZARDOUS CHEMICALS FREQUENTLY USED IN MEDICALACTIVlT1ES {Atuuhed to Decision No. 43!2(J(J7/QD-BIT of November 30,2007, afthe Minister ofHealth) Formaldehyde Photochemicalsubstances: Hydroquinone; Hydroxidekali; Silver, Glutaraldehyde Dissolvents: Halogen compounds: Methelene chloride, chloroform, freons, teichloro ethylene and 1.1.1 trichloromethane. Evaporating anaesthetics: Halothane (fluothane), enflurane (ethrane), isoflurane(forane). Sans-halogen compounds: cylene, acetone, iaopropenol, tolucn, cthylo acetate, acetonitrile, benzene. Ethyleneoxide Chemical compounds: Phenol Grease Cleausiug dissolVI:IILs Ethanol alcohol; methanol Acide. © VIETNAM LAW & LEGAL FORUM !Hue nos 03-O-1JDecembctr 2007 (Cbng BI!o nos829-832!December22,2007) Appemlix2 OFFICIAL GAZETIE Appelldix4 SOME TISSUE INTOXICANTS FREQUENTLY USED INMEDICALACI'MTIESAND MINIMUM TEMPERATURES FOR DESTRUCTION THEREOF (Attachedto Decision No, 4312007/QD~BIT of November30, 2007, oftheMinister ofHeoJth) Drugs Destruction tf·.mfM"r~tlltl:" (0C) Asparaginase 800 Bleomycin 1,000 Ouhoplatin 1,000 Carnustine 800 Cisplatin 800 Cyclophosphamide 900 Cytarabine \,000 Decarbazine 500 Dactinomycin 800 Dauncrubicin 700 Doxorubicin 700 Epirubicin 700 Etoposide \,000 Fluorouracil 700 Idarubicin 700 Melphalan 500 Metroptrexate 1,000 .Mithramycin 1,000 MitomycinC 500 Mitozantrone 800 Mustine 800 Thiotepa 800 Vinblastine 1,000 Vlnm<;:tinp: 1,000 Vindesine 1,000 LIST OF WASTES TO BE GATHERED FOR RECYCLING (Attached to Decision No. 43/2007/QD~BIT of November 30, 2007, oftheMinister qfHealth) General waste materialsneither stained with nor containing hazardous elerrents(contagious elements, hazardous chemicals, radioactive substances,tissue intoxicants), which are allowed to be celleczed far recycling, including: a/ Plastic: Plastic bottles containing solutions without hazardous chemicals, such as NaCIU.9%solution, Bicarbonatenatri, ringer lactat, molecular paste solution, kidney filtering fluid and plastic bottles containing other non-hazardous solutions. ~ Otherplastic materials notstainedwith hazardous elements. blGlass Glass bottles containing solutions without hazardous elcmeuts. Glass ampoules containing injection. drugs, not containinghazardouselements. cIPaper: Paper, newspapers, cardboard car<!boarl boxes, drug boxes and paper materials. dI Metal: Meral matertats not Stained with hazardous elements. © VJETNAM LAW & LEGAL FORUM