Risk assessment of sharps medical waste management using the HIRARC approach in a primary healthcare clinic
https://doi.org/10.52235/lp.v7i4.909
Keywords:
environmental health, medical waste, medical waste diposal, needlestick injuries, risk assesmentAbstract
Background: Medical sharps waste is a hazardous component of healthcare waste that may cause sharps injuries, exposure to infectious agents, and environmental contamination when inadequately managed. Suboptimal practices during segregation, containment, internal transportation, and temporary storage may increase health and safety risks for healthcare workers, waste-handling personnel, patients, and the surrounding environment.
Objective: This study aimed to identify hazards, assess risk levels, and evaluate risk-control measures in medical sharps waste management using the Hazard Identification, Risk Assessment, and Risk Control (HIRARC) approach at Rezky Medika Clinic, Palembang, Indonesia.
Methods: A descriptive qualitative design complemented by HIRARC-based risk assessment was employed from February to April 2026. Participants were purposively selected and comprised five informants for in-depth interviews and eight participants in focus group discussions. Data were collected through in-depth interviews, field observations, document review, and focus group discussions. Qualitative data were analyzed through transcription, coding, categorization, theme identification, verification, and source triangulation.
Results: The HIRARC assessment identified 12 risks across source segregation, containment, internal transportation, and temporary storage. The highest-ranked risk was needlestick injury associated with an overfilled safety box during the containment stage, with a risk score of 12 and classified as high risk. Moderate risks were primarily associated with waste spills, cross-infection, occupational accidents, and contamination of clinical areas during containment and internal transportation. Although several control measures were already implemented, gaps remained in procedural compliance, infrastructure availability, personal protective equipment use, supervision, and continuous staff training.
Conclusion: Medical sharps waste management remains associated with occupational and environmental health risks that require more systematic control. The HIRARC approach provides a practical framework for identifying critical risk points and prioritizing preventive measures to strengthen safe medical waste management in healthcare facilities.
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