{"id":24621,"date":"2020-05-01T20:35:46","date_gmt":"2020-05-01T20:35:46","guid":{"rendered":"http:\/\/www.odemocratagb.com\/?p=24621"},"modified":"2020-05-01T20:35:50","modified_gmt":"2020-05-01T20:35:50","slug":"opiniao-coronavirus-e-a-gestao-de-residuos-hospitalares-na-guine-bissau","status":"publish","type":"post","link":"https:\/\/www.odemocratagb.com\/?p=24621","title":{"rendered":"Opini\u00e3o: CORONAV\u00cdRUS E A  GEST\u00c3O DE RES\u00cdDUOS HOSPITALARES NA GUIN\u00c9-BISSAU"},"content":{"rendered":"\n<p>A propaga\u00e7\u00e3o do novo Coronav\u00edrus\n(SARS-CoV-2) ou Covid-19 estabelece uma grande inquieta\u00e7\u00e3o a n\u00edvel mundial em\ndiversas \u00e1reas principalmente \u00e0s autoridades sanit\u00e1rias e ambientalistas no que\nse refere \u00e0 gest\u00e3o e tratamento dos res\u00edduos hospitalares provenientes duma\nforma geral dos cuidados dos infetados.<\/p>\n\n\n\n<p>Este artigo t\u00e9cnico visa refor\u00e7ar as\nmedidas levadas a cabo pelas autoridades competentes (sanit\u00e1rias e ambientais).\nIgualmente destinada \u00e0 popula\u00e7\u00e3o em geral no contexto da preven\u00e7\u00e3o associada \u00e0\nprodu\u00e7\u00e3o, gest\u00e3o e tratamento de res\u00edduos hospitalares em situa\u00e7\u00e3o do Covid-19,\nincluindo abordagens dos seus impactes ambientais e igualmente das\nproblem\u00e1ticas ligadas \u00e0 sa\u00fade p\u00fablica.<\/p>\n\n\n\n<p>A situa\u00e7\u00e3o mundial no combate a esta\npandemia, despertou interesse dos profissionais ligados \u00e0 sa\u00fade p\u00fablica,\ninstitui\u00e7\u00f5es p\u00fablicas e privadas, as autoridades sanit\u00e1rias e peritos ambientais,\ntendo como objetivo controlar os riscos ligados \u00e0 gest\u00e3o de res\u00edduos nos\ncentros hospitalares e nos domic\u00edlios, evitando assim a propaga\u00e7\u00e3o da infe\u00e7\u00e3o,\ntanto dos profissionais de sa\u00fade, assim como os familiares dos infetados.&nbsp; <\/p>\n\n\n\n<p>Caracteriza-se res\u00edduo como qualquer\nsubst\u00e2ncia, produto ou objeto que uma pessoa ou entidade tenciona eliminar por\nn\u00e3o lhe apresentar caracter\u00edsticas adequadas ao uso ou consumo. Os res\u00edduos\nhospitalares s\u00e3o derivados das tarefas ou din\u00e2micas de presta\u00e7\u00e3o de servi\u00e7os de\nsa\u00fade a seres humanos, nas diferentes \u00e1reas de sa\u00fade nomeadamente na preven\u00e7\u00e3o,\ndiagn\u00f3stico, tratamento, reabilita\u00e7\u00e3o e situa\u00e7\u00e3o extrema em caso de epidemias\nou pandemia.<\/p>\n\n\n\n<p>Os res\u00edduos provenientes dos\ncuidados nas m\u00faltiplas unidades da presta\u00e7\u00e3o de servi\u00e7os sanit\u00e1rios, tanto\np\u00fablico bem como privadas e incluindo os cuidados domicili\u00e1rios, representam\numa grande amea\u00e7a do ponto de vista ambiental e para a sa\u00fade p\u00fablica. Nessa\nperspetiva, os res\u00edduos resultantes das obriga\u00e7\u00f5es de (presta\u00e7\u00e3o de servi\u00e7os)\nacima citadas requerem uma especial aten\u00e7\u00e3o na preven\u00e7\u00e3o da transmiss\u00e3o de\ninfe\u00e7\u00e3o desde equipamento de prote\u00e7\u00e3o individual utilizados na interven\u00e7\u00e3o,\nluvas, m\u00e1scaras, batas de prote\u00e7\u00e3o, agulhas entre outros objetos do uso m\u00e9dico\nrequeridos para esse fim. Normalmente, esses tipos de res\u00edduos s\u00e3o descart\u00e1veis\npara o sistema de tratamento de res\u00edduos sem qualquer valoriza\u00e7\u00e3o ou\nreutiliza\u00e7\u00e3o devido a contamina\u00e7\u00e3o presente nos mesmos.<\/p>\n\n\n\n<p>\u00c9 indispens\u00e1vel adotar medidas em\ntermos de gest\u00e3o integrada dos res\u00edduos provenientes dessas atividades. De modo\na facilitar a sua gest\u00e3o e tratamento ou elimina\u00e7\u00e3o, os res\u00edduos hospitalares\ns\u00e3o caraterizadas em 4 grupos distintos:<\/p>\n\n\n\n<p>Grupo I: Res\u00edduos hospitalares semelhantes a urbanos;<\/p>\n\n\n\n<p>Grupo II: Res\u00edduos hospitalares n\u00e3o perigosos;<\/p>\n\n\n\n<p>Grupo III: Res\u00edduos hospitalares de risco biol\u00f3gico;<\/p>\n\n\n\n<p>Grupo IV: Res\u00edduos hospitalares espec\u00edficos.<\/p>\n\n\n\n<p>O grupo III abrange res\u00edduos derivados de centros de\nhemodi\u00e1lise, unidades de autopsia ou patologia cl\u00ednica, centros de enfermarias\ncom assist\u00eancia aos doentes infeciosos, laborat\u00f3rios de investiga\u00e7\u00e3o\ncient\u00edfica, entre outros materiais ortop\u00e9dicos tais como gessos e ligaduras\ncontaminadas.<\/p>\n\n\n\n<p>\u00c9 importante salientar que, os\nres\u00edduos resultantes das atividades ou opera\u00e7\u00f5es do Covid-19 enquadram-se no\ngrupo III, ou seja, os que apresentam risco biol\u00f3gico devido a natureza da\ninfe\u00e7\u00e3o e consequente impacto na dissemina\u00e7\u00e3o da doen\u00e7a. No tratamento dos\nres\u00edduos hospitalares inclu\u00eddos neste grupo prescreve-se a aplica\u00e7\u00e3o de duas\nmetodologias:<\/p>\n\n\n\n<p>&#x25aa;\nDescontamina\u00e7\u00e3o, que engloba autoclavagem (esteriliza\u00e7\u00e3o), desinfe\u00e7\u00e3o qu\u00edmica,\nmicro-ondas e ioniza\u00e7\u00e3o. Esta metodologia \u00e9 eficaz do ponto de vista ambiental\ne disp\u00f5e duma capacidade de redu\u00e7\u00e3o excessiva de n\u00famero microrganismos nos\nobjetos de utiliza\u00e7\u00e3o m\u00e9dica.<\/p>\n\n\n\n<p>&#x25aa;\nIncinera\u00e7\u00e3o, caraterizada como processo de decomposi\u00e7\u00e3o de res\u00edduos \u00e0 altas\ntemperaturas atrav\u00e9s da queima controlada. Apresenta vantagens em termos de\nredu\u00e7\u00e3o da quantidade de res\u00edduos em cerca de 75 a 90%.&nbsp; <\/p>\n\n\n\n<p>Os res\u00edduos do grupo III s\u00e3o\ndestinadas a um pr\u00e9-tratamento adequado, nesse caso por autoclavagem ou\nesteriliza\u00e7\u00e3o dos materiais de utiliza\u00e7\u00e3o m\u00e9dica induzidas ao aquecimento de\nl\u00edquidos \u00e0s rea\u00e7\u00f5es qu\u00edmicas sob press\u00e3o em condi\u00e7\u00f5es de altas temperaturas. A\nesse grupo s\u00e3o tamb\u00e9m aplicados sistemas de incinera\u00e7\u00e3o abrangendo assim aos\nres\u00edduos resultantes do manuseamento m\u00e9dico e igualmente aplicados aos\npacientes, desde aventais, mascaras, luvas, agulhas, pin\u00e7as e esp\u00e1tulas\ndescart\u00e1veis, entre outros materiais.<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"746\" src=\"http:\/\/www.odemocratagb.com\/wp-content\/uploads\/2020\/05\/B5CE04C7-5795-466C-9EA3-8914E2EF9B9E-1024x746.jpeg\" alt=\"\" class=\"wp-image-24620\" srcset=\"https:\/\/www.odemocratagb.com\/wp-content\/uploads\/2020\/05\/B5CE04C7-5795-466C-9EA3-8914E2EF9B9E-1024x746.jpeg 1024w, https:\/\/www.odemocratagb.com\/wp-content\/uploads\/2020\/05\/B5CE04C7-5795-466C-9EA3-8914E2EF9B9E-300x219.jpeg 300w, https:\/\/www.odemocratagb.com\/wp-content\/uploads\/2020\/05\/B5CE04C7-5795-466C-9EA3-8914E2EF9B9E-768x559.jpeg 768w, https:\/\/www.odemocratagb.com\/wp-content\/uploads\/2020\/05\/B5CE04C7-5795-466C-9EA3-8914E2EF9B9E.jpeg 1105w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p>Fonte: Jovens rep\u00f3rteres para o ambiente: Res\u00edduos\nhospitalares, o dano colateral do Coronav\u00edrus. Consultado no dia 17 de abril de\n2020<\/p>\n\n\n\n<p><strong><em>No caso da Guin\u00e9-Bissau,\nrecomenda-se a aplica\u00e7\u00e3o da metodologia de incinera\u00e7\u00e3o dos res\u00edduos origin\u00e1rios\ndos cuidados aos pacientes do Covid-19 sendo que apresentam uma efic\u00e1cia em\ntermos da elimina\u00e7\u00e3o da contamina\u00e7\u00e3o e destrui\u00e7\u00e3o total dos microrganismos\ninfeciosos.<\/em><\/strong><\/p>\n\n\n\n<p>O procedimento habitual da <strong><em>incinera\u00e7\u00e3o\na c\u00e9u aberto<\/em><\/strong> na Guin\u00e9-Bissau, apresenta enormes riscos para a sa\u00fade\np\u00fablica e ambiente principalmente na emiss\u00e3o dos compostos org\u00e2nicos vol\u00e1teis\n(COV) para a atmosfera entre outros gazes de efeito estufa, tamb\u00e9m podem ser\ngerados dioxinas, vapores de merc\u00fario, isto \u00e9, dependendo da natureza dos\nres\u00edduos a incinerar. Por isso, recomenda-se nesse caso, que sejam feitas\nincinera\u00e7\u00f5es em <strong><em>fornos ou unidades de incinera\u00e7\u00e3o<\/em><\/strong> apropriada de\nforma a controlar e essencialmente monitorizar as emiss\u00f5es supracitadas.&nbsp; <\/p>\n\n\n\n<p>Em caso de aplica\u00e7\u00e3o de uma terceira\nmetodologia que consiste em deposi\u00e7\u00e3o dos tais res\u00edduos em aterro (que seja\nsanit\u00e1rio ou outro equivalente). Descreve-se aterro como instala\u00e7\u00e3o de\nelimina\u00e7\u00e3o de res\u00edduos atrav\u00e9s da sua deposi\u00e7\u00e3o acima ou abaixo da camada\nnatural usada para armazenamento tempor\u00e1ria. \u00c9 importante real\u00e7ar que um aterro\nsanit\u00e1rio deve apresentar estruturas adequadas para a prote\u00e7\u00e3o dos res\u00edduos\ndurante o per\u00edodo da sua vida \u00fatil. Em caso contr\u00e1rio, quando n\u00e3o se apresenta\nestruturas conforme, pode ocorrer o fen\u00f3meno da contamina\u00e7\u00e3o do solo, do len\u00e7ol\nfre\u00e1tico (reserva de \u00e1gua subterr\u00e2nea) e consequentemente uma nova etapa de\ndissemina\u00e7\u00e3o das doen\u00e7as.<\/p>\n\n\n\n<p>Como recomenda\u00e7\u00f5es, aconselha-se que\na <strong><em>triagem<\/em><\/strong> dos res\u00edduos produzidos durante o acompanhamento e\npresta\u00e7\u00e3o dos cuidados aos pacientes sejam feitas no local da produ\u00e7\u00e3o do\nres\u00edduo em quest\u00e3o. Indica-se que o processo da armazenagem seja feito num saco\nde pl\u00e1stico de 50 a 70 m\u00edcron dependendo do volume do res\u00edduo a descartar e\ndever\u00e1 ser efetuado em seguran\u00e7a como indica o esquema abaixo.<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"491\" src=\"http:\/\/www.odemocratagb.com\/wp-content\/uploads\/2020\/05\/D2B5FA38-8105-4D77-B287-1FC6F883D437-1024x491.jpeg\" alt=\"\" class=\"wp-image-24619\" srcset=\"https:\/\/www.odemocratagb.com\/wp-content\/uploads\/2020\/05\/D2B5FA38-8105-4D77-B287-1FC6F883D437-1024x491.jpeg 1024w, https:\/\/www.odemocratagb.com\/wp-content\/uploads\/2020\/05\/D2B5FA38-8105-4D77-B287-1FC6F883D437-300x144.jpeg 300w, https:\/\/www.odemocratagb.com\/wp-content\/uploads\/2020\/05\/D2B5FA38-8105-4D77-B287-1FC6F883D437-768x368.jpeg 768w, https:\/\/www.odemocratagb.com\/wp-content\/uploads\/2020\/05\/D2B5FA38-8105-4D77-B287-1FC6F883D437.jpeg 1185w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p>\u00c9 conveniente armazenar res\u00edduos em\ndois sacos de pl\u00e1sticos bem encerrados, antes de os depositar num tanque ou\noutro material de recolha como mostra o esquema. O n\u00famero de sacos pl\u00e1sticos\nvai depender da disposi\u00e7\u00e3o e da natureza dos sacos dispon\u00edveis no mercado\nnacional para esse fim.&nbsp; <\/p>\n\n\n\n<p>A periodicidade de recolha dos\nres\u00edduos nos centros hospitalares e nos domic\u00edlios a priori dever\u00e1 efetuar-se\ndiariamente, de modo a reduzir o risco de contamina\u00e7\u00e3o aos funcion\u00e1rios e\nfamiliares dos doentes do Covid-19. \u00c9 relevante diferenciar o caso de Bissau em\nrela\u00e7\u00e3o ao interior do pa\u00eds com o acesso condicionado, onde a possibilidade de\nrecolha pelas autoridades competentes \u00e9 quase inexistente. Aconselha-se que\nsejam feitas incinera\u00e7\u00f5es, englobando assim todos os cuidados de seguran\u00e7a e\nhigiene antes e depois da recolha at\u00e9 incinera\u00e7\u00e3o.<\/p>\n\n\n\n<p><strong><em>Conv\u00e9m destacar que a produ\u00e7\u00e3o\ndesses res\u00edduos pode n\u00e3o ser significativo (em grande quantidade) em rela\u00e7\u00e3o a\nprodu\u00e7\u00e3o per capita (por pessoa) dos res\u00edduos dom\u00e9sticos, mas \u00e9 importante\nsublinhar o grau da perigosidade que esses res\u00edduos representam na vida das\npessoas<\/em><\/strong><em>.&nbsp; <\/em><\/p>\n\n\n\n<p>Por \u00faltimo, e n\u00e3o menos importante,\n\u00e9 necess\u00e1rio real\u00e7ar a din\u00e2mica das institui\u00e7\u00f5es p\u00fablicas e privadas, da\nsociedade civil, das ONG, coletivos juvenis, pessoas de boa vontade que de\nalguma forma est\u00e3o a redobrar os esfor\u00e7os em termos de sensibiliza\u00e7\u00e3o \u00e0 adapta\u00e7\u00e3o\na nova realidade social na preven\u00e7\u00e3o do Covid-19.<\/p>\n\n\n\n<p>Resumidamente, deve-se <strong><em>refletir\nna implementa\u00e7\u00e3o desta mat\u00e9ria da extrema import\u00e2ncia<\/em><\/strong> sobre a gest\u00e3o e\ntratamento dos res\u00edduos hospitalares a n\u00edvel nacional com a finalidade de\nreduzir potencialmente o risco de cont\u00e1gio do Covid-19.&nbsp; <\/p>\n\n\n\n<p>Por: <strong>Hans Queta<\/strong><\/p>\n\n\n\n<p>Engenheiro\nAmbiental <\/p>\n","protected":false},"excerpt":{"rendered":"<p>A propaga\u00e7\u00e3o do novo Coronav\u00edrus (SARS-CoV-2) ou Covid-19 estabelece uma grande inquieta\u00e7\u00e3o a n\u00edvel mundial em diversas \u00e1reas principalmente \u00e0s&#8230;<\/p>\n","protected":false},"author":4,"featured_media":24618,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6,25],"tags":[],"class_list":["post-24621","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-inicio","category-opinioes","wpcat-6-id","wpcat-25-id"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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