HomeHealth Sciences Journalvol. 10 no. 1 (2021)

An analytical cross-sectional study on the knowledge, attitudes, and practices (KAP) on biomedical waste management among nurses and medical technologists in the Philippines*

Camille Therese M. Aldeguer | Eileen M. Alcaraz | Reginald Christian L. Alfaro | Alyssa Anne Z. Alfeche | Mark Christopher M. Abeleda | Rafael Gianlorenzo V. Abilgos | Tamam P. Abu Rayyan | Samantha Rose A. Abulencia | Julie Anne L. Acierto | Steffi G. Acuna | Angelie J. Aguilar | Josette Chase H. Aguiting | Jose Ronilo G. Juangco



Introduction Unregulated biomedical waste management is an emerging public health problem in the Philippines. This study aimed to differentiate the knowledge, attitudes, and practices of nurses and medical technologists toward biomedical waste management. Methods Using an analytic cross-sectional study design, an online survey of nurses and medical technologists from hospitals around the Philippines was conducted. A 27-item questionnaire covering knowledge, attitudes and practices was used. The percentages of correct answers and mean scores in each domain was compared between the nurses and medical technologists. Results A total of 196 respondents consisting of 77 registered nurses and 119 medical technologists were included in the study. Medical technologists had significantly better knowledge scores than nurses on disposal procedures for expired blood units and by-products waste (55% vs. 19%, p = 0.026). Both had low correct responses on adequate disposal of human tissue remains, throwing blood waste into domestic waste, and throwing of expired medications in domestic waste. There was no significant difference in the attitude of nurses and medical technologists. Nurses had significantly better practice scores on disposal of liquid waste in bags (84.4% vs. 68.9, p = 0.018), but medical technologists fared better at disposal of human tissue together with other waste (13.0% vs. 2.5%, p = 0.006). Conclusion Both nurses and medical technologists had adequate knowledge of some aspects but were lacking in others. There was no significant difference in the attitude of nurses and medical technologists towards biomedical waste management. Half of the respondents practiced proper biomedical waste management.


1. Olaifa A, Govender R, Ross A. Knowledge, attitudes and practices of healthcare workers about healthcare waste management at a district hospital in KwaZulu-Natal. South African Family Practice [Internet]. 2018; 60(5): 137-45. Available from: https://doi.org/10.1080/20786190.2018.1432137

2. Tayaben JL. Compliance with sharps injuries prevention guideline among nurses in tertiary care hospitals in the Philippines. Int J Infect Control [Internet]. 2015 June; 11(2). doi:10.3396/IJIC.v11i2.015.15

3. Rajan D. Occupational hazards: A comparative study among medical laboratory technicians. Int J Res Appl Sci Eng Technol [Internet]. 2014; 2(7). doi: 10.5958/2231- 0657.2014.00522.9

4. Mugabi B, Hattingh S, Chima S. Assessing knowledge, attitudes, and practices of healthcare workers regarding medical waste management at a tertiary hospital in Botswana: A cross-sectional quantitative study. Niger J Clin Pract [Internet]. 2018; 21(12): 1627-38. doi: 10.4103/njcp.njcp_270_17

5. Gilany A, El-Shaer S, Kashaba S, El-Dakroory S, Omar N. Knowledge, attitude, and practice (KAP) of ‘teaching laboratory’ technicians towards laboratory safety and waste management: A pilot interventional study. J Hosp Infect [Internet]. 2017; 96(2): 192-4. doi: 10.1016/j.jhin.2017.02.007

6. Sobh D, Fakhr y S, Mohamed H. Knowledge and practice of staff nurses related to health care waste management. Port Said Sci J Nurs [Internet]. 2018. Ava i l a b l e f r o m : h t t p s : / / p s s j n . j o u r n a l s. e k b. e g /article_33322_9b5c382f84cebf2ad47444eb673ba387.pdf

7. Muthoni MS, Nyerere K A, Ngugi CW. Assessment of level of knowledge in medical waste management in selected hospitals in Kenya. Appli Micro Open Access [Internet]. 2016; 2:4. doi: 10.4172/2471-9315.1000124

8. Department of Health. Healthcare Waste Manual [Internet]. Available from: http://www.doh.gov.ph/sites/default/files/publications/Health_Care_Waste_Management_Manual.pdf

9. World Health Organization. Quality assurance of pharmaceuticals: A compendium of guidelines and related materials. 2nd Ed. [Internet]. Available from: https://www.who.int/medicines/areas/quality_safety/quality_assurance/QualityAssurancePharmVol2.pdf

10. Agaceta CC, Diano GT, Lintag PMP, Loquias MM. Current practices and perceptions on pharmaceutical care of hospital pharmacists in Metro Manila. IJPTP [Internet].2013; 4(4): 821-5. Available from: https://www.iomcworld.org/abstract/current-practices-and-perceptions-on-pharmaceutical-care-of-hospital-pharmacists-in-metro-manila-43941.html

11. Jahan I, Ahmed M, Faruquee M. Knowledge, attitude and practices on bio medical waste management among the health care personnel of selected hospitals in Dhaka City. Int J Adv Res Technol [Internet]. 2018 Feb; 7(2). Available from: https://www.researchgate.net/publication/323550709Knowledge_Attitude_And_Practices_On_Bio_Medical_Waste_

12. Adogu P, Ubajaga C. Knowledge and practice of medical waste management. Asian J Sci Technol [Internet]. 2014; 5(12), 833-8. Available from: https://www.academia.edu/14181463/Knowledge_And_Practice_Of_Medical_Waste_Management_Among_Health_Workers

13. Molina VB. Waste management practices of hospitals in Metro Manila. The University of the Philippines Manila Journal [Internet]. 2002 Jul-Dec; 7(3-4): 17-22

14. Cruz C, Garcia R, Colet P, Cruz J, Alcantara J. Healthcare waste management of the government hospitals in Northern Philippines. Eur Sci J [Internet]. 2014; 10(26):114-22. Available from: https://eujournal.org/index.php/esj/article/download/4297/4119

15. Abrol A, Mahajan S, Chauhan M, Kumar N. Awareness and practices regarding biomedical waste management among health care workers in a tertiary care hospital in Himachal Pradesh. Indian J Microbiol Res [Internet]. 2019 Mar; 6(1). doi: 10.18231/2394-5478.2019.0019

16. Anozie OB, Lawani LO, Eze JN, et al. Knowledge, attitude and practice of healthcare managers to medical waste management and occupational safety practices: Findings from Southeast Nigeria. J Clin Diagn Res [Internet]. 2017 Mar; 11(3): IC01-IC04. doi: 10.7860/JCDR/2017/24230.9527

17. Deress T, Hassen F, Adane K. Assessment of knowledge, attitude, and practice about biomedical waste management and associated factors among the healthcare professionals at Debre Markos Town Healthcare Facilities, Northwest Ethiopia. J Environ Public Health [Internet]. 2018 Oct 2; 2018: 7672981. doi: 10.1155/2018/7672981

18. Jahan I, Ahmed DMR. Knowledge on Biomedical Waste Management among the Health Care Persons. Lambert Academic Publishing; 2018.

19. Parida A, Capoor MR, Bhowmik KT. Knowledge, attitude, and practices of biomedical waste management rules, 2016; Biomedical waste management (amendment) rules, 2018; and solid waste rules, 2016, among health-care workers in a tertiary care setup. J Lab Physicians [Internet].2019 Oct-Dec; 11(4): 292-9. doi: 10.4103/JLP.JLP_88_19

20. World Health Organization. Safe management of wastes from health care activities: A summary [Internet].2017. Available from: https://www.who.int/water_sanitation_health/publications/safe-management-of-waste-summary/en/

21. World Health Organization Guidelines for Safe Disposal of Unwanted Pharmaceuticals In and After Emergencies [Internet]. 1999 Mar. Available from: https://www.who.int/water_sanitation_health/medicalwaste/unwantpharm.pdf

22. Nwankwo C. Knowledge and practice of waste management among hospital cleaners. Occup Med (Lond) [Internet].2018 Aug 11; 68(6): 360-3. doi: 10.1093/occmed/kqy078

23. Mathur V, Ma Hassan S, Misra R. Knowledge, attitude, and practices about biomedical waste management among healthcare personnel: A cross-sectional study. Indian J Community Med [Internet]. 2011 Apr; 36(2): 143-5. doi:10.4103/0970-0218.84135

24. Department of Budget and Management–Department of Health. Revised Organizational Structure and Staffing Standards for Government Hospitals [Internet]. 2013. Available from: https://www.iomcworld.org/articles/current-practices-and-perceptions-on-pharmaceutical-care-of-hospital-pharmacists-in-metro-manila.pdf

25. Republic of the Philippines Department of Environment and Natural Resources (2003, September). Metro Manila Solid Waste Management Project (Rep.) [Internet]. Available from: http://v2020eresource.org/content/files/Solidwaste.pdf (accessed 19 Oct 2020)