Some time ago, the Sofia Municipality announced that the city's garbage plant would stop accepting household and hazardous waste from hospitals after it was mixed. Hazardous hospital waste has its own characteristics and dangers, and doctors and nurses are trained on how to protect patients from pathogens that are virulent and resistant, which means they are extremely dangerous. But what happens at the landfill… Stanislava Evtimova, manager of "Exsafe" Ltd., spoke to FACTI.
- Ms. Evtimova, there is talk of the initiative "The Earth Does Not Drink Medicines" when it comes to the collection and destruction of expired medicines, but is it possible with initiatives alone?
- "The Earth Does Not Drink Medicines" was an initiative of two private companies. We - from "Ecosafe" took over the organization of the collection, transportation and destruction of old medicines in our own facility - an incinerator. The campaign was held once in three cities - Sofia, Varna and Plovdiv and had a very serious media response and activity from citizens.
Such initiatives from the business side cause admiration, but in order to completely separate old medicines, and hazardous household waste in general, joint efforts of the state, municipalities, citizens and business are needed to educate the population and build an infrastructure for their transfer. It is important to have transparency and to make it clear that they are burned in an incinerator. The lack of information about what actually happens to the transferred pharmaceutical waste demotivates participants in the process. Also decisive for the success of the campaigns is the easy and accessible location for the transfer of old medicines, as well as the regularity of the campaigns. The lack of periodic repetition and advance announcement of locations and dates for delivery makes it difficult for citizens and discourages them from collecting separately.
- Do Bulgarians know how and where to dispose of old medicines?
- The Internet provides access to information explaining the risks of their improper management, but there is a lack of specifics about where they can be delivered, which largely determines the low activity on a national scale. Since there is no unified national policy and each municipality decides the issue piecemeal, citizens can receive the most accurate information on where and when hazardous household waste, including old medicines, can be delivered on the territory of the respective municipality from the municipality in whose territory they live.
We have concluded contracts for the collection of hazardous waste from households, including medicines, with over 20 municipalities across the country.
Here is how things look in practice from the experience we have. On the territory of the Municipality of Ruse, for example, there are five sites where people can go and hand over old medicines and other hazardous waste at any time. The Municipality of Varna has organized this process so that three times a year, within four consecutive days, citizens can hand over the collected waste to a mobile point of our company. The Municipality of Haskovo gives its residents the opportunity once a year, within one day - at a previously specified place, to hand over hazardous household waste to a mobile point.
At the moment, the most successful model in the country in terms of the organization of the collection of hazardous household waste, including medicines, has been built by the Sofia Municipality, with which we also have a contract. Since we have been serving the municipality, thanks to the joint efforts related to publishing materials in the press, active presence in social networks, organizing festivals and regular campaigns, we have managed to increase efficiency three times, with the results constantly improving. This year. The Sofia Municipality has assigned us 27 campaigns in different metropolitan areas. Additionally, festivals are being initiated such as MaGaTa –“Hand over waste from Basements, Garages and Attics“, the first edition of which exceeded expectations. In addition, the Sofia Municipality gives citizens the opportunity to be visited at home and to hand over old medicines and other collected hazardous waste free of charge. Our team keeps very precise statistics regarding the quantities of waste handed over by type and location, which allows us to be even more efficient.
- And above all, why is it important to dispose of expired medicines in specially designated places?
- Any waste that is managed incorrectly and ends up in a place where it should not be, poses risks to the environment and human health. The additional risk associated with the improper management of pharmaceutical waste is associated with the possibility of it ending up in water and soil, through which it can return to the food chain of humans and animals. This can contribute to the development of antibiotic resistance, which is described as the new medical problem and reduces the possibility of subsequent treatment of dangerous diseases. The place of old medicines is in incinerators.
- What is the role of the state, because over the years, once a regulation of the Ministry of Health says that medicines are disposed of separately, and at other times it can be in the general trash. Do we have a clear state policy in this direction?
- The fact is that there is a gap in the Bulgarian legislation regarding the management of pharmaceutical waste from households. The regulation on the destruction of medicines was issued by the Ministry of Health and categorically states that they must be burned in incinerators. However, the regulation excludes pharmaceutical household waste from its scope and refers to the Waste Management Act of the Ministry of Environment and Water. The law transfers the responsibility for collecting hazardous and mass-produced household waste to the Municipalities,
but other regulations determine that medicines are neither hazardous nor mass-produced waste, which effectively allows their disposal under Bulgarian law.
At the same time, if you pay attention to the leaflet for each medicine, it is categorically stated not to be thrown into the sewer or with household waste. This is also the European practice - old medicines are collected separately through systems and sent for burning in an incinerator. The positive thing is that despite this gap in the legislation, municipalities identify the problem and include it in the scope of the service for collecting hazardous household waste and medicines.
- In larger cities, mobile collection points for old medicines are organized. What is the effect of such a campaign? Have you participated in such campaigns…
- We have concluded contracts with over 20 municipalities across the country for a comprehensive service covering the provision of a mobile station and team, transportation of the collected waste to our facility in Devnya and its disposal in an incinerator. Since we own and operate our own incinerator, the path of the waste from the place of its collection to its final disposal is direct and easily traceable. I will share the results of the campaigns we conduct in Sofia and Varna.
In Sofia, in one year, we collected 23,437.7 kg of hazardous household waste, of which 7,255.02 kg are medicines.
On average, about 400 kg of hazardous waste are collected per campaign, with 1/3 of the hazardous waste handed over being medicines and 85% of the citizens visiting the station also handing over medicines. During the same period, 6419 kg of hazardous waste were handed over in Varna, of which 1785 kg were medicines, again approximately 1/3.
- Improperly disposed medicines end up in the soil and water, and through food and water sources, antibiotic residues can be ingested by people. Does anyone care about this…
- The good news is that the amounts of hazardous waste - including medicines, handed over to the points are increasing - for Sofia in times, for the country or at least for the municipalities we serve, at a slower pace. However, this shows that people are starting to be interested and think about the topic. Of course, a vision and joint efforts from the state, business, municipalities, citizens are needed to completely reverse the trend and for medicines to go to incinerators, where they belong, and not to landfills, even less to other places.
- We have excessive use of antibiotics in humans. But we also treat animals with antibiotics, and then we eat their meat. And what happens is that we take antibiotics without wanting to – pork, chicken…
- Since I am not a health expert, and my expertise is in the waste management sector, I will answer you this way - the animal vaccination regime and food safety control are carried out by the BFSA (Bulgarian Food Safety Agency). We have concluded contracts with the Food Agency for the destruction in the incinerator of vaccines as a result of marriage, their use or for other reasons for which the competent authority has deemed that they cannot be applied.