In The main objective of the Guidelines is

In
order to comply to Occupational Health and Safety Act (OSHA) 1994, provision of
first aid become a mandatory as part of employer responsibility as stated in
Section 15 of Occupational Safety and Health Act 1994 (OSHA 1994) and Section
25 of the Factories and Machinery Act 1967 (Occupational Safety and Health Act 1994); (Factories and Machinery Act,
1974).  As the provision of First Aid must be consistent
and efficient as part of employee’s welfare, Department of Safety and Health
(DOSH) with collaboration with few other contributors had come out with the Guidelines
on First-Aid In The Workplace up to Second Edition revised version in 2004. The
main objective of the Guidelines is to assists employers, occupiers and Occupational Safety and Health
practitioner to plan and implement proper first-aid facilities in the workplaces
(Guidelines on First-Aid In The Workplace
(2nd Edition), 2004). However, the contents of the
Guideline is not covering a holistic idea of first aid management as it is too
focusing on the requirements without expanding the guidance on disposal method.
As part of health care products, the need of proper disposal of unused or
expired first aid items become important to reduce the burden on domestic waste
treatment. Typical component of first aid items vary with different type of
products such as paper, wood, consumable products, solvent based items and drug
contained materials. Some of the contents of first aid items are
categorized as hazardous waste. Even
though the quantity of first aid wastes produced is in small quantity, there is
still some risks and potential dangers for environment related to mishandling
of wastes. The information provided in this paper was summarized to understand
the overview of current first aid management and risk exposed to environment to
justify the need of proper first aid management based on ‘cradle to grave’
concept.

3.0 First Aid as part of Health care

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3.1 Definition of Health care and First Aid

As stated in Guidelines
on The Handling and Management of Clinical Wastes in Malaysia, health care is
defined as any medical activities such as diagnosis, monitoring, treatment
prevention of disease of handicap in humans or animals performed under the
supervision of any person authorized by their professional qualifications (Guidelines on The Handling and
Management of Clinical Wastes in Malaysia (3rd Edition), 2009 ). While referring to the Guidelines
on First Aid in the Workplace by DOSH, first aid is defined as the assessment
and interventions performed by a first aider for the injury with minimal
equipment until qualified medical or health personnel arrive to provide
treatment. First aid provision is including all appropriate facilities, services
and personnel required for the immediate treatment of injury or illness at a
workplace (Guidelines on First-Aid In The
Workplace (2nd Edition)). First aid emphasized on
early treatment once casualty occurred while health care is covering all phases
of casualty treatment. By comparing both definition, first aid also can be categorized
as a subset of health care elements.

3.2 Requirement of first aid provision

First aid
provision in any premise is including first-aiders, first-aid box, first-aid
room and first-aid equipment. The number of all first aid provision typically
is based on type of industry, number of workers, number of work shifts and
location of workplace and status of infrastructure in relation to the nearest
medical clinic or hospital (Guidelines on First-Aid In The
Workplace (2nd Edition), 2004). Considering the large
headcount of employees in large premise, the provision of first aid items can
be as many as health care facilities.

3.3 Maintenance and replenishment of first
aid items

As part of OSHA
1994, all injuries in the premises must be recorded and reported to Department
of Safety and Health (DOSH) (Occupational Safety and Health Act 1994). This is parallel in what
stated in Guideline on First Aid in the Workplace as the record of the
treatment given by the first-aider should be made and kept for a period of five
years by the employer. The main responsibility for maintaining first aid
facilities including replenishment and regular inspection is belong to
employers. For this case, employers need to ensure that appointed first aiders
must able to maintain perform the responsibility as to ensure the services are
adequate at all times (Guidelines on First-Aid In The
Workplace (2nd Edition), 2004).

3.4
First Aid waste Categorization

Most of national
or international bodies will describe health or medical treatment waste as health
care, pharmaceutical, medical or clinical waste. The World Health Organization
(WHO) stated that all waste generated by health care establishment including
waste originating from ‘minor’ or ‘scattered’ source is defined as health care
waste (World Health Organization,
Definition and Characterization of health-care waste) .As first aid is part of
health and medical services, hence the waste can be categorized based on their components.
First aid products potentially end up to produce several categories of waste
such as infectious waste, sharps, pharmaceutical waste and chemical waste as
stated in WHO. In Guidelines on The Handling and Management of Clinical Wastes
in Malaysia, the categorization of first aid is almost as similar as WHO
categorization on health care waste. Table 1 is the list of first aid waste
categories;

Table 1: First Aid Waste Categories

Components

First Aid Products

Waste Category

Materials or equipment that have been in contact
with blood or other body parts of injured person suspected to contain
pathogens
 

Tissues (swabs, gauze pads and dressings)
Bandages (triangular, elastic and roller)
Eye pads
Gloves
Adhesive tape
Alcohol prep pads
Cotton buds
Barrier device for CPR (pocket mask, face shield

infectious waste,
(clinical waste)

Clinical waste

Any health care equipment with sharps or pointed
parts able to cause an injury to human.

Scissors
Safety pin
Cervical collar
plastic apron
Splints

Sharps
(clinical waste)

Waste containing pharmaceuticals that are expired
or no longer needed and items contaminated by pharmaceuticals product
 

Bottles and boxes of pharmaceuticals products
such as

pharmaceutical waste (clinical waste)

Waste containing chemical substances
or disinfectants that are expired or no longer
needed

Disinfectants
Antiseptic
Burn aid cream
Yellow lotion

chemical waste

Products or items in the solid state that are
expired or no longer needed

Cold pack compress gel
Unused absorbent paper
Unused swabs

Solid waste

Any products or tools that contained high
densities of poisonous metal.

Thermometer
 

Heavy metals

 As first aid facilities and items
are mainly used for early treatment of casualty, most of the study do not
really focusing much on the hazardous waste elements in first aid items. There
are no previous published studies assessing and categorized first aid elements
particularly in hazardous elements. The assessment and categorization was
always conducted in bigger scale of health care waste focusing in large health
care services such as hospitals, clinics, pharmacies and university clinics (Hossain, Santhanam, Nik Norulaini, & Omar, 2011); (Ananth, Prashanthini, & Visvanathan, 2010).