ETHICS

 

South African statutory regulations for dental practices

 

 

Mulder R^I; Mulder-van Staden S^II

^IBChD (UWC), MSö(Dent) (UWC). Lecturer, Department of Orthodontics and Paediatric Dentistry, University of the Western Cape, Tygerberg, Cape Town
^IIBChD (UWC), MChD (OralMedPerio) (UWC). Consultant, Department of Oral Medicine and Periodontics, University of the Western Cape, Tygerberg, Cape Town

Correspondence

 

 

INTRODUCTION

The Constitution of the Republic of South Africa dictates that: "every person has the right to a working environment that is not harmful to their health nor well-being".¹ The practitioner and/or health care facility as the employer should ensure a safe working environment as far as reasonably possible for all employees, as well as individuals attending the facility.^{2, 3}

The Centres for Disease Control in the United States of America has a comprehensive document that outlines every aspect of infection prevention in the dental setting.^{4, 5}

Oral Health Care Workers (OHCW) refers to any individual in the dental practice that is directly or indirectly involved in the processing and use of instrumentation and medical waste (Table 1).⁵ All OHCW should comply with HPCSA booklet 16: Guidelines for the Management of Health Care Waste.⁶ The integration of infection prevention strategies requires the OHCW to understand and apply the basic principles of infection control and to comply with the standard infection control precautions. All OHCW carry the responsibility to ensure the correct segregation, handling and disposal of hazardous waste in the dental practice setting.

 

 

WASTE MANAGEMENT

The Health Professions Council of South Africa (HPCSA) guidelines on waste management is set out in the booklet 16 section 6. This section states that: "It is the responsibility of all health care practitioners to have a health care waste management system in place or to have access to such a system. Such a system should be provided by an accredited waste service provider and be conducted in accordance with the relevant SABS code". The relevant SABS codes that serve as the basis for the HPCSA booklet 16 can be obtained from the SABS.^7,9

The HPCSA and the SABS regulations state that it is the responsibility of the practitioner to ensure that an accredited health care waste management company is utilised by their practice. Every practice need to provide evidence of compliance in terms of an acceptable waste management protocol and of effective record keeping thereof.^6,10

Designated departments in each province monitor the production of health care waste. Registration is required by each practice with this regulatory department. The registered health care waste service provider can assist you with the local or national government regulations applicable to your practice.^11,12

All bio-hazard containers should be in use for a maximum of 14 days and the contents should not exceed the prescribed weight of the container. Sharps containers may be filled to below the marked fill line and retained for a maximum of 90 days before removal by the registered medical waste service provider.

The collection records of all bio-hazard and the sharps containers should be retained for at least five years. These records should also reflect the weight of the monthly mass of the total health care risk waste generated and/or disposed of by the practice.

 

CONCLUSION

The production and management of health care waste is monitored by local provincial governments. The HPCSA expects compliance with the published SABS guidelines from all OHCW.

It is the responsibility of every OHCW to ensure a safe environment for staff, clients and the general public, by disposing of health care medical waste in accordance with the prescribed regulations.

 

ACRONYMS:

CDC: The Centres for Disease Control in the United States of America

OHCW: Oral Health Care Workers

HPCSA: Health Professions Council of South Africa

SABS: South African Bureau of Standards

 

References

1. Republic of South African Government. No. 108 of 1996: Constitution of the Republic of South Africa, No. 108 of 1996. Pretoria: Government Printer, 1996.         [ Links ]

2. Republic of South Africa. No. 85 of 1993: Occupational Health and Safety Act as amended by Occupational Health and Safety Amendment Act, No. 181 of 1993.         [ Links ]

3. Republic of South Africa Parliament. No61 of 2003: The National Health Act, No 61 of 2003. Vol. 469, 23 July 2004 No. 26595. Accessed on 14 March 2017: http://www.gov.za/sites/www.gov.za/files/a61-03.pdf        [ Links ]

4. Centers for Disease Control and Prevention. Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Oral Health; March 2016. Accessed 14 March 2017. https://www.cdc.gov/oralhealth/infectioncontrol/pdf/safe-care.pdf        [ Links ]

5. Centers for Disease Control and Prevention. Guidelines for Infection control in dental health-care settings. MMWR Recomm Rep 2003; 52(RR-17):1 - 61. Available at: www.cdc.gov/mmwr/PDF/rr/rr5217.pdf.         [ Links ]

6. Health Professions Council of South Africa. Guidelines for Good Practice in the Health Care Professions. Guidelines forthe Management of Health Care Waste. Government Gazette R717/2006 Booklet 16. Pretoria, May 2008. Accessed on 14 March 2017: http://www.hpcsa.co.za/conduct/Ethics        [ Links ]

7. South African Bureau of Standards. Part 1, SANS 10248-1:2008 (ED. 1.00) Accessed on 14 March 2017: http://store.sabs.co.za/catalog/product/view/id/219440/s/sans-10248-1 -2008-ed-1 -00/        [ Links ]

8. South African Bureau of Standards. Part 2, SANS 10248-2:2009 (ED. 1.00) Accessed on 14 March 2017: http://store.sabs.co.za/catalog/product/view/id/219443/s/sans-10248-2-2009-ed-1 -00/        [ Links ]

9. South African Bureau of Standards. Part 3, SANS 10248-3:2011 (ED. 1.00) Accessed on 14 March 2017: http://store.sabs.co.za/catalog/product/view/id/219446/s/sans-10248-3-2011 -ed-1 -00/        [ Links ]

10. Republic of South Africa Government Notice 452: Draft Health Care Risk Waste Management Regulations. Government Notice 452, Government Gazette No. 35405, 1 June 2012.         [ Links ]

11. Gauteng Local Government : Registration as a health care waste producer. Accessed on 14 March 2017: http://www.gwls.gpg.gov.za/pages/display/register/how        [ Links ]

12. Western Cape Local Government: Registration as a health care waste producer. Accessed on 14 March 2017: http://ipwis.pgwc.gov.za/ipwis3/public        [ Links ]

 

 

Correspondence:
R Mulder
Faculty of Dentistry, University of the Western Cape
Department of Orthodontics and Paediatric Dentistry
Private Bag X1, Tygerberg 7505
E-mail: rmulder@uwc.ac.za