Circular No. 31/2013/TT-BYT on environmental impact monitoring from hospital medical examination and treatment activities

CIRCULAR

Provisions on environmental monitoring from hospital medical examination and treatment activities

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The Prime Minister issues this Decision amending and supplementing certain provisions of the Regulation on Response Activities to Oil Spill Incidents issued together with Decision No. 02/2013/QĐ-TTg dated January 14, 2013 of the Prime Minister.

This Circular prescribes procedures for receiving, providing health care for domestic violence victims and statistical reports on domestic violence victims at medical facilities.

At the proposal of the Director of the Medical Environment Management Department;

The Minister of Health issues the Circular stipulating provisions on environmental monitoring from hospital medical examination and treatment activities,

PART I

GENERAL PROVISIONS

Article 1. Scope of Regulation

This Circular stipulates the contents, parameters, locations, methods, frequency, and reporting of results of environmental monitoring from hospital medical examination and treatment activities and district, urban district, town, and provincial city health centers with hospital beds (hereinafter referred to as hospitals).

Article 2. Interpretation of Terms

In this Circular, the following terms are understood as follows:

1. Environmental monitoring from hospital medical examination and treatment activities is a systematic activity for observing the quantity, composition, and level of harm of solid medical waste, emissions from incineration of solid medical waste, and medical wastewater at hospitals (hereinafter referred to as hospital environmental monitoring).

2. Hospital ambient air monitoring is the activity of monitoring ambient air outside departments and rooms but within the hospital premises.

Chapter II

CONTENTS, PARAMETERS, LOCATIONS AND METHODS OF MONITORING

Article 3. Monitoring of Solid Medical Waste

1. Monitoring contents:

a) Emission sources: Names and quantities of emission sources;

b) Composition (monitoring parameters):

- General waste;

- Hazardous medical waste including: Infectious waste, hazardous chemical waste, radioactive waste;

c) Quantity:

- Average daily amount of generated solid medical waste (kg/day);

- Total amount of generated solid medical waste during the reporting period (kg);

- Total amount of generated solid medical waste during the reporting period according to each type of waste as specified in Point b Clause 1 of this Article;

d) Methods of implementing classification, collection, transportation, storage, recycling, and disposal of solid medical waste.

2. Monitoring locations:

a) Departments and rooms of the hospital;

b) Centralized storage areas for solid medical waste of departments and rooms, hospital;

c) Areas for processing and disposing of solid medical waste of the hospital.

Article 4. Monitoring of Medical Wastewater

1. Monitoring contents:

a) Emission sources: Names and quantities of emission sources;

b) Composition (monitoring parameters):

Parameters for monitoring medical wastewater shall comply with the National Technical Regulation on Medical Wastewater QCVN 28:2010/BTNMT;

c) Quantity:

- Average daily and nightly volume of medical wastewater generated (m³/day, night);

- Total volume of medical wastewater generated during the reporting period (m³);

d) Methods of implementing collection and treatment of medical wastewater.

2. Monitoring locations:

a) Centralized collection area for medical wastewater before treatment;

b) Discharge outlet for treated medical wastewater.

Article 5. Monitoring of Emissions from Incineration of Solid Medical Waste

1. Monitoring contents:

a) Emission sources: Names and quantities of emission sources;

b) Composition (monitoring parameters):

Parameters for monitoring emissions from incineration of solid medical waste shall comply with the National Technical Regulation on Incineration of Solid Medical Waste QCVN 02:2012/BTNMT;

c) Methods of implementing treatment of emissions from incineration of solid medical waste.

2. Monitoring location: Incinerator for solid medical waste.

Article 6. Ambient Air Monitoring

1. Composition (monitoring parameters):

a) Basic parameters: Sulfur dioxide (SO₂), carbon monoxide (CO), nitrogen dioxide (NO₂);

b) Harmful substances: Hydrocarbons (C_{For power plants invested under the Build-Operate-Transfer (BOT) model, n is determined according to the operational period of the power plant stipulated in the BOT contract.}H_{t s}), ammonia (NH₃), formaldehyde (HCHO).

2. Monitoring locations:

a) Center of the hospital;

b) Main entrance of the hospital;

c) Starting and ending points of the main wind direction: At positions adjacent inside the hospital fence and along a straight line through the center of the hospital or equivalent point.

d) Starting and ending points perpendicular to the main wind direction: At positions adjacent inside the hospital fence and along a straight line through the center of the hospital or equivalent point.

đ) Surrounding areas of waste storage and treatment sites.

Article 7. Monitoring Methods

1. Medical solid waste:

a) Monitoring methods: Direct observation; weighing and measuring quantities; collecting data from relevant ledgers, certificates, inspection sheets, questionnaires;

b) Method for evaluating monitoring results on medical solid waste: Based on regulations on classification, collection, transportation, and treatment of medical solid waste as stipulated in the Medical Waste Management Regulation issued with Decision No. 43/2007/QĐ-BYT dated November 30, 2007 of the Minister of Health and Circular No. 12/2011/TT-BTNMT dated April 14, 2011 of the Ministry of Natural Resources and Environment on hazardous waste management.

2. Medical wastewater, emissions from medical solid waste incinerators, ambient air:

a) Method for determining values of pollution parameters and maximum allowable values of pollution parameters in medical wastewater according to QCVN 28:2010/BTNMT - National Technical Regulation on Medical Wastewater;

b) Method for determining values of pollution parameters and maximum allowable values of pollution parameters in emissions from medical solid waste incinerators according to QCVN 02:2012/BTNMT - National Technical Regulation on Medical Solid Waste Incinerators;

c) Method for determining values of air quality parameters and limits of basic parameters in ambient air according to QCVN 05:2009/BTNMT - National Technical Regulation on Ambient Air Quality;

d) Method for determining values of air quality parameters and maximum allowable concentrations of certain harmful substances in ambient air according to QCVN 06:2009/BTNMT - National Technical Regulation on Certain Harmful Substances in Ambient Air.

Chapter III

FREQUENCY AND REPORTING OF MONITORING RESULTS

Article 8. Frequency of Monitoring

1. Monitoring of medical solid waste, medical wastewater, emissions from medical solid waste incinerators: To be conducted quarterly once every three months.

2. Monitoring of ambient air: To be conducted semi-annually once every six months.

Article 9. Reporting System

1. Reporting Forms:

a) Hospitals report monitoring results of hospital environment according to the form prescribed in Appendix 1 issued together with this Circular;

b) Provincial Departments of Health (hereinafter referred to as "province") compile reports on monitoring results of hospitals' environmental conditions within their jurisdiction according to the form prescribed in Appendix 2 issued together with this Circular;

c) Central agencies under Ministries and sectors compile reports on monitoring results of hospitals under their management according to the form prescribed in Appendix 3 issued together with this Circular.

2. Reporting procedures and timeframes:

a) Hospitals submit Report No. 1 before July 10 of the year of implementation and Report No. 2 before January 10 of the following year as follows:

- State-owned hospitals under the management authority of the Provincial Department of Health, and private hospitals located within the province submit reports on hospital environmental monitoring results to the Provincial Department of Health;

- Hospitals directly under the Ministry of Health submit reports on hospital environmental monitoring results to the Health Environment Management Agency, Ministry of Health;

- Hospitals directly under Ministries and sectors submit reports on hospital environmental monitoring results to the central agency under the respective Ministry or sector managing them;

b) Provincial Departments of Health and central agencies under Ministries and sectors submit consolidated reports on hospital environmental monitoring results, Report No. 1 before July 20 of the year of implementation and Report No. 2 before January 20 of the following year to the Health Environment Management Agency, Ministry of Health.

Chapter IV

IMPLEMENTATION

Article 10. Responsibilities of the Health Environment Management Department

1. Directing, guiding, inspecting, summarizing, and evaluating the implementation of this Circular.

2. Compiling reports on the results of hospital environmental monitoring nationwide to report to the Ministry of Health leadership.

Article 11. Responsibilities of the Institute of Occupational Medicine and Environmental Hygiene, the National Institute of Hygiene and Epidemiology in Nha Trang, the Ho Chi Minh City Institute of Hygiene and Public Health, and the West Central Institute of Hygiene and Epidemiology

1. Cooperating to inspect hospital environmental monitoring activities at hospitals under the Ministry of Health and other hospitals upon request from competent authorities.

2. Conducting hospital environmental monitoring in accordance with Decree No. 27/2013/NĐ-CP dated March 29, 2013, of the Government stipulating conditions for organizations operating environmental monitoring services, or upon request from competent authorities.

Article 12. Responsibilities of the Department of Health

1. Managing, directing, guiding, and inspecting the implementation of hospital environmental monitoring work within the province.

2. Reporting compiled results of hospital environmental monitoring within the province in accordance with Article 9 of this Circular.

Article 13. Responsibilities of the health focal units of Ministries and sectors

1. Inspecting and supervising hospital environmental monitoring activities at hospitals managed by Ministries and sectors.

2. Reporting hospital environmental monitoring results in accordance with Article 9 of this Circular.

Article 14. Responsibilities of hospitals

1. Developing plans and organizing the implementation of hospital environmental monitoring in accordance with this Circular.

2. Reporting hospital environmental monitoring results in accordance with Article 9 of this Circular.

3. Implementing corrective measures when hospital environmental monitoring results do not meet requirements.

4. In addition to complying with reporting regulations for hospital environmental monitoring results stipulated in this Circular, hospitals must also implement regular environmental monitoring reporting systems as prescribed by current laws.

Chapter V

IMPLEMENTING PROVISIONS

Article 15. Reference Provisions

In cases where the referenced documents in this document are replaced or amended, implementation shall be in accordance with the replacement or amended document.

Article 16. Effective Date

This Circular takes effect from December 1, 2013.

Article 17. Responsibility for Implementation

The Health Environment Management Department is responsible for leading and coordinating with relevant units to organize guidance, direction, and inspection of the implementation of this Circular.

Any difficulties or obstacles encountered during implementation should be promptly reported to the Ministry of Health (Health Environment Management Department) for study and resolution./.