HEALTHCARE HYGIENE
WASTE DISPOSAL NEEDN’T BE LIKE PULLING TEETH
David O’Gorman, Health, Safety and Environment Manager at Cannon Hygiene UK, discusses the implications of incorrect waste separation in the dental sector and the areas that cause most confusion.
All healthcare-related workplaces are required to adhere to the strict procedures set out by the Health and Safety Executive (HSE). These identify a code of conduct for the healthcare sector that ranges from best practice patient safety to the correct disposal of medical waste.
Safe waste disposal is very important. Not only is it a regulatory matter, where fines can be imposed for improper separation of waste, it has a significant impact on the environment in the long-term and can affect the safety of those collecting waste.
As producers of hazardous waste, dental practices need to follow the correct protocols to ensure it is segregated and disposed of correctly by every member of staff in the practice.
RESPONSIBILITY Because of the nature of their waste, dental practices are legally required to use a specialist waste management company to collect and ensure correct disposal of it.
This also means dental practices have a responsibility to provide accurate information about all clinical waste in a ‘pre-acceptance audit’ before it can be taken away. These documents specify quantity, how it is packed and the substances to ensure that the correct disposal method is used.
By analysing these documents’ contents we have identified there are sometimes gaps in knowledge when it comes to separating certain waste – leading to significant consequences and fines.
SPECIALIST WASTE DISPOSAL One area where there’s confusion is the disposal of gypsum. As a non-toxic,
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non-infectious material used to create moulds of patients’ mouths, many may assume that this can be safely disposed of via a normal landfill method.
However, the material’s composition means it reacts with other landfill waste and produces hydrogen sulphide, a toxic gas that poses significant health and safety risks as well as being bad for the environment.
Given it’s prevalence in dentistry, it’s crucial that all dentists separate this from normal waste and either recycle via a specialist or use a robust container that prevents contact with other waste.
Like gypsum, controlled drugs also need to be disposed of in a specific way. For example, midazolam, which is used for anaesthesia, legally must be rendered irretrievable before disposal.
One way of doing so is by using a denaturing kit. Our kit, which is fully compliant with all current legislation, makes midazolam inaccessible once used by sealing the drug in a solid resin.
SHARPS Colour-coding guidelines suggested by the Government’s Health Technical Memorandum (HTM 07-01) help differentiate between sharps and how they should be separated.
However, when it comes to needles we find that some dentists will use an orange-lidded container as a default to dispose of these. These are only suitable for sharps that don’t contain any traces of medicine.
Any needles that have been used to administer non-hazardous (non- cytostatic and non-cytotoxic) medicines should be placed into separate yellow
lidded containers, while cytostatic and cytotoxic medicines must be placed in purple-lidded containers.
This is crucial as contents of yellow containers should be incinerated, whereas orange lidded containers may go for alternative treatment. Incorrect separation means the medicinal residue left behind may not be treated or destroyed properly.
Conversely if practices are overly cautious and dispose of needles using purple bins when they could go in yellow or orange containers, this will add unnecessary costs to their disposal programme.
GETTING IT RIGHT The key for dental practices is to educate staff about the issues that poor waste management can cause. With a whole host of reasons to separate waste correctly, it’s in the interest of the practice to encourage staff to follow national guidelines.
We work with a number of dental practices and offer recommendations on how clinical waste should be handled, transported and disposed. Those that do this correctly ensure that they are complying with national best practice regulation and aren’t unnecessarily damaging the environment.
This really makes sense for practices given the significant fines that can be imposed for regularly getting it wrong. Why increase your financial burden over something as simple as putting a needle in the correct container.
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Tomorrow’s Cleaning April 2016 | 63
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