WASTE MANAGEMENT
Managing clinical waste safely and effectively
The NHS produces up to 600,000 tonnes of waste per annum – more than 1 per cent of all domestic UK waste. The management of this waste is an essential part of the healthcare system, and yet it’s an area we rarely hear about. So, what happens to all the waste? David Williams, head of Safety, Health, and Compliance at Stericycle, one of the UK’s leading providers of healthcare waste services, explains.
Healthcare waste management is a strictly regulated industry, and for good reason. When healthcare waste is not managed properly, the adverse outcomes can include sharps-inflicted injuries, exposure to toxic pharmaceutical products or radioactive substances, air pollution, and the uncontrolled release of drugs and drug-resistant microorganisms into the environment. The waste generated by healthcare facilities demands a complex set of waste streams. About 85 per cent of the waste generated by such settings is general, non-hazardous waste, and does not pose any particular biological, chemical, radioactive or physical hazard. Much of the remaining 15 per cent is considered to be hazardous.
Healthcare waste can be broken down into these categories:
n Infectious clinical waste This waste is contaminated with potentially infectious blood and other bodily fluids (e.g. from discarded diagnostic samples), cultures, and stocks of infectious agents from laboratory work (e.g. waste from autopsies), or waste from patients with infections (e.g. swabs, bandages, and disposable medical devices).
n Offensive waste
Waste that may contain bodily fluids, and may be unpleasant to anyone who comes into contact with it, but is non-infectious, and doesn’t contain pharmaceutical or chemical substances.
n Anatomical waste
This is human tissues, organs, or fluids, and body parts.
n Sharps waste
Syringes, needles, disposable scalpels, and blades, which may be contaminated with blood or pharmaceutical products.
n Pharmaceutical waste
Expired, unused, and contaminated drugs and vaccines.
64 Health Estate Journal January 2019
The Bio Systems washing and disinfection line.
n Cytotoxic and cytostatic waste Waste containing substances with genotoxic properties (i.e. highly hazardous substances that are toxic, mutagenic, teratogenic, or carcinogenic), such as cytotoxic drugs used in cancer treatment and their metabolites.
n Chemical waste
Solvents and reagents used for laboratory preparations, disinfectants, sterilants, and heavy metals contained in medical devices (e.g. mercury in broken thermometers) and batteries.
n Radioactive waste
Products contaminated by radionuclides, including radioactive diagnostic material or radiotherapeutic materials.
Storage and transportation: the rules There are stringent processes covering every step of the waste management process. Healthcare organisations must
ensure that staff are trained in the handling and containment of all the clinical waste generated, and there are strict protocols around storage, transportation, and disposal. The onus is on the healthcare setting to ensure that the company providing the waste management service is meeting these requirements.
Different types of waste must be segregated, based on classification, at the point of production, and stored separately on site, even when they are destined for the same treatment site. It should be packaged for transportation according to the Carriage Regulations in UN-approved packaging, and marked with a UN number. Each type of waste is treated differently, so it is vital that every waste container is marked prior to
transportation to ensure that it enters the correct waste stream. At Stericycle, we also use tracking technology, which enables waste containers to be tagged
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