Health-Care Waste Management and It’s SOP

Health care waste: includes all the waste that is generated or product as a result
any of the following activities,

 Diagnosis, treatment, or immunization of human beings or animals

 Research pertaining to the above activities
 Production or testing of biologicals and
 Waste originating from minor or scattered sources.

According to WHO,

Of the total amount of waste generated by health-care activities, about 85% is

general, non-hazardous waste.
The remaining 15% is considered hazardous material that may be infectious,
toxic or radioactive.
Every year an estimated 16 billion injections are administered worldwide, but
not all of the needles and syringes are properly disposed of afterwards.
Open burning and incineration of health care wastes can, under some
circumstances, result in the emission of dioxins, furans, and particulate
matter.
Measures to ensure the safe and environmentally sound management of
health and environmental impacts from such waste including the unintended
release of chemical or biological hazards, including drug resistant
microorganisms, into the environment thus protection the health of patients,
health workers, and the general public.

Types of waste

1. Infectious waste: waste contaminated with blood and other bodily fluids,
cultures and stocks of infectious agents from laboratory work, or waste from
patients with infections.
2. Pathological waste: human tissues, organs or fluids, body parts and
contaminated animal carcasses.
3. Sharps waste: syringes, needles, disposable scalpels and blades, etc.
4. Chemical waste: solvents and reagents used for laboratory preparations,
disinfectants, sterilants and heavy metal contained in medical devices and
batteries.
 5. Pharmaceutical waste: expired, unused and contaminated drugs and
vaccines.
6. Cytotoxic waste: waste containing substances with genotoxic properties,
such as cytotoxic drugs used in cancer treatment and their metabolites.
7. Radioactive waste: products contaminated by radionuclides including
radioactive diagnostic material or radiotherapeutic materials
8. Non-hazardous or general waste: waste that does not pose any particular
biological, chemical, radioactive or physical hazards, such as petri dishes, test
tubes, forceps, pipettes, gloves, lab coats, kitchen waste, bottle, paper,
pesticide container, etc.

The major sources of health-care waste are:

 The hospitals and other health facilities

 Laboratories and research centers
 Mortuary and autopsy centres
 Animal research and testing laboratories
 Blood banks and collection services
 Nursing homes for the elderly etc.

Segregation Guidelines

Yellow: Human tissues, organs, body parts, items contaminated by blood/body

fluids, soiled cotton and dressing, soiled plaster casts, discarded medicines,
discarded medicines, discarded cytotoxic drugs

Red: Catheters, tubings, cannulae, syringes, used gloves, infected plastics,

specimen containers, lab waste, microbiology cultures, used or discarded bags of
blood, vaccines

Blue: Glass items, needles, syringes, scalpels, blades, used and unused sharps

Black: Radioactive and chemotherapy wastage

Green: General waste, non-infected plastic materials and papers, disposables,
cardboards, metal containers, office waste and food waste.

Waste Segregation and Packaging

 The key to minimization and effective management of health-care waste is

segregation and identification of the waste.
 The most appropriate way of identifying the categories of health-care waste is
by sorting the waste into colour-coded plastic bags or containers.
 General health-care waste should join the stream of domestic refuse for
disposal.
 Sharps should all be collected together, regardless of whether or not they are
contaminated. Containers should be puncture-proof and fitted with covers.
They should be rigid and impermeable so that they safely retain not only the
sharps but also any residual liquids from syringes. To discourage abuse,
containers are unavailable or too costly, containers made of dense cardboard
are recommended (WHO, 1997); these fold for ease of transport and may be
supplied with a plastic lining.
 Bags and containers for infectious waste should be marked with the
international infectious substance symbols.
 Highly infectious waste should, whenever possible, be sterilized immediately
by autoclaving. It therefore needs to be packaged in bags that are compatible
with the proposed treatment process: red bags, suitable for autoclaving, are
recommended.
 Cytotoxic waste, most of which is produced in major hospital or research
facilities, should be collected in strong, leak-proof containers clearly labeled
“Cytotoxic wastes”.
 Small amounts of chemical or pharmaceutical waste may be collected
together with infectious waste.
 Large quantities of obsolete or expired pharmaceuticals stored in hospital
wards or departments should be returned to the pharmacy for disposal.
 Large quantities of chemical waste should be packed in chemical resistant
containers and sent to specialized treatment facilities. The identity of the
 chemicals should be clearly marked on the containers: hazardous chemical
wastes of different types should never be mixed.
 Waste with a high content of heavy metals should be collected separately.
 Aerosol containers may be collected with general health-care waste once they
are completely empty, provided that the waste is not destined for incineration.
 Low-level radioactive infectious waste may be collected in yellow bags or
containers for infectious waste if these are destined for incineration.b

Safe management of wastes from health-care activities

Collection

Wastes should not be allowed to accumulate at the point of production. A routine

programme for their collection should be established as part of the health-care waste
management plan.

Certain recommendation should be followed by the ancillary workers in charge of

waste collection;

 Wastes should be collected daily and transported to the designated central

storage site.
 No bags should be removed unless they are labeled with their point of
production and contents
 The bags or containers should be replaced immediately with new ones of the
same types.

A supply of fresh collection bags or containers should be readily available at all

locations where waste is produced.

Storage

A storage location for health-care waste should be designated inside the health-care
establishment or research facility.

The waste in bags or container, should be stored in a separate area, room, or

building of a size appropriate to the quantities of waste produced and the frequency
of collection.
Cytotoxic waste should be stored separately from other health-care waste in a
designated secure locatopm.

Radioactive waste should be stored in containers that prevent dispersion, behind

lead shielding. Waste that is to be stored during radioactive decay should be labelled
with the type of radionuclide, the date, and details of required storage condition.

On-site transport

Health-care waste should be transported within the hospital or other facility by

means of wheeled trolleys, containers, or carts that are not used for any other
purpose and meet the following specifications:

 Easy to load and unload

 No sharp edges that could damage waste bags or containers during loading
and unloading
 Easy to clean

The vehicles should be cleaned and disinfected daily with an appropriate

disinfectant.

Off-site transportation of waste

1.Regulation and control system

The health-care waste producer is responsible for sage packaging and adequate
labeling of waste to be transported off-site and for authorization of its destination.

2.Special packaging requirements for off-site transport

The waste should be packaged in sealed bags or containers, to prevent spilling

during handling and transportation. The bags or containers should be appropriately
robust for their content and for normal conditions of handling and transportation,
such as vibration or changes in temperature, humidity or atmospheric pressure.

3.Labeling
All waste bags or containers should be labeled with basic information on their
content and on the waste producer. This information may be written directly on the
bag or container or on preprinted labels, securely attached.

4.Preparation for transportation

Before transportation of the waste, dispatch documents should be completed, all

arrangements should be made between consignor, carrier, and consignee, and in
case of exportation, the consignee should have confirmed with the relevant
competent authorities that the waste can be legally imported and that no delays will
be incurred in the delivery of the consignment to its destination.

5.Transportation vehicles or containers

 Waste bags may be placed directly into the transportation vehicle, but it is
safer to place them in further containers. This has the advantage of reducing
the handling of filled waste bags but results in higher disposal costs. These
secondary containers should be placed close to the waste source.
 Any vehicle used to transport health-care waste should fulfill the following
design criteria:
 The body of the vehicles should be of a suitable size commensurate with the
design of the vehicle
 There should be a bulkhead between the driver’s cabin and the vehicle body,
which is designed to retain the load if the vehicle is involved in a collision
 There should be a suitable system for securing the load during transport
 Empty plastic bags, suitable protection clothing, cleaning equipment, tools,
and disinfectant, together with special kits for dealing with liquid spills, should
be carried in a separate compartment in the vehicle\
 The internal finish of the vehicle should allow it to be steam-cleaned, and the
internal angles should be rounded.
 The vehicle should be marked with the name and address of the waste
carrier.
 The international hazard sign should be displayed on the vehicle or container,
as well as an emergency telephone number.
 Vehicles or containers used for the transportation of health-care waste should
not be used for the transportation of any other material.
6.Routing

 Health-care waste should be transported by the quickest possible route, which

should be planned before the journey begins.
 After departure from the waste production point, every effort should be made
to avoid further handling.
 If handing cannot be avoided, it should be pre-arranged and take place in
adequately designed and authorized premises.
 Handling requirements can be specified in the contract established between
the waste producer and the carrier.

Health Care Waste Minimization

Health care waste minimization is centered on the elimination or reduction of the

health care waste stream. These are several measures that can be instituted to
achieve waste minimization including the following;

1) Reduction at source

Some reduction involves measures that either completely eliminate use of a material
or generate less waste. Example, improving housekeeping practices to eliminate use
of chemical air fresheners, etc.

2) Re-use

Reuse is not only finding another use for a product but, more importantly, reusing
product over and over again for a given function as intended.

3) Recycling

Recycling is collecting waste and processing it into something new. Many items in
the hospital can be recycled. Items such as organic, plastic, paper, glass and metal
can be recycled easily.

4) Segregation of Waste

Segregation makes it easier to conduct assessments of the quality and composition

of different waste streams thereby allowing heath care facilities to obtain baseline
data, identify options, determine waste management costs, and assess the
effectiveness of waste minimization stratagies.
 5) Compacting

Composting is another important strategy to minimize waste such as food discards,

kitchen waste, cardboard, and yard waste. The resulting rich compost can be sold or
donated to local farmers and gardeners or used for plants around the health care
facility grounds.
 YANGON TECHNOLOGICAL UNIVERSITY

CIVIL ENGINEERING DEPARTMENT

DIPLOMA IN TRANSPORTATION ENGINEERING

Environmental Impact Assessement

Healthcare Waste Management and It’s SOP

Assignment

Written by,

Emmanuel

Dip. CTE-2