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Procedure for the Disposal of Clinical Waste
Introduction This document describes the procedure to be followed when any Department at the Royal Veterinary College wishes to dispose of Clinical Waste. The document also gives some guidance on the safe handling and storage of Clinical Waste. Departments must carry out the necessary risk assessments, etc., required by the Control of Substances Hazardous to Health (COSHH) Regulations, as Clinical Waste falls within the scope of these regulations. The Law The Environmental Protection Act imposes a duty of care for waste management which means that waste producers, and all those along the waste chain, have a duty, under the Environmental Protection (Duty of Care) Regulations 1991, to prevent anyone from dealing with their waste illegally; to prevent the escape of waste; to ensure waste is only transferred to an authorised person; and to ensure an accurate description of waste is provided when the waste is transferred and a transfer note is completed. Under the Control of Pollution (Amendment) Act 1989, waste may only be transported by a registered waste carrier. In order to comply with the "duty of care", waste producers should check the carrier's certificate of registration before handing over the waste. Definition of Clinical Waste Clinical Waste is defined in the Controlled Waste Regulations (1992) as: “A. Any waste which consists wholly or partly of human or animal tissue, blood or any other body fluids, excretions, drugs or other pharmaceutical products, swabs or dressings, or syringes, needles or other sharp instruments, being waste which unless rendered safe may prove hazardous to any person coming into contact with it; B. and any other waste arising from medical, nursing, dental, veterinary, pharmaceutical or similar practice, investigation, treatment, care, teaching or research, or the collection of blood for transfusion, being waste which may cause infection to any person coming into contact with it”. This allows for certain types of Clinical Waste to be excluded from this definition provided that it has been made safe, for example by disinfection or autoclaving. However, some wastes cannot easily be rendered safe, or will cause alarm or distress to anyone handling or finding them. It is therefore College policy to treat all Clinical Waste as such, whether it has been rendered safe or not and, with the exception of carcasses suitable for knackers and macerated carcasses, to send all such waste for incineration. Categories of Clinical Waste and its disposal Table 1 lists types of Clinical Waste produced at The Royal Veterinary College and indicates which containers should be used for its disposal. Groups A, B, C, D and E are taken from the Health and Safety Commission's guidance produced by the Health Services Advisory Committee entitled "Safe Disposal of Clinical Waste" (see ref. 1). It categorises Clinical Waste according to its potential risk to health and safety. Groups A, B and C offer the highest risks. Group C can be regarded as the most hazardous because, it includes cultures containing large numbers of pathogenic micro-organisms, while Group E is the lowest, although this waste may be more visually offensive than the others. Perceived Clinical Waste and Bedding from Animal Cages are categories not embraced by the definition of Clinical Waste. However, for the purposes of this document they may be treated as Clinical Waste.
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. pets for owner to collect • large animal carcasses/tissues potentially pathological • all human tissues including blood • waste materials where assessment indicates a risk to staff handling them. Sulo bin or Hopper knackers. scalpels and blades.0 Page 2 of 6 Estates .g. Group B • scalpel blades. e. faeces • other bodily secretions and other potentially infected waste eg hazardous and infected bedding Perceived Clinical Waste • needles. non-hazardous waste • infected waste • hazardous and/or infected waste Disposal via macerator yellow/red stripe bag . bag just head of big carcass. from infectious disease cases • swabs and dressings • glass and plastic blood tubes etc. used in non-clinical activities • plastic pipettes etc. items capable of puncturing bag • other objects normally associated with clinical work Bedding from Animal Cages (BSU) • non-infected.The Royal Veterinary College Table 1 Disposal and Containment of Clinical Waste Waste Group A • small animal carcasses/tissues • small animal carcasses/tissues • non-pathological animal carcasses from (Mill Reef) • carcass for individual cremation • carcass. autoclave and skip or yellow bag yellow bag Keep separate from all other waste Route of disposal depends on risk assessment Reviewed October 2008 Version 2. label body well (cold room if not picked up quickly within 2 hours) yellow/green stripe bag in cold room black bag CLEARLY LABELLED in cold room yellow/red stripe bag for carcass bits. in cold room yellow bag yellow bag Notes Keep separate from all other waste Waste assessed as infectious or hazardous should be double bagged or autoclaved prior to disposal depending on risk assessment yellow bag special waste drum sharps container sharps container sharps container yellow bag Keep separate from all other waste Keep separate from all other waste Autoclave prior to disposal Autoclave prior to disposal Keep separate from all other waste special waste drum yellow bag sharps container yellow bag after boxing or wrapping in newspaper yellow bag Keep separate from all other waste skip autoclave bag.to cold room to freezer. needles • small items of broken glass • other sharp instruments Group C • microbiological cultures and potentially infected waste pathological to humans • viable genetically modified organisms Group D • pharmaceutical waste Group E • items used to dispose of urine.
To Be Incinerated". Plastic pipettes should be placed in a cardboard box and sealed. At the bench. not mixed with other waste. There should be a space for sticking labels and written information. Clinical Waste Bags Clinical Waste bags should conform to EU standards.). bagged then initialled by the producer before being placed in a yellow bag with other laboratory clinical waste. yellow drums are used for the disposal of special wastes such as contaminated glass (blood tubes etc. Sharps containers should be placed in yellow bags. A spring balance should be available for weighing them. The weight should not exceed 4Kg when full. Containment All Clinical Waste containers should be capable of containing the waste without spillage or puncture. rigid. Personalised selfadhesive bar code labels (supplied by CPC). They should be puncture resistant. Sharps containers should be sealed when three-quarters full.The Royal Veterinary College 1. Bags should be covered when not in use. e. and name and telephone number of destination. laboratory chemicals. pharmaceuticals in bottles. with department and address of waste producer. Sharps containers should be clearly marked with the place and date of origin.0 Page 3 of 6 Estates . Reviewed October 2008 Version 2. they should carry the code UN3291. Filled bags should be sealed at the neck with a cable tie. especially during transport and handling. The bags should be opaque yellow and clearly marked with the words "Clinical Waste . laboratory waste should be accumulated in autoclave bags. must be affixed to every clinical waste bag. and when full. Sharps Containers Sharps containers should conform to BS 7320. Tube and bottle lids should be well secured to avoid leakage. The containers should be coloured yellow and clearly marked with the words "Danger Contaminated Sharps . Before commencing any work do a COSHH risk assessment. or wrapped in newspaper and taped up. They should be changed when they are three quarters full. Bags should be fitted to bag holders or in a rigid bin at the place of origin. d. f. and the bags should not exceed 4Kg when full. also written on the bag must be the disposal date and name of the user group. Clinical Waste should never be placed in black refuse bags and clinical waste bags should not be used for any other purpose. tied off and initialled by the producer. which will act as a point of reference should there be an accident or incident in the process of disposal.For Incineration Only". and ensure you are familiar with local rule and operating procedures b. and depict the biohazard sign. so that the source can be traced in the event of a subsequent accident or incident. Plastic clinical waste which is capable of puncturing the bag must be packaged to make it safe. Special Waste Drums Single-use. a. contamination and infection. Opaque yellow with red stripe bags should be used for disposing of carcass or meat waste. autoclaved if necessary. leak proof and capable of being handled and moved whilst in use with minimal danger of the contents spilling or falling out. before placing in a yellow bag. c.
Reviewed October 2008 Version 2.The Royal Veterinary College When full the drum lids should be pressed on tightly and the drum collected for incineration.0 Page 4 of 6 Estates .
DO NOT HANDLE CLINICAL SHARPS f. Sharps in containers must not be pressed down to create room for more. Spillage Procedure a. This could cause bags to split or burst. disposable protective clothing. sharps container. in the case of sharps. spare bags. The waste should not be allowed to accumulate in unsuitable places such as corridors. Obtain spillage kit c. Spilled sharps should not be handled directly. Put on disposable apron and gloves d. They supply lockable Sulo bins and hoppers. Handling Clinical Waste bags should be handled with care and by the neck only. Waste animal carcasses that cannot be disposed of immediately should be placed in a labelled yellow/red stripe bag and stored in a suitable freezer or cold room awaiting collection. Clinical Waste should be removed from its place of origin for storage prior to collection. exposing handlers to contaminated waste. then it should be removed to storage as soon as possible. Wash hands thoroughly Reviewed October 2008 Version 2.0 Page 5 of 6 Estates . Accidents and Spillages Areas should be washed down and disinfected immediately in the event of accidental spillage. rodents and insects. disposable scoop and spatula should be readily available. Warn people nearby to avoid contact b. Slide a new yellow bag over the burst bag e. birds. latex gloves. and equipment into the yellow bag and tie securely h. Storage areas for Clinical Waste should be designated by the Department. and can supply bags and rigid bins. domestic animals. disinfectant. Spillage kits comprising of disposable apron. They should be sited away from areas where food is prepared and general storage areas.The Royal Veterinary College Storage Registered contractors are employed to remove and incinerate carcasses and clinical waste from the college. accidents and incidents. into a new container. Bags should never be thrown or dropped. If waste is likely to present a risk due to its infectious or hazardous nature or become offensive. Thoroughly clean and wipe the area with disinfectant g. Departments should nominate a responsible person from each laboratory to carry out this task. Place all used paper. Ensure sharps containers are fastened i. Using the scoop and spatula shovel spilled waste into the new bag or. They should be capable of keeping Clinical Waste dry and secure from unauthorised persons. Departmental procedures should give clear local guidance for dealing with spillages.
by Departmental Administrators or their delegates. ISBN 011886355X Reviewed October 2008 Version 2. Transfer notes must be retained for two years after the date of transfer.The Royal Veterinary College Training All staff and students who are required to handle or move Clinical Waste should receive appropriate training which has been organised by the Department. Health Services Advisory Committee. incidents and spillages. and costs of transport and incineration services are charged to individual research groups/departments. Costs All the cost of bags. Transfer notes form part of the compliance procedure with the 'duty of care' as required by the Environmental Protection Act 1990. bins and bag holders.Safe Disposal of Clinical Waste. if required. Documentation All transfer notes describing the type and quantity of waste being transferred to the waste carrier are processed and retained by Departmental Administrators or their delegates. The training should include local arrangements for implementing the procedures outlined in this document. HMSO. Collection Clinical Waste will be collected from The Royal Veterinary College on a weekly basis by Cambridge Pet Crematorium or other approved and registered contractor. REFERENCES 1. sharps containers. Training should also be given on what action to take in the event of accidents.0 Page 6 of 6 Estates . Additional collections may be arranged.