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Hospital Waste Management
Article in Indian Journal of Community Health · December 1999
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S Gopalakrishnan Roshini Murali
Sree Balaji Medical College and Hospital, BIHER University University of Central Lancashire
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Indian Journal of Community Health (ISSN-0971-7420): 4 (2) and 5(1) 91-94 (1998-1999)
Hospital Waste Management
[Link], [Link]
Introduction
Hospital waste management is a global problem of immediate concern, due to rapid increase in the
hospital acquired infection both by the general public as well as the health personnel. On an
average waste generated per day per bed works out to be about 1.5 to 2 kg. From this we can
imagine about the waste generated from the Government and Private Sector hospitals. Therefore,
the Hospital Waste Management assumes utmost importance in the present public health scenario,
where the emergence and re-emergence of the infectious diseases is a major public threat.
The wastes generated by the hospitals add to the community waste, thereby putting the load on the
already scarce resources. Most of the hospital generated waste is potentially infectious and
therefore, spreads infection amongst the community causing a major health problem.
Type of Hospital waste
The waste generated by the hospitals is of two types
1. High risk waste (which require special handling)
2. Non risk waste (general wastes)
1. The High Risk Waste
Chemical Wastes: This comprises of materials discarded from diagnostic and experimental
works, cleaning, housekeeping and disinfecting work.
Pathological Wastes: Consists of tissues, organic body parts and human foetuses, which
may be infectious.
Highly Infectious Wastes: Contain pathogens in sufficient quantity, so that exposure could
result in diseases. This category includes cultures and stocks of infectious agents from laboratory
work, wastes from surgery and autopsies of patients with infectious diseases, waste from
infectious patients in isolation wards, etc.
Sharps: Include needles, syringes, scalpels, blades, broken glasses, nails and any other
material which can cause puncture.
Pressurized Containers: Include those containers used for demonstration or
instrumental purposes containing innocuous or inert gas and aerosol cans which may
explode, if incinerated or accidentally punctured. Pressurized Containers: Include wastes
which arise during storage and spillage of solid drugs and chemicals which may be toxic or
contaminated.
[Link]. Assistant Professor, [Link]. Professor
Dept. of Community Medicine. Kilpauk Medical College. Chennai 10 Page 1
Indian Journal of Community Health (ISSN-0971-7420): 4 (2) and 5(1) 91-94 (1998-1999)
Laboratory Wastes: Include pharmaceutical products, drugs and chemicals that have
been returned from wards, outdated, contaminated or discarded for any other reason.
2. General wastes
General wastes includes domestic wastes, packing material, non-infectious bleeding from
animals, garbage from hospital kitchens and other waste materials that are not infectious or
hazardous to the human health or environment.
In view of the large number of government hospitals and the rapidly increasing number of nursing
homes and clinics in the private sector, in the urban as well as in the rural areas, proper training
and awareness is essential for the safe and efficient management of hospital wastes. It is highly
desirable that the wastes disposed should be free from disease organisms, the disposal system
should prevent re-entry of the disease organisms in the community, there should be no
contamination of the surface soil, water and a check on air pollution (including odours).
Getting rid of the hospital wastes in a proper manner plays a major role in prevention of
emergence and re-emergence of infectious diseases and also other nosocomial infectious and
iatrogenic infections.
Hospital Waste Disposal
The Hospital wastes must be collected and stored separately in containers of adequate capacity so
that there is no spillage during transport. The storage should preferably be in closed containers.
Wastes which contain lesser moisture or are mostly dry can be stored in paper or plastic bag. This
bag should be safely sealed after use. The material and thickness of the bag should not give in or
tear off during handling.
Wastes should be stored in plastic or metal containers fixed on a stand with a foot operated lid. It is
important to clean and wash the container thoroughly. Paper bags must not be recycled and should
be disposed of along with the contents. Organic wastes should be disposed on the same day to
avoid problems of odour, transfer of infections, etc.
Internal and external transfer of hospital wastes is an integral part of the waste management
system. Internally, it is usually transported from its initial storage point to an assembly area or on
site incinerator by means of trolley and hand carts. Such equipment should be cleaned regularly
and used only for waste transport. Transport vehicles should have an enclosed air tight body and
cleaned after use.
Hospital wastes should be disposed of by the authorities themselves, preferably on their own
premises. Even wastes not normally infectious such as used medicine bottles or syringes are likely
to be misused, if sold with the labels intact. Hence, these should be carefully destroyed. The
garbage fraction can go to the municipal waste disposal site but should be transported quickly and
carefully. The remaining waste must, as far as possible, be burnt in the incinerator.
[Link]. Assistant Professor, [Link]. Professor
Dept. of Community Medicine. Kilpauk Medical College. Chennai 10 Page 2
Indian Journal of Community Health (ISSN-0971-7420): 4 (2) and 5(1) 91-94 (1998-1999)
Incinerators: Used for hospital waste are of two types.
a) Natural draft incinerators
b) Forced draft incinerators.
The natural draft incinerators are operated in the range of 500 to 700 C and may be able to bum the
combustible wastes. However, pathological autopsy and surgery wastes require destruction at 700
to 900 C which can be better achieved in forced draft incinerators.
Recommendations
1. Identification of Infective Wastes
a. Microbiology laboratory wastes, blood and blood products, pathology waste and sharp
items (especially needles) should be considered as potentially infective and handled and
disposed of with special precautions.
b. Infective waste from patients on isolation precautions should be handled and disposed of
according to the Guideline for Isolation Precautions in Hospitals.
2. Handling, Transport and Storage of Infective Wastes
a. Personnel involved in the handling and disposal of infective waste should be informed of the
potential health and safety hazards and trained in the appropriate handling and disposal
methods.
b. If processing and / or disposal facilities are not available at the site of infective waste
generation (i.e. laboratory, etc.) the waste may be safely transported in sealed impervious
containers to another hospital area for appropriate treatment.
c. To minimize the potential risk for accidental transmission of disease or injury, infective
waste waiting terminal processing should be stored in an area accessible only to personnel
involved in the disposal process.
3. Processing and Disposal of Infective Waste
a. Infective waste, in general, should either be incinerated or should be autoclaved prior to
disposal in a sanitary landfill.
b. Disposable syringes with needles, scalpel blades and other sharp items capable of causing
injury should be placed intact into puncture-resistant containers located as close to the area
in which they were used as is practical. To prevent needle-stick injuries, needles should not
be recapped, purposely bent, broken, or otherwise manipulated by hand.
c. Bulk blood, suctioned fluids, excretions and secretions may be carefully poured down a
drain connected to a sanitary sewer. Sanitary sewers may also be used for the disposal of
other infectious wastes capable of being ground and flushed into the sewer’s
[Link]. Assistant Professor, [Link]. Professor
Dept. of Community Medicine. Kilpauk Medical College. Chennai 10 Page 3
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