LABORATORY WASTE MANAGEMENT

A SEMINAR PRESENTED
BY
ADARAMOLA, SAMUEL OLUWASEUN

AT THE MEDICAL LABORATORY SCIENCE

EDUCATION UNIT, UNIVERSITY COLLEGE
HOSPITAL, IBADAN

10th OCTOBER, 2019.

1
 OUTLINE
• DEFINATION OF TERMS
• INTRODUCTION
• CLASSIFICATION OF LABORATORY WASTE
• LABORATORY WASTE MANAGEMENT
• RISK ASSOCIATED WITH IMPROPER HANDLING OF
LABORATORY WASTE
• CHALLENGES OF LABORATORY WASTE MANAGEMENT
• STEPS TOWARDS IMPROVEMENT
• CONCLUSION
• REFERENCES

2
 DEFINITION OF TERMS
• Laboratory: A laboratory is a facility that provides
controlled conditions in which scientific or technological
research, experiments, and measurement may be
performed (Laposata, 2016).

• Medical laboratory: It is a laboratory where clinical

pathology tests are carried out on clinical specimen to
obtain information about the health of a patient to aid in
diagnosis, treatment, prognosis and prevention of
diseases (Farr and Laurence, 2010).

• Waste: It is anything that no longer has a use or purpose

and needs to be disposed off or recycled (Muck and Brass,
2009). 3
 INTRODUCTION 1/1
• Laboratory waste is defined as the total waste from
laboratory or research facilities that includes both
potential risk waste and non-risk waste materials (WHO,
2010).

• About 75-90% of the waste generated in healthcare

facilities is not potentially infectious and is similar to
domestic waste. However, 10-25% is infectious or
hazardous (Conrardy et al., 2010).

• Of about 10-25% of infectious/hazardous waste

generated in healthcare facilities, the laboratory
constitute about 20-38% of the infectious/hazardous
waste (Conrardy et al., 2010). 4
 INTRODUCTION 1/2
• Improper waste management by medical laboratory
personnel can result in increased health risk to those
exposed, contamination of the sanitary waste stream and
environmental pollution (Reinhardt et al., 2012).

• Proper waste management procedures must be adopted by

laboratory personnel to fulfill good laboratory practices
(Akter, 2015).

• A correct disposal procedure should include knowledge of

waste management steps and waste group of each of the
waste substances handled (Akter, 2015).
5
 CLASSIFICATION OF LABORATORY WASTE
Laboratory waste can either be in solid, liquid or gaseous
form. Regardless of the forms, they can be further classified
into 9 main categories;
1. General waste
2. Pathological waste
3. Sharps
4. Infectious waste
5. Chemical waste
6. Radioactive waste
7. Pharmaceutical waste
8. Pressurized containers
9. Genotoxic waste
6
 CLASSIFICATION OF LABORATORY WASTE
Table 1: Classification, description and Examples of laboratory waste (WHO, 2014)
Waste categories Description and Examples

General waste No risk to human health e.g. office paper,

wrapper, wraps of snacks, general sweeping
e.t.c.
Pathological waste Human tissues or fluid e.g. body parts, blood,
body fluids
Sharps Sharp waste e.g. Needle, scapels, knives,
blades, broken glasses e.t.c.

Infectious waste Waste which may transmit bacterial, viral,

fungi or parasitic diseases to humans e.g.
laboratory cultures, excreta, tissues (swabs)
bandage e.t.c.

Chemical waste Waste containing chemical substances e.g.

laboratory reagents, disinfectant, film
developer, expired solvent e.t.c.
7
 CLASSIFICATION OF LABORATORY WASTE
Table 2: Classification, description and Examples of laboratory waste (WHO, 2014)

Waste categories Description with examples

Radioactive waste Waste containing radioactive substances e.g.

unused liquids from radiotherapy or laboratory
research, urine or excreta from patients
treated or tested with unsealed radionuclides,
contaminated glassware etc.

Pharmaceutical waste Waste containing pharmaceuticals e.g.

pharmaceuticals that are expired or no longer
needed, items contaminated by or containing
pharmaceuticals etc.

Pressurized containers Gas cylinder, aerosol cans etc.

Genotoxic waste Waste containing substances with Genotoxic
properties e.g. waste containing cytostatic
drugs (often used in cancer therapy),
Genotoxic chemicals etc.
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 LABORATORY WASTE MANAGEMENT
• Waste management (or waste disposal) are the activities
and actions required to successfully manage waste from its
inception to its final disposal (Coker, 2014).

• Waste generated in the laboratory should be managed by

following an appropriate and well identified stream from
their point of generation until their final disposal (Olubukola,
2009).

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 LABORATORY WASTE MANAGEMENT

There are six main streams for proper waste

management;
1. Segregation
2. Handling
3. Collection
4. Storage
5. Transportation
6. Treatment and disposal

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 WASTE SEGREGATION
• Segregation means the separation of the entire waste
generated in a facility according to different waste groups,
scientific treatment and disposal requirement (Olubukola,
2009).

• Segregating hazardous waste from non-hazardous waste

reduces also greatly the risk of infecting workers handling
laboratory waste (Coker, 2014).

• A recommended way of identifying the various waste

category categories is by sorting the waste into colour-
coded and well-labelled bags or containers marked with a
symbol (WHO, 2014).
11
 WASTE SEGREGATION
Table 3: Colour coding for waste segregation (WHO, 2014)
Categories Examples Colour of bin liner
Non-infectious Paper, packaging materials, Black
plastic bottles, food, cartons
Infectious Blood, dressings, blood, body Yellow
fluid, used specimen
container
Highly infectious Anatomical waste, Red
pathological waste
Chemical Formaldehyde, batteries, Brown
photographic chemicals,
solvents, organic chemicals,
inorganic chemicals

Radioactive Any solid, liquid or Yellow with radioactive label

pathological waste
contaminated with
radioactive isotopes of any
kind

Sharps Used needles, glass slides, Sharp box with hazard sign
coverslips 12
 WASTE HANDLING
• Great care should be taken when handling laboratory
waste.

• The most important risks are linked with the injuries that
sharps can produce (PATH, 2017).

• When handling laboratory waste, sanitary staff and

cleaners should always wear protective clothing including,
as minimum, overalls or industrial aprons, boots and heavy
duty gloves (PATH, 2017).

13
 WASTE COLLECTION
• In order to avoid accumulation of laboratory waste, it must
be collected on a regular basis at least once a day and
transported to a central storage area within the laboratory
facility before being treated or removed (Abah and Ohimain,
2016).

• Each type of waste must be collected and stored separately

with different known signs on the containers.

• The collection must follow specific routes through the

laboratory facility to reduce the passage of loaded carts
through clean areas in the laboratory (Abah and Ohimain,
2016).
14
Figure 1: Various carts for collection of laboratory waste
(AIHPPRP, 2007) 15
Figure 2: Cart for collection of waste in UCH Ibadan
16
 WASTE STORAGE
• Upon successful collection, laboratory waste can be
temporarily stored before being treated / disposed of on-
site or transported off-site.

• A maximum storage time should not exceed 24 hours.

• Non-risk laboratory waste should always be stored in a

separate location from the infectious / hazardous
laboratory waste in order to avoid cross-contamination
(ICRC, 2011).

17
Figure 3: A temporary hospital waste storage site
(AIHPPRP, 2007)
Figure 4: A temporary waste storage site at UCH Ibadan
19
Figure 5: A temporary waste storage site at Pathology
department UCH Ibadan 20
Figure 6: A temporary waste storage site at Medical
Microbiology department UCH Ibadan 21
 WASTE TRANSPORTATION
• Transportation is required when hazardous laboratory
waste is treated outside the laboratory facility or treated
waste is disposed off outside the laboratory facility.

• The waste producer is responsible for the proper

packaging and labelling of the waste containers that are
transported.

• The transportation should always be properly documented

and all vehicles should carry a consignment note from the
point of collection to the treatment facility (Longe and
Williams, 2014).
22
Figure 7: A vehicle for conveying laboratory waste
(AIHPPRP, 2007) 23
Figure 8: Vehicle that conveys waste generated at UCH
Ibadan 24
 WASTE TREATMENT
• Hazardous / infectious laboratory waste can be treated to
reach a level of hazard / infectiousness that is considered
as acceptable (Ogbonna, 2015).

• Thus, after treatment, they follow the non-risk laboratory

waste stream and are disposed of with the general solid
waste.

• Hazardous / infectious laboratory waste can be treated

on-site (i.e. in the laboratory facility itself) or off-site (i.e.
in an other laboratory facility or in a dedicated treatment
plant).

25
 WASTE TREATMENT
There are different types of treatment method;

1. Incineration
2. Chemical disinfection
3. Autoclaving
4. Encapsulation
5. Inertization
6. Air filtration

(Ogbonna, 2015)

26
INCINERATION
• Incineration is the process by which organic waste are
burnt in high temperature producing mainly ashes and
gaseous emissions including steams, carbon dioxide,
nitrogen oxides.

• It is one of the oldest and most commonly used treatment

method in waste treatment facilities.

• It is suitable for infectious/pathological waste, animal

carcasses .

• Pressurized gas containers, waste with high mercury or

cadmium content should never be incinerated.
27
(Akter, 2015)
Figure 9: Showing an incinerator at UCH Ibadan
28
CHEMICAL DISINFECTION
• This method is appropriate for treating liquid waste
such as blood, urine, stool or laboratory sewage.
However, other waste can also be chemically
disinfected before disposal (Ogbonna, 2015).

• Anatomical parts, animal carcasses are usually not

disinfected.

• Examples of chemical disinfectant includes 10%

hypochlorite solution, alcohol, 5% Lysol etc.

29
Figure 10: The sewage treatment plant at UCH Ibadan
30
AUTOCLAVING
• Autoclaving is an efficient wet thermal pressurized
disinfection process done using an autoclave. The disinfection
is achieved at a pressure of 15psi and temperature of 121°C.

• This method can be used to sterilize solids, liquids, and

instrument of various shapes and sizes.

• It is used to sterilize reusable laboratory equipment like

scalpels, forceps etc.

(Ogbonna, 2015)

31
ENCAPSULATION
• Encapsulation involves immobilizing solid waste within a
plastic, cubic boxes or steel drums.

• These steel drums or boxes are not completely filled (75%

filled). The remaining portion is filled by pouring medium
such as cement, cement/lime mixture and allowed to dry.

• When dried, the steel drum lid should be sealed ideally by

spot welding and disposed at the base of landfills.

• It is mostly suitable for pharmaceutical waste.

(Abah and Ohimain, 2016) 32

INERTIZATION
• This is similar to encapsulation but often used for ashes and
pharmaceutical waste.

• The waste is grinded and a mixture of cement, lime and water

is added to form a homogenous paste. The typical portion of
the mixture is 65% waste, 15% lime, 15% cement and 5%
water.

• The paste is transported in the semi-liquid state by concrete

mixer trucks to landfills and discarded.

• The paste sets and disperse within the waste present in the
landfill.
33
AIR FILTRATION
• Air filtration is the process by which solid particulates such
as dust, pollen, mold and bacteria are removed from air
(Reinhardt et al., 2012).

• The process is done using air filters.

• Examples of air filters includes membrane filters, Ultra-low

particulate air (ULPA) filter, High-efficiency particle arrester
(HEPA) filter, High efficiency gas absorption (HEGA) filter.

• Air filtration ensures the gaseous waste generated in the

laboratory is well treated before been released out of the
laboratory.
34
 WASTE DISPOSAL

• Upon successful treatment, waste are disposed off at

disposal site.

• There are two distinct type of waste disposal;

1. Open dumps
2. Sanitary landfills

(HCWC, 2012)

35
OPEN DUMPS
• An open dump is a disposal site at which waste are
disposed off in an illegal manner.

• Open dumps are unmanaged and waste are scattered,

increasing the risk of further transmission of infection or
disease.

• Open dumps threatens the health and safety of everyone

around it especially children and older adult.

• It can be very hazardous to the environment as toxic

materials are released into surface water and groundwater.
(HCWC, 2012)
36
SANITARY LANDFILL
• Sanitary landfill is a modern engineering landfill where
waste is allowed to decompose into biologically and
chemically inert materials in a settings isolated from the
environment.

• The base and sides is prepared of a protective lining

which serves as a barrier between waste and ground
water.

• Sanitary landfill prevents contamination of soil, surface

water and groundwater.

(HCWC, 2012) 37
 RISK ASSOCIATED WITH IMPROPER
HANDLING OF LABORATORY WASTE
• Transmission of disease through infectious waste
• Air pollution
• Environmental hazards.
• Public health implications
• Fire hazard

38
 CHALLENGES OF LABORATORY
WASTE MANAGEMENT
• Lack of awareness about the health hazards related to
laboratory waste.
• Inadequate training in proper waste management.
• Insufficient financial and human resources.
• Poor implementation of the national policy on waste
management.
• Low priority given to waste management.

(PATH, 2017)
39
 STEPS TOWARDS IMPROVEMENT

• Building a comprehensive system for addressing

responsibilities, resource allocation, handling and
disposal.
• Raising awareness of the risks related to laboratory
waste, and of safe and sound practices.
• Selecting safe and environmentally-friendly management
options, to protect people from hazards when collecting,
handling, storing, transporting, treating and disposing off
waste.
• Continuing government commitment and support.

(PATH, 2017)
40
 CONCLUSION
Proper management of laboratory waste potentially reduces
exposure of laboratory workers, waste handlers, patients,
and the community at large to infection, injuries and varying
toxic effect. However, in most countries including Nigeria
such waste are not properly managed thus, exposing
laboratory professionals, waste handlers, and patient to
various health hazards. It is thus advisable to train
professional laboratory workers and equip them with the
appropriate knowledge and skills needed to properly
manage waste generated in the laboratory.

41
 REFERENCES
• Abah, S.O. and Ohimain, E.I. (2016). Assessment of
Dumpsite Rehabilitation Potential using the Integrated Risk
Based Approach: A case study of Eneka, Nigeria. World
Applied Science journal, 48(4), 436-442.
• Akter, N. (2015). Medical Waste Management: A Review.
Asian Institute of Technology, Thailand, 45: 8-9.
• Avian Influenza Control and Human Pandemic Preparedness
and Response Project. (2007). Final report on Medical
Waste Management Plan, Environquest, Nigeria.
• Coker, A. (2014). Medical waste management in Ibadan,
Nigeria: Obstacles and Prospects. Iranian Journal of
Environmental Health Sciences and Engineering, 49(2), 804-
811.
42
 REFERENCES
• Conrardy, J., Hillanbrand, M., Myers, S. and Nussbaum, G.F.
(2010). Reducing medical waste. Association of prioperative
registered Nurse Journal, 91: 711–721.
• Farr, J.M. and Laurence, S. (2010). Best jobs for the 21st century.
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• International Committee of the Red Cross (ICRC). (2011).
Medical Waste Management,. 19, avenue de la Paix 1202
Geneva, Switzerland., 164, Available at, http//www.icrc.org.,
(Accessed 26th August, 2012).
• Laposata, M. (2016). Insufficient Teaching of Laboratory
Medicine in US Medical Schools. Academy Pathology, 3: 1-2.
• Longe, E.O. and Williams, A. (2014). A preliminary study on
medical waste management in Lagos Metropolis, Nigeria.
Iranian Journal of Environmental Health Sciences and
Engineering, 33(3), 1333-139.
43
 REFERENCES
• Muck, E. and Brass, S. (2009). The waste business smells of
money.” The Economist, pg. 10-12.
• Ogbonna, D.N. (2015). Characteristics and waste
management practices of Medical wastes in healthcare
institutions in Port Harcourt, Nigeria. Journal of Soil
Science and Environmental Management, 12(5), 132-141.
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Care Waste Management Practice in Two General
Hospitals in Nigeria. Available at,
http://www.ecoweb.com/edi/index.htm., Accessed August
10, 2012.
• Program for appropriate technology in health. (2017).
Achieving effective sharps waste management in GAVI host
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• Reinhardt, P., Denys, G., Gordon, J. and Rau, E. (2012).
Clinical Laboratory Waste Management; Approved Guideline
2nd edition. Wayne, PA: National committee for clinical
laboratory standards, 22(3). GP5-A2.
• The Hazardous Chemicals and Wastes Conventions (HCWC).
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_sanit/MHCWHanbook.htm.   45
THANKS FOR LISTENING

46