CLINICAL WASTE MANAGEMENT

CLINICAL WASTE

 MANAGEMENT

1. Introduction

                 

               Waste is anything discarded by an individual, household or organization. As a result waste is a complex mixture of different substances, only some of which are intrinsically hazardous to health. The generation, transport and disposal of wastes may present threats to the environment and public health, but potential impacts depend on the types of waste management options chosen and their implementation.

                The health care sector has a “duty of care” to protect public health and the environment in relation to wastes. It is important that the sector ensures that there are no adverse health and environmental consequences of activities associated with waste handling, treatment, and disposal.

Certain components of clinical and related wastes require special disposal. Some categories of waste produced through healthcare (such as cytotoxic, radioactive or laboratory waste) can undoubtedly be hazardous to health and the environment in certain circumstances.

However, the risks associated with clinical waste are often overstated and are based more often on public perception, the visual offence some components may cause or evidence from poor management practices. For example, the main risk of clinical waste is the danger of sharps injury resulting in infection. However international research has shown that general household waste contains large numbers of microorganisms that exceed the levels found in hospital clinical waste 1,2,3,4,5.

The risks from clinical and related wastes are dependent on the potential for exposure. Properly segregated and managed the components of these waste streams should provide few opportunities for exposure and present minimal risk to those involved in their management and disposal.

                 Anyone associated with the generation, segregation, containment, storage, transportation and final disposal processes should be appropriately informed about safe management practices for clinical and related wastes. Similarly, these practices should be employed to ensure that safe work systems protect everyone involved in all aspects of the waste management process.

  

2. Definitions

The definitions adopted by the WA Health are those described in the Australian / New Zealand Standard AS/NZS 3816:1998 Management of clinical and related wastes and any subsequent revisions.

2.1 Clinical Waste

These are wastes that have the potential to cause disease, sharps injury or public offence including sharps, human tissue waste, laboratory waste and animal waste resulting from medical or veterinary research or treatment or any other waste as specified by the WA Health facility. Clinical waste is further categorised into:

                 

·         Animal waste: waste arising from the whole or any part of an animal, or excreta.

·         Sharps waste: objects or devices having sharp points or protuberances or cutting edges capable of causing a penetrating injury to humans.

·         Human tissue waste: body tissue, organs, limbs and any free-flowing liquid body substance e.g. blood; Excludes teeth, hair and nails.

·         Laboratory waste: a specimen or culture discarded in the course of medical, dental or veterinary practice or research, including genetically manipulated material and imported biological material or any material grossly contaminated thereby.

2.2 Related Waste

Other wastes generated within health care settings which are contaminated with cytotoxic drugs or other pharmaceuticals, chemicals and radioactive materials and can be further categorised into:

• Chemical waste: waste material generated from the use of chemicals in medical, dental, veterinary, laboratory, ancillary and disposal procedures

• Cytotoxic waste: waste material, including sharps, contaminated with a cytotoxic drug.

·         Pharmaceutical waste: may be generated by various means including, but not limited to:

                 

               

               

                Expired pharmaceutical products

                 

·         Pharmaceutical products discarded due to being in a substandard state (e.g. non-compliant storage, damaged or contaminated packaging, and failed quality control specifications during manufacture)

·         Pharmaceutical products returned by patients, discarded by the public, no longer required by the public or no longer required by a healthcare facility

·         Waste generated by the manufacture or via the administration of pharmaceutical products

·         Preparations of drugs added to an intravenous solution

·         Other waste contaminated with pharmaceuticals.

                 

     Pharmaceutical wastes exclude:

·         Pharmaceutical drugs and their metabolic by-products excreted by patients undergoing therapy.

·         Empty bottles (containing no liquid), empty pill bottles or strip packages where all tablets/capsules have been removed or other similar uncontaminated packaging.

·         Materials with trace quantities of pharmaceutical products (with the exception of cytotoxic drugs) such as used syringes and used intravenous sets (although they may be classed as clinical waste including sharps). Empty glass ampoules are classed as sharps and should be disposed of accordingly.

·         Simple intravenous solutions such as saline or dextrose, liquid nutrient preparations and electrolyte solutions. These may disposed of as normal liquids through the sewage system.

Radioactive waste: Waste material, including sharps, contaminated with a radioisotope which arises from the medical or research use of radionuclide, e.g. during nuclear Medicine, radioimmunoassay and bacteriological procedures, which may be of solid, liquid or gaseous form, and which emit a level of radiation above the level set by regulatory authorities as exempt.

2.3 General Waste

This waste stream comprises any waste material which is not otherwise specified in the above definitions.

2.4 Recyclable Waste

Are those products, packages or element there of that can be diverted from the waste stream and through existing processes, be collected, processed and returned to use in the form of raw materials or products.

This policy refers specifically to Clinical and Related Wastes. The majority of waste generated from a WA Health facility can be classified as general or recyclable waste. Classification of commonly produced healthcare waste is described in Appendix 1. The list is not definitive and WA Health facilities are advised to clarify correct classification and disposal options for unlisted items.