Clinical Waste Management
Making sure that your clinical waste management is compliant with current legislation is important for all healthcare practices and environments where this type of waste can be produced. Failure to make sure that the right containers are used and the appropriate disposal methods are chosen can not only lead to prosecutions and fines but could put the general public at risk.
Hospitals nowadays either have an onsite incinerator they use for disposing of hazardous waste or employ a contractor who offers the service and transports the waste to an industrial scale incinerator.
What is Clinical Waste?
Any waste arising from healthcare practices, treatments and even teaching can be considered clinical waste. The specific areas that it normally covers are:
- Human and animal body tissue.
- Body fluids such as blood.
- Excretions such as faecal matter or urine.
- Pharmaceutical products such as drugs.
- Dressings, swabs and other products associated with medical practices.
- Sharps such as needles and syringes.
Each of these types of clinical waste has to be separated and treated in a particular way. This usually involves having specific containers, hermetically sealed, that protect people from the hazards they present.
Legislation Relating to Clinical Waste
With the threat to public safety from clinical waste, there is naturally a significant amount of legislation in place that healthcare practices have to adhere to. This revolves around the four principles of segregation, storage, disposal and documentation. There are also four primary bits of legislation that practices need to comply with and these are:
- The Environmental Protection Act 1990
- The Controlled Waste Regulations 2012
- The Hazardous Waste Directive 2011
- The Carriage of Dangerous Goods Regulations
The Environmental Protection Act includes the provision that practices have a duty of care when it comes to disposing of clinical waste and should have the right management processes in place. Failure to do so can lead to prosecution and this includes having the right paperwork in place that provides a clear audit trail of what happens to any clinical waste.
Find out more about compliance and clinical waste.
Pre-Contract Audit of Clinical Waste
Any company that is handling clinical waste for a healthcare practice will first need what is called a pre-acceptance audit. This means that a healthcare practice will be required to define the kind of waste that it has and whether it is suitable for a particular form of disposal. This applies to all healthcare practices from hospitals and dentists to ambulance trusts and drug manufacturers. Failure to carry out a pre-acceptance audit can lead to prosecution and large fines if found guilty.
The management of clinical waste overall should follow a similar structure as that outline below:
- An audit of your waste streams and how they are to be disposed of.
- Classifying your waste appropriately according to European Waste Catalogue (EWC) codes.
- Choosing the right storage and packaging for your waste and arranging suitable frequent collections.
- Keeping records on file and passing them onto the final disposal site.
- Reviewing procedures annually to make sure that you are compliant with current legislation.
Comprehensive guidance for handling clinical waste can be found in the Government’s Health Technical Memorandum 07-01: Safe management of healthcare waste publication.
Segregation and Storage of Clinical Waste
All clinical waste should be separated and stored according to its type and there must be clear signage on containers that say what kind of waste it is. Bins and containers are now colour coded so that waste should always go to the right container. The process of segregating clinical waste involves a number of stages from identifying the waste to where it fits in the list of hazardous substances. The is key to successful clinical waste management is the handling of separation and safe storage and includes not mixing non-hazardous waste with hazardous waste.
Disposal of Clinical Waste
While some healthcare practices such as hospitals might handle clinical waste disposal onsite with their own incinerator, many choose to employ the services of a third party carrier who is responsible for the actual disposal of the waste.
People working for such organisations should have the appropriate training to handle the clinical waste and the company itself should comply with the Carriage of Dangerous Goods and Transportable Pressure Equipment Regulations. Certain waste can only be transported using UN recommended packaging – for instance, dangerous goods relating to UN 2814 such as an infectious substance dangerous to humans needs to have P620 packaging in place which includes extra layers of protection to stop potential problems such as leaking.
Documentation of Waste
One of the most important parts of clinical waste management is the maintenance of a clear audit trail. That means all waste needs to have a consignment note which includes the details of the healthcare practice, the type of waste and how it was shipped and the European Waste Catalogue (EWC) code to which it belongs. Quarterly return notes also need to be produced noting waste volumes and the EWC codes relating to each consignment. This area of documentation has recently been strengthened in the legislation meaning that anyone dealing with clinical waste has to show a duty of care when handling the paperwork. This includes whether you are using a registered contractor and if they are taking the waste to suitably licensed site – something all practices need to check.