Waste Management – Process, Guidelines & Facts

Waste Management – Process, Guidelines &				Spill management
Facts				Containment and sharps containers
INTRODUCTION:				Tracking
Health Care Facilities must be committed to				MGBs and trolleys
waste management principles. Waste				Holding areas
management is implemented by the establishment				Transport
of a waste management committee and the				Waste Disposal
development and implementation of a Waste				Contracts with waste transporters and waste
Management Plan. The Generic Waste				treatment / disposal subcontractorsmust be
Management Plan provides supplementary detail				documented and should be consistent with
and forms a practical tool to implement the				relevant Regulations.
Guidelines.				Occupational health and Safety
These Guidelines will assist managers and				Provision of information, education and training and
personnel of any facility to implement standards				safe systems of work
and comply with relevant legislation. Adoption and				Employee's responsibilities
commitment by each facility through the				OH&S committee
establishment of a Waste Management				Monitoring performance
Committee and adoption of a Waste Management				Personal protective equipment
Plan will assist the facility to manage their waste				Standard Operating Procedures
streams correctly, efficiently and effectively.				Legislative Compliance
These Guidelines continue with the concepts of				All health facilities have a statutory obligation to
waste segregation into various waste streams,				comply with applicable legislation. The development
labeling and containment, handling, storage and				of these Guidelines has considered relevant
transport, treatment / disposal, auditing,				legislation. It is the responsibility of each facility to
Occupational Health and Safety, training and legal				consult with other authorities and to be aware of
requirements.				their specific legislative requirements.
HEALTH-CARE WASTE:				Licensing
Health-care waste includes all the waste				Who Needs a License?
generated by health-care establishments, research				The following is a summary of the license
facilities and laboratories, including health-care				requirements under the Waste Regulation.
waste produced at home (dialyses, insulin				The Waste Regulation provides for the licensing
injections etc.)				of:
CATAGORIES OF HEALTH-CARE WASTE:				Those who generate or store hazardous (clinical)
Infectious waste (containing pathogens, excreta,				waste (controlled wasteactivities)
etc.)				Waste facilities that treat, store or dispose of
Pathological waste (body parts, blood, foetuses,				hazardous (clinical) waste -
etc.)				(Controlled waste activities)
Sharps (needles, infusion sets, broken glass, etc.)				Transporters of hazardous waste - (Waste
Pharmaceutical waste (old medicines, etc.)				transporters)
Genotoxic waste (cytostatic drugs, etc.)				Waste Segregation
Chemical waste (laboratory material, film				Waste segregation should follow immediately after
developer, etc.)				waste is generated. Effective segregation will
Heavy metal waste (batteries, thermometers,				reduce costs, promote recycling and protect the
etc.)				health and safety of all.
Pressurised containers (gas cartridges, etc.)				What is Segregation?
Radioactive waste (waste from radiotherapy,				Waste segregation is the practice of classifying
etc.)				waste and placing it into the appropriate waste
IMPROPER DISPOSAL:				container immediately after the waste is
Hospitals and public health care units are supposed				generated.
to safeguard the health of the community.				Importance of Waste Segregation
However, the waste produced by the medical				Facilities should accurately segregate waste to
care centers if disposed off improperly, can pose				protect personnel from injury and infection by
an even greater threat than the original disease				preventing hazardous waste entering inappropriate
themselves. In most of the cases there are no				waste streams and divert problematic waste
systematic approaches to medical waste disposal.				from incorrect waste streams. Correct
Hospital wastes are simply mixed with the				segregation is necessary to ensure that materials
municipal waste in collecting bins at roadsides and				which are reusable or recyclable are not discarded.
disposed off similarly. Some waste is simply buried				Correct segregation and containment of all wastes
without any appropriate measure. While all the				are required in order to comply with the
equipment necessary to ensure the proper				provisions of the Waste Regulation. The mixing of
management of hospital waste probably exists,				wastes is not permitted. If mixing occurs, wastes
the main issue lies in the staff who fails to				containing more than 200g of hazardous waste
prepare and implement an effective disposable				are to be classified as hazardous.
policy.				Segregation Practice Achievement
In general disposable syringes and needles are also				Effective segregation can be best achieved
not disposed off properly. Some patients, who				through:
routinely use syringes at home, do not know how				Providing education and training programs to all
to dispose them off properly. They just throw				personnel who generate waste)
them in a dustbin or other similar places, because				Identification of material composition (Material
they think that these practices are inexpensive,				Safety Data Sheet);
safe, and easy solution to dispose off a potentially				Establishing identifiable color coding, and labeling;
dangerous waste item.				Provide suitable containers in appropriate and
How does hospital waste affect us?				suitable locations;
If hospital waste is not managed properly it				Incorporating quick and efficient waste disposal
proves to be harmful to the environment. It not				methods into patient care
only poses a threat to the employees working in				Procedures. This may require the redesign or
the hospital, but also to the people surrounding				reorganization of procedure trolleys and working
that area Infectious waste can cause diseases like				environments; and ensuring all waste can be
Hepatitis A & B, AIDS, Typhoid, Boils, etc.Many				easily, safely and properly segregated at the point
drug addicts also reuse the syringes that can				of generation.
cause AIDS and other dangerous and contagious				Training
diseases. If a syringe, previously used by an AIDS				Importance of training in the processes of
patient, is reused, it can affect the person using it.				achieving continuousimprovement in waste
So, the hospital staff should dispose off the				management.
syringes properly, by cutting the needles of the				Training and Promotion
syringes with the help of a cutter, so that the				Area Health Services and HCF must train
needle ca not be reused. When waste containing				managers, supervisors and employees in waste
plastics are burnt, Dioxin is produced, which can				management and reinforce knowledge with
cause Cancer, birth defects, decreased				promotional activities and special emphasis
psychomotor ability, hearing defects, cognitive				programs. Training programs must be revised as
defects and behavioral alternations in infants. Flies				new equipment is introduced or as technological
also sit on the uncovered piles of rotting garbage.				change occurs. All casual staff needs to be trained
This promotes mechanical transmissions of fatal				in waste management before starting
diseases like Diarrhea, Dysentery, Typhoid,				employment. Continuous improvement may be
Hepatitis and Cholera. Under moist conditions,				achieved by regularly reinforcing awareness of
mosquitoes transmit many types of infections,				waste management issues.
like Malaria and Yellow fever. Similarly, dogs, cats				The following topics should be covered (effective
and rats also transmit a variety of diseases,				training stuff)
including Plague and Flea born fever, as they				Operating manuals outlining safe and approved
mostly live in and around the refuse. A high				work practices;
tendency of contracting intestinal, parasitic and				Material Safety Data Sheets;
skin diseases is found in workers engaged in				Staff awareness of policies at orientation to the
collecting refuse.				HCF;
Purpose of the Guidelines				Legislative compliance;
The purpose of the Guidelines is to provide a				Provision of and compliance with the use of
framework of waste management strategies to				personal protective equipment;
assist in the day to day and long term				Hygiene procedures;
management of waste by implementing the				Waste stream definitions and waste segregation
following essential strategies:				practices;
Waste management committees, plans and waste				Costs and benefits of waste management;
audits;				Explanation of recycling programs;
Waste minimization, avoidance, segregation,				Details of employee vaccination program;
recycling and re-use;				Management of needle stick and blood body
Waste labeling and containment; C proper waste				substance exposure; and
handling, storage and transport;				WMP.
Correct waste treatment / disposal				Community languages should be used where
Uniform application of these Guidelines to all				appropriate.
facilities will help to reduceuncertainty when staff				Information, Education, Training and Safe Systems
moves between facilities. This assists with				of Work
providing a safe working environment.				Facilities management should be responsible
Aims				providing appropriate information, education,
The aims of these Guidelines are to:				training and ensuring that safe systems of work
Protect public health and safety;				are developed and maintained.
Provide a safer working environment;				This should include the provision of OH&S and
Minimize waste generation and environmental				public health information relating to the equipment
impacts of waste treatment / disposal;				and chemicals/drugs used in the facility , e.g.
Ensure compliance with legislative requirements.				Material Safety Data Sheets for chemicals,
Infection Risk Associated with Waste				Operating manuals for clinical devices using /
Infection Control measures are adopted to				decontaminating hazardous substances, etc.
prevent cross infection between patients and				Information
staff. Changes in infection control and advances in				Facilities employees who handle waste should be
technology have resulted in the increased use of				provided with the following information:
disposable clinical products, which have in turn				Occupational hazards and management of
increased waste treatment/disposal volumes.				exposure to blood and body fluids;
When clinical waste is appropriately handled and				Policies and procedures for specific waste handling
contained through good work practice and the				and prevention of injury and disease.
use of protective apparel, the risk of infection is				Details on available immunization programs (for
minimized. It is essential to correctly segregate				Hepatitis B in particular);
waste to ensure that safe work systems protect				Access to medical care and counseling services
all workers. The most significant risk associated				with rights to privacy; and
with clinical waste is transmission of a blood borne				Management of needle stick and blood body
virus from a needle stick injury. The detrimental				substance exposure.
impacts on the environment of increased				The information should emanate from one source
disposable items have included pollution and the				only to avoid the distribution of conflicting
depletion of non-renewable natural resources. The				information.
adoption of waste minimization practices should				Education and Training
reduce environmental degradation, without				Management should provide education and training
compromising infection control standards.				to waste generators, handlers, collectors,
Waste Management Plan (WMP)				transporters, and key managers instrumental in
Each Health Care Facility must implement a Waste				the implementation of the WMP, and waste
Management				treatment facility operators. Handlers must be
Plan. To implement an effective WMP:				trained and equipped to undertake the handling,
Establish a Waste Management Committee at				internal transport, spill management and storage
facility;				requirements for the different types of wastes
Coordinate major issues such as avoidance,				arising at the facility. The purpose of education
reduction, reuse and recycling;				and training is to minimize the risk of injury
Conduct an audit to assist with performance				associated with waste handling and facilitate
improvement.				efficient waste management.
Audit procedures in the WMP.				Education and training programs should include:
Establish benchmarks to facilitate monitoring.				Approved work practices;
The following key issues are considered essential				Regulatory requirements and methods of
components of a WMP.				compliance;
Organizational Issues				The use of required personal protective
Employers legal responsibilities				equipment;
Employees responsibilities				Waste minimization, segregation, labeling,
Licensing requirement				containment and disposal strategies;
Waste management committees				First aid and medical treatment for needle stick
Purchasing policies				and other waste handling related injuries;
Education and training.				Hand washing strategies.
Waste Management Strategies				Education and training should be provided at the
Hospital waste audits				induction of new employees, on an ongoing basis,
Numerical profile				with the introduction of new equipment, and at
Segregation audit				times of technological change. Approved work
Waste minimization				practices should be documented and promoted.
Waste Handling, Containment and Transport				Multilingual translations are to be provided to
Waste handling by staff				personnel who may not be proficient in English.

Arkon Safety

Waste Management – Process, Guidelines & Facts