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Healthcare Waste: Difference between revisions
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==Offensive Waste== | ==Offensive Waste== | ||
'''Offensive Waste''' is: | '''Offensive Waste''' is non-infectious waste which is unpleasant and may cause offence to those coming into contact with it. It includes<ref name="Net">[https://www.netregs.org.uk/environmental-topics/waste/managing-waste-materials/offensive-waste/ NetRegs]</ref>: | ||
* | *outer dressings and protective clothing e.g. masks, gowns and gloves that are not contaminated with body fluids | ||
* | *hygiene waste and sanitary protection e.g. nappies and incontinence pads | ||
*falls within [[EWC]] waste codes [[EWCChap18 | 18 01 04]], [[EWCChap18 | 18 02 03]] or [[EWCChap20 | 20 01 99]] | *autoclaved laboratory waste. | ||
*falls within [[EWC]] waste codes [[EWCChap18 | 18 01 04]], [[EWCChap18 | 18 02 03]] or [[EWCChap20 | 20 01 99]]. | |||
Offensive waste does not include <ref name="Net" />: | |||
*sharps | |||
*anatomical waste e.g.body parts, organs or blood | |||
*chemicals, medicines | |||
*dental amalgam | |||
*any waste that is infectious (i.e. a clinical waste) | |||
==Management of Healthcare Waste== | ==Management of Healthcare Waste== | ||
The management of Healthcare Wastes is set out in '''Healthcare Technical Memorandum 07-01 - Safe Management of Healthcare Waste'''<ref name= | The management of Healthcare Wastes is set out in '''Healthcare Technical Memorandum 07-01 - Safe Management of Healthcare Waste'''<ref name='Tech1'>[https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/167976/HTM_07-01_Final.pdf Link to pdf document]</ref> which replaced the Safe Management of Healthcare Waste in 2013 <ref>Published in 2006, this removed the clinical waste classification system categorising into 5 types; A to E</ref>. Management of Healthcare Waste for regulated facilities with an environmental permit is the subject of guidance issued in July 2020 <ref>[https://www.gov.uk/guidance/healthcare-waste-appropriate-measures-for-permitted-facilities Healthcare Waste:Appropriate Measures for Permitted Facilities]</ref> by the [[EA]] which sets out appropriate measures in the following sections: | ||
* When appropriate measures apply | * When appropriate measures apply | ||
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==Healthcare Waste - Packaging Colour and Appropriate Waste Management== | ==Healthcare Waste - Packaging Colour and Appropriate Waste Management== | ||
The types of [[Healthcare Waste]] are grouped and designated by packaging colour set out in the table below (can be bag colour or lid colour)<ref>[https://assets.publishing.service.gov.uk/media/5f05a7fae90e0712d0206e88/Types_of_healthcare_waste_table.pdf Types of Healthcare Waste]</ref> <ref name = | The types of [[Healthcare Waste]] are grouped and designated by packaging colour set out in the table below (can be bag colour or lid colour)<ref>[https://assets.publishing.service.gov.uk/media/5f05a7fae90e0712d0206e88/Types_of_healthcare_waste_table.pdf Types of Healthcare Waste]</ref> <ref name ='Tech1'/>: | ||
{| class="wikitable" | {| class="wikitable" | ||
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!colspan="3"| Colour of Packaging: Orange | !colspan="3"| Colour of Packaging: Orange | ||
|- | |- | ||
|Appropriate healthcare waste management activities||Storage, '''alternative treatment or | |Appropriate healthcare waste management activities||Storage, '''alternative treatment or [[Incineration]]''' | ||
|- | |- | ||
|rowspan=5|Waste types and List of Waste (LoW) code(s)||rowspan=5|'''Infectious waste''', not contaminated with chemicals or medicines | |rowspan=5|Waste types and List of Waste (LoW) code(s)||rowspan=5|'''Infectious waste''', not contaminated with chemicals or medicines | ||
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! colspan="3"|Colour of Packaging: Yellow | ! colspan="3"|Colour of Packaging: Yellow | ||
|- | |- | ||
|Appropriate healthcare waste management activities||Storage and ''' | |Appropriate healthcare waste management activities||Storage and '''[[Incineration]]''' | ||
|- | |- | ||
|rowspan=6|Waste types and List of Waste (LoW) code(s)||rowspan=3|'''Infectious waste''', contaminated with chemicals: | |rowspan=6|Waste types and List of Waste (LoW) code(s)||rowspan=3|'''Infectious waste''', contaminated with chemicals: | ||
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! colspan="3"|Colour of Packaging: Red | ! colspan="3"|Colour of Packaging: Red | ||
|- | |- | ||
|Appropriate healthcare waste management activities||Storage and ''' | |Appropriate healthcare waste management activities||Storage and '''[[Incineration]]''' | ||
|- | |- | ||
|rowspan=12|Waste types and List of Waste (LoW) code(s)||rowspan=3|Infectious '''anatomical waste''', chemically preserved: | |rowspan=12|Waste types and List of Waste (LoW) code(s)||rowspan=3|Infectious '''anatomical waste''', chemically preserved: | ||
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! colspan="7"|Colour of Packaging: Purple | ! colspan="7"|Colour of Packaging: Purple | ||
|- | |- | ||
|Appropriate healthcare waste management activities||Storage and ''' | |Appropriate healthcare waste management activities||Storage and '''[[Incineration]]''' | ||
|- | |- | ||
|rowspan=6|Waste types and List of Waste (LoW) code(s)||rowspan=3|'''Cytotoxic and cytostatic''' medicines: | |rowspan=6|Waste types and List of Waste (LoW) code(s)||rowspan=3|'''Cytotoxic and cytostatic''' medicines: | ||
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! colspan="3"|Colour of Packaging: Blue | ! colspan="3"|Colour of Packaging: Blue | ||
|- | |- | ||
|Appropriate healthcare waste management activities||Storage and ''' | |Appropriate healthcare waste management activities||Storage and '''[[Incineration]]''' | ||
|- | |- | ||
|Waste types and List of Waste (LoW) code(s)||Other '''waste medicines''', excluding cytotoxic and cytostatic medicines||[[EWCChap18|18 01 09]], [[EWCChap18|18 02 08]] or [[EWCChap20|20 01 32]] | |Waste types and List of Waste (LoW) code(s)||Other '''waste medicines''', excluding cytotoxic and cytostatic medicines||[[EWCChap18|18 01 09]], [[EWCChap18|18 02 08]] or [[EWCChap20|20 01 32]] | ||
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! colspan="3"|Colour of Packaging: Black and Yellow ('tiger bags') | ! colspan="3"|Colour of Packaging: Black and Yellow ('tiger bags') | ||
|- | |- | ||
|Appropriate healthcare waste management activities||Storage, ''' | |Appropriate healthcare waste management activities||Storage, '''[[Incineration]]''' or '''[[Landfill]]'''. Compaction, where specifically permitted. | ||
|- | |- | ||
|rowspan=4|Waste types and List of Waste (LoW) code(s)||rowspan=3|Non-infectious '''offensive waste''': | |rowspan=4|Waste types and List of Waste (LoW) code(s)||rowspan=3|Non-infectious '''offensive waste''': | ||
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! colspan="3"|Colour of Packaging: Not Specified | ! colspan="3"|Colour of Packaging: Not Specified | ||
|- | |- | ||
|Appropriate healthcare waste management activities||Storage, ''' | |Appropriate healthcare waste management activities||Storage, '''[[Incineration]]''' or '''[[Landfill]]'''. Compaction, where specifically permitted. | ||
|- | |- | ||
|rowspan=4|Waste types and List of Waste (LoW) code(s)||rowspan=3|Non-infectious '''offensive waste''': | |rowspan=4|Waste types and List of Waste (LoW) code(s)||rowspan=3|Non-infectious '''offensive waste''': | ||
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|} | |} | ||
==Treatment of Healthcare Waste== | ==Treatment and Disposal of Healthcare Waste== | ||
With regard to the table above, it can be seen that there are options for '''incineration''' and '''alternative treatment'''. | With regard to the table above, it can be seen that there are options for '''incineration''' and '''alternative treatment''' and in some specific cases [[landfill]] is acceptable. | ||
===Incineration=== | |||
For [[incineration]], Healthcare Waste will normally be incinerated in [[High Temperature and Clinical Waste Incineration]]. Some [[Residual Waste EFW]] incinerators are able to dispose of specific Clinical Waste streams, and as a result of the COVID-19 pandemic the [[EA]] published a Regulatory Position Statement (RPS C23) clarifying the circumstances where COVID-19 waste can be [[Incineration|incinerated]] with Municipal Waste Waste ([[MSW]]) until July 2021. <ref>[https://www.gov.uk/government/publications/incinerating-specified-healthcare-wastes-at-a-municipal-waste-incinerator-rps-c23/incinerating-specified-healthcare-wastes-at-a-municipal-waste-incinerator-rps-c23#conditions-you-must-comply-with RPS C23]</ref> | |||
===Alternative Treatment=== | |||
There are several types of Alternative Treatments (AT) available for the treatment of [[Healthcare Waste]] all of which must demonstrate that the [[Healthcare Waste]] is 'rendered safe'<ref name='Tech1'/>. 'Rendered safe' means: | |||
* demonstrates the ability to reduce the number of infectious organisms present in the waste to a level at which no additional precautions are needed to protect workers or the public against infection from the waste; | * demonstrates the ability to reduce the number of infectious organisms present in the waste to a level at which no additional precautions are needed to protect workers or the public against infection from the waste; | ||
* destroys anatomical waste such that it is no longer generally recognisable; | * destroys anatomical waste such that it is no longer generally recognisable; | ||
* renders all | * renders all Clinical Waste (including any equipment and sharps) unusable and unrecognisable as Clinical Waste; | ||
* destroys the component chemicals of chemical or medicinal and medicinally-contaminated waste. | * destroys the component chemicals of chemical or medicinal and medicinally-contaminated waste. | ||
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* [[Microwaves]] | * [[Microwaves]] | ||
* [[Irradiation]] | * [[Irradiation]] | ||
* [[Chemical | * [[Chemical Disinfection]] | ||
* [[Dry Heat]] | * [[Dry Heat]] | ||
* [[ | * [[Thermal Disinfection]] | ||
Mechanical Treatment is also available as a pre-treatment option for any of the AT's outlined above. By pulverising, shredding, crushing etc the [[Healthcare Waste|waste]] this results in a reduction of the volume of the [[Healthcare Waste|waste]] by 60% plus although it does not kill any pathogens, microorganisms or disinfect equipment<ref>[https://www.malsparo.com/treat2.htm Malsparo]</ref>. | |||
==NHS Management of Healthcare Waste [[ERIC]]== | |||
The [[wikipedia:National Health Service| NHS]] report their management of Healthcare Waste via the Estates Returns Information Collection ('''[[ERIC]]''') dataset<ref>https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection</ref> which gives a break down the tonnage, management approach, and associated cost of waste - including Healthcare/Clinical Waste. The figure below for the ERIC data over the last four years shows a downward trend for Healthcare Waste going to incineration<ref>The data for 2017 and 2018 is on a different basis within ERIC and represents the total waste sent for incineration, leading to an exaggeration of the drop in incineration in the figure</ref><ref>For the data for 2020/21 the figure produced by Monksleigh adjusts the ERIC data for 4 NHS Trusts that appear to have reported in kg rather than tonnes. This is the subject of a review by NHS Digital as it also impacts the Clinical Waste tonnage treated as a whole by the NHS estate</ref> (against a backdrop of increasing tonnage overall, notwithstanding the impacts of the [[wikipedia: COVID-19|pandemic]], this means increasing tonnage has gone to treatment). The figure also shows that the proportion of waste incinerated from the [[wikipedia:National Health Service| NHS]] has dropped relative to the total Healthcare Waste incinerated - reflecting that non-NHS facilities (such as private hospitals, care homes etc)<ref>https://digital.nhs.uk/services/organisation-data-service/file-downloads/non-nhs-organisations</ref> have relied more heavily on incineration than treatment for the management of their waste over recent years. | |||
[[File:NHS Tonnage Incinerated vs Total.png|500px|center|NHS Clinical Waste Incinerated vs total Clinical Waste Incinerated - all rights reserved Monksleigh Ltd]] | |||
==References== | ==References== | ||
<references /> | <references /> | ||