Safe management of wastes from health-care activities

Size: px
Start display at page:

Download "Safe management of wastes from health-care activities"

Transcription

1 Safe management of wastes from health-care activities Second edition Edited by Yves Chartier, Jorge Emmanuel, Ute Pieper, Annette Prüss, Philip Rushbrook, Ruth Stringer, William Townend, Susan Wilburn and Raki Zghondi

2 Safe management of wastes from health-care activities 2nd edition

3 WHO Library Cataloguing-in-Publication Data Safe management of wastes from health-care activities / edited by Y. Chartier et al. 2nd ed. 1.Medical waste. 2.Waste management. 3.Medical waste disposal methods. 4.Safety management. 5.Handbook. I.Chartier, Yves. II.Emmanuel, Jorge. III.Pieper, Ute. IV.Prüss, Annette. V.Rushbrook, Philip. VI.Stringer, Ruth. VII.Townend, William. VIII.Wilburn, Susan. IX.Zghondi, Raki. X.World Health Organization. ISBN (NLM classification: WA 790) World Health Organization 2014 All rights reserved. Publications of the World Health Organization (WHO) are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: ; fax: ; Requests for permission to reproduce or translate WHO publications whether for sale or for non-commercial distribution should be addressed to WHO Press through the WHO web site (www.who.int/about/licensing/copyright_form/en/index.html). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the WHO be liable for damages arising from its use. The named editors alone are responsible for the views expressed in this publication. Declarations of interest The members of the health-care waste-management working group completed the WHO standard form for declaration of interests prior to the meeting. At the start of the meeting, all participants were asked to confirm their interests, and to provide any additional information relevant to the subject matter of the meeting. It was from this working group that chapter authors and lead editors were selected. None of the members declared current or recent (<1 year) financial interests related to commercial organizations. Two members declared consultation contracts for work relevant to the subject matter of the meeting. Bill Townend: Consultant for two industry nongovernment organizations, one of which the International Solid Waste Association is a nongovernmental organization in official relations with WHO, and provided technical and financial support for the publication. Ute Pieper: Consultant in health-care waste management in projects financed by international agencies, development banks and bilateral government agreements. These interests were not considered to give rise to a conflict with the aims of the meeting and the publication arising from the meeting and formed the basis of the expertise of the panel. The following participants were adjudged to have no potentially conflicting interests in the subject matter of the meeting, based on their completed declarations: Jorge Emmanuel, Philip Rushbrook and Ruth Stringer. Cover images (from top to bottom): tacartoons Dreamstime.com; Jorge Emmanuel; J. Emmanuel; Sudok1 Dreamstime.com; J. Emmanuel; Global Methane Initiative (GMI) program; J. Emmanuel Technical editing and design by Biotext, Australia Printed in Malta

4 Contents Foreword to the first edition...xiii Acknowledgements...xv Acronyms and abbreviations...xvii 1 Introduction Definition and characterization of health-care waste General definition and classification Sharps waste Infectious waste Pathological waste Pharmaceutical waste, including genotoxic waste Chemical waste Radioactive waste Non-hazardous general waste Sources of health-care waste Generation of health-care waste Physicochemical characteristics Minimum approach to overall management of health-care waste Desirable improvements to the minimum approach References and further reading Risks associated with health-care waste Overview of hazards Types of hazards Persons at risk Hazards from infectious waste and sharps Hazards from chemical and pharmaceutical waste Hazards from genotoxic waste Hazards from radioactive waste Hazards from health-care waste-treatment methods Public sensitivity Public health impact Impacts of infectious waste and sharps Impacts of chemical and pharmaceutical waste Impacts of genotoxic waste Impacts of radioactive waste Survival of pathogenic microorganisms in the environment The need for further research and epidemiological surveys References and further reading Legislative, regulatory and policy aspects of health-care waste Importance of a national policy Guiding principles International agreements and conventions The Basel Convention...42 iii

5 4.3.2 The Bamako Convention The Stockholm Convention The environment and sustainable development conferences United Nations Committee of Experts on the Transport of Dangerous Goods United Nations Economic Commission for Europe Aarhus Convention of the United Nations Economic Commission for Europe Available guidance World Health Organization Guidance The International Solid Waste Association ISWA policy document on health-care waste management National legislation Technical guidelines Minimum approach to developing health-care waste-management policy Desirable improvements to the minimum approach References and further reading Health-care waste-management planning The need for planning National plans Purpose of a national health-care waste-management plan Action plan for developing a national programme Waste-management plan for a health-care facility Assignment of responsibilities Management structure, liaison arrangements and duties Assessment of waste generation Development of a hospital waste-management plan Implementation of the waste-management plan Minimum approach to planning Desirable improvements to the minimum approach References and further reading Health-care waste minimization, reuse and recycling The waste-management hierarchy Waste minimization Environmentally preferable purchasing Green procurement Recycling symbols for plastics Safe reuse Recycling and recovery Environmental management systems Minimum approach to waste minimization Desirable improvements to the minimum approach References and further reading Segregation, storage and transport of health-care waste Guiding principles Segregation systems Waste containers, colour codes and labels Beyond basic segregation...82 iv Safe management of wastes from health-care activities

6 7.2.3 Waste containers: specifications and siting Setting and maintaining segregation standards Collection within the health-care facility Interim storage in medical departments Onsite transport of waste General requirements Transport trolleys Routing Central storage inside health-care facilities General requirements Hazardous waste storage Layout of waste-storage areas Documentation of the operation of storage places Offsite transport of waste Logistic staff Vehicle requirements Labelling of the transport vehicle Cleaning of container and vehicle Transport documentation Minimum approach to segregation, storage and transport Desirable improvements to the minimal approach References and further reading Treatment and disposal methods Selection of treatment methods Overview of waste-treatment technologies Thermal processes Chemical processes Irradiation technologies Biological processes Mechanical processes Suitability of treatment methods for infectious waste Steam treatment technologies Autoclaves Integrated steam-based treatment systems Microwave treatment technologies Dry-heat treatment technologies Chemical treatment technologies Internal shredding of waste Chemical disinfectants Microbial resistance Alkaline hydrolysis Incineration Combustion Pyrolysis and gasification Required waste characteristics Energy recovery Types of incinerators for health-care waste Contents v

7 8.8.6 Environmental control of incinerators Dust removal Encapsulation and inertization Emerging technologies Applications of treatment and disposal methods to specific waste categories Sharps Anatomical waste, pathological waste, placenta waste and contaminated animal carcasses Pharmaceutical waste Cytotoxic waste Chemical waste Waste containing heavy metals Land disposal Municipal and other external disposal sites Minimum approach to treatment and disposal Desirable improvements to the minimum approach References and further reading Collection and disposal of wastewater Characteristics of health-care wastewater Hazards of wastewater from health-care facilities Wastewater-related diseases Hazards from liquid chemicals in wastewater Hazards from pharmaceuticals in wastewater Hazards from radioactive substances Quantity of wastewater Quality of wastewater by hospital department Collection and pretreatment of liquid health-care waste Sewerage systems for health-care facilities Pretreatment of hazardous liquids Discharge into municipal sewage systems Onsite wastewater treatment Wastewater-treatment systems Disinfection of wastewater Disposal of sludge Emerging technologies Reuse of wastewater and sludge Offsite treatment and disposal in specialized facilities Operation and monitoring of sewerage systems Operation and maintenance of wastewater systems Monitoring of wastewater systems Minimum approach to wastewater management Sanitation system Minimal liquid hazardous waste-management system Basic wastewater-treatment systems Desirable improvements to the minimum approach References and further reading vi Safe management of wastes from health-care activities

8 10 Economics of health-care waste management Guiding principles Cost elements Costs at a health-care facility level Costs at a central treatment facility level Costs at a national level Cost estimation Cost and financing Methods of financing Costing tools Pricing models for a treatment provider Recommendations for cost reductions Minimum approach to health-care waste management costing Desirable improvements to the minimum approach References and further reading Health and safety practices for health-care personnel and waste workers Guiding principles Occupational health risks Health hazards Cytotoxic safety Exposure prevention and control Hierarchy of controls (applied to bloodborne pathogens) Dealing with spillages Reporting accidents and incidents Protective equipment Occupational post-exposure prophylaxis Training Minimum approaches to health and safety practices Desirable improvements to the minimum approach References and further reading Hospital hygiene and infection control Guiding principles Chain of infection Epidemiology of nosocomial infections Transition from exposure to infection Sources of infection Routes of transmission Prevention of nosocomial infections Standard precautions Isolation of infected patients and standard precautions Cleaning Sterilization and disinfection Hand hygiene Measures for improving infection control Minimum approach to hygiene and infection control Desirable improvements to the minimum approach References and further reading Contents vii

9 13 Training, education and public awareness Importance of training and education Education and training of health-care personnel Planning and implementation Employees to be trained Content of education programmes Follow-up and refresher courses Training responsibility Implementation of a training course The training package Selection of participants Training health-care waste handlers Health-care personnel Cleaning staff Staff who transport waste Treatment plant operators Landfill operators Integrating training with public education on risks of health-care waste Minimum approach to training, education and public awareness Desirable improvements to the minimum approach Improvements to the minimum approach Improvements to more advanced approaches References and further reading Health-care waste management in emergencies Guiding principles Phases for the safe management of health-care waste in emergencies Phase one: rapid initial assessment Phase two: emergency response Phase three: recovery phase Contingency planning and emergency preparedness References and further reading Future issues Changing patterns of disease Emerging diseases and multidrug-resistant organisms Pandemics Environmental issues Climate change Other environmental issues Waste technology Social, cultural and regulatory changes References and further reading viii Safe management of wastes from health-care activities

10 Annex 1 Contributors to the first edition Annex 2 Example training programmes in health-care waste management Annex 3 Chemical destruction methods for cytostatic drugs Annex 4 Clearance levels for radioactive waste Annex 5 Accidental contamination by mutagenic and carcinogenic products Annex 6 Disposal of pathological waste Glossary Tables Table 2.1 Table 2.2 Categories of health-care waste...4 Chemical waste from health-care activities...7 Table 2.3 Examples of health-care waste from different sources...12 Table 2.4 Table 2.5 Table 2.6 Table 2.7 Table 2.8 Table 2.9 Table 2.10 Table 3.1 Table 3.2 Table 3.3 Table 5.1 Daily data-collection form...14 Total and infectious waste generation by type of health-care facility (Pakistan, Tanzania, South Africa)...17 Total and infectious waste generation by type of health-care facility: high-income country (United States of America)...18 Bulk densities of health-care waste by components...18 Average material composition of health-care waste...19 Moisture content (%) of health-care waste components...19 Heating value of health-care waste components...20 Potential infections caused by exposure to health-care wastes, causative organisms and transmission vehicles...27 Frequency of procedure that health-care workers were using at the moment of percutaneous injury, selected countries...32 Viral hepatitis B infections caused by occupational injuries from sharps (USA)...33 Sample sheet for assessing waste generation...62 Table 7.1 WHO-recommended segregation scheme...79 Table 7.2 Advantages and disadvantages of needle cutters/destroyers...83 Table 7.3 Table 8.1 Table 8.2 Table 10.1 Table 10.2 Table 10.3 Table 10.4 Table 10.5 Table 10.6 Table 10.7 Selected United Nations packaging symbols...97 Typical reaction conditions and products from pyrolysis, gasification and incineration processes Emission guidelines for health-care waste incinerators Estimated capital and operating costs for available treatment methods Investment costs for incinerators in Indonesia Investment costs for incinerators in Africa Investment costs for large central incinerators that meet international standards Investment costs for alternative treatment solutions Positive and negative effects of fixed pricing Positive and negative effects of variable pricing Table 11.1 Risk of transmission of infection following occupational exposure Table 11.2 Hazards to health-care waste workers Table 11.3 Table 12.2 Table 12.3 Table 14.1 Table 14.2 Table A2.1 Table A2.2 Table A2.3 Example of a list of items for spillage cleaning The main forms of hand hygiene Ways to improve infection control Segregation of health-care waste in emergencies Summary of pharmaceutical disposal methods in and after emergencies Programme of the Certificate Programme in Health Care Waste Management Schedule for WHO-Euro s three-day course on health-care waste management Content of the UNEP health-care waste-management training modules Contents ix

11 Table A3.1 Table A3.2 Table A4.1 Table A4.2 Table A4.3 Formulation of reconstituted and administration solutions of cytostatic drugs Efficiency of the degradation methods tested on 32 cytostatic drug formulations Generic clearance levels for solid waste Liquid discharge rates to sewers, rivers or other large water bodies Gaseous releases into the open air Figures Figure 2.1 Figure 2.2 Figure 2.3 Figure 2.4 Figure 5.1 Figure 5.2 Figure 6.1 Figure 7.1 Figure 7.2 Typical waste compositions in health-care facilities...3 Total and infectious waste generation in selected hospitals (kg per bed per day)...15 Total and infectious waste generation in selected hospitals (kg per occupied bed per day or kg per patient per day)...16 Total and infectious waste generation in small clinics, health centres and dispensaries (in kg per patient per day)...16 Action plan for national programme of sound health-care waste management...54 Hospital waste-management structure...58 The waste-management hierarchy...67 Biohazard, radiation and chemical hazard symbols...79 Comparison of common hazardous waste symbols...80 Figure 7.3 Cardboard safety boxes...84 Figure 7.4 Figure 7.5 Figure 7.6 Example of a waste-segregation poster...85 Examples of interim waste storage places...87 Medical waste transport trolleys outside a hospital in Thailand...88 Figure 7.7 Example of a health care facility site plan with waste collection points (yellow circles)...89 Figure 7.8 Figure 7.9 Figure 7.10 Figure 7.11 Example labels outside the storage facility...90 Example labels inside the storage facility...90 Label for a pathological waste storage room...91 Examples of storage places for chemical waste...93 Figure 7.12 Sketch of waste-storage area...94 Figure 7.14 Figure 7.15 Figure 7.16 Figure 7.17 Figure 8.1 Figure 8.2 Figure 8.3 Example of a vehicle used for transporting health-care waste in the United Kingdom...97 Specifications for placards (e.g. UN 3291 Infectious [Biomedical] Waste)...99 Example of consignment note for carriage and disposal of infectious waste Example of an emergency response intervention card Simplified schematic of a pre-vacuum autoclave Simplified schematic of batch and semicontinuous microwave technologies Simplified flow scheme of the incineration process Figure 8.4 Simplified schematic of a rotary kiln incinerator Figure 8.5 Figure 8.6 Figure 8.7 Figure 9.1 Figure 9.2 Figure 9.3 Figure 9.4 Figure 9.5 Sample design of a concrete sharps vault Routes of exposure to hazards caused by open dumping Example of a low-cost pit cover Deaths due to improper water and sanitation systems per 1000 population Improper disposal of photochemicals into the sewerage system Activated sludge wastewater-treatment system in a hospital in Sonla, Vietnam Horizontal reed bed system Basic hospital wastewater-treatment system with two treatment stages Figure 9.6 Sample of a septic tank Figure 9.7 Figure 11.1 Basic lagooning system at a hospital Recommended protective clothing for health-care waste transportation in small hospitals in Thailand Figure 12.1 The spread of nosocomial infections Figure 12.2 Aide memoir for standard precautions in health care x Safe management of wastes from health-care activities

12 Figure 12.3 Figure 12.4 Figure 14.1 Figure 14.2 Hand hygiene technique with alcohol-based formulation Hand washing technique with soap and water Construction of a pit for onsite waste burial Special cells or trenches for disposal of biocontaminated wastes in a municipal dumping site (10 m long, 3 m wide and 2 m deep) Figure 14.3 Double-chamber incinerator in a health-care centre dumping site Figure 15.1 Anticipated extension in the range of malaria in Figure A3.1 Figure A3.2 Figure A3.3 Figure A3.4 Figure A3.5 Figure A3.6 Figure A3.7 Figure A3.8 Figure A3.9 Schematic representation of procedure for destruction of doxorubicin or daunorubicin Schematic representation of procedure for destruction of methotrexate or dichloromethotrexate using potassium permanganate/sulfuric acid Schematic representation of procedure for destruction of methotrexate using aqueous alkaline potassium permanganate Schematic representation of procedure for destruction of methotrexate using aqueous sodium hypochlorite Schematic representation of procedure for destruction of cyclophosphamide and ifosfamide using alkaline hydrolysis in the presence of dimethylformamide Schematic representation of procedure for destruction of cyclophosphamide using acid hydrolysis followed by addition of sodium thiosulfate and aqueous hydrolysis Schematic representation of procedure for destruction of vincristine sulfate and vinblastine sulfate Schematic representation of procedure for destruction of 6-tioguanine and 6-mercaptopurine Schematic representation of procedure for destruction of cisplatin by reduction with zinc powder Figure A3.10 Schematic representation of procedure for destruction of cisplatin by reaction with sodium diethyldithiocarbamate Figure A3.11 Schematic representation of procedure for destruction of procarbazine using potassium permanganate in sulfuric acid Figure A6.1 Figure A6.2 Figure A6.3 Boxes Example of a placenta pit A dome biogester A biogas plant Box 2.1 Common genotoxic products used in health care a...6 Box 2.2 Box 2.3 Box 2.4 Box 3.1 Box 3.2 Box 3.3 Box 3.4 Box 5.1 Box 5.2 Box 6.1 Box 6.2 Box 6.3 Box 6.4 Box 6.5 Box 6.6 Box 7.1 Common recyclable materials from health-care facilities...9 Major sources of health-care waste...9 Minor sources of health-care waste...10 Chain of infection...26 Health sector contribution of mercury in the environment...29 Cytotoxic drugs hazardous to eyes and skin...30 Occupational transmission of HIV in France and the United States of America...33 Parameters to be monitored by the waste-management officer...60 Details to include in the waste-management plan...63 Examples of practices that encourage waste minimization...68 Reuse of medical devices in Canada...70 Examples of sterilization methods for reusable items...71 Recycling at the Heart of England NHS Foundation Trust...72 Recycling infectious waste in Nepal...72 Hospital food waste composting...73 Recommendations for storage facilities for health-care waste...89 Box 7.2 Decay storage of radioactive waste a sample calculation of decay storage time...94 Box 8.1 Box 8.2 Characteristics of sodium hypochlorite (NaOCl) as a chemical disinfectant Essential elements for the design and operation of sanitary landfills Contents xi

13 Box 10.1 Box 10.2 Costs of construction and operation of a health-care waste-treatment plant (incinerator, autoclave, microwave, etc.) Tools for estimating total costs of health-care waste management Box 11.1 Controls framework Box 11.2 Box 12.1 Box 13.1 Box 13.2 Box 13.3 Box 13.4 Box 13.5 Box 13.6 Box 13.7 Box 14.1 Example of general procedure for dealing with spillages Classification of pathogenic organisms Example of a training set-up Training tools examples (World Health Organization-related) Training health-care personnel Training cleaning staff Training waste-transport staff Training treatment plant operators Issues to address when training treatment plant operators Rapid initial assessment Box 14.2 Generic terms of reference for conducting a rapid initial assessment Box 14.3 Box 14.4 Box 15.1 Box 15.2 Box 15.3 Box 15.4 Box 15.5 Issues to remember when collecting information in emergencies Key points to address during a recovery phase Key points relating to changing disease patterns Key points relating to climate change Key points relating to environmental issues Key points relating to waste technology Key points relating to social, cultural and regulatory changes xii Safe management of wastes from health-care activities

14 Foreword to the first edition In pursuing their aims of reducing health problems and eliminating potential risks to people s health, health-care services inevitably create waste that may itself be hazardous to health. The waste produced in the course of healthcare activities carries a higher potential for infection and injury than any other type of waste. Wherever waste is generated, safe and reliable methods for its handling are therefore essential. Inadequate and inappropriate handling of health-care waste may have serious public health consequences and a significant impact on the environment. Sound management of health-care waste is thus a crucial component of environmental health protection. In both the short term and the long term, the actions involved in implementing effective health-care waste management programmes require multisectoral cooperation and interaction at all levels. Policies should be generated and coordinated globally, with the management practices implemented locally. Establishment of a national policy and a legal framework, training of personnel, and raising public awareness are essential elements of successful health-care waste management. Improved public awareness of the problem is vital in encouraging community participation in generating and implementing policies and programmes. Management of health-care waste should thus be put into a systematic, multifaceted framework, and should become an integral feature of health-care services. To achieve this aim, the World Health Organization (WHO), together with WHO s European Centre for Environment and Health in Nancy, France, set up an international working group (in 1995) to produce a practical guide, addressing particularly the problems of health-care waste management in developing countries. The group included representatives of the private sector involved in waste management activities and members of the public. This handbook, the result of their efforts, is intended to be comprehensive, yet concise, user-friendly and oriented towards practical management of health-care waste in local facilities. It provides guidelines for the responsible national and local administrators, and is the first publication to offer globally relevant advice on the management of health-care waste. The guidelines complement and supplement those produced in different regions in the past. WHO strongly encourages the widespread implementation of these guidelines and is ready to assist users in adapting them to national settings. This handbook has been prepared as a practical response to the need for improved health-care waste management, especially in developing countries. Continuing efforts are being made to refine this response, and feedback from users of the handbook would be appreciated. Comments and suggestions based on experience of this handbook s use may be sent to: Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva 27, CH-1211, Switzerland. xiii

15

16 Acknowledgements WHO wishes to express its appreciation to all whose efforts and valuable contributions made this production possible. In particular, WHO gratefully acknowledges the contributions of the following international experts who contributed to and reviewed the handbook. Editorial Yves Chartier, WHO, Switzerland Jorge Emmanuel, UNDP GEF Global Healthcare Waste Project, United States of America Ute Pieper, ETLog Health GmbH, Germany Annette Prüss-Ustun, WHO, Switzerland Philip Rushbrook, Foreign & Commonwealth Office, United Kingdom Ruth Stringer, Health Care Without Harm, United Kingdom William King Townend, International Environmental Consultancy, United Kingdom Susan Wilburn, WHO, Switzerland Raki Zghondi, WHO Regional Centre for Environmental Health Activities, Jordan Authors Ashok Agarwal, IGNOU, India Franck Bouvet, UNICEF, Switzerland Yves Chartier, WHO, Switzerland Christopher Drew, Golder Consulting, United Kingdom Jorge Emmanuel, UNDP GEF Global Healthcare Waste Project, United States of America Ed Krisiunas, WNWN International, United States of America Jan-Gerd Kühling, ETLog Health GmbH, Germany Leo Leest, Management and Technical Solutions for Waste, the Netherlands Ute Pieper, ETLog Health GmbH, Germany Philip Rushbrook, Foreign & Commonwealth Office, London, United Kingdom Ruth Stringer, Health Care Without Harm, United Kingdom William King Townend, International Environmental Consultancy, United Kingdom Andrew Trevett, UNICEF, United States of America Susan Wilburn, WHO, Switzerland Raki Zghondi, WHO Regional Centre for Environmental Health Activities, Jordan Contributors Ashok Agarwal, IGNOU, India Franck Bouvet, UNICEF, Switzerland Yves Chartier, WHO, Switzerland Diego Daza, WHO, Colombia Jorge Emmanuel, UNDP GEF Global Healthcare Waste Project, United States of America xv

17 Shinee Enkhtsetseg, WHO, Germany Ed Krisiunas, WNWN International, United States of America Jan Gerd Kühling, ETLog Health GmbH, Germany Leo Leest, Management and Technical Solutions for Waste, the Netherlands Maria Mahon, GWB, United Kingdom Victoria Masembe, JSI, Uganda Nancy Muller, PATH, United States of America Mahesh Nakarmi, Health Care Foundation Nepal, Nepal Carib Nelson, PATH, United States of America Ute Pieper, ETLog Health GmbH, Germany Preethi Pratap, University of Illinois at Chicago School of Public Health, United States of America Joanie Roberston, PATH, Vietnam Marcia Rock, global health consultant, United States of America Philip Rushbrook, Foreign & Commonwealth Office, London, United Kingdom Dejana Selenic, CDC, United States of America Ruth Stringer, Health Care Without Harm, United Kingdom Ruma Tavorath, World Bank, India William King Townend, International Environmental Consultancy, United Kingdom Paul Williams, Consultant, United Kingdom Anne Woolridge, Independent Safety Services Ltd, United Kingdom Raki Zghondi, WHO Regional Centre for Environmental Health Activities, Jordan WHO wishes to acknowledge gratefully the secretarial support of Lesley Robinson and Saydy Karbaj to the development of this volume. WHO also gratefully acknowledges the experts who contributed to the first edition of this report (1999), whose names are listed in Annex 1. The development of this second edition was made possible with the financial support and collaboration of the Bill & Melinda Gates Foundation, the International Solid Waste Association, the GAVI Alliance and the French Ministry of Social Affairs and Health. In memoriam The second edition of Safe management of wastes from health-care activities is dedicated to our distinguished colleague and dear friend Yves Chartier ( ), Public Health Engineer, who led the development of this work, and inspired involvement in and commitment to health-care waste management. Yves was the co-author of many WHO publications on environmental health in the health sector. This edition is also dedicated to our colleague Carib Nelson ( ), whose contributions consistently showed us a practical way through sound health-care waste management options. xvi Safe management of wastes from health-care activities

18 Acronyms and abbreviations ADR AIDS AOX ATSDR BAT BEP Blue Book CAT CDC CFU ClO 2 DEHP DNA ECAT EMS EPP GEF HBV HCl HCV HEPA HIV H 2 SO 4 IARC IGNOU ILO ISO ISWA MBR NaOCl NGO NHS PEP PET POP PPE PVC STAATT TB UN UNDP European agreement concerning the international carriage of dangerous goods by road acquired immunodeficiency syndrome absorbable organic iodinated compounds United States Agency for Toxic Substances and Diseases Registry best available techniques best environmental practice shortened title for this handbook, Safe management of wastes from health-care activities cost-analysis tool Centers for Disease Control and Prevention colony forming unit chlorine dioxide diethylhexyl phthalate deoxyribonucleic acid expanded cost-analysis tool environmental management system environmentally preferable purchasing Global Environment Facility hepatitis B virus hydrochloric acid hepatitis C virus high-efficiency particulate air human immunodeficiency virus sulfuric acid International Agency for Research on Cancer Indira Gandhi National Open University International Labour Organization International Organization for Standardization International Solid Waste Association membrane biological reactors sodium hypochlorite nongovernmental organization National Health Service post-exposure prophylaxis polyethylene terephthalate (also known as PETE) persistent organic pollutants personal protective equipment polyvinyl chloride State and Territorial Association on Alternate Treatment Technologies tuberculosis United Nations United Nations Development Programme xvii

19 UNECE UNICEF UV WHO United Nations Economic Commission for Europe United Nations Children s Fund ultraviolet World Health Organization Safe management of wastes from health-care activities xviii

20 1 Introduction This is the second edition of the World Health Organization (WHO) handbook on the safe, sustainable and affordable management of health-care waste commonly known as the Blue Book. The original Blue Book was a comprehensive publication used widely in health-care centres and government agencies to assist in the adoption of national guidance. It also provided support to committed medical directors and managers to make improvements and presented practical information on waste-management techniques for medical staff and waste workers. The first edition in 1999 was published at an influential point in time. Public interest in emerging and developing countries to improve health services was growing, and poor waste practices within health-care facilities were being challenged increasingly by interest groups and communities. In the more developed countries, there was a renewed concern about consumption of resources and impacts on global changes to climate and the environment. In many countries, knowledge about the potential for harm from health-care wastes has now become more prominent to governments, medical practitioners and civil society. Increasingly, managers and medical staff are expected to take more responsibility for the wastes they produce from their medical care and related activities. The indiscriminate and erratic handling and disposal of waste within health-care facilities is now widely recognized as a source of avoidable infection, and is synonymous with public perception of poor standards of health care. It has been more than 10 years since the first edition of the Blue Book. During the intervening period, the requirements on generators of health-care wastes have evolved and new methods have become available. Consequently, WHO recognized that it was an appropriate time to update the original text. The purpose of the second edition is to expand and update the practical information in the original Blue Book. In June 2007, WHO held a workshop in Geneva with specialists from 31 countries. The specialists reviewed the Blue Book chapter by chapter and proposed new information to ensure the advice remains relevant to current demands on health-care facilities. During the following four years, every chapter was revised by authors from around the world. These authors gave their time voluntarily, and their drafts were extensively peer-reviewed before being edited into a final form. The new Blue Book is designed to continue to be a source of impartial health-care information and guidance on safe waste-management practices. The editors intention has been to keep the best of the original publication and supplement it with the latest relevant information. The audience for the Blue Book has expanded. Initially, the publication was intended for those directly involved in the creation and handling of health-care wastes: medical staff, health-care facility directors, ancillary health workers, infection-control officers and waste workers. This is no longer the situation. A wider range of people and organizations now have an active interest in the safe management of health-care wastes: regulators, policymakers, development organizations, voluntary groups, environmental bodies, environmental health practitioners, advisers, researchers and students. They should also find the new Blue Book of benefit to their activities. Chapters 2 and 3 explain the various types of waste produced from health-care facilities, their typical characteristics and the hazards these wastes pose to patients, staff and the general environment. Chapters 4 and 5 introduce the guiding regulatory principles for developing local or national approaches to tackling health-care waste management and transposing these into practical plans for regions and individual health-care facilities. Specific methods and technologies are described for waste minimisation, segregation and treatment of health-care wastes in Chapters 6, 7 and 8. These chapters introduce the basic features of each technology and the operational and environmental characteristics required to be achieved, followed by information on the potential advantages and disadvantages of each system. 1

Workshop December, 2014

Workshop December, 2014 Workshop December, 2014 Key points Sharps are the most likely health care waste to cause injury and/or exposure. so, at a minimum a waste management program must focus on sharps handling. Proper segregation

More information

BIOMEDICAL WASTE MANAGEMENT

BIOMEDICAL WASTE MANAGEMENT BIOMEDICAL WASTE MANAGEMENT Facilitator: Dr. NAVPREET Assistant Professor, Department of Community Medicine Govt. Medical College & Hospital, Chandigarh. Specific Learning Objectives At the end of session,

More information

2.3. The management in each HCF shall be responsible for ensuring good waste management practices in their premises.

2.3. The management in each HCF shall be responsible for ensuring good waste management practices in their premises. 1. PURPOSE Health-care activities lead to production of medical waste that may lead to adverse health effects. Most of this waste is not more dangerous than regular household waste. However, some types

More information

BIO MEDICAL WASTE MANAGEMENT

BIO MEDICAL WASTE MANAGEMENT Bio Medical Waste Management MODULE 5 BIO MEDICAL WASTE MANAGEMENT 5.1 INTRODUCTION Bio medical waste (BMW) may be defined as any solid, fluid or liquid waste material including its container and any other

More information

CHAPTER V: DISPOSAL OF WASTES CONTAMINATED WITH INFECTIOUS AGENTS

CHAPTER V: DISPOSAL OF WASTES CONTAMINATED WITH INFECTIOUS AGENTS CHAPTER V: DISPOSAL OF WASTES CONTAMINATED WITH INFECTIOUS AGENTS These biohazard waste disposal guidelines are designed to not only protect the public and the environment, but also laboratory and custodial

More information

"ADOPTED STANDARDS FOR THE REGULATION OF MEDICAL WASTE" IN HEALTH CARE FACILITIES LICENSED BY THE MISSISSIPPI STATE DEPARTMENT OF HEALTH

ADOPTED STANDARDS FOR THE REGULATION OF MEDICAL WASTE IN HEALTH CARE FACILITIES LICENSED BY THE MISSISSIPPI STATE DEPARTMENT OF HEALTH "ADOPTED STANDARDS FOR THE REGULATION OF MEDICAL WASTE" IN HEALTH CARE FACILITIES LICENSED BY THE MISSISSIPPI STATE DEPARTMENT OF HEALTH REGULATED MEDICAL WASTE "Infectious medical wastes" includes solid

More information

Global Journal of Medicine and Public Health www.gjmedph.org

Global Journal of Medicine and Public Health www.gjmedph.org Global Journal of Medicine and Public Health www.gjmedph.org Bio Medical Waste Management- An Emerging Problem Mohd Inayatulla Khan 1, Prasant MC 2, Fareedi Mukram Ali, 3 Vinit Aher, 4 Sanjay Kar 5, Imran

More information

Laboratory Biosafty In Molecular Biology and its levels

Laboratory Biosafty In Molecular Biology and its levels Laboratory Biosafty In Molecular Biology and its levels Workshop 16-17 Oct..2012 Guidelines Does not mean optional Laboratory Biosafety The Laboratory Biosafety Manual is an important WHO publication

More information

WASTE MANAGEMENT. This document is applicable to all staff and students of the premises of the Department of Medicine.

WASTE MANAGEMENT. This document is applicable to all staff and students of the premises of the Department of Medicine. WASTE MANAGEMENT INTRODUCTION So as to maintain and promote a safe and healthy workplace, efforts should be made to ensure that staff, students and visitors meet government regulations concerning hazardous

More information

Health and safety practices for health-care personnel and waste workers

Health and safety practices for health-care personnel and waste workers 12 Health and safety practices for health-care personnel and waste workers 12.1 Principles Health-care waste management policies or plans should include provision for the continuous monitoring of workers

More information

INSTITUTIONAL POLICY AND PROCEDURE (IPP)

INSTITUTIONAL POLICY AND PROCEDURE (IPP) HOSPITAL NAME INSTITUTIONAL POLICY AND PROCEDURE (IPP) Department: Manual: Section: TITLE/DESCRIPTION POLICY NUMBER HAZARDOUS WASTE: HANDLING AND DISPOSAL EFFECTIVE DATE REVIEW DUE REPLACES NUMBER NO.

More information

THE DISPOSAL OF HEALTHCARE WASTE BY NHS GRAMPIAN FROM ACUTE HOSPITAL WARDS

THE DISPOSAL OF HEALTHCARE WASTE BY NHS GRAMPIAN FROM ACUTE HOSPITAL WARDS THE DISPOSAL OF HEALTHCARE WASTE BY NHS GRAMPIAN FROM ACUTE HOSPITAL WARDS Arrangements for the Collection and Disposal of Healthcare Waste NHS Grampian provides a range of healthcare waste disposal services

More information

MEDICAL WASTE DISPOSAL POLICY. EFFECTIVE DATE: January 31, 1991 REVISED DATE: April 1, 2008 I. AUTHORITY TO ESTABLISH DISPOSAL POLICY:

MEDICAL WASTE DISPOSAL POLICY. EFFECTIVE DATE: January 31, 1991 REVISED DATE: April 1, 2008 I. AUTHORITY TO ESTABLISH DISPOSAL POLICY: MEDICAL WASTE DISPOSAL POLICY EFFECTIVE DATE: January 31, 1991 REVISED DATE: April 1, 2008 I. AUTHORITY TO ESTABLISH DISPOSAL POLICY: The authority by which the Municipality of Anchorage, Solid Waste Services

More information

THE SAFE DISPOSAL OF CLINICAL/DOMESTIC WASTE

THE SAFE DISPOSAL OF CLINICAL/DOMESTIC WASTE Section V THE SAFE DISPOSAL OF CLINICAL/DOMESTIC WASTE The Trust is currently reviewing the requirements of the recent guidelines Health Technical Memorandum Safe Management of Healthcare Waste (HTML 07-01).

More information

Medical Waste Management

Medical Waste Management Medical Waste Management GEMS Environmental Compliance-ESDM Training Series Africa-Asia-Latin America-Middle East 2013-2014 What is Medical Waste? The term includes what is commonly described as garbage,

More information

Professional Certification in Biological Waste Management Examination Content, Sample Questions & References

Professional Certification in Biological Waste Management Examination Content, Sample Questions & References Professional Certification in Biological Waste Management Examination Content, Sample Questions & References The IFBA s Professional Certification (PC) in Biological Waste Management identifies individuals

More information

Medical Waste Management Issues in Asia

Medical Waste Management Issues in Asia Medical Waste Management Issues in Asia C. Visvanathan Environmental Engineering & Management Program Asian Institute of Technology Thailand 1 visu@ait.ac.th Web: http://www.faculty.ait.ac.th/visu/ Asia

More information

INFECTIOUS/BIOLOGICAL WASTE MANAGEMENT PROTOCOL

INFECTIOUS/BIOLOGICAL WASTE MANAGEMENT PROTOCOL INFECTIOUS/BIOLOGICAL WASTE MANAGEMENT PROTOCOL UNIVERSITY RISK MANAGEMENT Occupational Safety and Health Programs 19 Hagood Avenue, Suite 908 Charleston, SC 29425 843-792-3604 Revised: March 2015 TABLE

More information

Healthcare Waste Management Training

Healthcare Waste Management Training WHO Regional Office for Europe Healthcare Waste Management Training Module 6 International & national regulations, guidelines, policies Content International principles for handling waste Kenya s guidelines

More information

PROCEDURES FOR LABORATORY CHEMICAL WASTE DISPOSAL

PROCEDURES FOR LABORATORY CHEMICAL WASTE DISPOSAL PROCEDURES FOR LABORATORY CHEMICAL WASTE DISPOSAL In an effort to create a more effective, cost efficient and environmentally friendly waste management system on campus, we are proposing the following

More information

CLINICAL AND RELATED WASTE OPERATIONAL GUIDANCE

CLINICAL AND RELATED WASTE OPERATIONAL GUIDANCE INDUSTRIAL WASTE RESOURCE GUIDELINES CLINICAL AND RELATED WASTE OPERATIONAL GUIDANCE CONTENTS INTRODUCTION... 1 WHO GENERATES CLINICAL AND RELATED WASTE?... 1 WASTE MANAGEMENT PRINCIPLES & RESPONSIBILTY...

More information

CHS Medical Group Hazardous Waste Management In Service

CHS Medical Group Hazardous Waste Management In Service CHS Medical Group Hazardous Waste Management In Service Objective Educate staff how to properly manage Regulated Medical Waste (RMW), Chemotherapy Waste and EPA RCRA Hazardous Waste Ensure compliance with

More information

Laboratory Waste Disposal

Laboratory Waste Disposal Laboratory Waste Disposal 1. Purpose This guideline details the procedures to follow in disposing of hazardous waste that is generated in the laboratory in order to minimise risks associated with the disposal

More information

Utah Division of Solid and Hazardous Waste Solid Waste Management Program

Utah Division of Solid and Hazardous Waste Solid Waste Management Program Utah Division of Solid and Hazardous Waste Solid Waste Management Program Mailing Address Office Location Phone (801) 536-0200 P.O. Box 144880 195 North 1950 West Fax (801) 536-0222 Salt Lake City, Utah

More information

Decontamination and Waste Management www.biosecurity.sandia.gov

Decontamination and Waste Management www.biosecurity.sandia.gov Decontamination and Waste Management www.biosecurity.sandia.gov SAND No. 2006-3684C Sandia is a multiprogram laboratory operated by Sandia Corporation, a Lockheed Martin Company, for the United States

More information

Revision 5. Calvin College Medical Waste Management Plan. Date: Health and Safety

Revision 5. Calvin College Medical Waste Management Plan. Date: Health and Safety Calvin College Medical Waste Management Plan Prepared by: Date: Environmental 6/10/1 Health and Safety Approved By: Date: Revision 1.0 Policy The following medical waste management plan has been established

More information

GUIDE for SUSTAINABLE WASTE MANAGEMENT in the HEALTH-CARE SECTOR

GUIDE for SUSTAINABLE WASTE MANAGEMENT in the HEALTH-CARE SECTOR LIFE ENVIRONMENT EMAS AND INFORMATION TECHNOLOGY IN HOSPITALS LIFE04 ENV/GR/000114 GUIDE for SUSTAINABLE WASTE MANAGEMENT in the HEALTH-CARE SECTOR Developed by: EPTA Ltd. 15, Olofytou Str, 11142 Athens,

More information

MEDICAL WASTE COLLECTION, TREATMENT, AND DISPOSAL

MEDICAL WASTE COLLECTION, TREATMENT, AND DISPOSAL CHAPTER 11 Solid Waste Management Privatization Procedural Manual MEDICAL WASTE COLLECTION, TREATMENT, AND DISPOSAL SOLID WASTE TECHNICAL ASSISTANCE Ministry of State for Environmental Affairs U.S. Agency

More information

Collection and disposal of wastewater

Collection and disposal of wastewater 10 Collection and disposal of wastewater 10.1 Characteristics and hazards of wastewater from health-care establishments Wastewater from health-care establishments is of a similar quality to urban wastewater,

More information

Recommendations for the Safe Use of Handling of Cytotoxic Drugs

Recommendations for the Safe Use of Handling of Cytotoxic Drugs Recommendations for the Safe Use of Handling of Cytotoxic Drugs Introduction Cytotoxic drugs are toxic compounds and are known to have carcinogenic, mutagenic and/or teratogenic potential. With direct

More information

ENVIRONMENTAL HEALTH, SAFETY & RISK MANAGEMENT. Hazardous Materials &Waste Management Plan at

ENVIRONMENTAL HEALTH, SAFETY & RISK MANAGEMENT. Hazardous Materials &Waste Management Plan at ا السلامة و معالجة المخاطر لصحة البيي ية ENVIRONMENTAL HEALTH, SAFETY & RISK MANAGEMENT Hazardous Materials &Waste Management Plan at AUB-MC 1 Outline 1. Objectives 2. Definitions of Hazardous Waste 3.

More information

Biohazardous Waste Disposal. Table of Contents

Biohazardous Waste Disposal. Table of Contents 1 of 6 The purpose of these guidelines is to ensure compliance with legislation related to the disposal of biohazardous waste. Table of Contents 1. Definitions... 1 2. Biohazardous waste assessment...

More information

Nu G Medical Waste System Technology (Pyrolysis / Thermal Decomposition)

Nu G Medical Waste System Technology (Pyrolysis / Thermal Decomposition) Product Description: Nu G Medical Waste System Technology (Pyrolysis / Thermal Decomposition) The NU G System uses pyrolysis thermal decomposition to treat infectious wastes typically generated in hospitals.

More information

Guideline C-4: The Management of Biomedical Waste in Ontario

Guideline C-4: The Management of Biomedical Waste in Ontario Guideline C-4: The Management of Biomedical Waste in Ontario November 2009 Disclaimer: This guideline is not and should not be construed as legal advice. Please review the Environmental Protection Act

More information

Pharmaceutical waste disposal Guideline. Guideline for Disposal of Pharmaceutical waste (1 st Edition, 2014)

Pharmaceutical waste disposal Guideline. Guideline for Disposal of Pharmaceutical waste (1 st Edition, 2014) Guideline for Disposal of Pharmaceutical waste (1 st Edition, 2014) 1 Contents 1. Definition... 3 2. Principle and General Requirements... 3 3. Process flow chart... 4 4. Procedure... 5 5. Recording and

More information

HAZARDOUS WASTE MANAGEMENT AT HEALTHCARE FACILITIES

HAZARDOUS WASTE MANAGEMENT AT HEALTHCARE FACILITIES HAZARDOUS WASTE MANAGEMENT AT HEALTHCARE FACILITIES *Dr. D. Shreedevi *Associate Professor, Apollo Institute of Hospital Administration, Apollo Health City, Jubilee Hills, Hyderabad 500096. (M) 9441885258

More information

MEDICAL WASTE MANAGEMENT

MEDICAL WASTE MANAGEMENT MEDICAL WASTE MANAGEMENT I. INTRODUCTION Medical waste disposal has become a growing concern for most medical facilities because of increasing regulations and growing public perception. To address these

More information

School Of Medicine & Biomedical Sciences. Waste Management Policy

School Of Medicine & Biomedical Sciences. Waste Management Policy School Of Medicine & Biomedical Sciences. Waste Management Policy Introduction The management and disposal of waste has become highly regulated over the past few years. As a result every employee and student

More information

Biomedical Waste Management A Step Towards A Healthy Future

Biomedical Waste Management A Step Towards A Healthy Future Biomedical Waste Management 927 162 Biomedical Waste Management A Step Towards A Healthy Future KAMLESH TEWARY, VIJAY KUMAR, PAMIT TIWARY INTRODUCTION The management of health-care waste is a subject of

More information

3. Please state whether applying for fresh authorization or for renewal: (New Authorisation)

3. Please state whether applying for fresh authorization or for renewal: (New Authorisation) FORM-I APPLICATION FOR AUTHORISATION (To be submitted in duplicate) To, The Prescribed Authority : Goa State Pollution Control Board Dempo Towers, 1 st Floor, Patto Plaza, Panaji-Goa. Fax-432740 1. Particulars

More information

GOVERNMENT NOTICES GOEWERMENTSKENNISGEWINGS

GOVERNMENT NOTICES GOEWERMENTSKENNISGEWINGS 4 No. 37654 GOVERNMENT GAZETTE, 23 MAY 2014 GOVERNMENT NOTICES GOEWERMENTSKENNISGEWINGS DEPARTMENT OF HEALTH DEPARTEMENT VAN GESONDHEID No. R. 375 23 May 2014 THE NATIONAL HEALTH ACT, 2003 (ACT NO. 61

More information

Chapter 8. Waste management at medical centres

Chapter 8. Waste management at medical centres WASTE MANAGEMENT AT MEDICAL CENTRES Chapter Waste management at medical centres The term medical centre can be used to refer to field hospitals, outpatient clinics and any other location where medical

More information

Clinical Waste Management & Sharps Injury Prevention. Clinical Skills

Clinical Waste Management & Sharps Injury Prevention. Clinical Skills Clinical Skills Clinical Waste Management and Sharps Injury Prevention Clinical Skills and Simulation Team Cardiff and Vale Waste Management Team Aims & Outcomes Aims & Outcomes The aim of this module

More information

Training on Standard Operating Procedures for Health Care Waste Management Swaziland 12 May, 2011

Training on Standard Operating Procedures for Health Care Waste Management Swaziland 12 May, 2011 Training on Standard Operating Procedures for Health Care Waste Management Swaziland 12 May, 2011 Safe Infectious Waste Handling and Transport Objective Waste Overview Roles and Responsibilities of Waste

More information

Compliance Bulletin Solid Waste Medical Waste Treatment reviewed/revised February 2012

Compliance Bulletin Solid Waste Medical Waste Treatment reviewed/revised February 2012 Compliance Bulletin Solid Waste Medical Waste Treatment reviewed/revised February 2012 Medical waste can be divided into two basic types for treatment purposes: 1) infectious wastes like blood and body

More information

Waste Management Program

Waste Management Program EOSMS 210 Date: 04/01/2014 Page 1 of 7 1. Purpose Non-hazardous and hazardous chemical wastes, biohazardous wastes, regulated medical wastes and universal wastes generated by KSU will be handled according

More information

11. The key for waste management Waste segregation

11. The key for waste management Waste segregation 11. The key for waste management Waste segregation 11.1 Segregation at the place of origin The background idea Segregation means the separation of the entire waste generated in a hospital in defined, different

More information

HAZARDOUS CHEMICAL WASTE DISPOSAL SECTION 7

HAZARDOUS CHEMICAL WASTE DISPOSAL SECTION 7 HAZARDOUS CHEMICAL WASTE DISPOSAL According to Ontario environmental legislation, generators of hazardous waste are responsible for properly packaging and labelling such wastes. The University of Toronto

More information

PHARMACEUTICAL AND CHEMICAL WASTE MANAGEMENT

PHARMACEUTICAL AND CHEMICAL WASTE MANAGEMENT Medicines and Medical Devices Agency of Serbia PHARMACEUTICAL AND CHEMICAL WASTE MANAGEMENT Ivana Bozic, MSc Health, Safety and Environment ISWA Beacon Conference, Novi Sad, 08 10 December 2010 458, Vojvode

More information

Hazardous Waste Procedures. Faculty of Science University of Ottawa

Hazardous Waste Procedures. Faculty of Science University of Ottawa Hazardous Waste Procedures University of Ottawa Contents Hazardous Materials Waste Overview:... 3 Regulations:... 3 General requirements related to packaging waste:... 4 Table 1: List of Appropriate Waste

More information

Laboratory chemical waste disposal guidelines

Laboratory chemical waste disposal guidelines Laboratory chemical waste disposal guidelines August, 2014 Contents 1. Background... 2 2. How do I arrange disposal of my chemical waste?... 2 3. Information requirements... 2 4. What types of wastes are

More information

Biohazardous Waste Management Plan

Biohazardous Waste Management Plan Central Michigan University Biohazardous Waste Management Plan This document has been prepared to provide guidance to Central Michigan University (CMU) employees in the use and disposal of biohazardous

More information

GOVERNMENT OF PAKISTAN MINISTRY OF ENVIRONMENT NOTIFICATION

GOVERNMENT OF PAKISTAN MINISTRY OF ENVIRONMENT NOTIFICATION GOVERNMENT OF PAKISTAN MINISTRY OF ENVIRONMENT NOTIFICATION Islamabad, the 3 rd August,2005. S.R.O.1013 (1)/2005.- In exercise of the powers conferred by section 31 of the Pakistan Environmental Protection

More information

Protocol for Disinfection of Cell Culture and Tissue Culture in Media:

Protocol for Disinfection of Cell Culture and Tissue Culture in Media: Protocol for Disinfection of Cell Culture and Tissue Culture in Media: Location: Hickory Hall 001 Director: Dr. Guido Verbeck DECONTAMINATION OF CELL CULTURE WASTE Cell culture has become a common laboratory

More information

The University of Texas at San Antonio Office of Environmental Health, Safety and Risk Management. Part A. Biological Waste Management Safety Plan

The University of Texas at San Antonio Office of Environmental Health, Safety and Risk Management. Part A. Biological Waste Management Safety Plan The University of Texas at San Antonio Office of Environmental Health, Safety and Risk Management Part A Biological Waste Management Safety Plan i. SIGNATURE PAGE This Biological Waste Management Safety

More information

Connecticut Biomedical Waste (BMW) Requirements (22a-209-15) and Common Industry Practices

Connecticut Biomedical Waste (BMW) Requirements (22a-209-15) and Common Industry Practices Connecticut Biomedical Waste (BMW) Requirements (22a-209-15) and Common Industry Practices Mark Latham CT DEP, Waste Engineering and Enforcement Division Common Synonyms for BMW Regulated Medical Waste

More information

MUNICIPALITY OF ANCHORAGE

MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE Solid Waste Services Department MEDICAL WASTE DISPOSAL POLICY EFFECTIVE DATE: January 31, 1991 REVISED DATE: November 1, 2013 I. AUTHORITY TO ESTABLISH DISPOSAL POLICY: The authority

More information

OCCUPATIONAL SAFETY AND ENVIRONMENTAL HEALTH GUIDELINE

OCCUPATIONAL SAFETY AND ENVIRONMENTAL HEALTH GUIDELINE OSEH Occupational Safety & Environmental Health OCCUPATIONAL SAFETY AND ENVIRONMENTAL HEALTH GUIDELINE Subject: Biohazardous (Medical) Waste Disposal Date: 08/19/09 Revision: 03 Page: 1 of 7 TABLE OF Section

More information

BIOMEDICAL WASTE MANAGEMENT: NEED FOR HUMAN CIVILIZATION

BIOMEDICAL WASTE MANAGEMENT: NEED FOR HUMAN CIVILIZATION RESEARCH ARTICLE BIOMEDICAL WASTE MANAGEMENT: NEED FOR HUMAN CIVILIZATION Prerna Thareja 1, Brijendra Singh 2, *, Surjit Singh 3, Dushyant Agrawal 4, Prabhpreet Kaur 5 1 Senior Resident, Dept. of Dentistry,

More information

Infectious Waste Management Plan

Infectious Waste Management Plan Infectious Waste Management Plan Infectious Waste Management Plan USC Health & Safety Programs Unit 777-5269 POLICY: A. In keeping with the University of South Carolina's policy of providing protection

More information

SOLID WASTE MANAGEMENT PROGRAM WASTE MANAGEMENT DIVISION DEPARTMENT OF ENVIRONMENTAL CONSERVATION AGENCY OF NATURAL RESOURCES STATE OF VERMONT

SOLID WASTE MANAGEMENT PROGRAM WASTE MANAGEMENT DIVISION DEPARTMENT OF ENVIRONMENTAL CONSERVATION AGENCY OF NATURAL RESOURCES STATE OF VERMONT Waste Management Division 103 South Main Street Waterbury, Vermont 05671-0407 (802) 241-3444 FAX (802) 241-3296 SOLID WASTE MANAGEMENT PROGRAM WASTE MANAGEMENT DIVISION DEPARTMENT OF ENVIRONMENTAL CONSERVATION

More information

Medical Waste Management Plan

Medical Waste Management Plan Medical Waste Management Plan The Kern County Environmental Health Division is the local agency designated by the California Department of Public Health to implement the Medical Waste Management Act. This

More information

A Guide to Managing Your Biological Waste at the University at Albany

A Guide to Managing Your Biological Waste at the University at Albany A Guide to Managing Your Biological Waste at the University at Albany Section 1 - What you need to know: Definition: "Regulated Medical Waste (RMW) shall mean any of the following waste which is generated

More information

Standard Operating Procedure for Dacarbazine in Animals

Standard Operating Procedure for Dacarbazine in Animals Standard Operating Procedure for Dacarbazine in Animals 1. Health hazards Dacarbazine, also known as DTIC, DIC, and Imidazole Carboxamide, is an antineoplastic chemotherapy drug used in the treatment of

More information

Understanding Regulated Medical Waste & Best Management Practices

Understanding Regulated Medical Waste & Best Management Practices Understanding Regulated Medical Waste & Best Management Practices Regulations & References The information provided in this presentation is based on the referenced Code of Federal Regulations and State

More information

Biohazardous Waste and Sharps Disposal

Biohazardous Waste and Sharps Disposal Biohazardous Waste and Sharps Disposal Federal OSHA Occupational Exposure to Bloodborne Pathogens Standard 29 CFR 1910.1030 State California Code of Regulations (CCR), Medical Waste Management Act, Chapter

More information

Administrative Procedure

Administrative Procedure Administrative Procedure Number: 410 Effective 1/30/98 Supercedes: 1 of Subject: MEDICAL WASTE MANAGEMENT PLAN 1.0. PURPOSE: The purpose of the California State University Los Angeles Medical Waste Management

More information

IFC ENVIRONMENTAL GUIDELINES FOR HEALTH CARE FACILITIES Effective May 8, 2003 Page 1. Environmental and Social Guidelines for Health Care Facilities

IFC ENVIRONMENTAL GUIDELINES FOR HEALTH CARE FACILITIES Effective May 8, 2003 Page 1. Environmental and Social Guidelines for Health Care Facilities IFC ENVIRONMENTAL GUIDELINES FOR HEALTH CARE FACILITIES Effective May 8, 2003 Page 1 Environmental and Social Guidelines for Health Care Facilities This guideline contains the performance levels and measures

More information

of health-care waste

of health-care waste Safe management of wastes from health-care activities 2 Definition and characterization of health-care waste 2.1 Health-care waste: definition and classification 2.1.1 Definition Health-care waste includes

More information

ORDINANCE ON MEDICAL WASTE MANAGEMENT

ORDINANCE ON MEDICAL WASTE MANAGEMENT THE MINISTRY OF ENVIRONMENTAL PROTECTION AND PHYSICAL PLANNING 2247 Pursuant to Article 104, paragraph 1, subparagraph 8, of the Waste Act (Official Gazette 178/04 and 111/06), the minister competent for

More information

TARLETON STATE UNIVERSITY Biohazardous Waste Program

TARLETON STATE UNIVERSITY Biohazardous Waste Program TARLETON STATE UNIVERSITY Biohazardous Waste Program Program Name: Biohazardous Waste Office Name: TSU Risk Management & Compliance Rev. No.: 1 Concurrence and Approval Risk Management & Compliance This

More information

Hazardous Waste Procedures

Hazardous Waste Procedures Hazardous Waste Procedures Hazardous waste is defined as a waste, or combination of wastes, which because of its quantity, concentration, or physical or chemical characteristics may pose a substantial

More information

Hazardous Waste Management & Waste Minimization Training

Hazardous Waste Management & Waste Minimization Training Hazardous Waste Management & Waste Minimization Training Environmental Health and Safety Safety Training Building Inspections Accident Investigations Fire Safety Hazardous Materials Management Laboratory

More information

SPECIAL MEDICAL WASTE PROGRAM

SPECIAL MEDICAL WASTE PROGRAM SPECIAL MEDICAL WASTE PROGRAM Department of Environmental Health & Safety Phone: (410) 704-2949 Fax: (410) 704-2993 Emergency: (410) 704-4444 Email: Safety@towson.edu Website: www.towson.edu/ehs/index.html

More information

MANAGEMENT AND DISPOSAL OF BIOLOGICAL WASTE AT TEXAS A&M INTERNATIONAL UNIVERSITY

MANAGEMENT AND DISPOSAL OF BIOLOGICAL WASTE AT TEXAS A&M INTERNATIONAL UNIVERSITY MANAGEMENT AND DISPOSAL OF BIOLOGICAL WASTE AT TEXAS A&M INTERNATIONAL UNIVERSITY TABLE OF CONTENTS I. Introduction..2 II. III. IV. Responsibility 3 Segregation of Biological Waste in the Laboratory..

More information

Safe Management of Healthcare Waste A Guide to Good Practice in Secondary Care (England and Wales) January 2008

Safe Management of Healthcare Waste A Guide to Good Practice in Secondary Care (England and Wales) January 2008 Safe Management of Healthcare Waste A Guide to Good Practice in Secondary Care (England and Wales) January 2008 The Department of Health Document Safe Management of Healthcare Waste was released in December

More information

MANAGEMENT AND DISPOSAL OF BIOLOGICAL WASTE TEXAS A&M UNIVERSITY. July 2003

MANAGEMENT AND DISPOSAL OF BIOLOGICAL WASTE TEXAS A&M UNIVERSITY. July 2003 MANAGEMENT AND DISPOSAL OF BIOLOGICAL WASTE AT TEXAS A&M UNIVERSITY July 2003 MANAGEMENT AND DISPOSAL OF BIOLOGICAL WASTE AT TEXAS A&M UNIVERSITY A. INTRODUCTION The purpose of this document is to provide

More information

Managing Regulated Medical Waste in New Mexico

Managing Regulated Medical Waste in New Mexico Managing Regulated Medical Waste in New Mexico Prepared by: Dr. Joe King Camino Real Environmental Research Center Sunland Park, New Mexico History of Medical Waste Regulations 1988 Legislation in response

More information

MEDICAL WASTE DEFINITION OF TERMS HEALTH & SAFETY CODE, PART 14; COUNTY ORDINANCE #7646

MEDICAL WASTE DEFINITION OF TERMS HEALTH & SAFETY CODE, PART 14; COUNTY ORDINANCE #7646 GARY W. ERBECK DIRECTOR County of San D iego DEPARTMENT OF ENVIRONMENTAL HEALTH HAZARDOUS MATERIALS DIVISION P.O. BOX 129261, SAN DIEGO, CA 92112-9261 (619) 338-2222 FAX (619) 338-2377 1-800 - 253-9933

More information

BIO-MEDICAL WASTE MANAGEMENT

BIO-MEDICAL WASTE MANAGEMENT 1 BIO-MEDICAL WASTE MANAGEMENT The management of this waste stream requires a number of upgrades as outlined in the Auroville Solid Waste Management Strategy. Appendix A presents an overview of the composition

More information

APPENDIX D INFECTIOUS WASTE MANAGEMENT GUIDE

APPENDIX D INFECTIOUS WASTE MANAGEMENT GUIDE APPENDIX D INFECTIOUS WASTE MANAGEMENT GUIDE TABLE OF CONTENTS INTRODUCTION... PAGE 1 SUMMARY OF REGULATIONS... PAGE 1 WRIGHT STATE UNIVERSITY INFECTIOUS WASTE STRATEGY... PAGE 5 PROCEDURES FOR WSU INFECTIOUS

More information

* * * * * * * * * * * * * * * *

* * * * * * * * * * * * * * * * Medical Waste Management Plan University of California, Davis Center for Neuroscience Updated: December 4, 2015 This Program document provides a step-by-step method to assist managers of medical waste

More information

HOSPITAL WASTE MANAGEMENT ISSUES AND STEPS TAKEN BY THE GOVERNMENT OF PAKISTAN OCT 2006

HOSPITAL WASTE MANAGEMENT ISSUES AND STEPS TAKEN BY THE GOVERNMENT OF PAKISTAN OCT 2006 HOSPITAL WASTE MANAGEMENT ISSUES AND STEPS TAKEN BY THE GOVERNMENT OF PAKISTAN OCT 2006 Presentation By: JAWED ALI KHAN DIRECTOR MINISTRY OF ENVIRONMENT Sequence of Presentation Introduction Situational

More information

UNIVERSITY OF RICHMOND REGULATED MEDICAL WASTE MANAGEMENT GUIDELINES

UNIVERSITY OF RICHMOND REGULATED MEDICAL WASTE MANAGEMENT GUIDELINES UNIVERSITY OF RICHMOND REGULATED MEDICAL WASTE MANAGEMENT GUIDELINES November 2003 Table of Contents Section Page I. Introduction.... 1 II. Characteristics of Regulated Medical Waste 1-2 III. Exclusions...2-3

More information

LABORATORY WASTE DISPOSAL GUIDELINES

LABORATORY WASTE DISPOSAL GUIDELINES WHS Unit LABORATORY WASTE DISPOSAL GUIDELINES Contents 1 Introduction... 2 2 Scope... 2 3 Definitions... 2 4 General Principles... 3 5 Laboratory Procedures... 4 5.1 Summary of Waste Disposal... 9 6 Special

More information

Treatment and Disposal Technologies for Medical Wastes in Developing Countries

Treatment and Disposal Technologies for Medical Wastes in Developing Countries Treatment and Disposal Technologies for Medical Wastes in Developing Countries Mohd Nasir Hassan, PhD Environmental Engineer WORLD HEALTH ORGANIZATION (WHO) (Cambodia/Lao PDR) Where do We Start? Definition>>>>Legal

More information

Pharmaceutical Waste Program for Inpatient Pharmacy. Portland Service Area Pharmacy Leadership Team

Pharmaceutical Waste Program for Inpatient Pharmacy. Portland Service Area Pharmacy Leadership Team Pharmaceutical Waste Program for Inpatient Pharmacy Portland Service Area Pharmacy Leadership Team What is Pharmaceutical Waste? Pharmaceutical waste is waste generated through IV preparation, compounding,

More information

Guide for Training of Waste Handlers

Guide for Training of Waste Handlers Training Health Workers in the Management of Sharps Waste Guide for Training of Waste Handlers Contents 1. Training Overview...43 2. Sharps Waste Overview...45 3. Health Worker Safety...48 4. Segregation

More information

THE UNIVERSITY OF NEWCASTLE- SCHOOL of BIOMEDICAL SCIENCES

THE UNIVERSITY OF NEWCASTLE- SCHOOL of BIOMEDICAL SCIENCES Page: 1 of 7 1. Purpose: 1.1. To describe the procedures to be used when dealing with chemical or microbiological spills. 2. Equipment: 2.1. Spill Kit 2.2. Miscellaneous items as listed 3. Materials: 3.1.

More information

From: Chief, Bureau of Medicine and Surgery To: Ships and Stations Having Medical Department Personnel

From: Chief, Bureau of Medicine and Surgery To: Ships and Stations Having Medical Department Personnel BUMEDINST 6280.1A BUMED-24 BUMED INSTRUCTION 6280.1A From: Chief, Bureau of Medicine and Surgery To: Ships and Stations Having Medical Department Personnel Subj: MANAGEMENT OF INFECTIOUS WASTE Ref: (a)

More information

Health Care Workers in the Community

Health Care Workers in the Community Waste Management for Health Care Workers in the Community Adapted from Waste Management for Health Care Workers in the Community with the permission of Capital Health, Regional Public Health. Distributed

More information

Roger Williams University. Bloodborne Pathogens Exposure Control Plan

Roger Williams University. Bloodborne Pathogens Exposure Control Plan Roger Williams University Bloodborne Pathogens Exposure Control Plan Revised 12/2010 ROGER WILLIAMS UNIVERSITY BLOODBORNE PATHOGENS EXPOSURE CONTROL PLAN I. STATEMENT OF POLICY It is the policy of Roger

More information

Tufts Environmental Health and Safety April 2010

Tufts Environmental Health and Safety April 2010 7. HAZARDOUS WASTE 7.1 Hazardous Chemical Waste The Resource Conservation and Recovery Act (RCRA) of 1976 gave the Environmental Protection Agency the authority to regulate the generation, transportation,

More information

Policies and Procedures Manual Waste Management Plan Policy No. 06:04:00 Page 1 of 12

Policies and Procedures Manual Waste Management Plan Policy No. 06:04:00 Page 1 of 12 Page 1 of 12 Revision Responsibility: Director of Facility Services and Safety Responsible Executive Officer: Vice President for Financial & Administrative Services Source / Reference: Tennessee Division

More information

AUTOCLAVE PROGRAM. SOP Bio-006 FOR THE USE OF AUTOCLAVE FOR STERILIZATION OF MATERIALS AND BIOLOGICAL WASTE SOP

AUTOCLAVE PROGRAM. SOP Bio-006 FOR THE USE OF AUTOCLAVE FOR STERILIZATION OF MATERIALS AND BIOLOGICAL WASTE SOP ENVIRONMENTAL AND EMERGENCY MANAGEMENT ENVIRONMENTAL HEALTH AND SAFETY 175 Cabot St. Wannalancit Suite 311 Lowell MA 01854 Ruth Medina, Ph.D. Tel: 978-934-2778 Senior Biosafety Specialist/Biosafety Officer

More information

Infection Control Manual - Section 8 Sharps & Clinical Waste. Infection Prevention Control Team

Infection Control Manual - Section 8 Sharps & Clinical Waste. Infection Prevention Control Team Title Document Type Document Number Version Number Approved by Infection Control Manual - Section 8 Sharps & Clinical Waste Policy IPCT001/10 3 rd Edition Infection Control Committee Issue date August

More information

GREEN HOSPITALS. CONCEPT MANUAL FOR IMPROVING INFRASTRUCTURE SECTION 4 Best Practice: Healthcare Waste Services

GREEN HOSPITALS. CONCEPT MANUAL FOR IMPROVING INFRASTRUCTURE SECTION 4 Best Practice: Healthcare Waste Services GREEN HOSPITALS CONCEPT MANUAL FOR IMPROVING INFRASTRUCTURE SECTION 4 Best Practice: Healthcare Waste Services Additional sections available - go to EPOS Green Hospitals page to view all: Section 1: Best

More information

HEALTH CARE WASTE CATEGORIES

HEALTH CARE WASTE CATEGORIES WASTE MANAGEMENT IN PUBLIC HOSPITALS 0 HEALTH CARE WASTE CATEGORIES HEALTH CARE GENERAL WASTE: Waste that does not pose an immediate hazard or threat to human health or to the environment and poses no

More information

WASH Package for Ebola Care and Treatment Centres/Units. Guidance Note

WASH Package for Ebola Care and Treatment Centres/Units. Guidance Note WASH Package for Ebola Care and Treatment Centres/Units Guidance Note UNICEF Programme Division 10 October 2014 Page 1 Page 2 1. Introduction UNICEF offices and sector partners in Ebola-affected and at-risk

More information

Policy for the Disposal of Biological Waste

Policy for the Disposal of Biological Waste Policy for the Disposal of Biological Waste I. Biological Waste II. Regulated Medical Waste Prepared by: Rutgers Environmental Health and Safety 24 Street 1603 Building 4127, Livingston Campus Piscataway,

More information