MANAGEMENT OF VETERINARY CLINICAL WASTE

Transcription

1 MANAGEMENT OF VETERINARY CLINICAL WASTE C4 New Zealand Standard NZS 4304:2002 details hw healthcare (including veterinary) waste is managed. T ensure cmpliance, veterinary clinics shuld btain a cpy frm Standards New Zealand. The essentials are summarised here but the Standard shuld be cnsulted fr detail. Management f sme hazardus waste will require reference t ther surces (e.g. Natinal Radiatin Labratry Cde r cntrls under the HSNO Act). Healthcare waste refers t all waste generated by a healthcare facility and includes nn-hazardus, cntrlled and hazardus waste. Nn-hazardus waste cnstitutes the bulk f waste generated and is managed in the same way as husehld waste. Hazardus waste requires prper handling, strage, transprt and dispsal t minimise risk t persnnel, the public and the envirnment, and t prevent causing cultural r aesthetic ffence. A fundamental principle f waste management is the minimisatin f waste. Categrisatin f healthcare waste needs t be categrised as hazardus, cntrlled r nn-hazardus. that falls int mre than ne categry is classified accrding t the highest risk categry. Healthcare Hazardus Cntrlled Nn-hazardus Sharps Nn-sharps Other Cyttxic Radiactive Infectius Hazardus Cyttxic Radiactive Infectius and Bdy Parts Figure 1 Healthcare waste categrisatin Hazardus waste This is initially classified as either sharps r nn-sharps waste. Sharps waste is categrised as radiactive, cyttxic r infectius and is subject t cntrls fr bth sharps and the apprpriate hazardus waste. Nn-sharps waste is categrised as infectius (including bdy parts), radiactive, cyttxic r ther (e.g. slvents, chemicals, pharmaceuticals). 21 June 2007 Page 1 f 8

2 Cntrlled waste This includes waste that is recgnisable as cming frm a healthcare facility and that is cntaminated with bdy fluids (that cannt be expressed) r may be aesthetically ffensive. It includes intravenus tubing, catheters, cannulas, empty syringes (n needles), dispsable sheeting, dispsable scpes, used dressings, dispsable glves r ther surgical garments. Nn-hazardus waste Categrised as recyclable (paper, glass, plastics, metal) r general waste (slid r liquid). Respnsibilities f the clinic generating waste The waste generatr is respnsible fr ensuring the safe management f waste frm generatin t dispsal. The clinic must: develp a waste management plicy (in cnsultatin with lcal authrity, transprter and waste landfill peratr t ensure all requirements cnsidered) appint a waste management fficer segregate, package, label and stre all waste verify that transprt and dispsal cntractrs cmply with their respnsibilities and relevant legislatin and standards establish a waste tracking system maintain an emergency waste management plan establish prcedures fr the crrect handling f waste develp and implement waste management training prgrammes fr staff. Segregatin must be segregated accrding t its categry at the time and place it is generated, and then be bagged, packaged r cntainerised as apprpriate. Sharps must be placed in sharps cntainers. Hazardus waste requiring refrigeratin must be stred in a dedicated refrigeratr. Radiactive waste must be segregated and stred in accrdance with the Natinal Radiatin Labratry Cde f Safe Practice. Cntainers and packaging Figure 2 shws the apprpriate cntainers fr packaging different categries f healthcare waste. 21 June 2007 Page 2 f 8

3 Healthcare Hazardus Cntrlled Nn-hazardus Sharps Nn-sharps Recyclable General Other Cyttxic Radiactive Infectius Hazardus Cyttxic Radiactive Purple Cntainer Red r Yellw Cntainer Yellw Cntainer Purple Bag Infectius and Bdy Parts Yellw Bag Where apprpriate package and label in accrdance with NZS 5433; therwise package in apprpriate cntainers Package in apprpriate cntainers Package in apprpriate cntainers label as DG 6.1 label in accrdance with NRL C3 label as DG 6.2 label in accrdance with NZS 5433 label as DG 6.1 label in accrdance with NRL C3 label as DG 6.2 UN 2814 UN 2900 UN 3291 UN 2814 UN 2900 UN 3291 Figure 2 Segregatin and packaging prcess Bags Bags fr the cllectin and strage f waste ther than sharps must have sufficient strength t cntain the waste cmply with NZS 7603 (fr plastic bags) cnfrm t the clur cding and marking system in Table 1 be filled t nt mre than tw-thirds f their capacity allw fr the secure final clsure when tw-thirds full be secured with clsure devices that d nt have sharp prtuberances (e.g. staples). Paper bags must nt be used fr hazardus waste. 21 June 2007 Page 3 f 8

4 categry/type Clur cde fr cntainer Marking fr internal facility use Transprt label Infectius Yellw Cyttxic Purple Radiactive Red r Yellw All ther waste Nt specified As specified by relevant regulatins As specified in NZS 5433 Table 1 Identificatin f waste Sharps cntainers These must meet the requirements in AS/NZS 4261 (Reusable cntainers fr the cllectin f sharp items used in human and animal medical applicatins). Rigid-walled cntainers Reusable rigid-walled cntainers (e.g. mbile garbage bins) shuld be resistant t leakage, impact rupture and crrsin and shuld be inspected after each use t ensure they are intact. Packaging and labelling fr transprt Hazardus and cntrlled waste must be packaged, labelled and dcumented fr transprt in accrdance with NZS 5433 (Transprt f dangerus gds n land). Mvement f waste at healthcare premises Within healthcare premises: waste in bags shall be mved nly when the bags are securely clsed segregatin must be maintained during the mvement and handling rigid-walled cntainers must be securely clsed during mvement 21 June 2007 Page 4 f 8

5 trlleys used t mve hazardus and cntrlled waste must be capable f cntaining accidental leakage mvement thrugh patient treatment r client waiting areas shuld be avided r restricted t times when there are n r few peple abut waste mvement rutes shuld be well lit, easy t traverse and where pssible kept separate frm supply rutes hazardus and cntrlled waste in transit must nt be left unattended in public areas. tracking prgramme The waste generatr must develp a tracking prgramme dcumenting the mvement f hazardus and cntrlled waste and cnfirming the transprt and dispsal details. Healthcare waste strage Hazardus and cntrlled waste must be stred in designated areas and must nt be left unattended at rad-side r ther area where the public may have unsupervised access. The strage area must be sufficient t maintain segregatin f waste and separatin frm ther stred materials. It must: be secure be vermin-prf and easily cleaned, with walls and flrs f impervius material and flrs bunded r graded t a valved sewer utlet; have adequate access and space fr mvement have adequate lighting s it can be effectively cleaned and infrmatin n cntainers and dcuments easily read have adequate ventilatin t remve durs and exhaust vents must prevent exhaust entering buildings r public areas be identified with signs apprpriate t the categries f waste stred must have ready access t materials fr managing spills, suitable prtective clthing and handwashing facilities. water frm any cleaning prcess must be discharged int a sump where it shall be treated t the satisfactin f the relevant cntrl authrity befre discharge int the sewer. Transprt The transprter shall meet relevant legislatin and standards, have a waste tracking system and emergency management plan, and meet ther requirements referred t abve. Vehicles must meet requirements specified in the Standard. treatment and dispsal In sme cases it may be practicable t pre-treat hazardus r cntrlled wastes t allw re-categrisatin as a lwer risk r nn-hazardus waste categry. Cmpactin may reduce the vlume f nn-hazardus 21 June 2007 Page 5 f 8

6 waste requiring transprt and dispsal. The Standard elabrates n acceptable methds f waste treatment and dispsal. Table 2 utlines acceptable dispsal methds fllwing specified treatment methds. categry sub-categry Pre-treatment Acceptable dispsal methds Nn-hazardus General Slid C I, Lf, SLf Recyclable Liquid C S (see 7.9) R, Cm Hazardus Sharps Nil I St and G Lf, SLf Infectius Bdy part Slid 1 Nil I, Cr M, G S, I, Cr 1 St and G, M I, SLf, Cr, S Bdy part Liquid 1, 2 Dilute S St S Slid Nil I, Cr M I, S, Cr St I, SLf, Cr Liquid Dilute I, S St S Cyttxic Nil I, S 3 Radiactive In accrdance with NRL cde. Other hazardus I, S 3, R 4, SLF 3 Cntrlled C 5, St, G, M I, SLf NOTE - (1) Only minr, minute and nn-recgnisable bdy parts may be dispsed f t the sewer. Bdy parts may be released t family/ whānau. Refer t bdy parts plicy. (2) Diluted embalming and bdy fluids may be dispsed f t the sewer. (3) As apprved by lcal authrity (4) Recycling may nly be suitable fr a limited range f ther hazardus waste. (5) May be cmpacted nly if any liquid expressed is fully cntained. Pre-treatment: Acceptable dispsal methds: C = Cmpactin I = Incineratin R = Recycling M = Maceratin Lf = Landfill Cm = Cmpsting St = Sterilisatin (varius methds) SLf = Sanitary Landfill Cr = Crematin G = Grinding S = Sewer Table 2 Healthcare waste pre-treatment and dispsal methds handling T prevent injury and disease t staff invlved in waste handling, any persn r rganisatin handling healthcare waste must cmply with the Health and Safety in Emplyment Act and: ensure staff practise standard precautins in handling waste minimise physical handling f waste ensure n manual handling f cntents f hazardus waste cntainers ffer staff apprpriate immunisatin prgramme ensure persnal prtective equipment is apprpriate, available, cmplies with apprpriate standard and is in gd wrking rder and checked regularly ensure prcedures fr dealing with incidents r injuries invlving waste (first aid, medical fllw-up, recrd keeping). 21 June 2007 Page 6 f 8

7 Emergency preparedness T anticipate and identify ptential actins fr emergencies, an emergency waste management plan shuld: assess all aspects f waste management and identify the predictable disruptins, which may include spills rad accidents disruptins in transprt and dispsal arrangements disruptins f services within the rganisatin failure f refrigerated r ther special strage arrangements discntinuance f supply f waste cntainers cntaminatin f lwer-risk waste by higher-risk waste emergencies that may significantly increase the vlume f waste prduced, especially f mre hazardus waste civil emergency causing widespread disruptin f service fr each situatin specified: identify the hazards prepare a cntingency plan fr cntrl f the hazards specify the persns respnsible fr implementing all parts f the plan ensure sufficient equipment is maintained r available t implement the cntingency plan establish list f cntacts (e.g. plice, fire service, hazardus chemical respnse unit, lcal authrities and transprter) Staff required t handle waste during emergencies must have received apprpriate training. Training All new and relieving staff must be trained in waste management t enable them t carry ut their rles, with clear understanding f the risks frm waste, the prcedures t fllw t minimise risks, their rle in waste management and their rle in any waste emergency. The detail and extent f training will depend n the nature f the risk and cmplexity f the wrk prcedures and cntrl measures t minimise the risk f expsure. Refresher training shuld be prvided regularly. The training must include: recgnising the hazards f healthcare waste methds f preventing injury and disease transmissin frm handling waste first aid safety prcedures fr dealing with waste generated, handled, transprted r dispsed f by the rganisatin crrect segregatin, handling mvement, transprt and dispsal f the different categries f waste crrect use f persnal prtective equipment 21 June 2007 Page 7 f 8

8 prcedures fr actin and ntificatin in the event f an accident r incident spill cntainment and clean-up prcedures educatin n standard precautins. Recrds f attendance at training shall be kept fr all staff and cntractrs. Standard precautins Standard precautins are used t prtect staff frm rganisms transmitted by expsure f mucus membranes and brken skin surfaces t bld r bdy substances (e.g. zntic infectins). Fr veterinary clinics these wuld include: hand-washing after tuching bld r bdy fluids r secretins mask r face shield t prtect mucus membranes frm splashes gwn, plastic aprn r verall t prtect skin and clthing frm splashes glves fr tuching fluids, secretins, excretins and cntaminated items handling f sharps: needles nt recapped, bent, brken r manipulated by hand, and all sharps placed in apprved cntainer envirnmental cntrl fr cleaning and disinfectin f items and envirnment. Reference NZS 4304:2002 and ther standards are available frm Standards New Zealand, Private Bag 2439, Wellingtn; telephne ; Safety data sheets fr chemicals and pharmaceuticals shuld be cnsulted fr dispsal instructins. 21 June 2007 Page 8 f 8