WASTE MANAGEMENT POLICY Document Reference

WASTE MANAGEMENT POLICY Document Reference P052 Version Number 3.00 Author/Lead Job Title Director s Name Anthony J Goforth Environmental Manager Mark Brooks Director s signature Date Date last reviewed, ratified and 9 July 2012 implemented (this version) Date of Next Review July 2015 Consultation (Date and nature of contact) Date Ratified Name of Ratifying Committee Waste Management Group Sustainability Committee 9 July 2012 Governance Committee VALIDITY Policies should be accessed via the Trust internet to ensure the current version is used. CHANGE RECORD Version Date Change details 2.01 3.00 9/7/12 Reviewed and harmonised with ERYPCT. Version 3.00, July 2012 Page 1 of 41

Contents 1. INTRODUCTION... 3 2. SCOPE... 3 3. POLICY STATEMENT... 3 4. DUTIES & RESPONSIBILITIES... 4 5. PROCEDURES... 5 6. EQUALITY & DIVERSITY... 5 7. MENTAL CAPACITY... 6 8. BRIBERY ACT... 6 9. IMPLEMENTATION... 6 10. MONITORING & AUDIT... 7 11. REFERENCES/EVIDENCE/GLOSSARY/DEFINITIONS... 7 WASTE MANAGEMENT PROCEDURES... 8 Appendix 1 Waste Bags and Containers Colours... 22 Appendix 2 Clinical Waste Bin Tags... 23 Appendix 3 Documentation Waste Consignment Notes... 24 Appendix 4 Segregation of Waste... 27 Appendix 5 Waste Codes... 29 Appendix 6 Sharps Containers... 30 Appendix 7 - Pharmaceutical Waste... 31 Appendix 8 Information from ERYC website... 32 Appendix 9 Disposing of Electrical Equipment... 34 Appendix 10 Disposal of Redundant IT Equipment... 35 Appendix 11 Battery Recycling... 36 Appendix 12 Removal and Handling of Healthcare Waste... 37 Appendix 13 Healthcare Waste Spillages... 38 Appendix 14 Waste Bins and Risk Assessment... 39 Appendix 15 Waste Bags... 41 Version 3.00, July 2012 Page 2 of 41

1. INTRODUCTION The Trust provides a wide range of health related services to the people in and around Hull and East Yorkshire. The Trust recognises its duties and legal responsibilities to ensure, as far as reasonably practicable, the health, safety and welfare of its employees and other people who may be affected by its activities and its duty to the environment in which it operates. This policy document describes the Trust s arrangements for discharge of these responsibilities particularly under: 2. SCOPE The Trust s policy is to reduce all organisational risks including those associated with waste management. The Trust will ensure that the requirements, both legislative and best practice, for the management, handling and disposal of waste, are observed in all areas for which it is responsible. The Trust recognises the importance of correct waste disposal and the part all staff must play to achieve this. Staff will be given training, both at induction and regularly thereafter, in the segregation and handling of waste. It is the Trust s objective: To ensure that waste is managed safely and legally. To reduce the quantities of waste generated and to maximise segregation, re-use, re-cycling and recovery of those materials which enter the waste stream. To ensure that waste is managed with minimum impact on the environment. All staff members have a duty to ensure that all potential hazards from waste are correctly assessed and identified, and that appropriate measures are taken to protect the health of employees and those who are contracted out to transport and dispose of the waste. 3. POLICY STATEMENT This will be achieved: By providing procedures for the safe handling of those wastes for which the Trust is responsible, from the locations at which it arises until its responsibility for its transportation and disposal is formally transferred to an approved Contractor(s). By ensuring that the Trust complies with current relevant legislation and established best practice guidelines. By establishing targets for reducing the quantity of waste produced by the Trust for disposal each year. The segregation of waste at the point of production into suitable colour coded packaging is vital to good and safe management of waste. Waste should be stored safely and securely before transportation for disposal elsewhere and should not be allowed to accumulate in corridors and other areas accessible to the public. By minimising the risk to staff whose duties involve handling waste and others who may be exposed to it: - By having assessed the risks from the waste and providing the facilities and means for its handling and disposal in the most appropriate and safe manner. - By training staff, as appropriate, to deal with waste safely and appropriately. - By maintaining and communicating procedures and other guidance detailing the Trust's arrangements for the segregation, primary containment and storage of waste. - By providing primary and secondary containers for each type of waste. - By regularly removing waste to secure and safe storage facilities pending collection by licensed transport Contractors for disposal by approved methods. Version 3.00, July 2012 Page 3 of 41

- By maintaining and communicating procedures for the management of untoward events such as spillage s and other accidents, arising from the handling of waste. By maintaining comprehensive records to monitor and review progress and demonstrate the effectiveness, in terms of safety and cost, of the arrangements and procedures for the management of waste. This Policy statement will be supported by detailed procedures which set out how the policy objectives are to be achieved. 4. DUTIES & RESPONSIBILITIES The Chief Executive Is responsible to the Trust Board for waste management and has delegated responsibility to the Director of Finance and Deputy Director of Infrastructure and Informatics to ensure that the objectives set in this policy are attained and that any associated procedures are complied with. Waste Control Officer The Trust's nominated Waste Control Officer is responsible for advising and monitoring the handling, disposal and storage of waste is in accordance with approved practices and include:- Advice and guidance as required on safe practices and procedures. Investigation of any failures in the Trust's procedures for the safe disposal of waste. Liaison with Operational staff, Infection Control, Porters and Domestic staff in the internal movement of waste until the transfer to the Trust s licensed waste carrier and disposal agents. Monitoring under Duty of Care to ensure that the Trust s licensed waste carrier and disposal agents continue to carry out their waste carrier and disposal contract in a due and diligent manner. Liaise with local environmental and other authorities to assure appropriate waste disposal procedures and communications are maintained. Arranging and co-ordinating of regular Internal Audits and External Audits by suitably qualified staff and consultants. Managers Managers should ensure that the procedures relating to the management of waste are followed. This will include: Reviewing on a regular basis, the department's management of waste. Introducing and following the new classification and colours for waste bags, bins and receptacles including orange for infectious waste that can be treated and tiger bags for offensive waste. Co-ordination of staff training in the safe handling, storage, segregation and disposal of waste. Monitoring the control and segregation of waste in departments. Ensuring maximum practical segregation of waste, its correct identification and storage originating in their department. Where segregation compliance cannot be met with Department of Health Environment & Sustainability, Health Technical Memorandum, 07-01: Safe management of healthcare waste, then a Risk Assessment must be prepared and submitted and approved by the Risk Management Committee. Identifying ways of reducing waste, and recycling. Ensuring that waste is stored safely prior to collection, and in the appropriate fire resistant containers. Ensuring that waste material containing pharmaceutical products is dealt with in line with the Disposal of Medicines section of the Trusts Procedures for Safe and Secure Handling of Medicines. Ensuring that waste is collected from departments at regular intervals. Version 3.00, July 2012 Page 4 of 41

Providing assistance during internal and external audits by qualified Trust staff and external consultants. Ensuring that training is provided and attended by all members of staff who may come into contact with hospital waste. Taking corrective action to rectify deviation from policy, including the reporting of any adverse incidents or near misses associated with the management of waste in accordance with the Trust s Risk Management Strategy and Incident Reporting Procedure. Ensure all Contractors they employ are made aware of this policy and their responsibilities for the waste they produce. Staff Staff should follow all procedures relating to the management of waste. This will include: Compliance with the Trust's policy and procedure for the safe handling, segregation and storage of waste in your place of work. Anyone who generates, handles, transports and/or disposes of waste has a legal responsibility to ensure that it is done correctly. All employees have a statutory duty to follow procedures in place for their safety at work. Ensuring that all bags and sharps bins are sealed and labelled, stating contents, ward/department and day and date of disposal in accordance with laid down procedures. Ensure that waste is correctly segregated, labelled and handles and the correct bins are used. Ensuring that all waste bags are stored correctly in a secure environment prior to collection from the area. Ensuring that types of waste bags are kept separately at all times, including storage and collection. Attending training seminars on the correct method of handling, safe disposal and storage of waste. Reporting any adverse incidents or near misses associated with the management of waste in accordance with the Trust s Risk Management Strategy and Incident Reporting Procedure. Providing assistance during internal and external audits by qualified Trust staff and external consultants. Waste Handlers are responsible for transferring waste bags from the point of use to the waste container and must follow requirements of Personal and Protective Equipment. Contractors Contractors employed to work on or about the Trusts sites must act in accordance with this policy. It is the responsibility of the employing manager to ensure all contractors staff are made aware of the contents of this policy. Any contractor who does not comply with this policy may be requested to cease work or to leave a site until an undertaking is given to work within the remit of the Waste Management Policy. 5. PROCEDURES See Waste Management Procedures and Guidance Notes 6. EQUALITY & DIVERSITY An Equality and Diversity Impact Assessment has been carried out on this document using the Trust approved EIA. No adverse impact was identified and therefore a full EDIA was deemed not necessary. Version 3.00, July 2012 Page 5 of 41

7. MENTAL CAPACITY Non-clinical policy therefore not relevant. 8. BRIBERY ACT The Bribery Act 2010 makes it a criminal offence to bribe or be bribed by another person by offering or requesting a financial or other advantage as a reward or incentive to perform a relevant function or activity improperly performed. The penalties for any breaches of the Act are potentially severe. There is no upper limit on the level of fines that can be imposed and an individual convicted of an offence can face a prison sentence of up to 10 years. The Bribery Act applies to this policy. 9. IMPLEMENTATION All employees will have access to the and this will be on the Trust s intranet and a hard copy should be retained by each department for their policy and waste files. All locums, seconded, bank, agency staff and volunteers should be made aware of the policy by their Team Manager. Contractors and Sub-Contractors will also be provided with a copy of the policy, details of workplace Waste Management procedures and their responsibilities for the waste they produce, at the contract meeting. All Managers and staff and Team Leaders are responsible for Waste Management within their area as described in the guidance notes attached to this policy and they must ensure that the team members read and understand the implications of the policy in their area in accordance with Health Technical Memorandum 07-01 Safe Management of the Healthcare Waste. All teams are lead by an experienced manager who must undertake appropriate risk assessments which identify any hazards within the workplace and the environment, that present a risk to staff, clients and the public. Where this risk is considered to be significant, there needs to be a risk assessment in place that identifies control measures within the department to reduce the risk as far as is practically possible. All staff must be aware and be appropriately trained and supervised with regard to Safe Management of Healthcare Waste. Waste Management Training Prior to commencing work all new staff will be given training on waste to ensure safe handling and disposal of all types of waste. It is the intention of the Trust to ensure all new staff receive information on waste management procedures through the department s induction training process. Staff who handle and dispose of drugs will also receive training following the Trusts Procedures for Safe and Secure Handling of Medicines document. All other staff will receive information via a training package applicable to Waste Management. This will be developed for e-learning and for Unit Managers to implement within their Units to all members of staff. All Unit Managers will be required to attend a training session so that this can be disseminated to all their unit staff to ensure that the procedures are followed correctly. Version 3.00, July 2012 Page 6 of 41

There will be a requirement for all staff to record their attendance or non-attendance at a relevant Waste Management training session. It is all employees responsibility to ensure that they have received Waste Management training and that they are fully aware of the new procedures under Safe Management of Healthcare Waste. Waste training will be delivered using various methods including Train the Trainer where key staff are trained to pass the information on to others and the development of an e-learning package. To achieve compliance with the latest regulations and achieve full compliance extra financial resources may be required 10. MONITORING & AUDIT As part of the continued development of Waste Management procedures across the organisation, all staff levels will be audited against the specific responsibilities and requirements within this policy to ensure adherence to it and the effective management of the Waste Management Procedures by all staff. It will be the responsibility of all Managers to ensure that staff are made aware of this policy at all times. The Infection Control team will carry out annual audits of the Safe Management of Infectious Waste of in-patient areas of the Trust. Unit General Managers, Heads of Service and Community/Unit Managers will carry out monitoring to ensure that the Waste Procedures are followed within their areas of responsibility. The Estates Maintenance Manager will monitor Waste Procedures within the Estates Department and the general storage and transportation arrangements. The Estates Department, where practical, will monitor quantities of waste generated. 11. REFERENCES/EVIDENCE/GLOSSARY/DEFINITIONS Gloucester Hospitals NHS Foundation Trust - waste information The Hazardous Waste (England and Wales) Regulations 2005 Department of Health - Safe management of healthcare waste The Carriage of Dangerous Goods and Transportable Pressure Equipment Regulations 2004 (as amended) The Environmental Protection Act 1990 The Health and Safety at Work act 1974 The Control of Substances Hazardous to Health Regulations (COSHH) 2002 The Special Waste Regulations 1996 The Waste Electrical and Electronic Equipment Regulations 2006 Department of Health Environment & Sustainability, Health Technical Memorandum, 07-05: The treatment, recovery, recycling and safe disposal of waste electrical and electronic equipment 2007 The Controlled Waste Regulations 1992 The Controlled Waste (Registration of Carriers and Seizure of Vehicles) Regulations 1991 The Radioactive Substances Act 1993 The Landfill (England and Wales) Regulations 2002 Waste Management Licensing Regulations 1994 Version 3.00, July 2012 Page 7 of 41

WASTE MANAGEMENT PROCEDURES 1. INTRODUCTION The disposal of waste is an essential part of the day to day work of everyone within the Trust. Contravention of the Waste Regulations and The Department of Health guidance document Safe Management of Healthcare Waste can have crucial consequences for the Trust, particularly at the hands of external regulatory authorities who regulate Waste Management procedures and all waste which leaves the Trust premises. Within the UK a single violation, for example, clinical waste exported in domestic waste bags, can result in fines and in some cases, liability of an individual to prosecution, it is often difficult to actually trace an individual offender, the Head of Department may also be held responsible. Therefore it is pertinent for all Staff to read and ensure that the following aware of the new Waste Management procedures. Anyone who generates, handles, transports and/or disposes of waste has a legal responsibility to ensure it is done correctly. All employees have a statutory duty to follow procedures in place for their safety at work. All staff members have a duty to ensure that all potential hazards from waste are correctly assessed and identified, and that appropriate measures are taken to protect the health of employees and those who are contracted out to transport and dispose of the waste. Departmental risk assessments will identify risks or harm caused by waste and the appropriate control measures to minimise or reduce the risks. 2. LEGISLATION To effectively manage wastes generated on healthcare premises we must comply with the requirements of three separate regulatory regimes: Health and Safety including COSHH Environmental and waste Transport 3. DUTY OF CARE The main responsibilities are to: Describe the waste fully and accurately on waste transfer notes or consignment notes prior to the waste being collected. Segregate waste into the correct waste stream. Store waste safely and securely on site. Pack waste correctly and securely. Make sure waste carriers are licensed correctly. Ensure waste falls within the terms of the waste Contractors waste management licence or permit. 4. WASTE SEGREGATION Segregation of waste at the point of production into suitable colour coded packaging is vital to good waste management. Health and Safety, carriage and waste regulations require that waste is handled, transported and disposed of in a safe and effective manner. The standard colour-coded system will be used by all sites that produce healthcare wasted (see Appendix 1). Correct waste segregation can most easily be achieved by ensuring that the right bin is nearest to where that particular type of waste is generated. Putting all packaging into Version 3.00, July 2012 Page 8 of 41

appropriate wasted containers will reduced the amount of hazardous/non hazardous waste and therefore reduces the overall cost of disposal. 5. SAFE STORAGE OF WASTE Waste containers and wheelie bins will need to be stored before transport for disposal elsewhere. The size, location and layout of storage will depend upon the type and quantity of waste produced and frequency of collections. Waste should not be allowed to accumulate in corridors or other places accessible to members of the public. The clinical waste bins are chipped to identify them and recorded on the contractors electronic recording system and identify it on route to the disposal plant. Bins should be tagged to identify the type of waste it contains (see Appendix 2). DIFFERENT TYPES OF WASTE SHOULD NOT BE MIXED IN THE BINS. i.e. sharps bins and bagged waste should not be mixed. The main features of an appropriate store for waste are as follows: Reserved for waste only, enclosed and secure. Sited away from food preparation and general storage areas, and from routes used by the public. Provided with separate storage for sharps receptacles and waste medicines, which may need a higher degree of security to prevent unauthorised access. Sited on a well-drained, impervious hard standing, well-lit and ventilated. Readily accessible but only to authorised people and kept locked when not in use. Secure from entry by animals and free from insect or rodent infestations. Clearly marked with warning signs. Provide clearly labelled areas for waste that requires, rather than is destined for, different treatment/disposal options. Have a water supply located nearby. 6. DOCUMENTATION Under Section 34 of the Environmental Protection Act, the Trust is required to fulfil its Duty of Care on Waste. Evidence must be available to demonstrate that waste is not illegally disposed of, is handled by an authorised person and is transferred with a Waste Transfer or Consignment Note. For each of the waste streams described in this document, the following documentation must be retained: For hazardous waste a Consignment Note between Trust and appointed disposal contractor. For non hazardous waste a Waste Transfer Note between Trust and appointed disposal contractor. Copies of Waste Carrier s Licences for all contractors moving the waste until its final resting point. Copies of Waste Management Licences for each site receiving the waste until and including its final resting point. Where licences cannot be provided, contractors are required to provide appropriate exemption certificates. To assist future internal and external audits, including those by the Environment Agency, the Trust will maintain this documentation centrally at each site in a Yellow Waste File. Version 3.00, July 2012 Page 9 of 41

Designated members of staff at each site will be responsible for signing the documentation and keeping the Waste File up to date. The Trust could be audited by the Environment Agency at any time therefore staff must know where the key documentation is kept. 6.1 Waste Transfer Notes Waste Transfer Notes allow waste to be transferred from one party to another. Waste Transfer Notes must: Give a description and quantity of waste. State the name and address of the persons transferring and receiving the waste. State whether the person taking the waste is a waste collection authority, holder of a waste management license, a person exempt from such a license or a registered waste carrier. Where the waste type, quantity, source and destination are the same (known as repeat movements) a single waste transfer note may be written to cover all movements within a 12 month period. Transfer Notes should be retained for a minimum of 2 years onsite and filed in the waste file. 6.2 Consignment Notes The layout and content of a Hazardous Waste Consignment Note is specified in the Hazardous Waste Regulations 2005 (see Appendix 3). The waste contractor will assist in the completion of the consignment note. However, the waste producer has a responsibility to ensure the information is correct to ensure the waste stream is compliant and is treated correctly. The waste consignment note requires the following: Show the 6-digit European Waste Catalogue (EWC) code for the waste. Provide a written description of the waste. Give information about the hazardous nature of the waste and if applicable to each hazardous substance (this may involve attaching supplementary sheets to consignment notes). Information about the number of waste containers used their colour and size. The consignment note must be handed to the waste carrier s representative prior to removal. The Consignment Note must travel with the waste consignment. Consignment Notes should be kept for a minimum of three years. 6.3 Licence Sites as Hazardous Waste Sites Under the Hazardous Waste Regulations 2005, healthcare sites producing in excess of 200kg of Hazardous Waste must notify the premises to the Environment Agency. The 200kg does not include waste produced by maintenance contractors who collect waste that they produce in the course of their business from premises at which they are visiting. The Estates Team will be responsible for the annual registration of the relevant sites and any future new sites. Registration number and information is held within the site Yellow Waste file. 7. WASTE TYPES AND DEFINITION Waste is broadly defined as any substance or objects that is discarded, intended or required to be discarded and as such is subject to a number of regulatory requirements. Even if material is sent for recycling or undergoes in house treatment it is still regarded as waste and dealt with in accordance with the law. Version 3.00, July 2012 Page 10 of 41

Waste regulation requires the classification of waste on the basis of its hazardous characteristics. 7.1 Definition of Healthcare Waste Waste generated as a result of treatment either at Trust premises or in third party/private house. Historically this has been termed clinical waste and in general terms there was little requirement to segregate the waste into different categories. However the Hazardous Waste Regulations 2005 require the Trust to assess the waste it produces and segregate it accordingly (see Appendix 4). Healthcare waste could be: Cytotoxic/cytostatic that requires incineration (yellow/purple bags and containers). Infectious that requires incineration (yellow bags), Infectious that can be treated (orange), or Offensive (yellow with black stripe/tiger bags) 7.2 COSHH The overriding regulation is The Control of Substances Hazardous to Health Regulations (COSHH). This specifically requires those dealing with potential infectious materials (including waste) to assess the risk to the public, patients and staff that may come into contact with it. 7.3 Waste Codes (Appendix 5) The European Waste Catalogue (EWC) categorises waste into 20 chapters; and each chapter is linked to a production sector. Within each chapter, each type of waste is described using a six-digit numerical code: the first two digits of the code relate to the production sector the second two digits relate to any sub-grouping within the production sector the final two digits are unique to the waste. Chapter 18 of the EWC covers wastes from human or animal health care and/or related research (except kitchen and restaurant wastes not arising from immediate health care). 8. HOW HEALTHCARE WASTE IS CATEGORISED, SEGRATED AND DISPOSED OF? 8.1 Infectious Waste (ECW Code 18 01 03) (Appendix 15) The waste should be placed in the correct coloured bag, and when full, securely closed and sealed appropriately in a safe manner. Details of the type of waste, where it was produced and who is collecting it should be affixed to the bag or printed on the bag itself. The bags must be removed from the workplace at least daily or when no more than two thirds full whichever is earlier. Waste bags must not be allowed to accumulate in corridors or clinics. The bags will normally be removed by the domestic services staff. In exceptional cases where the bags are full and no domestic services staff are on duty, the site staff should remove the bags to the storage containers. The bags are to be placed into the designated container that is clearly marked as containing the type of waste. The designated container should be used for infectious waste only. Domestic waste must not be placed in these containers. Version 3.00, July 2012 Page 11 of 41

The designated container must be kept locked at all times. Keys are to be held by the designated personnel and licensed waste contractor. The bins will be picked up by a registered carrier to be taken to a licensed waste disposal facility. Infectious waste describes wastes whose collection and disposal is subject to special requirements in order to prevent infection. The NHS has divided this into two subcategories: Yellow-stream infectious waste requires disposal by incineration in a suitably licensed or permitted facility. This will be placed into yellow bags. This will not normally be generated by the Trust as it would contain Category A pathogens. The infection control team would advise on an individual basis if required. Orange-stream infectious waste requires minimum treatment/ disposal to be rendered safe in a suitable licensed or permitted facility. This will be placed into an orange bag and will be the infectious waste generated by the Trust. Infectious waste includes dressings, swabs, pads, bed pan, liners and urine containers. 8.2 Offensive Waste (ECW Code 18 01 04) (Appendix 15) Soiled waste such as sanitary products and nappies are not considered to be infectious unless a healthcare practitioner gives specific advice to the contrary. Waste contaminated with non-infectious bodily fluids is capable of causing offence and therefore requires packaging to alert those in the disposal chain of the contents. Examples of offensive waste include: Incontinence and other waste produced from human hygiene Sanitary waste Nappies Medical/Veterinary items and equipment which do not pose a risk of infection including plaster casts, etc. At most sites there is a separate sani-waste contract that provides a disposal and exchange bin service. Normal disposal route is to a suitably licensed landfill or permitted facility. 8.3 Sharps Disposal Containers (Appendix 6) Do not separate the needle from body - dispose of whole. There is no requirement in waste legislation to fully discharge syringes. 8.3.1 Sharps NOT contaminated medicines - Yellow bin with orange lid (ECW Code 18 01 03 / 18 01 09) The term sharps shall mean anything sharp. This includes syringes, needles, forceps, scalpel blades, giving sets, pipettes, pipette tips, broken glass and single use instruments not contaminated with medicine. Sharps not contaminated with medicines must be discarded directly into UN approved ORANGE LIDDED sharps bins. They must never be discarded in any other receptacle. Appropriate disposal of the sharp is the responsibility of the individual using it. When ¾ full the bin must be completely closed, sealed and tagged by Nursing or Medical staff who will indicate the source of the waste. In low use areas where sharps bins take a long time to fill, they must be sealed and sent for disposal every six weeks (as a maximum) regardless of content volume. Sharps bins should be dated and signed by staff at the time of assembly and when sealing the bin for disposal. Sharps containers should be removed to the Version 3.00, July 2012 Page 12 of 41

designated storage containers by site staff or domestic services staff. The designated container must be kept locked at all times, keys are to be held by the designated personnel and licenses waste contractor. The bins will be picked up by a registered carrier to be taken to licenses waste disposal facility. At no time are sharps containers to be placed in healthcare waste bags or medicines placed into them. 8.3.2 Partially discharged sharps contaminated with medicinal waste - Yellow bin with yellow lid (ECW Code 18 01 03 / 18 01 09) All partially discharged sharps not contaminated with cyto medicines must be discarded directly into UN approved YELLOW LIDDED sharps bins. They must never be discarded into any other receptacle. Appropriate disposal of the sharp is the responsibility of the individual using it. When ¾ full the bin must be completely closed, sealed and tagged by Nursing or Medical staff. In low use areas where sharps bins take a long time to fill, they must be sealed and sent for disposal every six weeks (as a maximum) regardless of content volume. Sharps bin should be dated and signed by staff at time of assembly and when sealing the bin for disposal. Sharps containers should be removed to the designated storage containers by site staff or domestic service staff. The designated container must be kept locked at all times, keys are to be held by the designated personnel and licensed waste contractor. The bins will be picked up by a registered carrier to be taken to licensed waste disposal facility. At no time are sharps containers to be placed in healthcare waste bags or medicines placed into them. 8.3.3 Sharps contaminated with cytotoxic or cytostatic medicines - Yellow bin with purple lid (ECW Code 18 01 08) This type of medicine must be kept separate from other waste medicines and labelled pharmaceutical waste hazardous. This will include any medicine that is: Carcinogenic or Mutagenic Toxic for reproduction Toxic All partially discharged sharps not contaminated with medicines must be discarded directly into UN approved PURPLE LIDDED sharps bin stating CLINICAL WASTE FOR INCINERATION. They must never be discarded into any other receptacle. Appropriate disposal of the sharp is the responsibility of the individual using it. When ¾ full the bin must be completely closed, sealed and tagged by Nursing or Medical staff. Sharps bin should be dated and signed by staff at the time of assembly and when sealing the bin for disposal. Sharps containers should be removed to the designated storage containers by site staff or domestic services staff. The designated container must be kept locked at all times, key are to be held by the designated personnel and licensed waste contractor. The bins will be picked up by a registered carrier to be taken to licenses waste disposal facility. 8.4 Pharmaceutical Waste The Trust uses two different bins to dispose of this type of waste (see Appendix 7). 8.4.1 Yellow Topped Rigid Container (ECW Code 18 01 09) For non-hazardous pharmaceutical waste including: Empty containers contaminated with pharmaceuticals i.e. bottles and blister foils Version 3.00, July 2012 Page 13 of 41

Out of date drugs Waste patients labelled drugs e.g. patients own drugs, non stock medicines, etc. IV/drip bags and tubing. No cytotoxic or cytostatic pharmaceutical waste. For controlled drugs, please refer to current safe and secure handling of medicines. 8.4.2 Purple Topped Rigid Container (ECW Code 18 01 08) For hazardous pharmaceutical waste including cytotoxic and cytostatic. Please refer to hazardous pharmacy list for other items. Empty containers contaminated with hazardous pharmaceuticals i.e. bottles and blister foils Out of date hazardous drugs IV/drip bags and tubing used with hazardous pharmaceuticals. Please note that outer packaging from pharmaceuticals is general waste but delete patient name if on dispensing label. At no time is pharmaceutical waste to be placed in healthcare waste bags. All pharmaceutical waste containers should be kept in a secure area until handed over for collection and identified with the ward or department. 8.5 X-Ray Waste (ECW Code 09 01 04, 09 01 06, 09 01 07, 09 01 08) All x-ray machines within the Trust will in the future be digital. Currently the x-ray machines discharge fixed and developer into the sewer, with the former being passed through a silver recovery unit, which is regularly maintained. Photographic film and paper is not deemed to be hazardous regardless of whether it contains silver and can be disposed of via the domestic waste stream. 8.6 Amalgam Waste (ECW 18 01 10) Dental amalgam is classified as a hazardous waste and should not be permitted to enter the public sewer. Any dentistry clinics with the Trust must collect the materials in an approved white rigid receptacle with a mercury suppressant for disposal kept in a secure area either via amalgam separators fitted to the chairs or separate containers for other generation routes. At no time is Dental Amalgam to be placed in healthcare waste bags. Amalgam waste should be sent to suitable licensed or permitted waste management facilities where the waste undergoes a mercury recovery process. 8.7 Feminine Hygiene within Healthcare Premises (ECW Code 18 01 03) The Trust has a contractual arrangement for this to be collected from specific sites, but not all sites. At sites that are included on that contract the waste shall be deposited within the approved receptacles that have been specifically provided for the purpose. At sites that are not included on that contract, or if no such receptacle is available, the waste shall be placed in a tiger waste bag and treated as offensive waste. The Trust will then manage the system for disposal of waste within the feminine hygiene receptacles. 8.8 Waste generated away from Healthcare Premises The requirements for disposal of waste from patient s homes are detailed below. Staff must ensure that they and their patient is aware of the procedure for disposal of the waste. Version 3.00, July 2012 Page 14 of 41

8.8.1 Risk Assessment In the home, the source population is generally healthy but management of clinical waste should be based on an assessment by the clinician who will carry out a risk assessment of risk of transmission of infection to staff, patients and the rest of the community. The risk assessment should take into account: Any factors about the patient s condition which are likely to mean that any waste generated is an infection risk. The volume of waste produced (large quantities of non-infectious waste needs to be taken into account). The Trust will adopt the risk assessment procedure used in the document Safe Management of Healthcare Waste. 8.8.2 Documentation The assessment and plan for waste disposal must be recorded in the care plan to inform others who may be involved in the care of that patient. 8.8.3 Disposal Methods Following a risk assessment the disposal method can be determined: Non-Infectious Waste (household waste) Staff should wrap the waste in a newspaper and then place the waste in a carrier bag or plastic bag which must be sealed to render it inoffensive to anyone else and to avoid leakage. The bag should then be placed in a black plastic refuse sack. In most cases, a suitable bag will be provided in the dressing pack or dressing aid. The waste is then placed in the same container as other household waste. Infected Waste (clinical waste) Large quantities of body fluid contaminated waste generated will be classified as Hazardous by Infection (EWC 18 01 03) which must be placed in a yellow bag which is securely closed. Arrangements should be made with the waste collection department of the local authority for regular collection of the yellow bags. In the meantime they should be stored in a safe place. The Community Nurse is responsible for this waste until collected. Local authorities have a duty to collect this waste and arrange for its collection. East Riding of Yorkshire Council offers a free collection for clinical waste in the community. (See Appendix 8.) Sharps Sharps must be disposed of through the Trust s own waste collection system in containers which conform to BS7320 and UN3291. When no more than ¾ full the sharps container must be securely closed. The sharps container must be placed in a secondary container, but not in a bag. The secondary container must be kept free from contamination on the outside. The secondary container should be a lockable UN approved container. The lid and body need to contain a label indicating contents (hazardous waste) and a contact number of the Waste Manager. The secondary container should be kept locked in the boot of the car. It should be kept out of sight and labels should not be obviously visible. For frequent users a sharps container may be left with the patient. A sharps information leaflet must always be left with the sharps container so that the patient is aware of disposal requirement. Sanpro Waste In most cases these can be disposed of via the household waste system. However, if there are large quantities of such waste (or such waste is assessment to be an infection risk) a Local Authority waste collection service Version 3.00, July 2012 Page 15 of 41

should be required. This is because large quantities increase the risk factor and are often offensive. 8.9 Contaminated Mattresses Mattresses that are contaminated with unknown substances can be treated as hazardous healthcare waste. Contact the Estates Helpdesk who will arrange for a mattress bag to be supplied. Once bagged, arrangements will be made for collection and disposal by the Trusts Contractors. For surplus non-contaminated mattresses these are dealt with through the Trusts Disposal procedures. 9. CATEGORISATION OF NON-CLINICAL WASTE AND IT S DISPOSAL Domestic waste should not contain any infectious materials, sharps or medicinal products. Domestic waste may be placed in black or clear bags for disposal. (See Appendix 15.) It is likely that domestic waste produced by the Trust will include some if not all of the wastes stated below, although this list should not be seen as exhaustive. The waste stream is likely to arise in both clinical and non-clinical areas, although any waste thought to be infectious see Healthcare Waste section. In clinical and non-clinical areas, full clear or black bags will be removed to a designated point by the domestic services staff, dependent upon the particularly site. The individual removing the full bag is responsible for replacing it with a new bag. The bags should be placed in non hazardous waste containers for disposal. The containers will be picked up by a registered carrier to be taken to a licenses waste disposal facility. On a regular basis, the Trust will review this waste stream in line with the waste hierarchy, looking for techniques to avoid, reduce, reuse and/or recycle waste before disposal options are considered. All items should be disposed of in the manner outlined below, unless recycling is available. 9.1 Confidential Waste (ECW Code 20 01 01) If possible confidential waste should be disposed of via an onsite cross cut shredder and placed into the domestic waste stream for re-cycling if available. Sites wishing to dispose of large amounts of confidential waste should request a supply of appropriate sacks and arrange regular collection. Confidential Waste should be loaded into the bags provided. The bags should only be half filled. Confidential waste must be stored in a manner that ensures it remains secure and cannot be accessed by unauthorised persons. When an external company is used to shred the waste off-site and recycle it a certificate of destruction should be provided for each shipment. Records will be maintained by the designated staff member on site. 9.2 Cardboard and Paper (ECW Code 20 01 01) Cardboard should be flattened at source for collection by the domestic staff. Cardboard packaging should be deposited in the containers for recycling where possible. Only cardboard waste that is contaminated with blood or body fluids should be dealt with as infectious waste. 9.3 Fluorescent Tubes (ECW Code 20 01 21) Sites should inform the Estates Department if a fluorescent tube requires replacement. Defective tubes will be replaced and will be placed in the container on site to ensure that Version 3.00, July 2012 Page 16 of 41

the small amount of mercury contained within them is managed appropriately. Paperwork will be maintained by the designated staff member on site. 9.4 Toner and Ink Cartridges (ECW Code 08 03 17) Used toner cartridges should be recycled by depositing in the appropriate containers on site where arrangements will be made for collection. All empty cartridges should be put into their original packaging when a cartridge is changed. Paperwork will be maintained by the designated staff member on site. Containers for collection these are available from the Estates Department. 9.5 Waste Electrical and Electronic Equipment (ECW Code 20 01 35) Waste Electrical and Electronic Equipment (WEEE) should not be disposed of via the domestic waste stream or at Household Waste Recycling Centres. WEEE is classified by the definition provided in the WEEE Directive (2002/96/EC). Generally it covers the following ten product categories below: List of common items Large household appliances (i.e. washing machines, cookers) Small household appliances (i.e. toasters, irons, hairdryers) IT and telecommunications equipment (i.e. PCs, copiers, phones, mobiles) Consumer equipment (i.e. TVs, videos, hi-fis) Lighting equipment Electronic and electrical tools Toys, leisure and sports equipment (i.e. video games, bike computers, slot machines) Medical devices (except implanted and infected products) Monitoring and control instruments (i.e. smoke detectors, thermostats) Automatic dispensers (i.e. drinks dispensers, chocolate dispensers, ATMs) As a result of this, all equipment must be disposed of via the Estates Department. Decontamination should also be carried out for infected medical devices. Paperwork will be maintained by the designated staff member on site (see Appendices 9 and 10). IT equipment should be checked by the Trust IT Department prior to disposal. All computer hard drives are to be removed for secure disposal. 9.6 Trust Mobile Phones and Devices These should be disposed on via the IT Department to ensure they are removed from Trust contracts. 9.7 Batteries (ECW Code 20 01 34) (see Appendix 11) Batteries are generated throughout the Trust from use in hearing aids, electronic medical devices and other portable equipment. We need to make sure these are recycled and not discarded in general waste and end up at landfill disposal sites. Small 5 litre buckets are supplied to all areas. These should be kept in a prominent but secure position. Waste portable batteries should be placed into this bin instead of the general waste bin. Batteries should be kept dry, not broken open and not exposed to excessive heat or fire. Any large batteries will need to be disposed of by a different route and you should contact the Estates helpdesk for further information. 9.8 Food Waste (ECW Code 20 01 08) Food waste should be treated in the same manner as domestic waste unless specific composting facilities are available. Version 3.00, July 2012 Page 17 of 41

9.9 Aerosols Any aerosols should be treated in the same manner as domestic waste. 9.10 Plastic (ECW Code 20 01 39) Any plastic containers should be treated in the same manner as domestic waste unless specific recycling facilities are available. 9.11 Aluminium and Tin Cans (ECW Code 15 01 04) Aluminium and tin cans should be treated in the same manner as domestic waste unless specific recycling facilities are available. 9.12 Glass (ECW Code 15 01 07) Uncontaminated glass waste should be disposed of by wrapping in paper and placing in domestic bins unless specific recycling facilities are available. Any glass which has been in any way contaminated should be dealt with as Sharps. 9.13 Other Waste In the event of works being carried out a location generating non hazardous waste not directly related to day to day housekeeping, a separate waste container/skip will be required and a Waste Transfer Note issued by the carrier to the Trust/location to cover the transfer of this waste must be raised. Contact the Trust Estates Helpdesk for advice on the disposal of any other wastes not included in this policy. 10. MATERIALS FOR RECYCLING Materials identified for recycling, examples of which are paper, cardboard, toner cartridges, glass bottles, plastics, tins and batteries will need to be collected prior to transfer to a registered recycling facility. The material must be picked up by a registered/exempt carrier. Please note at no time must the Trust waste be put into community or household recycling collection containers or taken to Council waste facilities. 11. GENERAL RESPONSIBILITIES Handling healthcare waste is a hazardous operation. Staff may be exposed to an infection risk. All Staff have the following responsibilities: - Ensure personal protective equipment and clothing as provided will be used. This includes particular protection against needle-stick injuries for the waste collection team. Do not leave Healthcare waste bags unattended at any time whilst in transit on site. Handle Waste bags the least number of times, so far as is reasonably practicable. Ensure Waste bags will be sealed properly. Decontaminate the suitable storage units in which clinical waste is transported or stored on a regular basis or following any spillage. Management will provide: - Adequate personal protective equipment and clothing. Adequate training for all Staff that handles all waste. Suitable storage units in which waste is transported or stored. Vaccination of Staff involved in the movement of all waste for Hepatitis B. 12. SAFE WORKING PRACTICES 12.1 Healthcare Waste All bags must be sealed by swan necking and using tags/labels as provided for each department. Bags must be sealed individually and not put into each other. Healthcare waste bags must not be used for any other purpose. All healthcare waste must be placed in a secure waste storage area. Version 3.00, July 2012 Page 18 of 41

12.2 Sharps Containers Must be correctly assembled. The person responsible for the task must date and sign the label in the appropriate place. All used sharp instruments e.g. needles, lancers, used disposable syringes and broken glass are to be placed in the sharps containers. Sharps containers are not to be overfilled. Once the bin is 2 / 3 full at the marked full position it must be sealed. Remove the full sharps container to the secure waste storage area. 12.3 Pharmaceutical Waste Waste material containing pharmaceutical products are to be dealt with in line with the Disposal of Medicines section of the Trusts Procedures for Safe and Secure Handling of Medicines. 12.4 Cytostatic/Cytotoxic Waste Waste sharps, vials and ampoules are to be sealed in purple lidded sharps boxes and clearly labelled Cytostatic/Cytotoxic. Cytotoxic waste is to be kept separate from hospital waste in a locked area. Separate arrangements for disposing of Cytostatic/Cytotoxic waste must be made. Such waste is to be clearly identified as such. 12.5 X-Ray Waste X-ray films and silver recovery are to be disposed of in accordance with the X-ray Policy. 12.6 General Waste All other types of waste not listed separately fall into this category. All waste bags other than yellow, orange and tiger bags are to be collected as general waste. Clear bags are to be used to dispose of general waste. All cardboard boxes are to be flattened. 12.7 Recycling All items should be segregated and placed in the respective bins. Note: Full recycling facilities are currently not available at all sites. It is hoped to introduce these in the future when suitable disposal routes become available. 13. STORAGE PRECAUTIONS In Trust premises the healthcare waste bags, when marked, should be taken to a collection point and placed in a suitable dedicated container, i.e. hazardous waste disposal bin. Trolleys and carts used for the movement of clinical waste within the premises should be designed and constructed so that the surfaces that convey are smooth and impermeable, that they do not offer harbourage to insects, and can be easily and drained and will allow the waste to be handled without difficulty. Steam cleaning is preferred but disinfecting at the end of the day is an acceptable alternative. 14. PROTECTIVE CLOTHING AND AVOIDANCE OF INJURY People who are repeatedly moving bags from one small receptacle to a larger container may become complacent with the routine activity. The risk of injury is therefore increased for those staff handling the waste in large quantities. Version 3.00, July 2012 Page 19 of 41

Those who handle the different types of waste for disposal should be made aware of the hazards of the different types of waste. When moving sacks hold them by the closed end and away from the body. Careful consideration must be given by all Staff in the methods used for transferring waste at all stages of disposal route in order that the risk of injury is reduced to a minimum. All Staff involved in the process of handling waste bags should wear the following items for protection: Heavy duty gloves Disposable plastic apron Sturdy shoes. The hazard most likely to endanger health is injury through a sharp, which may have been wrongly disposed of in a waste bag. When an accident occurs however small, involving sharps or contaminated by blood or body fluids, it must be reported to an immediate superior and the Trust Sharps Policy should be followed. 15. WASTE MANAGEMENT TRAINING PLAN a. Members of the Waste Management Working Group will attend meetings to provide overview/audit of the compliance. b. Prior to commencing work all new staff will be given training on waste to ensure safe handling and disposal of all types of waste. c. Training will also be given at Trust Induction sessions on the safe handling of all types of waste produced within the Trust. d. Ongoing training will be given for all members to ensure appropriate instruction in the safe handling and disposal of all types of waste. e. Monitoring will be carried out to ensure that Staff are complying with the Waste Management Policy and waste is being disposed of correctly. f. Waste training will be delivered using various methods including Train the Trainer where key staff are trained to pass the information on to others and the development of an e-learning package. 16. TRAINING PROGRAMME During Workplace Induction and ongoing training the following will be covered:- a. Trust waste policy, strategy and procedures b. Production levels and costs c. Waste disposal and waste treatment d. Waste segregation issues e. Recycling f. Colour code system. g. Hazardous waste h. Duty of Care i. Waste Management Licensing Regulations j. WEEE Regulations k. Marking of bins, bags, sharps boxes. l. Disposal system. m. Waste Consignment Notes, Waste Transfer Notes & Waste Carriers n. Dealing with spillage s of waste and the use of protective clothing i. Inside the confines of building ii. Outside the confines of building iii. During Transport. o. Reporting of spillages or incidents of a dangerous nature related to the Waste Management Policy. Version 3.00, July 2012 Page 20 of 41

p. Auditing and Monitoring 17. REMOVAL AND HANDLING OF HEALTHCARE WASTE For details of how to safely handle and remove healthcare waste see Appendix 12 and for dealing with waste spillages see Appendix 13. 18. WASTE BINS & RISK ASSESSMENT Following a Blue Light Alert issued in July 2009 concerning some of the waste bins used within the Trust, various types of bins and different bags have been identified for use, depending on the risk involved and which is the most appropriate for each location. See Appendix 14 for the Waste Bin Risk Assessment process. Version 3.00, July 2012 Page 21 of 41

Appendix 1 Waste Bags and Containers Colours Colour Description Waste which requires disposal by incineration Minimum treatment / disposal required is by incineration in a suitably licensed or permitted facility 18 01 02 & 18 01 03 Waste which may be treated Minimum treatment / disposal required is to be rendered safe in a suitably licensed or permitted facility Dealt with at an alternative treatment plants (ATP) However this waste may also be disposed of by incineration. 18 01 03 Cytotoxic/cytostatic waste Minimum treatment / disposal required is by incineration in a suitably licensed or permitted facility. 18 01 08 & 18 01 03 Offensive waste Minimum treatment / disposal required is by landfill in a suitably licensed or permitted site. 18 01 04 Clear Bags Domestic waste Minimum treatment / disposal required is by landfill in a suitably licensed or permitted site. Clear / Opaque or black bags may also be used for domestic waste. 20 03 01 Amalgam Waste For recovery. 18 01 10 Version 3.00, July 2012 Page 22 of 41

Appendix 2 Clinical Waste Bin Tags CLINICAL WASTE - BIN TAGS BINS CONTAINING SHARPS BINS ONLY ********************************************************************* BINS CONTAINING ORANGE BAGS ONLY ********************************************************************* BINS CONTAINING OFFENSIVE WASTE TIGER BAGS ONLY Version 3.00, July 2012 Page 23 of 41

Appendix 3 Documentation Waste Consignment Notes DOCUMENTATION Waste Consignment Notes You should start to complete the consignment note only when the load is ready for collection these need to be completed accurately. The codes used need to match what is actually being disposed of irrespective of the disposal route. Version 3.00, July 2012 Page 24 of 41

Before the waste is removed, the Producer or Holder of the waste, as appropriate, must: Prepare a copy of the consignment note for the Producer or Holder, the Carrier and the Consignee. An extra copy is required for the Consignor if he is not the Producer or Holder. Complete Parts A and B on each copy as detailed below. Give every completed copy to the Carrier. PART A- Notification details 1. Consignment note code: Each collection of waste requires a consignment note containing a consignment note code. A consignment note code required for a collection of Hazardous Waste must be unique in accordance with Regulation 33. In order for the number to be unique the consignment note code must follow. If the waste has previously been rejected an r should be added to indicate this. The Coding Standard shown below: Coding Standard = 6 digit Registration Number/5 digit alphanumeric e.g. NAK167/00001 or XYZ123/HW025 2. The waste described below is to be removed from: Complete the details for the premises from where the waste is being collected. 3. Premises Code: The premise code is the code that was given when the site was registered with the Environment Agency, then the Premises Code, if the premises are exempt from registration this should be stated here by writing N/A. 4. The waste will be taken to (name, address and postcode): This provides details about the Consignee. 5. Waste Producer Where the producer of the waste is different to that named in section 2. PART B- Description of the waste 1. The process giving rise to the waste(s) was: A full written description of the process that gave rise to the waste. Where there is more than one waste consigned, produced by more than one process, the primary production process should be recorded. 2. SIC For the process giving rise to the waste: The Standard Industrial Classification (SIC) classifies businesses and other operations. The 2003 version of the SIC is split into 17 Sections. For Hazardous the SIC is 85.11/1 Public sector hospital activities, 85.12 Medical Practice activities, 85.13 Dental Practice activities or 85.14 other human health activities. 3. Waste Details: Description of Waste: A detailed written description not just a description used for the European Waste Codes. If the waste is a collection of chemicals each waste must be identified and detailed! List of wastes: It is important that you choose the EWC that is representative of the waste. The determination of the correct EWC code is described in Environment Agency guidance WM2 Interpretation of the definition and classification of Hazardous Waste : Version 3.00, July 2012 Page 25 of 41

Quantity (kg): This should be the weight in kg of each waste that is coded. Where waste is a liquid use the conversion 1 litre= 1 kilogram The average bin weights for the waste that is sent to them to enable you to fill out the weight section on the consignment note for Healthcare Waste. WASTE RECEPTACLE AVERAGE WEIGHT (Kgs) Community sharps bin 0.5 5 litre sharps bin 1.0 7 litre sharps bin 1.0 11 litre sharps bin 2.0 22 litre sharps bin 5 Hazardous waste bag 2.5 30 litre sealed unit 10 60 litre sealed unit 15 360 litre wheeled bin 25 820 litre wheeled bin 55 The chemical/biological components of the waste and their concentrations are: All components and their concentrations should be shown so that Carriers, Consignees or other parties are aware of what is in each waste. This will include components that do not render the waste hazardous. This will enable the waste to be disposed of via the correct method. Physical Form: Only one description should be given for each waste that is coded. Hazard Code: This must be completed for all hazards appropriate to the waste H1-H14 (reference the Hazardous Waste). Container type, number and size: Each container of waste must be described with its size and quantity e.g. 4 x 45 gallon drums, 1 x 14 cubic yard skip. Packing Group(s). UN identification number(s), Proper shipping name(s), UN Class(es): These items are required for transport purposes where the waste is also dangerous for carriage. Where waste is not classed as dangerous for transport this part does not need to be completed. Guidance on this may be found on the web sites of the Department for Transport and the Carriage of Dangerous Goods Manual, produced by the Health and Safety Executive: For multiple collections please see the Environment Agency website. Special handling requirements: This is additional information about other problems with the waste that might help the carrier or consignee. The bins are chipped but also need to be easily identifiable and should be identified with the correct colour coded tag to help identify the waste. Waste consignment Notes need to be kept on site for three years Version 3.00, July 2012 Page 26 of 41

Appendix 4 Segregation of Waste SEGREGATION OF WASTE HEALTHCARE WASTE RECEPTACLE Hazardous Infectious Waste Cytotoxic or cytostatic contaminated Yellow Plastic Bags with purple stripe (must be incinerated) Hazardous Infectious Waste No Cytotoxic or cytostatic contamination Yellow Plastic Bags (must be incinerated) Infectious Waste Orange Plastic Bags (may be autoclaved) Offensive Waste Yellow & black striped Plastic Bags (can go to landfill not to be compacted) Hazardous sharps Needles, Blades etc. Cytotoxic or cytostatic contamination Hazardous sharps - Needles, Blades etc. contaminated with medicines but No cytotoxic or cytostatic contamination Purple lidded BS 7320/UN 3291 Approved Sharps Container with purple stripe (must be incinerated) Yellow lidded BS 7320/UN 3291 Approved Sharps Container (must be incinerated) Sharps - fully discharged & not used for medicines, needles, blades etc. Orange lidded BS 7320/UN 3291 Approved Sharps Container (can be autoclaved) Pharmaceutical waste Yellow BS 7320/UN 3291 Approved Container (must be incinerated) Purple lid for hazardous waste including cytotoxic and cytostatic (see pharmacy list for other items) Yellow lid for non hazardous waste Version 3.00, July 2012 Page 27 of 41

OTHER WASTE RECEPTACLE Hazardous General (domestic type) Waste e.g. Ni-Cd batteries & fluorescent tubes Approved Containers (must be separated from other domestic waste & consigned as hazardous waste) General (domestic type) Waste Clear Plastic Bags Food Waste Normally disposed via Waste Disposal Units if a problem Clear Plastic Bags are used Glass and Aerosol Cans Paper Sacks that are clearly labelled Glass and aerosol cans: not to be incinerated Plastic Bottles Tins and Cans (washed and not contaminated) In clear plastic bags Paper (clean & dry) Card (not contaminated) Appropriate Container for recycling as Supplied Confidential Waste Shred at Source or use Appropriate Container as Supplied Obsolete, broken or redundant electrical items WEEE (Waste Electrical and Electronic Equipment) Contact the Estates Helpdesk so that suitable disposal or take back can be arranged Do not dispose of via the general waste bin Obsolete, broken or redundant IT equipment Recycled via Second Byte I.T. Ltd, a local social enterprise. Contact the Estates Helpdesk so that collection can be arranged. All Hard Drives to be removed by I.T. prior to collection. Version 3.00, July 2012 Page 28 of 41

Appendix 5 Waste Codes EWC code WASTE CODES Description of waste 18 01 XX Waste from natal care, diagnosis, treatment or prevention of disease in humans 18 01 01 Sharps except 18 01 03* 18 01 02 Body parts and organs including blood bags and blood preserves, (except 18 01 03*) 18 01 03* Waste whose collection and disposal is subject to special requirements in order to prevent infection 18 01 04 Waste whose collection and disposal is not subject to special requirements in order to prevent infection, e.g. nappies, human hygiene products, plaster casts 18 01 06* Chemicals consisting of dangerous substances 18 01 07 Chemicals other than those listed in 18 01 06* 18 01 08* Cytotoxic and cytostatic medicines 18 01 09 Medicines other than those mentioned in 18 01 08* 18 01 10* Amalgam waste from dental care Healthcare waste producers are likely to produce a broad range of waste materials, many of which should be classified using EWC codes other than those stated in chapter 18 of the EWC. For example: X-ray fixer and developer may be best described using the EWC codes in chapter 9 of the EWC, which includes waste from the photographic industry. Version 3.00, July 2012 Page 29 of 41

Appendix 6 Sharps Containers SHARPS CONTAINERS YELLOW BIN WITH ORANGE LID Infectious sharps not contaminated with pharmaceuticals Needles and syringes (used for bloods, saline, etc) Blades / razor blades Other sharp instruments (not contaminated with drugs) YELLOW BIN WITH YELLOW LID Infectious sharps including those contaminated with pharmaceuticals Needles and syringes (used for drugs) Other sharp instruments (contaminated with drugs) Part-used and empty vials or ampoules of drugs YELLOW BIN WITH PURPLE LID Infectious sharps contaminated with cytotoxic/ cytostatic pharmaceuticals Needles and syringes (used for cytos) Other sharp instruments (contaminated with cytos) Part-used and empty vials or ampoules of cytos PLEASE REFER TO THE POLICY IF FURTHER INFORMATION IS REQUIRED Version 3.00, July 2012 Page 30 of 41

Appendix 7 - Pharmaceutical Waste HOW TO DEAL WITH PHARMACEUTICAL WASTE YELLOW TOPPED RIGID CONTAINER Non-Hazardous Pharmaceutical Waste including Empty containers contaminated with pharmaceuticals i.e. bottles & blister foils Out of date drugs Waste Patients labelled drugs e.g. patients own drugs, non stock medicines, etc IV/drip bags & tubing NO CYTOTOXIC or CYTOSTATIC PHARMACEUTICAL WASTE Supplies codes 30L FSL751/FSW370 60L FSL128/FSW367 FOR CONTROLLED DRUGS PLEASE REFER TO CURRENT SAFE & SECURE HANDLING OF MEDICINES ECW Code 18 01 09 PURPLE TOPPED RIGID CONTAINER Hazardous Pharmaceutical Waste including cytotoxic and cytostatic please refer to hazardous pharmacy list for other items Supplies code 30L FSL752 Empty containers contaminated with hazardous pharmaceuticals i.e. bottles & blister foils Out of date hazardous drugs IV/drip bags & tubing used with hazardous pharmaceuticals ECW Code 18 01 08 GENERAL WASTE BIN CLEAR BAG Outer packaging from pharmaceuticals (Delete patient name if on dispensing label) NO PHARMACEUTICAL OR CONFIDENTIAL WASTE FOR FULL DETAILS OF HOW TO DEAL WITH PHARMACY WASTE PLEASE REFER TO THE CURRENT PROCEDURES FOR THE SAFE AND SECURE HANDLING OF MEDICINES PLEASE NOTE THAT THIS COLOUR CODE IS SPECIFIC TO THE HUMBER NHS FOUNDATION TRUST S WASTE MANAGEMENT POLICY AND PROCEDURES - PLEASE REFER TO THE POLICY IF FURTHER INFORMATION IS REQUIRED Version 3.00, July 2012 Page 31 of 41

Appendix 8 Information from ERYC website Information from East Riding of Yorkshire Council website The council classes clinical waste as the following items: Syringes Colostomy waste Dialysis waste Soiled dressings Please note: incontinence pads do not require a clinical waste collection and can be double bagged and placed in the green bin. For the items listed above, the council operates a free clinical waste collection service. Please call us on (01482) 393939 to request this service, and we will deliver some waste sacks. You can also request more sacks through this number. The clinical waste must be placed in the yellow clinical waste sacks which are provided free of charge to residents and collected weekly. Sharps boxes for syringes and needles are not provided by the council, but can be obtained by contacting your GP. Sharps boxes are collected on an ad hoc basis when you have at least two sharps boxes that need emptying. All clinical waste must be left outside in a safe and discreet place. When arranging a collection, customers will be informed of the collection day. An on line booking facility is available at http://www2.eastriding.gov.uk/environment/bins-rubbish-recycling/clinical-waste/ Please note: clinical waste must not be taken to the tips as it is classed as hazardous waste and must be incinerated. Please view the map to see which day the council collect clinical waste from each area: Version 3.00, July 2012 Page 32 of 41

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Appendix 9 Disposing of Electrical Equipment Helping You to Dispose of Electrical Equipment Safely and Responsibly It is now a requirement to send old electrical products for re-cycling this is part of European legislation - the Waste Electrical and Electronic Equipment Directive (WEEE for short). The aim of the legislation is to: What is WEEE? Make better use of electrical equipment by recycling it rather than disposing in landfill. Stop any equipment which may contain hazardous substances going to landfill. The regulations apply to most Electrical and Electronic Equipment (EEE) used in households, businesses and other organisations. This includes household appliances, IT and telecommunications equipment, audio-visual equipment, lighting equipment, electrical and electronic tools, toys, leisure and sports equipment, medical devices and automatic dispensers. In essence, every item with a mains plug must be separately collected and where present, hazardous substances removed and treated. Items will display a crossed out wheelie bin identifying this as WEEE. WEEE that is Hazardous Some items such as fluorescent tubes, televisions, V.D.U. s, refrigerators and freezers are also classed as hazardous waste and must be disposed and consigned correctly and not disposed of via the waste bin. What to do with WEEE? If you have any obsolete electrical equipment make sure it is not disposed of via the waste bin, keep it separate and make the Estates Helpdesk aware so that suitable disposal or take back can be arranged. Remember do not put any electrical items in the general waste bin. Version 3.00, July 2012 Page 34 of 41

Appendix 10 Disposal of Redundant IT Equipment Disposal of Redundant IT Equipment Old computers, Printers or other IT hardware The has a responsibility to ensure that all obsolete IT equipment is disposed of correctly; this is also an internal audit requirement. In the past this service was provided by Refurbit at a cost but after careful consideration we have signed up with another company called Second Byte IT Ltd who provides a similar service but at no cost to the Trust. Second Byte I.T Ltd is a not for profit social enterprise based in Scunthorpe that specialises in the collection of redundant I.T & Electrical waste throughout the North of England and Midlands. Established in 2003 the company s clients include Local Authorities, NHS Trusts, PCT s, and Schools, Colleges, Universities, Multinationals, and Banking & Retail sector organisations. Their aims are to; Minimise land fill and ensure maximum recycling to best environmental standards or disposal in accordance with relevant waste regulations. Provide valuable opportunities for employment, training and personal development for the unemployed, ex-offenders, and disabled. Provide quality new & refurbished computer equipment for learners, charities, voluntary and community groups and low income families at low cost. Provide PC servicing and leasing, web site advice and design for schools, charities, and voluntary community groups at low cost. To save travel, costs and CO 2 emissions the new procedures are. Any obsolete or redundant IT equipment that needs disposal please keep it separate, log this as a job with the Estates Helpdesk on 01482 389389 who will at the next opportunity arrange for this to be collected for evaluation at Willerby Hill. If the equipment cannot be reused it will be stored for collection by Second Byte. Please Note: All computer Hard Drives are to be removed by the Trust IT Department prior to the equipment being collected. Version 3.00, July 2012 Page 35 of 41

Appendix 11 Battery Recycling Battery Recycling To help ensure Britain meets its legal requirement to achieve 25% battery recycling by 2012 and 45% by 2016, we all need to help. The Trust like many other organisations wants help recycle batteries and ensure that they are not discarded and end up at landfill disposal sites. We have teamed up with Battery Back to ensure we can start to collect small portable batteries within the Trust and send them for recycling. The company will then sort them into chemical type, treat them and recover base metals for re-use; this helps the environment and also to keep down the cost of new batteries. Small 5 litre Buckets will be supplied to all areas these should be kept in a prominent but secure position, waste portable batteries should be placed into this bin instead of the general waste bin. Batteries should be kept dry not broken open and not exposed to excessive heat or fire. Any large batteries need to be disposed of by a different route contact the Estates helpdesk for further information. When the bins are full contact the Estates helpdesk on 01482 389389, they will arrange for a new container to be supplied and the batteries recycled. Remember do not put batteries in the waste bin Use the battery bin instead If you require any further information please contact Tony Goforth. Trust Environmental Manager on 01482 389354 or email Anthony.goforth@humber.nhs.uk Version 3.00, July 2012 Page 36 of 41

Appendix 12 Removal and Handling of Healthcare Waste REMOVAL AND HANDLING OF HEALTHCARE WASTE General safety rules for moving and handling. 1 In order to reduce the possible risk of cross infection and needle stick injuries it is important that healthcare waste bags are handled as little as possible. 2 Always wear personal protective clothing and gloves provided. 3 Identify faulty bins. 4 Always ensure empty and full bins are locked. 5 If you have to handle the healthcare waste bags lift them by the neck and hold them away from the body. 6 Healthcare waste bags should not be thrown or dropped; doing so could result in spillage. 7 Remove personal protective clothing when you have completed clinical waste run. 8 Wash hands thoroughly. Removal to Storage Area All employees have a legal responsibility to follow the. 1 Collect healthcare waste bags. 2 If there are no empty bins available report this to Waste Manager. 3 When dealing with spillages wear the appropriate garments. 4 Yellow bins must be kept locked. 5 Any sharps injury or splash to skin mucous membrane as a result of dealing with healthcare waste must be dealt with immediately. Sharps Injury/Splash Injury Encourage wound to bleed, wash under running water cover with waterproof dressing and go to Occupational Health or dedicated area (out of hours) and complete Incident form. Version 3.00, July 2012 Page 37 of 41

Appendix 13 Healthcare Waste Spillages KEY POINTS HEALTHCARE WASTE SPILLAGES Wear personal protective equipment. Thoroughly clean the mop and bucket after use. Wash your hands Note: If a bag is ruptured do not remove it, report to the Duty Clinical Manager to ensure that this is reported to the appropriate person to clean up. Clean up spillages Personal protective clothing must be worn. Cytotoxic spillage kits should be used for spillages involving cytotoxic materials. Spillages of sharps must not be dealt with by hand contact. Items must be disposed of by collecting and placing into a larger approved container. Blood and body fluids must be dealt with using an approved disinfectant in accordance with the Trust s Disinfection Policy. The spiller is the person who is responsible for ensuring that the spillage is cleaned up without delay. All personnel involved must be able to identify the waste spilled by the type of container involved. Personnel cleaning up the spillage must be alert for any sharps amongst the waste. The exception is if the spiller is a patient in this case it is a member of staff who is responsible to clean up the spillage Procedure for dealing with a damaged or leaking clinical waste bag Put on a plastic apron. Put on protective gloves. Place leaking bag into another bag. Soak up the spill with paper towels and place the used towels into the hazardous waste stream. Disinfect the contaminated area by using the recommended disinfectant to the manufacturer s instructions. Version 3.00, July 2012 Page 38 of 41

Appendix 14 Waste Bins and Risk Assessment Waste Bins & Risk Assessment Clinical Waste Metal Lidded foot operated bin with no elastic band containing an orange or yellow clinical waste bag. Kept in a secure location General Waste Areas posing no risk Metal Lidded foot operated bin with no elastic band containing a clear waste bag. General Waste Risk Assessed Areas Kitchen Areas where metal bins are a risk Subject to a Risk Assessment Plastic Foot operated bin with rigid liner insert and clear bag or paper sack. Toilet and Bathroom Areas where metal bins are a risk Subject to a Risk Assessment Plastic Foot operated bin with rigid liner insert and clear bag or paper sack or an open white plastic bin with clear bag, paper sack or no liner. Patient Rooms where metal bins are a risk Subject to a Risk Assessment Open black plastic bin with clear bag, paper sack or no liner. Other bins may need to be used if further risks are identified Version 3.00, July 2012 Page 39 of 41

Bin Suppliers & Costs Clinical Waste bin and General Waste bin without elastic band Obtained via Estates from:- Environmental Hygiene Products Ltd Blarliath Industrial Estate Tain Ross-shire IV19 1EB Tel: 01862 893978 Rubbermaid Step on Waste Bin / Container 30.3 Litre In White plus rigid liner - Costs 70-80 each, liners 21 for 2 Product number: 6143 Tight fitting overlapping lid Perfect for sanitary use Heavy duty pedal Capacity: 30.3 Litres Height: 43.5cm Width: 43.1cm Depth: 40cm Colour: white Available via procurement department from various suppliers Acorn Catering Equipment Gateshead Tel: 0845 002 0645 Rubbermaid Products / Soho Consulting Beckenham Tel: 0870 777 3028 The Bin Company Banbury Tel: 0845 6023 630 Plastic General Bin Available via procurement department from NHS Supply chain WZP832-547794 @ 1.33 Costs updated 20/03/2012 Version 3.00, July 2012 Page 40 of 41

Appendix 15 Waste Bags WASTE BAGS TIGER PLASTIC BAG Clinical Non - Infectious waste includes Colostomy bags Nappies Incontinence Pads Non gypsum plaster casts (Used on or from non-infectious patients) NO INFECTIOUS, POTENTIALLY INFECTIOUS, ANATOMICAL OR PHARMACEUTICAL WASTE ORANGE PLASTIC BAG Clinical Infectious waste includes Dirty dressings Wipes Gloves/aprons Empty blood bags (Used on or from infectious or potentially infectious patients) NO ANATOMICAL OR PHARMACEUTICAL WASTE CLEAR PLASTIC BAG Domestic Waste includes Clean Packaging Food Dead Flowers Paper hand towels NO INFECTIOUS, SHARPS, ANATOMICAL OR PHARMACEUTICAL WASTE Version 3.00, July 2012 Page 41 of 41