ANATOMICAL WASTES Cardiff and Vale University Health Board: APPENDIX 8 1 Defining Anatomical Waste Anatomical waste is defined for the purposes of this procedure as a 'recognisable' body part, tissue or organ arising from healthcare activities, excluding that which is generated post-mortem. The removal, storage and disposal of human organs and tissue post-mortem are subject to The Human Tissue Act 2004 and so fall outside the scope of this procedure. Table 1 describes examples of the clinical wastes that are included by this definition and where the term 'recognisable' begins and ends. NB: Wastes described in this list not deemed to be 'anatomically recognisable' are suitable for Alternative Heat Treatment so must be disposed in accordance with Appendix 1. Table 1 Limbs (whole or Part) Defining Anatomical Waste Description of Anatomical Waste Whole or Part Fingers, Toes, Ears, Eyes or other appendages Whole or Part Bones Whole or Part Organs Skin / Muscle (when individual pieces are greater than approximately 4 cm 2 /cm 3 ) Afterbirth / Placenta Foetal Remains (seek further specialist advice) Teeth Finger-nails/Toe-nails Hair Blood soaked swabs, dressings etc containing traces of human tissue e.g. wound repair, blood vessels or shards of bone Post Mortem Anatomical Waste (See Pathology Directorate Protocol for Human tissue Disposal) Animal Carcass (whole or part) NB: fallen wild birds and road kill carcass are domestic waste but are best handled in the healthcare environment as clinical waste for the benefit of infection control purposes Anatomical / 1 of 6
2 Containing and Identifying Anatomical Waste It is likely that human related Anatomical Waste will only be produced by Operating Theatres, Pathology, Maternity or other specialist workplaces. All Anatomical Waste listed 'recognisable' as above must be packaged in approved yellow rigid containers (burn bins) and segregated from all other waste as an Incineration Only waste. The assembler of a 'Burn Bin' must ensure that the bin lids are securely fitted to the base such that it safely contains the waste during storage and the journey to final disposal. All information requested on the Burn Bin label must be completed or indelibly marked where no label exists to provide the following details; Hospital: Department: Box closed by: Date of Disposal: Burn Bins must not be placed in bags or mixed with bags. Burn Bins may only be placed directly into yellow clinical waste trolleys when it is known that the trolley is designated for Anatomical Waste only. It has been known for toes etc. to fall off when patients suffer from diabetes or other ailments where the health centre/clinic district nurse has no anatomical disposal route available. As this rarely occurs it is acceptable to place the small piece of anatomical waste (e.g. toe) in to a sharps box knowing that a sharps box will receive high temperature incineration. It is an offence under the Hazardous Waste Regulations 2005 to knowingly mix and dispose of any non hazardous waste e.g. domestic waste with clinical waste. Table 2 on Page 4 describes the colour code packaging required to ensure healthcare wastes receive appropriate treatment. 3 Storing Anatomical Waste When refrigerated storage is available, Anatomical Waste shall be frozen or chilled to minimise decomposition of the material during on site storage. The containers must not be filled more than 3/4 full and must be sealed tightly shut to prevent escape of the waste. NB: Some forms of Anatomical Waste can increase in volume when frozen, causing the lid of a Burn Bin to burst open. Container sizes must be carefully chosen to account for the potential increase in volume. Once sealed in rigid plastic Burn Bins the Anatomical Waste must be placed for collection in designated anatomical waste trolleys or freezers and the Waste Management Department must be notified of its arising. When designated trolleys are provided specifically for this purpose they must be utilised in accordance with local procedures such that the anatomical waste is kept separate from all other types of waste. Yellow clinical waste trolleys are labelled with an Blue BioTrack bar-coded label that defines its destination to incineration. 2 of 6
Trolleys should be fit for purpose at all times during delivery and despatch and the integrity shall not be compromised by users, transporters or owners. The clinical waste trolleys should be kept closed and locked when no additional security is offered by a designated storage compound or secure area. When non refrigerated storage is used the waste shall be collected no less than daily and shall be removed from the site within 24 hours. 4 Transporting Anatomical Waste The regulations require human healthcare waste and veterinary waste to be separately consigned. Contractors collecting anatomical waste for Incineration will normally use refrigerated storage. All transportation trolleys used to contain Anatomical Waste must be filled with care to ensure that the mixture with any other waste does not occur. Trolleys must remain closed, locked and must be accompanied by a completed Hazardous Waste Consignment Note that describes the waste in accordance with the regulations. 3 of 6
Table 2 The Classification of Clinical Waste for Packaging and Treatment Description of the waste Treatment / Packaging Continued overleaf 4 of 6
Table 2 The Classification Of Clinical Waste For Packaging And Treatment Description of the waste Treatment / Packaging INCINERATION ONLY waste from Operating Theatres such as; Recognisable Anatomical Waste Frozen tissue waste e.g. Placentas Profusion Waste Any apparatus partly or wholly made of metal that is contaminated with blood or other infectious materials including tools, implanted medical devices, plates, screws, etc (not destined for CSSD returns) Any substance or material potentially or knowingly contaminated with TSE/vCJD NB: Use Leak proof containers as required INCINERATION ONLY Leak Proof ALL YELLOW BAGS OR ALL YELLOW RIGID CONTAIINERS/SHARPS BOXES 5 of 6