What is Clinical Waste?
Any facility that provides medical services has the potential to produce medical waste. In the field of healthcare waste management, definitions are specific – and understanding those definitions is the key to proper healthcare waste segregation, compliance, and safety. Waste is defined as any substance or object that is discarded or is required to be discarded. But what does that mean in medical care scenarios? Numerous waste streams are identified in medical settings. As an example, offensive waste is a non-infectious and non-clinical waste that doesn’t contain any chemical or pharmaceutical substances. It must be segregated from clinical and/or other mixed wastes.
Cytotoxic wastes include medicines that may contain one or more characteristics including toxicity, has the potential to be mutagenic or carcinogenic, or toxic for reproduction. Sharps waste can be contaminated with cytotoxic or cytostatic materials or other pharmaceuticals that may be deemed hazardous. They may also be contaminated with pathogenic bacterial or viral properties that make them hazardous. Anatomical waste can include components of animal or human bodies, organs, or tissues that can be deemed hazardous or non-hazardous.
So what is ‘clinical’ waste?
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What is the Definition of Clinical Waste?
The Department of Health’s Healthcare Technical Memorandum (HTM) 07 01 – Safe Management of Healthcare Waste, defines clinical waste as something “which unless rendered safe may prove hazardous to any person coming into contact with it.”
In further detail sections 4.8 through 4.9 of the memorandum define clinical waste as “any waste which contains wholly or partly of human or animal tissue, blood or other body fluids, excretions, drugs or other pharmaceutical products, swabs or dressings, syringes, needles or other sharp instruments, being waste which unless rendered safe may prove hazardous to any person coming into contact with it…” and basically any type of waste generated in a medical, veterinary, treatment, research, or other practice where the waste may infect or otherwise cause harm or illness to a person coming into contact with it.
Dealing with Clinical Waste
Clinical waste is often generated in hospitals, outpatient clinics or centres, and other facilities where any kind of professional healthcare or medical service is provided. It also applies to veterinary services, pharmaceutical dispensaries, and research labs.
A few examples of clinical waste include but is not limited to:
- Blood and/or bodily fluids including excretions
- Human or animal tissues
- Wound dressings, swabs, or any tool or device that comes into contact with potentially infectious blood or bodily fluids, including personal protective equipment (PPE) worn during patient care
- Needles, syringes, or other sharp devices and instruments known as “sharps” which can also include lancets, scalpels, pipettes, broken vials, or other broken or discarded glass laboratory instruments
If clinical waste in your hospital is not correctly categorised, it can’t be properly disposed of.
In order to determine the classification of waste, healthcare employees must be able to assess the properties of that waste at the time of its generation for:
Other infectious properties.
Is Clinical Waste Hazardous or Not?
Hazardous clinical waste is broken into three classifications or categories of material:
- Any healthcare waste that poses a risk of infection;
- Certain healthcare wastes that may trigger a chemical hazard;
Medicines and medicinally-contaminated waste that contains a pharmaceutically active agent.
Identifying a clinical waste as hazardous or non-hazardous can be a bit confusing, which is why the Department of Health produced the memorandum. It’s a valuable reference for medical providers throughout the UK when it comes to medical waste management.
As such, clinical waste can be hazardous or non-hazardous. For example, clinical waste can be non-infectious anatomical waste, even when chemicals are present, although it can also be an infectious anatomical waste with no chemicals present.
In the UK, hazardous clinical waste has the potential to be both infectious and chemically contaminated, such as the type found in a diagnostic kit, and as such, must be placed in the yellow bag waste stream.
Basics for Handling and Storage of Healthcare Waste
A number of basic storage, segregation, and handling measures are defined by the UK. For example:
- Any bagged waste on-site must be “fully” enclosed in rigid, leak-proof, weather-proof and lockable bulk containers (such as carts)
- Maximum storage capacity of a site must be clearly established with a designated storage area that cannot exceed those maximum capacities
- Anatomical waste and/or animal carcasses must be stored in a designated refrigeration unit (below 5°C), unless they are stored on site for less than 72 hours (or 72 hours if over a weekend)
- The integrity of waste packaging must be maintained and designed in such a way as to minimise waste handling
Healthcare waste must be stored based on waste type and ultimate destination. Separate storage areas or containers are required for clinical waste bags destined for incineration as well as those for alternative treatments
Infectious clinical waste can be stored up to seven days if outside or for 14 days stored within a building. Anatomical waste can be refrigerated for up to 14 days. Prioritise the treatment of waste or off-site transfer procedures based on recommendations for duration of storage on site.
In order to prevent pollution and improper medical waste disposal, the collection of clinical waste from hospitals is privately handled through certified medical waste disposal companies. It is the duty of care of the medical facility or provider to ensure proper licensing and certification and disposal permits for these companies before the transfer of clinical waste occurs.
The determination of ‘is it or isn’t it’ a clinical waste often comes down to specific wording. For example, according to the memorandum, "clinical waste that is considered infectious for carriage purposes must possess the hazardous property H9: Infectious designation. It further states that the only healthcare waste that can be both clinical and non-hazardous are non-cytotoxic and non-cytostatic medicines.
Infectious waste (not containing chemicals or medicine or other contamination) is to be placed in an orange bag or orange-lidded, rigid yellow container and is managed through clinical waste incineration or alternative treatments.
In the UK, waste streams must be properly segregated, stored and handled. Each waste stream comes with its own set of handling, transferring, and permits or processes for disposal. If uncertain of what to do regarding the proper and compliant processes for handling medical waste, refer to the UK government website page “Healthcare waste: appropriate measures for permitted facilities” published by the Environment Agency in 2020. The page provides detailed information regarding instructions for waste storage, segregation, and handling for facilities that are regulated and have environmental permits for the treatment or transfer of healthcare waste.
If In Doubt, Call Sharpsmart
Sharpsmart provides valuable resources, solutions, and guidance to ensure that your facility maintains compliance. We focus on reducing the volume of medical waste in landfills, increasing safety for healthcare providers, and reducing the risk of fines and penalties for non-compliance. For information regarding clinical waste management, handling, storage or transportation solutions, contact Sharpsmart today.