Waste Management Awareness Handbook 1
HEALTH SERVICE EXECUTIVE
Waste Management Awareness Handbook
2014
Storage Ca
G
2
Document Document William RobanReference Number HSQE-WM3 Developed by Estates Directorate
Dublin Mid-Leinster
Revision Number Rev A Document Estates Head ofApproved by Health Safety, Quality
and Environment
Approval Date February 2011 Responsible for All HSE EmployeesImplementation
Revision Date 5 Years Responsible for Estates Manager forEvaluation and Environment and
Audit Waste
Waste Management Awareness Handbook 2011
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Introduction...................................................................................................................6Scope ...........................................................................................................................7
1. Health Service Executive (HSE) Waste Policy .............................................................82. National Legislation .....................................................................................................92.1 Waste Management Statutory Requirements ......................................................10
3. Responsibility of Holder of Waste ..............................................................................124. Prevention and Minimisation ......................................................................................134.1 Policies and Targets .............................................................................................134.2 Details of Prevention/Minimisation/Reuse............................................................144.3 Good Practice Notes from C&AG Value For Money Report, 2005 .......................154.4 Green Procurement .............................................................................................154.4.1 Life Cycle Analysis (LCA) .............................................................................154.4.2 Green Procurement ......................................................................................154.4.3 Producer Responsibility Schemes ................................................................154.4.4 HSE Social Responsible Policies and Procedures .......................................16
5. Healthcare Waste ......................................................................................................175.1 Segregation and Packaging ................................................................................205.2 Storage ................................................................................................................215.2.1 Hospitals .......................................................................................................215.2.2 Health Centres/Clinics ..................................................................................225.2.3 Storage Units for Healthcare Risk Waste......................................................235.2.4 Waste Containment.......................................................................................25
5.3 Health & Safety Considerations ...........................................................................255.3.1 Handling .......................................................................................................255.3.2 Spillages .......................................................................................................265.3.3 Sharps .........................................................................................................26
5.4 Waste Tracking and Record Keeping ...................................................................266. Contractors, Transport and Final Disposal .................................................................276.1 Collection Permits ................................................................................................296.2 Waste Transfer Form (WTF) ...............................................................................306.3 Transfrontier Shipment (TFS) Form .....................................................................306.4 Dangerous Goods Regulations (ADR) .................................................................316.5 Trade Effluent .......................................................................................................32
7. Waste Audits .............................................................................................................33
Table of Contents
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Traditional perception of landfill
Figure 1: Healthcare Waste Catergorized .......................................................................7Figure 2: Waste Management Hierarchy ........................................................................9Figure 3: Life Cycle Analysis .........................................................................................15Figure 4: Clonakilty/Monaghan CTC Audit (PCCC) ......................................................19Figure 5: Waterford EPA Audit (Acute) ..........................................................................19Figure 6: Origin of Food Waste in a Hospital ................................................................19Figure 7: Healthcare Waste Segregation ......................................................................20Figure 8: Waste Audit Procedure ..................................................................................33Figure 9: The Results of a Typical Healthcare Risk Waste Audit ..................................36Figure 10: Waste Segregated during the Healthcare Risk Waste Audit ........................36Figure 11: Waste Segregated into Non-Risk Waste and Risk Waste Fractions ............36
List of Figures
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Appendix A Poster Segregation and Packaging for Healthcare Risk and Non-RiskWaste
Segregation of Healthcare Waste Figure 6.1 from The Segregation,Packaging and Storage Guidelines for Healthcare Risk Waste
Standard Precautions Poster
Appendix B Example of Waste Transfer Form (WTF) and European Waste CatalogueList (EWC)
Appendices
Poor waste management
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1 Comptroller and Auditor General Report on Value for Money Examination, Report No. 49, Value for Money inHospitals, 2005. www.audgen.gov.ie
Many different waste streams are generatedin the delivery of the health services. Theresponsible management and disposal ofsuch wastes is an onerous task forhealthcare personnel, involving environ-mental, health and safety considerations.
This handbook has been prepared by theEstates Directorate of the HSE acting in anadvisory capacity, to help developawareness of good practice in wastemanagement for all staff working in thehealthcare sector. A general overview ofwaste management principles is providedand details of further references areincluded for those who require more specificinformation.
The Handbook, together with appropriatetraining, aim to inform staff, reduce thehealth and safety risk associated withhealthcare waste and assist in achievingcompliance with Government policies,statutory requirements and other relevanthealth sector guidelines. In doing so, theyshould also help to reduce the impact on the
environment as well as result in savingsfrom the efficient management of the wastegenerated.
The Comptroller & Auditor General (C&AG)carried out a Value for Money examinationof waste management in hospitals in 2004.The C&AG’s report, published in 2005,found that while healthcare risk waste waswell managed there was considerablescope for improvements in the managementof other waste steams and the level ofrecycling was low. The C&AG report1
sought to identify current practices in wastemanagement, the level and type of wasteproduced and the associated disposalcosts. The report highlighted a number ofareas for improvement – notably theidentification of costs and quantities for thedisposal of some wastes and the lack oftargets and performance measurement inhospital waste management plans. Inresponse, the HSE has acknowledged thefindings and has made waste management,as it relates to environmental protection andvalue for money, a key priority.
Introduction
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The Guidelines use as their basis:
• DOHC/HSE Segregation Packaging and Storage Guidelines for Healthcare RiskWaste – 2010 November 2010
• Comptroller & Auditor General (C&AG) Value for Money Report on WasteManagement in Hospitals – 2005
• Healthcare Services Executive (HSE) Waste Management Policy - EstatesDirectorate Statement of Principles December 2010
The guidance given in this document in relation to Healthcare Waste is of a general nature.Those requiring more specific advice in this area are referred to the DOHC 2004Guidelines updated 2010 by HSE.
Healthcare Waste is defined as solid or liquid waste arising from healthcare or healthrelated facilities. This waste comprises two fractions, namely risk waste and non-risk wasteas illustrated below.
Figure 1: Healthcare Waste Catergorized
Scope
This is categorised as waste whichis potentially harmful to those whocome into contact with it, due to itsinfectious, biological,chemical,radioactive, sharp content; It isclassified as hazardous.
This category of waste, includeswastes which are not classified ashazardous.
*Note: The term non-risk is use todistinguish this waste from hazardouswaste. it should not be taken as implyingthat the waste is without risk if carelesslyhandled
(Hazardous) (Non-Clinical Healthcare Waste)*
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HSE WASTE MANAGEMENT POLICY2
Mission Statement:“The Health Services Executive is commit-ted to maintaining a waste managementsystem that is safe, efficient, cost effectiveand respectful of the environment”
AIMS: To protect public health & safety. To provide a safe working environment
for staff. To minimise the environmental impact of
waste generation, transport, treat-mentand disposal.
Reduce waste handling and disposalvolumes and costs without compromis-ing health care standards.
OBJECTIVES: Foster commitment from all staff and
management to actively participate in 1. Waste avoidance2. Waste reduction3. Waste reuse4. Waste recycling programs
To comply with Environmental, Safetyand Welfare legislation and Policies.
To adopt and implement the WasteManagement Policy throughout theHSE.
To monitor performance and reviewWaste Management practices at leastannually.
Develop practical guidelines for:1. Waste minimisation2. Use of returnable packaging3. Re-usable products4. Recycling equipment within purchasing guidelines
Introduce a continuing waste manage-ment education program for all staff toincrease awareness of OccupationalHealth and Safety issues and wasteminimisation principles.
Adopt policies and procedures tominimise the environmental impact ofwaste treatment and disposal.
1. Health Service Executive (HSE) Waste Policy
2 Healthcare Services Executive (HSE) Waste Management Policy - Estates Directorate Statement of PrinciplesDecember 2010.
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All national policies and strategies aim to implement the waste management hierarchy(Figure 2). This prioritizes waste options in terms of environmental impact. These policiesprioritise waste management options in terms of environmental impact. The first step ingood waste management practise is to prevent or minimise the waste we produce. If wasteproduction cannot be prevented then reuse and recycling are the next preferable options.Generating energy from waste is the next option, while the least favoured option isdisposal.
Figure 2: Waste Management Hierarchy
The three principal policy documents that provide the framework on which to base wastemanagement practices are as follows:
Waste Management - Changing Our Ways, Department of Environment & LocalGovernment 1998,
Preventing and Recycling Waste - Delivering Change,Department of Environment &Local Government 2002, and
Waste Management, Taking Stock and Moving Forward, Department of Environment& Local Government 2004.
A list of the relevant legislation pertaining to waste in the healthcare sector is set out below.It is important that HSE waste management practices are compliant with all relevantlegislation.
2. National Legislation
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LEGISLATIONWaste Management Act, 1996 (S.I. No.10) and amendments (S.I. No. 146 of1998) and (S.I. No. 166 of 1998)
Waste Management (Amendment) Act,2001 (S.I. No. 36)
Protection of the Environment (PoE) Act,2003 (S.I. No. 27)
Waste Management (Licensing)Regulations, 1997, 2001, 2004
(S.I. No. 133) (S.I. No. 397) (S.I. No.395) (Refer also to Section 7)Waste Management (Facility Permit andRegistration) Regulations 2007 & thewaste management (Facility Permit andRegistration)(Amendment) Regulations 2008
(S.I. 821 0f 2007) entered into force on1 June 2008 Waste Management (Collection Permit)Regulations, 2007
(S.I. No. 820) (Refer also to Section 7)
Waste Management (Packaging) Regu-lations, 2007 (S.I. No. 798)
Waste Management (Movement of Haz-ardous Waste) Regulations, 1998 (S.I.No. 147)
(Refer also to Section 7)
MAIN ASPECTS• Obligation to prevent and minimise waste• Introduction of Producer Responsibility• Application of higher standards in accordance with
EU and national waste management requirements• Waste Management Plans made a Local Authority
executive function• Responsibility of waste management planning placed
on local authorities• Allows for environmental levies• Definition of hazardous waste*• New powers for the EPA to gather and use evidence
for prosecutions• Presumption that landowners are complicit in illegal
dumping activity• Licensing by the EPA for waste facilities • Application for a waste license to be made to the EPA
• Recovery of wastes requires a facility permit orregistration certificate
• Application for facility permits or registrationcertificates to be made to the local authority
• Non compliance of these regulations is an offense
• Collection of waste on a commercial basis must bepermitted
• Application for a collection permit to be made to thelocal authority
• Non compliance of these regulations is an offense• These regulations impose obligations on producers
who supply packaging to the Irish market to promotethe recovery and recycling of packaging waste
• Movement of hazardous waste within Ireland• Non compliance of these regulations is an offense
under Section 36(3) of the Waste Management Act,1996
2.1 Waste Management Statutory Requirements
*Refer to EPA Publications European Waste Catalogue and Hazardous Waste List, 2002 and the Hazardous WasteClassification Tool and Final Report, 2003 for more information on hazardous waste (see also Appendix B EWC List). www.environ.ie/en/Publications/Environment/Waste/WEEE/FileDownLoad,1343,en.pdf
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LEGISLATIONWaste Management (Shipments ofWaste) Regulations, 2007 (S.I. No. 419)
(Refer also to Section 7)
European Communities (Carriage ofDangerous goods by Road andPressure Equipment) Regulations (S.I.No. 349 of 2011)(Refer to Part 9; on safety advisors)for further information on the Carriage ofDangerous Goods, appointment andduties of Safety Advisers contact Healthand Safety Authority at www.hsa.ieEuropean Communities (Carriage ofDangerous Goods by Road) (ADRMiscellaneous Provisions) Regulations2010 (S.I. No. 620 of 2010
Waste Management (Electrical andElectronic Equipment) Regulations,2005 (S.I. No 290)
Waste Management (Electrical andElectronic Equipment) Regulations,2005 (S.I. No 402)
Waste Management (Restriction ofCertain Hazardous Substance inElectrical and Electronic Equipment)Regulations, 2005 (S.I. No. 341)
The Waste Management (End of LifeVehicles) Regulations, 2006 (S.I. No.282)
www.irishstatues.book.ie – refer to this website for updateWater Pollution Act 1977 & 1990: Waste Discharge Licensing, Waste Management (Batteries& Accumulators) Regulations (SI 508/2008), Food Waste Regulations 2009 (SI 508 /2009).
MAIN ASPECTS• Controls placed on movement of waste within, into
and out of the European community• Non compliance of these regulations is an offense
under Section 39(3) of the Waste Management Act,1996
• Outlines ADR requirements to be adhered to whentransporting Dangerous Goods by road which applythe provisions of the ADR 2011 European AgreementConcerning the International Carriage of DangerousGoods by Road
• Requires that a Dangerous Goods Safety Adviser(DGSA) be appointed to oversee all the necessaryrequirements when transporting Dangerous Goods
• The Regulations contain provisions on an ECharmonised approach to the road checks aspect oftheir enforcement. They also implement certainexemptions which are in addition to those containedin the Annexes A and B to the “European AgreementConcerning the International Carriage of DangerousGoods by Road” (ADR) 2011
• Amended the Waste Management Act, 1996 byinserting Part VB Waste Electrical and ElectronicEquipment after section 53F and the WasteManagement Act is now referred to as “WasteManagement Acts 1996-2005”
• Impose obligations on suppliers and producers topromote the recovery of WEEE
• Prohibits the use of certain heavy metals in theproduction of electrical and electronic equipment
• Non compliance of these regulations is an offenseunder Section 53 of the Waste Management Act,1996
• Target of 85% reuse/recovery by Jan 2006 (byaverage weight per vehicle) and 95% reuse/recoveryby Jan 2015
• Ensure all end-of-life vehicles are dismantled, treatedand recovered in a manner that does not causeenvironmental pollution
• Minimise the use of specified hazardous substancesin vehicles
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It is the responsibility of the manager ineach location to comply with relevant wastemanagement legislation. Each healthcarefacility as a generator or holder of waste isresponsible for ensuring that the waste isproperly stored, transported and disposedof in compliance with statuory requirements.
The holder of waste can be defined as theowner, person in charge, or any otherperson having possession or control of thewaste. For example a GP’s surgery,dentist’s surgery, nursing home or hospitalmanager are all holders of waste.
The holder of waste must ensure thatanyone that the waste is passed onto suchas a waste contractor is authorised to take
it. If the waste is illegally disposed of thoseresponsible will be legally accountable forthis. This obligation has no time limit andextends until the waste has either beenfinally and properly disposed of orrecovered.
The holder of waste should ensure that at aminimum:
All waste is stored and disposed ofproperly to ensure that it will not causeenvironmental pollution or cause ahealth and safety risk,
Waste is only handled by individuals orcompanies that are authorised to dealwith it, and
A record is kept of all wastes.
HSE Producer Responsibilities:
Ensure that waste contractors hold a valid waste collection permit. i. Obtain a copy of their waste collection permit.ii. Check that each waste contractor is permitted to carry the waste concerned
from your Local Authority (EWC – European Waste Catalogue codes forhealthcare risk waste and non risk waste should be stated on the wastecollection permit).
iii. Check that the vehicle registration used to carry waste is listed on wastecollection permit.
Ensure that all appropriate documentation – Waste Transfer Form (WTF) iscompleted before the hazardous or risk waste leaves site.
Ensure your waste is being taken to an EPA licensed facility for processing i.e.processing/treatment facility or landfill.
If the holder of waste does not comply as outlined above they can be prosecuted underSection 32 (6) of the Waste Management Acts 1996-2005.
Line-managers at all HSE facilities are responsible for managing their waste in compliancewith the Regulations.
3. Responsibility of Holder of Waste
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4.1 National Policies and Targets The Department of Environment & LocalGovernment’s ‘Changing Our Ways’ policystatement was issued in September 1998.It set out national policy and key targetswhich the local authorities would implementand enforce to enable the regional wastemanagement plans to deliver on nationaltargets.The key targets of ‘Changing Our Ways’ for2013 were: Diversion of up to 50% of household
waste away from landfill, Diversion of a minimum of 65% of
biodegradable waste from landfill, Development of waste recovery facilities
for biodegradable waste up to 300,000tonnes per annum,
Recycling of 35% of municipal wasteper annum,
Reduction in number of municipal wastelandfills to 20 state of the art facilities,
Reduce landfill methane emissions by80%, and
Recycling of at least 85% of C&D waste.Delivering Change - Preventing andRecycling Waste was published in March2002. It reflects the basics ‘Changing ourWays’ and advances to practicalapplications in achieving the policy. Movingaway from landfilling is a major aspect ofthis policy provided through prevention andminimisation of waste. New nationalinitiatives were accepted to speed up theprocess of change in social behaviour withinthe country. These included: A plan to set up a National Waste
Prevention Programme, and A proposal to establish Recycling
Consultative Forum and a MarketDevelopment Group.
Waste Management, Taking Stock andMoving Forward is the latest publishedpolicy issued in April 2004. This policy wasa progression report on waste managementin Ireland. It reaffirmed the importance of thewaste hierarchy to attain a sustainablewaste management program.
There are twenty-one key points in thisdocument some of which include: Launching of the National Waste
Prevention Programme with immediateeffect,
Launching of a Market DevelopmentGroup with immediate effect to developa programme for recyclable materials,
Allocation of funding for a range of localauthority recycling projects,
Advancements in development ofthermal treatment and the lessening oflandfilling works, and
Developments in the ProducerResponsibility Initiatives in relation toWEEE and telephone directories as wellas the tyre and newsprint sectors.
The National Waste Prevention Programmewas launched in April 2004 which is beingled by the EPA. The aim of the Programmeis to deliver waste prevention and min-imisation through a range of initiativesaddressing awareness-raising, technicaland financial assistance, training andincentive mechanisms (www.nwpp.ie).
4. Approach to Waste Management
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4.2 Waste Prevention/Minimisation/Reuse
Avoiding waste generation is the best optionfor dealing with waste. The amount of riskwaste can be reduced by propersegregation of risk waste and non-riskwaste. Waste audits indicate that non-riskwaste placed in the risk waste streamincrease the volumes of risk waste, which isfive times more expensive to treat.
There are many means of preventing non-risk waste some examples which are listedbelow:
Prevention Packaging - Ensure all purchasing
contracts have a measure put in placeto reduce and prevent packaging. Try toreduce packaging by asking suppliers tocut down on product packaging and geta guarantee that suppliers will take backbulky packaging items such as pallets,cardboards and plastic outer wrapping.
Refills - Use refillable dispensers wherepossible e.g. soap, paper towels etc.Use refill toner cartridges for printers,copiers and fax machines.
Cleaning products - Purchase non-toxic cleaning products to avoidhazardous waste disposal.
Food - Waste audits indicate that 75%of food waste is food ordered forhospital patients, but not consumed. Toprevent food wastage provide differentportion sizes and remove unpopularmenu choices.
Try and source products locally and checkthat they are from a renewable resourceand/or a recycled material. If waste cannotbe prevented then effort must be made tominimise it or segregated so that it issuitable for recycling.
Minimisation Cardboard - Change to reusable
packaging for daily deliveries. Paper - Print on both sides of the paper.
Place posters near printers withinstructions for double sided printing.Use e-mail memos instead of leavingnotes. Store data on disc rather thanpaper copies.
Equipment - Try to purchase durableequipment to increase life of product.Buy products that are guaranteed by awarranty.
Batteries - Use rechargeable batterieswhere possible.
After prevention and minimisation reuse isthe next best option when dealing withwaste.
Reuse/Recycling* Cooking oil - Install equipment in
kitchens to filter waste oil so it can bereused.
Paper - Reuse scrap paper for internalnotes. Shredded paper can be reusedfor packages.
Stationery - Reuse interoffice en-velopes, file folders and boxes.
Cardboard - Reuse boxes for outgoingdeliverers.
Furniture - Repair and donate oldfurniture and equipment to charity.www.wastechange.ie
Crockery - Reuse ceramic instead ofpolystyrene or plastic.
Glass - Glass should be chosen overplastic as it is easier to recycle.
*The above list is not exhaustive; many other materials such as timber, metals, food waste textiles, construction anddemolition waste can be reused or recycled.
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4.3 Good Practice Notes from C&AG Value For Money Report, 2005(Waste Management in Hospitals)
The Comptroller & Auditor General’s(C&AG) Value For Money Report, 2005,outlined areas for improvement in wastemanagement practices in hospitals in ninegood practice notes: 1. Cutting down on the amount of wasteproduced,
2. Recycling suitable material,3. Saving on the cost of risk wastecontainers,
4. Saving on the cost of treating anddisposing of risk waste,
5. Making waste storage areas secure,6. Ensuring staff are aware of the latest ingood practice,
7. Performance based waste managementplans,
8. Key performance measures for wastemanagement, and
9. Learning from waste-related incidents.
4.4 Green Procurement4.4.1 Green ProcurementGreen Procurement can be defined as theprocedure where environmental con-siderations are included in the procurementprocess. Public procurement accounts for16% of EU Gross Domestic Product. TheHSE accounts for 52% of Government'sprocurement allocation. Greening procure-ment would therefore have benefits for theenvironment. See Department for theEnvironment, Community and localGovernment's Green Tenders, An ActionPlan on Green Public Procurement,January 2012 at http://www.environ.ie/en/PublicationsDocuments/FileDownLoad,29208,en.pdf
4.4.2 Waste Producer Responsibility Schemes
The producer responsibility concept focuseson the need for producers to takeresponsibility for the environmental impactof putting goods on the market.
Existing compliance schemes in Ireland,dealing with Packaging Waste, End of LifeVehicles (ELV’s) and Waste Electrical &Electronic Waste (WEEE), batteries andaccumulators are supported by Regulationsmade under the Waste Management Acts,1996-2005.
Figure 3: Life Cycle Analysis
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4.4.3 Procurement PolicyWaste generation and the impact on theenvironment, particularly when viewed overthe lifetime of a product, can be greatlyinfluenced at the procurement stage. TheHSE policy on procurement includes astatement on the protection of theenvironment and sustainability
HSE Procurement Policy onEnvironment As a significant public sector purchaser theHSE recognises that it has a particular roleto play in contributing to the protection of theenvironment and the promoting ofsustainable development, while pursuingbest value for money for its contracts. TheHSE will, therefore, endeavour to:
Waste Electronic Electrical Equipment (WEEE) White Goods
Comply with all relevant environmental legislation.
Encourage and persuade suppliers to investigate and introduce environmentally-friendlyprocesses and products.
Specify, whenever possible and reasonably practicable, the use of environmentally-friendly processes and products.
Ensure that, where appropriate, environmental criteria are used in the award ofcontracts.
Ensure that consideration is given to inclusion, within all specifications, of a facility forpotential suppliers to submit prices for environmentally-friendly alternatives.
Ensure that appropriate consideration is given to the costs and benefits ofenvironmentally-friendly alternatives.
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Within the HSE, waste is produced by staff, patients and members of the public. The wastetypes generated in the healthcare sector are outlined below:
NON RISK WASTE
WASTE TYPES
Healthcare Waste
Municipal Waste
Canteen/Food Waste*
Cooking Oil/Grease/Fats
Paper & Cardboard
Confidential Waste
Textiles
Glass
Metal
Plastic
Consumable items pertainingto the use of medical equip-ment
Potentially Offensive Material
DESCRIPTION
RISK WASTE
Healthcare Waste is defined as solidor liquid waste arising from health-care or health related facilities.
Consists of general household items
Food residue and peelings
Used oil
Packaging material, paper and non-confidential paper
Confidential paper files, documentsetc. shredded.
Clothes, Curtains, Bed linen etc.
Bottles
Drink cans/metal furniture etc.
Drink, food and medicine packaging
Plastic items, packaging, bottles,tubing, masks etc. (only plastics thatcarry the recycling logo can berecycled).
Incontinence wear, stoma bags,urinary drainage bags
DESTINATION (BEST PRACTICE)
Disinfection/EnergyRecovery or Disposal andThermal Treatment
Recycling/Residual for Landfill Disposal
Composting
Recycling
Recycling
Shredding and Recycling
Recycling
Recycling
Recycling
Recycling
Recycling
Disposal to Landfill
5. Healthcare Waste
*See CRÈ/HSE food waste fact sheet at FOODWaste.ie. Also S.I. No. 508 of 2009. Waste Management Food Regulations 2009
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**MBCA Guide to Construction & Demolition Waste Legislation, May 2003.www.ncdwc.ie/html/documents/GuidetoConstructionandDemolitionWasteLegislation.pdf
WASTE TYPES
Construction & Demolition(C&D) Waste
Green Waste
Bulky Waste
Wastewater
WEEE
Batteries, Fluorescent Tubes,Ink Jet Cartridges
Obsolete paints, engine oil,cleaning agents, weed killer,chemicals
DESCRIPTION
NON RISK WASTE
Wastes arising from construction,renovation and demolition activitiessuch as soil, rubble, bricks, metalsetc.**
Waste that arises from landscapingor gardening work
Beds, mattresses and obsoletefurniture
HAZARDOUS WASTE
Waste Electrical and ElectronicEquipment including hazardouscomponent i.e. transformers andcapacitors containing PCBs
Disposal to waters/sewer. Any discharge to sewer other thandomestic sewage must be licenced by a Local Authority (Section3 provides details on Discharge License Application Process)
DESTINATION (BEST PRACTICE)
Recycling/Residual for Landfill Disposal
Composting
Reuse/Recycling/Residualfor Landfill Disposal
Removal of hazardouscomponent and recycling
Removal of hazardouscomponent and recycling
Removal of hazardouscomponent and recycling
Segregated and baled paper and cardboard for recycling
Food waste by area
Origin of Food Waste in a Hospital
5%5%
15%
75%
Daycare
Wards
Kitchen
Canteen
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Waste Audit Results
* - textiles refer to non-recyclable incontinence wear
0.0%5.0%
10.0%15.0%20.0%25.0%30.0%35.0%40.0%
Cork ‘08
Monaghan ‘07
45.0%
Text
iles
Org
anic
Pap
er
Car
dboa
rd
Pla
stic
Oth
erC
ompo
site
s
Met
al
Woo
d
Gla
ss
*Hospital Equipment, Construction & Demolition waste, Timber Pallets & Textiles were excluded from this waste audit.
Protective Equipment (e.g. Gowns)
Food Waste
Paper Towels, etc
Healthcare Textiles
15%
Composition of Hospital Waste, 2001(Waterford Regional Hospital)
Other Non-Packaging
Cardboard
Newspapers and Magazines
Office Paper
Glass Packaging
Other Packaging
11% 7% 6%
16%8% 6%
7%
16%
8%
Figure 4: Clonakilty/Monaghan CTC Audit (PCCC)
Figure 5: Waterford EPA Audit (Acute)
Figure 6: Origin of Food Waste in a Hospital
The following figure show samples results of waste audits.
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5.1 Segregation and PackagingFor a more detailed guidance on themanagement of healthcare risk wasterefer to the Segregation and PackingGuidelines. 3
The correct segregation of waste at thepoint of generation is crucial to themanagement of all wastes. Figure 7illustrates the basic segregation andpackaging requirements for risk waste.Appendix A provides more details.
The first level of segregation involvesthe division of healthcare waste into riskand non-risk waste.
Risk waste is classified as DangerousGoods under ADR requirements, there-
fore, the Medical Waste packaging mustbe UN Approved. Two different types ofpackaging are used for healthcare riskwaste, bags and rigid containers. Yellowplastic bags should not be used forsharp or breakable items or for liquids.
There are no particular packaging andsegregation requirements for non-riskwaste but segregation where possible tomeet the requirements of recyclingschemes should be completed.
Non-risk waste is usually packaged inblack or transparent bags. Howevertransparent bags provide for ease ofidentification of waste types and preventcross-contamination with risk waste.
3 Segregation, Packaging and Storage Guidelines for Healthcare Risk Waste, DOHC/HSE, 2010 by HSE.
Figure 7: Healthcare Waste - Basic segregation and packaging schematic
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5.2 Storage The following are typical examples of bestpractice for storage of healthcare waste.
5.2.1 HospitalsIn hospitals waste should be stored at acentral location with sub-collection stationsat designated locations within the hospital.
5.2.1.1 Central Waste Store Specification (External and Internal)
Sufficient capacity for the frequency ofcollection including additional storagespace for missed collections or accu-mulations during public holidays,
Secure ventilated room for the storageof hazardous and other sensitive waste.This room should be equipped with afreezer cabinet for the storage of largeanatomical items,
Separate covered storage area forclean healthcare risk waste bins prior todistribution,
Appropriate warning signs indicating thepresence of healthcare risk waste/bio-hazard displayed at all entrances,
If flammable wastes are stored, a nosmoking policy must be enforced,
Secure from interference by unautho-rised persons, children or animals,
Well ventilated, well lit, drained with animpervious hardstanding floor and havea covered storage area for full health-care risk waste wheelie bins,
Easily accessible to collection vehicles, Equipped with spillage kits and washing/
cleaning and disinfection facilities fordealing with spillages etc.
5.2.1.2 Waste Sub-Collection Stations
(Internal) Dedicated rooms which provide short-
term storage requirements, Storage of both non-risk and risk waste
should be kept separate, Waste brought to the collections
stations in yellow bags and rigid boxesand other containers will normally betransferred into wheeled bins or trolleysin the collection station,
Access should be limited to staff, The area should be well lit and have
washable walls and floors which areresistant to disinfectants anddetergents, and
Appropriate safety and first aid equip-ment should be provided.
Acute hospital waste storage facility
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5.2.2 Health Centres/ClinicsStorage Units for Healthcare Risk Waste:
WASTE STOREDimensions: 1500w x 1500d x 2200h mm (4.5 cubic metres)
LARGE CAPACITY WALK IN STOREDimensions: 2400w x 2400d x 2400h mm (11 cubic metres)
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5.2.3 Storage Units for Healthcare Risk Waste
Features should include: Suitable for external or internal use, Secure and vandal proof, Large capacity bunds to capture and
retain spillages,
Emergency spill kit, Lockable internal safety cabinet to
segregate hazardous chemicals/waste(Amalgam etc.),
Safety/warning signage, and Ventilation panels.
Examples of waste storage units. Suitable for general practice and small healthcentres/clinics.
WASTE CABINETModel Storage Capacity DimensionsGP.05 0.5 cubic metres 915w x 460d x 1220h mmGP1.5 1.57 cubic metres 1500w x 700d x 1500h mm
WASTE BUNKERModel Storage Capacity DimensionsGPB.05 0.5 cubic metres 1200w x 600d x 850h mmGPB1.0 1.0 cubic metres 2000w x 600d x 850h mm
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HEALTH RISK WASTE WHEELED-BINStorage Capacity Dimensions770 Litres 785w x 1260d x 1370h mm
FOOD WASTE WHEELED-BINStorage Capacity Dimensions240 Litres 580w x 725d x 1075h mm
DOMESTIC WASTE WHEELED-BINStorage Capacity Dimensions1100 Litres 985w x 1380d x 1370h mm + 200mm for wheels
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5.2.4 Waste Containment
CHEMICAL WASTE CABINET Dimensions: 1500W x 1500W X 2200H (4.4Cubic metres)
PHARMA WASTE UNIT (Secure cabinet used in conjunction with a 50 Litre Sharps/Pharma Waste Container). Dimensions: 430w x 470d x 770h mm
5.3 Health & Safety Considerations5.3.1 HandlingThe general principles when handlinghealthcare waste are as follows: Appropriate Personal Protective
Equipment (PPE) should be worn whenhandling waste and all employeeshandling infectious waste must bevaccinated (Refer to ImmunisationGuidelines for Ireland, NationalImmunisation Advisory Committee ofRoyal College of Physicians of Ireland,2002 edition), and
Waste bags, boxes and containersshould be closed when two-thirds full orat the manufacturer's fill line andlabelled, tagged and securely sealed toprevent spillages,
Containers holding liquid must havesufficient absorbent material or jellyingagent to prevent leakages from thecontainer.
Porters/care assistants should notremove bags/containers unless they arelabelled/tagged appropriately,
Manual handling of waste bags/containers should be minimised,
Waste bags should be picked up by theneck only and should not be thrown ordropped to avoid puncture or otherdamage,
To prevent the risk of injury waste bagsshould not touch the body duringhandling and containers should becarried by the handle,
Wash hands thoroughly after handlingwaste with soap and hot water.
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5.3.2 SpillagesAll spillages from healthcare risk wastebags or containers should be treated aspotentially hazardous and dealt with asfollows: Do not leave spillages unattended. A
member of staff should remain in thearea while another gets assistance
Adequate protective clothing should beworn when cleaning up spillages
In the event of a spillage of healthcarerisk waste, the Department Managershould be informed and the area shouldbe disinfected
All staff involved in any aspect ofpackaging storage and transport ofhealthcare risk waste should receivestandard precaution training asappropriate to their task this shouldinclude: Hand hygiene, Proper use of appropriate Personal
Protective Equipment (PPE) Management of blood and body
fluid spillage 5.3.3 Sharps2
Do not recap needles after use.A needle stick injury should be dealt with asfollows: Clean the wound, Encourage bleeding immediately by
squeezing the site of the injury andwash with warm water and soap,
Do not suck the wound, If there is a protruding foreign body/
object, do not press on the object. Apply firm pressure on either side of the
would and build up padding on eitherside of the object,
Secure with a bandage and seekmedical advice immediately, and
Report the incident to your DepartmentManager immediately.
Appendix A contains a copy of thestandard precautions poster that includessome precautions that are relevant tohealthcare risk waste.
5.4 Waste Tracking and Record KeepingAll healthcare risk waste containers shouldbe traceable to the point of generation (forexample in hospitals from the ward/sectionwhere the waste originated from). A taggingor bar coding system provides a trackingsystem for healthcare risk waste. Thefollowing information should be recorded toassist traceability: details of point of generation date of collection tags and tracers reference numbers waste type and quantities details of waste contractor and carriers destination of waste disposal/treatment methodsIt is the waste generators responsibility toensure that the despatch documentation isin order and completed correctly. Annualaudits of the waste contractor should becarried out this should include the wastecarrier and facility of destination. Taggingrecords should be kept on file for threeyears and copies of completed WasteTransfer Form kept on file for a minimum offive years (for hazardous waste only).
2 Guidelines for the Prevention and Management of Percutaneous Injuries and other Exposure Incidents inHealthcare Workers of Health Board Managed Health Care Facilities within the Health Service Executive,ERHA, Infection Control Advisory Committee, 2001.
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The transportation of healthcare waste isgoverned by several sets of regulationsdealing with different concerns relating tothe materials transported. All waste carriersrequire waste collection permits/licenses.Waste Transfer Form (WTF), TFS formsand Dangerous Goods/ADR requirementsapply to hazardous/healthcare risk waste.Every step of the waste management chainis strictly regulated. Waste generatorsshould remember that they have aresponsibility to ensure that waste sent off-site is managed in a responsible manner.Working correctly with your waste serviceprovider can ensure this objective. Thefollowing list gives some ideas of bestpractice. It is up to each generator to keepabreast of the relevant environmentalhealth and safety legislation.
DoAssessing/sorting your waste Do determine the source, nature and
quantity of waste generated i.e. is itrecyclable or non-recyclable? Is it non-hazardous or hazardous waste? Aspecialist waste contractor is required todeal with hazardous waste.
Do segregate your waste streamscorrectly on-site.
Do not place hazardous waste withother non-hazardous waste.
Do ensure that hazardous waste is notmixed with other categories ofhazardous waste or with non-hazardouswaste.
Do not put liquid slops or cooking oil intocompactors. This can lead to a dis-charge, during uplift or transport,causing slippage hazards.
Do provide the service provider with asafe means of access and egress fromyour on-site waste storage area atagreed times.
Do train staff to store and handle wastestreams correctly on-site.
Getting the Documentation right Do develop a written waste procedure. Do provide information to the waste
service provider on safe working pro-cedures on-site and any temporaryhazards associated with the collectionand handling of the waste.
Do obtain documentary proof of wastetransfer, receipt and final recovery ordisposal by the waste serviceprovider(s) involved.
Do realise that movement of hazardouswaste within the state must beaccompanied by a Waste Transfer Form(WTF) in accordance with the WasteManagement (Movement of hazardousWaste) Regulations.
Do be aware that waste transferred outof the state must comply with therequirements of the TransfrontierShipment (TFS) Regulations.
Do keep detailed records of allhazardous waste shipments for aminimum of five years. These recordsshould include TFS and WTFdocumentation.
6. Contractors, Transport and Final Disposal
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Choosing/working with your serviceprovider Do examine the credentials of
prospective waste service provider(s)and their facilities/services.
Do verify this information and the wasteservice provider’s compliance historywith the Environmental ProtectionAgency (EPA) or local authority.
Do ensure that the waste haulagecontractor (who collects the waste)holds a valid waste collection permit inaccordance with the WasteManagement (Collection Permit)Regulations.
Do ensure the service provider’s facilityhas sufficient capacity to accept anddeal with your waste stream in thecorrect manner.
Do ensure that the facility’s licenseauthorities it to accept the particular typeof waste involved.
Do ensure your waste is collected anddelivered to an appropriately licensed/
permitted facility. Under waste manage-ment law all waste managementfacilities must be either licensed by theEPA or permitted by the relevant localwaste authority.
Do liaise with your service provider ondesigning a waste storage area on-site.Talk to your service provider aboutmaximising the use of your wastemanagement equipment on-site e.g.compactor skip, bins and balers.
Do notify the service provider if there isany changes in the waste’scomposition.
Don’t Do not transfer waste to hauliers who do
not have a valid waste collection permit. Do not move hazardous waste within
the state without a Waste Transfer Form(WTF).
Do not use unlicensed facilities forwaste disposal/recovery. It is illegal.
Unsegregated mixed waste
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This is issued by the EPA and defines the nature ofenvironmentally acceptable waste management activities at awaste facility. Details of facilities with a waste license can beobtained from the EPA (www.epa.ie).
This is issued by the local authority and authorises waste collectionactivities. Holders of a waste collection permit can only collectwithin the jurisdiction of the issuing local authority and they arereviewed every 2 years. Hauling waste or passing waste on to anunauthorised collector is an offense.
The local authority issues this permit. It legitimates the operationof the waste infrastructure that is not big enough or does not posea large enough impact on to the environment, to warrant a wastelicense. It is usually issued for the temporary storage of non-hazardous waste for more than 6 months. It is up to you to ensurethat your contractor has a permit for the area in which waste isbeing collected and whether the proposed waste movement is inaccordance with any conditions contained in the permit.
Issued by the local authority for the temporary storage ofhazardous waste (less than 6 months).
Waste License
Waste CollectionPermit
Waste Permit
RegistrationCert
Checklist of Waste Contractor’s licenses and permits
This is used to track movements of hazardous waste from its sourceto the waste management facility, to be used for disposal orreclamation. It needs to be completed by each party in the wastetransaction. Exceptions from using a Waste Transfer Form (WTF) are: Authorised movements of hazardous waste when such
materials are to be exported from Ireland to other countries. Hazardous waste collected from bring centres or by
segregated collection services provided to members of thepublic.
Transfer of waste oils. Movement of End of Life Vehicles (ELVs).
This is required when exporting waste from Ireland for disposal,as well as for hazardous wastes passing to recovery. It is madeup of 2 parts: Notification form, which must be completed before waste is
moved. This sets out the advance consent of the affected EUmember states.
Movement/Tracking form, which accompanies the shipmentwhen it is moved. It provides information on the actualmovement of each load.
Waste TransferForm (WTF)
TransfrontierShipment from(TFS)
6.1 Collection PermitsUnder the Waste Management (CollectionPermit) Regulations, 2007 (S.I. No. 820)waste carriers must apply for a wastecollection permit. These permits are issued
by the local authority. It is the responsibilityof the waste holder to ensure that the wastecarrier possess a valid waste collectionpermit number, for the waste type inquestion.
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6.2. Waste Transfer Form (WFT Form)When hazardous waste (includinghealthcare risk waste) is transported off-sitewithin Ireland a Waste Transfer Form (WTF)Must be completed by the consignor andaccompany the waste during carriage inaccordance with Waste Management(Movement of Hazardous Waste)Regulations 1998 (S.I. No. 147).
New Legislation introduced in 2011 makesDublin City Council, National TFS Officesole authority for the administration ofWaste Transfer Forms. The Waste TransferForm replaces the original C1 form.
The fundamental change to the old C1approach is a move to an online systemwhich does away with the requirement toretain paper records of waste movements.This reduces the administrative burden forthose transporting the same type of wasteregularly e.g. healthcare risk waste. Wastecollections from multiple locations arepermitted on a single Waste Transfer Form.As with the original C1 form a copy of theWTF will satisfy ADR information for theCarriage of Dangerous Goods Regulations. Appendix B contains an example of acompleted Waste Transfer Form, along withEuropean Waste Catalogue (EWC) andHazardous waste list numbers, required tocomplete a Waste Transfer Form. Forfurther information see below link toNational TFS Office, Dublin City Councilwebpage http://www.dublincity.ie/WaterWasteEnvironment/Waste/National_TFS_Office/Pages/NewRegulationsontheShipmentofHazardousWastewithinIreland.aspx
6.3 Transfrontier Shipment (TFS) FormThe legal requirements on moving wastefrom Ireland to other countries are set out inthe Waste Management (Shipments ofWaste) Regulations, 2007 (S.I. No. 419)and in the Regulation (EC) No. 1013/2006of the European Parliament and of theCouncil of 14 June 2006 on shipments ofwaste. The TFS Form consists of a two partdocument: Notification Document Movement/Tracking DocumentThe TFS Form can be used for singleshipment or for a “general notification” for aspecified number of shipments and eachhas a unique number for tracking purposes.Dublin City Council is designated as theNational TFS Office. When the waste hasbeen processed the Form is completed andis sent to the National TFS Office with theCertification of Disposal/Recovery/Destruction.Refer to Transfrontier Shipment of WasteGuidelines for Exporting Waste from andImporting Waste in the Republic of Ireland,National TFS Office Waste ManagementSection, Dublin City Council.
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6.4 Dangerous Goods Regulations (ADR)Under agreed international rules for thetransportation of all types of DangerousGoods for the different modes of transport.There are specific requirements for theclassification, packaging, labelling anddocumentation of dangerous goods as wellas the training of personnel involved in thetransport of such dangerous goods. Furtherinformation is provided on www.hsa.ie.The two classes of dangerous substanceswhich are specifically relevant to wastehealthcare are Class 6.1-toxic substancesand Class 6.2-infectious substances. Legislation requires that safety adviser (SA)be appointed to oversee all the necessaryrequirements when transporting DangerousGoods. The duties of a SA are outlined asfollows:Healthcare institutions generating haz-ardous waste must be able to call on anappropriate qualified Safety Adviser toadvise on the packaging and transport ofsaid waste.Functions of Safety AdvisersThe functions of a safety adviser shallinclude in particular the following: (a) monitoring compliance with the rules
governing the transport of dangerousgoods;
(b) advising the undertaking on thetransport of dangerous goods;
(c) ensuring that an annual report to theundertaking is prepared on the activitiesof the undertaking concerning thetransport of dangerous goods;
(d) monitoring the following practicesand procedures relating to the activitiesof the undertaking which concerns thetransport of dangerous goods –(i) the procedures for compliance with
the rules governing the ident-ification of dangerous goods beingtransported,
(ii) the practice of the undertaking intaking into account, whenpurchasing means of transport,any special requirements inconnection with the dangerousgoods to be transported,
(iii) the procedures for checking theequipment used in connection withthe transport of dangerous goods,
(iv) the proper training of theundertaking’s employees and themaintenance of records of suchtraining,
(v) the implementation of properemergency procedures in theevent of any accident or incidentthat may affect safety during thetransport of dangerous goods,
(vi) the investigation of and, whereappropriate, preparation of reportson serious accidents, incidents orserious infringements recordedduring the transport of dangerousgoods,
(vii) the implementation of appropriatemeasures to avoid the recurrenceof accidents, incidents or seriousinfringements,
(viii) the account taken of the legalprescriptions and specialrequirements associated with thetransport of dangerous goods inthe choice and use of sub-contractors or third parties,
(ix) verification that employeesinvolved in the transport ofdangerous goods have detailedoperational procedures andinstructions,
(x) the introduction of measures toincrease awareness of the risksinherent in the transport ofdangerous goods,
(xi) the implementation of verificationprocedures to ensure thepresence, on board the means oftransport, of the documents andsafety equipment which mustaccompany transport and thecompliance of such documentsand equipment with health andsafety regulations, and
(xii) the implementation of verificationprocedures to ensure compliancewith legislation governing loading andunloading of dangerous goods.
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*“Trade Effluent” means effluent from any works, apparatus, plant or drainage pipe used for the disposal to waters or toa sewer of any liquid (whether treated or untreated), either with or without particles of matter in suspension therein,which is discharged from premises used for carrying on any trade or industry (including mining), but does not includedomestic sewage or storm water.
Discharge License Application Process
6.5 Trade EffluentIt is an offense under Irish legislation tocause or permit any pollutant matter to enterwaters. There is a waste water licensingsystem that allows certain discharges intowater or sewer as long as it meets therequirement of the discharge license. Thedischarges must be monitored andrecorded, the licence may require thelicence holder to take and test dischargesamples at least four times per annum. Records must be maintained and submittedto the Local Authority. The Local Authoritymust also be informed, without delay of anymodification or extensions as these mayrequire a review of the license. The public have a legal right to examinedocumentation and make representationsregarding an application for a proposedlicense (see Discharge License ApplicationProcess below).
A discharge license is granted subject to thefulfilment of certain conditions. They mayinclude the following:
Local Authorities place particularsignificance on accidental discharges andthere consequences; it is important that allpotential liquid waste is contained on-site.
The Local Authority will require policies andprocedures to be put in place to deal withemergency situations; accidental spillages,liquid isolation and mop-up.
Times the discharges What effect theare made. discharges will have?
Sampling Records and informationof discharge. supplied to the Local
Authority.
Discharge outlet Existence of metres,construction. manhole inspection
points.
Preventive measures. Emergency routines.
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7. Waste Audits
The hospital/line manager should ensurethat a competent person is made responsi-ble for waste management and that auditsof waste activities are carried out regularly. A waste audit is defined as an examinationof the waste in your organisation to quantitythe amount and type of waste produced andhow it is currently managed. The contentsof waste containers should be examinedonly by suitable trained persons, whoare properly equipped to carry out sucha procedure.
Figure 8 provides a step by stepbreakdown of the steps involved in carryingout a waste audit. It is worthwhile to use a questionnaireduring the audit. A sample questionnaire isshown below. Waste characterisation is defined “as theprocess by which the composition ofdifferent waste streams is analysed.”A waste management plan can beformulated following the waste auditoutlining recommendations for improvementin waste management.
Figure 8: Waste Audit Procedure
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Sample Waste Management QuestionnaireInterviewee’sQuestion GuidanceComments
Responsibility1. Has a person responsible for
waste management, within thehospital, been identified? Ifyes, Who?
Waste segregation
2. Are wastes segregated into appropriate categories? Non-Risk Waste.Risk Waste.Hazardous.Recyclable Waste.
3. Are staff aware of segregationrequirements via training, written procedures or notices?
Storage containers
4. Are appropriate containersused for storing waste?UN approved yellow containersfor risk waste.
5. Are the containers sensibly located?
6. Are the containers suitably labelled?
Waste handling
7. Are wastes handled in a safemanner? Use of personal pro-tective equipment?
8. Are containers lidded andtagged where appropriate? Arethey locked/lockable?
Waste storage area
9. How and where is the wastestored?
Allocate responsibility for the implementation,assessment and updating of the sites wastemanagement plan to a named individual.
Cost can be reduced and risks minimised ifwastes are segregated appropriately. Theindiscriminate mixing of hazardous and nonhazardous waste will result in the whole loadhaving to be disposed of by the more expensivehazardous waste disposal method.
Successful waste management depends uponstaff using the facilities properly.
The size of the container should be appropriatefor the volumes of waste produced and the fabricof the container should be compatible with thenature of the waste. Controls are necessary toensure correct use.
Place the containers in a suitable location toencourage users to segregate recyclables and toavoid accidental contamination from incorrect wastetypes and to minimise handling and transport.
Labelling ensures correct segregation and makesoperators aware of any associated hazards.
Containers for waste are likely to be placed closeto the point of production, where they will bemoved to an outside area for collection fortransport and disposal. Ensure that appropriatesafety measures are in place.
To prevent spillage and littering of site. Healthcarerisk waste should be tagged and secure beforeleaving the area of production.
Store waste in a secure designated area to minimisepotential harm to the environment, employees andwaste contractors. Ensure proper supervision andinspect regularly. Provide safe access and egressfor both the placing of waste into storage and for itsremoval by waste contractors.
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Sample Waste Management QuestionnaireInterviewee’sQuestion GuidanceComments
Waste storage area10. How long are wastes stored
prior to transport?
11. What safety and emergencyprocedures are in place?
12. Are records kept of wasteproduced and of their safeand correct disposal?
13. Are transfer notes completedfor all controlled wastes andhazardous wastes generatedon the site?
14. Are all waste carriers permit-ted or licensed?
Procedures
15. What procedures exist cover-ing general waste manage-ment operations?
Costs
16. How are recovery/disposalcosts allocated?
Recycling and waste minimisation
17. Are ways of reusing waste reviewed?
18. Are opportunities for recyclingpursued?
Records should be kept of wastes stored.Procedures should be in place to prevent thebuild up of particular types of waste which maybe difficult to dispose of or cause a potentialhazard, e.g. fire risk, spillage or leakage.
The external waste storage area should becovered with a hardstanding material resistant tocorrosion and suitably impervious. If hazard liquidwastes are stored, the area should be bunded. Ifflammable wastes are stored, a no smokingpolicy must be enforced.
Details of dates, quantities, disposal methods,disposal location, contractor and costs should berecorded and centrally accessible.
Transfer notes for hazardous waste should bekept on site for five years for inspection as part ofthe Duty of Care requirements. However, allhazardous waste consignment notes must bekept on site for a minimum of five years.
All waste carriers should be licensed under the WasteManagement (Collection Permit) Regulations, 2001;S.I. No. 402 of 2001. Copies on file.
Detailed procedures are required to coversegregation, handling, containers, labelling,safety requirements and hazardous disposal orhandling methods required. Include records oftracking tags for risk waste.
Identify the disposal costs for each type of waste.Seeing disposal costs allocated to a particularhospital/department/section raises the incentiveof producers to reduce waste generation andmanage waste properly.
Consider reusing cardboard boxes, envelopes orusing shredded paper as protective packaging.
Continue to assess the cost effectiveness ofintroducing new recycling schemes.
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Figure 9 is an example of results from oneacute hospital healthcare risk waste auditthat was carried out in 2006. From the totalamount of waste collected in the audit(177kg) healthcare risk waste made up 45%(79kg) and healthcare non-risk waste madeup 44% (78kg) of the waste with theremaining 11% (20kg) containing sharps
boxes. The result in this case shows thepotential for savings, given that the 44%non risk waste faction could be disposed ofto landfill at on fifth the cost of healthcarerisk waste. Regular training on risk wastesegregation is essential to reduce wastecosts.
Figure 9: The Results of a Sample Healthcare Risk Waste Audit
Figure 10: Photo of Non-Risk & Risk Waste Mixed before Segregation
Figure 11: Photo of Waste Segregated into Non-Risk Waste and Risk Waste Fractions
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ORGANISATION CONTACT DETAILS
Department of Health and Children www.dohc.ie
Cré Composting Association of Ireland Teo www.cre.ie
Department of the Environment Heritage & Local Government (DEHLG) www.environ.ie Tel: 01 888 2000
ENFO - Information on the Environment www.enfo.ie Tel: 01 888 2001 or 1890 200 191
Enterprise Ireland www.envirocentre.ie Tel: 01 808 2229
Environmental Protection Agency (EPA) www.epa.ie Tel: 1890 33 55 99
EPA National Waste Prevention Programme www.epa.ie/whatwedo/resource/prevent/nwpp/
National TFS Office http://www.dublincity.ie/WaterWasteEnvironment/Waste/National_TFS_Office/Pages/NewRegulationsontheShipmentofHazardousWastewithinIreland.aspx
Health and Safety Authority (HSA) www.hsa.ie Tel: 01 6147000
Health Service Executive (HSE) www.hse.ie
ICLEI - Local Governments for Sustainability www.iclei-europe.org/procurement
Institute of Wastes Management (Irish Centre) www.ciwm.co.uk Tel: 0044 1604 620426
Irish Statute Book www.irishstatutebook.ie
Life Cycle Assessment (LCA) http://waste.eionet.europa.eu www.oced.org
Race Against Waste www.raceagainstwaste.ie Tel: 1890 667639
Repak Ltd. www.repak.ie Tel: 01 4670190
National Construction and Demolition Waste Council www.ncdwc.ie
Sources of information
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ADR 2011 European Agreement Concerning the International Carriage of DangerousGoods by Road.
Comptroller and Auditor General Report on Value for Money Examination - WasteManagement in Hospitals, Department of Health and Children, March 2005
European Waste Catalogue and Hazardous Waste List, EPA, 2002www.environ.ie/en/Publications/Environment/Waste/WEEE/FileDownLoad,1343,en.pdf
Guidelines for the Prevention and Management of Percutaneous Injuries and otherExposure Incidents in Healthcare Workers of Health Board Managed Health CareFacilities within the Health Service Executive, ERHA, Infection Control AdvisoryCommittee, 2001
Immunisation Guidelines for Ireland, National Immunisation Advisory Committeeof Royal College of Physicians of Ireland, 2002 editionwww.ndsc.ie/hpsc/A-Z/vaccinePreventable/vaccination/Guidance/
MBCA Guide to Construction & Demolition Waste Legislation, May 2003www.ncdwc.ie/html/documents/GuidetoConstructionandDemolitionWasteLegislation.pdf
National Hazardous Waste Management Plan, EPA, 2008www.epa.ie/downloads/pubs/waste/haz/nhwmp2001/
National Strategy on Biodegradable Waste, Department of the Environment, Heritage and Local Government, 2006www.cre.ie/National_Strategy_BioWaste.html
Preventing and Recycling Waste - Delivering Change, Department of the Environment, Heritage and Local Government, 2002www.epa.ie/downloads/pubs/waste/plans/name,11646,en.html
Procedure for Identifying Hazardous Components of Waste, EPA, 2004www.epa.ie/downloads/pubs/waste/plans/name,11651,en.html
Race Against Waste Action at Work, Department of the Environment, Heritage and Local Government, 2005www.raceagainstwaste.com/take_action/large_org/
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Report on the Second National Acute Hospitals Hygiene Audit, NHO, HSE, 2006www.hse.ie
Segregation, Packaging and Storage Guidelines for Healthcare Risk Waste, DOHC/HSE November 2010.www.dohc.ie/publications/segregation_packaging.html
Transfrontier Shipment of Waste Guidelines for Exporting Waste from and ImportingWaste in the Republic of Ireland, National TFS Office, Dublin City Council, EblanaHouse, 68-71 Marrowbone Lane, Dublin 8, [email protected]
Waste from Electrical & Electronic Equipment, EPA, May 2001www.epa.ie/downloads/pubs/waste/weee/name,11649,en.html
Waste Management - Changing Our Ways, Department of the Environment, Heritage and Local Government, 1998www.epa.ie/downloads/pubs/waste/plans/name,11643,en.html
Waste Management, Taking Stock and Moving Forward, Department of the Environment, Heritage and Local Government, 2004www.epa.ie/downloads/pubs/waste/plans/name,11660,en.html
Healthcare Services Executive (HSE) Waste Management PolicyEstates Directorate Statement of Principles December 2010.
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Biodegradable Content: the percentagecontent of waste which is biodegradable.For municipal waste this usually fluctuatesaround 60%-70%.Biodegradable Municipal Waste (BMW)or Organic Waste: municipal waste that iscapable of undergoing anaerobic or aerobicdecomposition, such as food and gardenwaste, paper and paperboard.Bio-hazard: or biological hazard is anorganism, or substance derived from anorganism, that poses a threat to (primarily)human health.Biological Treatment: involves composting,anaerobic digestion, mechanical/biologicaltreatment or any other process forstabilising and sanitising biodegradablewaste.Bulky Waste: Large items of solid wastesuch as obsolete furniture, beds andmattresses. Commercial/Industrial (C/I) Waste: wastefrom a premises used wholly or mainly forthe purposes of a trade or business(including non-processed industrial waste)or for the purposes of sport, recreation,education or entertainment but does notinclude household, agricultural or industrialwaste.Compost: the stable, sanitised and humus-like material rich in organic matter and freefrom offensive odours resulting from thecomposting process of separately collectedbiowaste.Composting: the autothermic andthermophilic biological decomposition ofseparately collected biowaste in thepresence of oxygen in order to producecompost.Construction & Demolition (C&D) Waste:All waste that arises from construction,renovation and demolition activities and allwastes referred to in Chapter 17 of theEuropean Waste Catalogue (EWC) e.g.concrete, bricks, tiles, mortar, wood etc.
Cytotoxic and Cytostatic Medicines: anymedicinal product that has one or more ofthe following hazardous properties: Toxic(H6), Carcinogenic (H7), Mutagenic (H11)or Toxic for Reproduction (H10).Dangerous Goods: A dangerous good isany solid, liquid or gas that can harmpeople, other living organisms, property, orthe environment (See ADR 2011). Disinfection: is the destruction of patho-genic and other kinds of micro-organisms.Disposal to Landfill: means a wastedisposal facility used for the deposit ofwaste onto or under land.Domestic/Household Waste: the wasteproduced within the grounds of a building orself-contained part of a building used for thepurposes of living accommodation.Energy Recovery: Process where energyis recovered from thermal treatment ofwaste.Green Waste: waste arising from gardens,public parks consisting of garden trimmings,leaves, shrubs, plants, grass, trees etc.Hazardous Waste: means “waste of aclass listed in the current Hazardous WasteCatalogue, which either: constitutes Category I type waste as
specified in Part I of the SecondSchedule to the Waste Management Act1996 and has any of the propertiesspecified in Part III of the sameSchedule; or
constitutes Category II type waste asspecified in Part I of the SecondSchedule to the Waste Management Act1996 that contains any of theconstituents specified in Part II of thesame Schedule and has any of theproperties specified in Part III of thesame Schedule.
Glossary of terms used
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Healthcare Waste: Healthcare waste isdefined as the solid or liquid waste arisingfrom healthcare. This waste comprises twofractions, namely risk waste and non-riskwaste. Healthcare Non-Risk Waste: This iscategorised as non-risk waste. The termnon-risk is use to distinguish this waste fromhazardous waste. it should not be taken asimplying that the waste is without risk ifcarelessly handled.Healthcare Risk Waste: This iscategorised as waste which is potentiallyharmful to those who come into contact withit, due to its infectious, biological, chemical,radio-active, sharp content; It is classifiedas hazardous.Incineration: a process by which heat isapplied to waste in order to reduce its bulk,prior to final disposal which may or may notinvolve energy recovery.Material Recovery Facilities: facilitieswhere recyclables are sorted into specificcategories and processed, or furthertransported to processors for remanu-facturing.Municipal Waste: waste from households,as well as commercial and other waste,which because of its nature or composition,is similar to waste from households, or anyother waste having any of the propertiesspecified in Part III of the Second Scheduleto the Waste Management Act, 1996 thatmay be prescribed as hazardous waste.Packaging Waste: any material containeror wrapping, used for or in connection withthe containment, transport, handling,protection, promotion, marketing or sale ofany product or substance, including suchpackaging as may be prescribed.PP: Polypropylene, category of plastic.Producer Responsibility: imposesaccountability over the entire lifecycle ofproducts and packaging introduced on themarket. This means that companies whichmanufacture import or sell products and
packaging are required to be financially orphysically responsible for such productsafter the useful life.PVC: Polyvinyl chloride, category of plastic.Recovery: any activity carried out for thepurpose of reclaiming, recycling or re-usingwaste in whole or in part.Recyclables: waste materials that may besubjected to any process or treatment tomake it re-useable in whole or in part.Recycling: the subjection of waste to anyprocess or treatment to make it re-useablein whole or in part.Residual Municipal Waste: the fraction ofmunicipal waste remaining after the sourceseparation of municipal waste fractions,such as food and garden waste, packaging,paper and paperboard, metals, glass and isusually unsuitable for recovery or recycling.Resource Recovery: the extraction anduse of resources from waste material.Reuse: Use the material again withoutprocessing.Segregated Collections: entail wastecollectors collecting a range of recyclablewaste, employing separate bins for the mainwaste streams (usually dry recyclables,organic waste, and residual waste).Thermal Treatment: a process by whichheat is applied to waste in order to reduceits bulk, prior to final disposal. Thermaltreatment can involve a number ofprocesses such as incineration, pyrolysisand gasification.Treatment Facilities: facilities where wasteundergoes thermal, physical, chemical orbiological processes that change thecharacteristics of waste in order to reduceits volume or hazardous nature or facilitateits handling, disposal or recovery.Waste Audit: An examination of the wastein your organisation to see the amount andtype of waste produced and how it iscurrently dealt with.
42
Waste Characterisation: The process bywhich the composition of different wastestreams is analysed.Waste Electrical and ElectronicEquipment (WEEE): General rule if it has aplug or battery it’s WEEE. Ten Categories ofWEEE identified: large/small householdappliances, IT & telecommunication equip-ment, consumer equipment, lightingequipment, electrical and electronic tools,toys, leisure and sports equipment, medicaldevices, monitoring and control equipment,automatic dispensers. Waste Management Facility: a site orpremises used for the recovery or disposalof waste.Waste Management Plan: A plan of actionoutlining recommendations for improve-ments in waste management.
Waste Prevention/Minimisation/Reduction:any technique, process or activity that eitheravoids, reduces or eliminates waste at itssource, or results in re-use or recycling.Waste Producer: a person whose activitiesproduce waste or who carries out pre-processing, mixing or other operationsresulting in a change in the nature orcomposition of waste.Waste Segregation: The separate of wasteinto individual material fractions at source. Waste: any substance or object which theholder discards, or intends, or is required todiscard, and anything which is discarded asif it were a waste, as per the WasteManagement Act, 1996.
Baled and segregated material for recycling
43
APPENDIX ASegregation and Packaging Poster for Healthcare Risk and Non-Risk Waste
Segregation of Healthcare Waste Figure 6.1 from The Segregation, Packaging and Storage Guidelines for Healthcare Risk Waste,
Department of Health and Children & Health Service Executive
& Standard Precautions Poster
44
45
YELL
OW B
AG
ALL BL
OOD-STAINE
DOR CO
NTAM
INATED
ITEM
S INCL
UDING:-
DRES
SING
S, SWAB
S,BA
NDAG
ES,
PERS
ONA
LPR
OTE
CTIVE
EQUIPM
ENT (GOWNS
,AP
RONS
, GLO
VES)
SU
CTION CA
THET
ERS,
TUBING
AND
WOUN
DDR
AINS
INCO
NTINEN
CEWAS
TE FRO
M KNO
WN
OR SU
SPEC
TED
ENTE
RIC INFE
CTIONS
NB. BAG
S MUS
T NO
T BE
USED
FOR
SHA
RP ITEM
S,BR
EAKABLE ITEM
S OR
LIQU
IDS
DO N
OT O
VERF
ILL
BAG MUS
T BE
SEC
URELY
CLOSE
D WITH CA
BLE TIE
OR TAPE
WHE
N 2/3 FU
LLMAX
IMUM
Figu
re 6
.1SE
GREG
ATIO
N OF
HEA
LTHC
ARE
WAS
TE+
–ty
pica
l con
tent
s
LIQU
IDS:
Dan
gero
us G
oods
Reg
ulat
ions
requ
ire th
e us
e of
abs
orbe
ntm
ater
ial o
r gel
ling
agen
t to
prev
ent a
ny s
pilla
ges
from
UN
pack
agin
gco
ntai
ning
hea
lthca
re r
isk
wast
e in
volv
ing
free
liqui
ds u
nles
s th
eco
ntai
ner i
s spe
cific
ally
appr
oved
for l
iqui
ds. A
ll sig
nific
ant q
uant
ities
of
liqui
d m
ust b
e in
“lea
k-pr
oof”
con
tain
ers.
BLAC
K BA
G* -
FOR
NON-
RISK
WAS
TE
INCO
NTINEN
CE WEA
R (from
non-
infectious patients)
OXY
GEN
FAC
E MAS
KS
EMPT
Y UR
INAR
Y DR
AINA
GE
BAGS
CL
EAR TU
BING
(e.g. oxygen,
urinary catheters, ventila
tor, I.V.,
N.G.)
EN
TERIC FE
EDING BAG
S
GIVING SET
S WITH TIPS
REMOVE
D
ALL OTH
ER HOUS
EHOLD
NON-
RECY
CLAB
LE WAS
TE
DO N
OT O
VERF
ILL
YELL
OW R
IGID
BIN
OR
BOX
WIT
H BL
UE L
ID4
UN
-REG
ULATED
MED
ICINAL
/PH
ARMAC
EUTICA
L SU
BSTANC
ESi.e. products not classifie
d as
DANG
EROUS
GOODS
under ADR
Regulations
Note
:These waste substances are
best managed by returning them for
disposal to the pharmacy in their
original packaging.
If the products belong to a different
“dangerous goods” class e.g. toxic or
flammable solids, liq
uids or aerosols,
they must be packaged and labelled in
accordance with their classific
ation and
entry in ADR
as instructed by the Sa
fety
Advis
er.
Note
s:
(1) A
ll bags and containers must have an individ
ual tracin
g tag or label.
(2) + Containers, markin
g and labels for healthcare risk waste must conform to ADR
requirements.
(3)* So
me Waste Authorities may require healthcare non-risk waste to be packaged in clear, or otherwise identified plastic
bags
(4) B
lue (or grey) lid
ded containers are suggested for this stream
- see 6.4.1.3 and related footnote
YELL
OW R
IGID
BIN
OR B
OX W
ITH
YELL
OW L
ID
BLOOD AN
D BL
OOD
ADMINISTR
ATION
SETS
BO
DY FLU
IDS (not in
bulk)
SEE NO
TE RE LIQUIDS
BELO
W
DISP
OSA
BLE
SUCT
ION LINE
RS
REDIVA
C DR
AINS
BIOLO
GICAL
HIST
OLO
GY WAS
TE
NO
N-CU
LTUR
ED LAB
WAS
TE &
AUTO
CLAV
EDMICRO
BIOLO
GICAL
CULTUR
ES
SPUT
UM CONT
AINE
RSFR
OM KNO
WN OR
SUSP
ECTE
D TB
CASE
S
DO N
OT O
VERF
ILL
BOX MUS
T BE
SEC
URELY
CLOSE
D WHE
N AT
MAX
IMUM
3/4 FUL
L OR, AT
MAN
UFAC
TURE
R’S FILL
LINE
YELL
OW S
HARP
SBI
N OR
BOX
USED
SHA
RP M
ATER
IALS
SUCH
AS:
NE
EDLE
S
SY
RING
ES
SC
ALPE
LS
SH
ARP TIPS
OF I.V.
SETS
CO
NTAM
INATED
SLIDES
BL
OOD-STAINE
D OR
CONT
AMINATED
GLA
SS
ST
ITCH
CUT
TERS
GUIDE
WIRES
/TRO
CHAR
S
RA
ZORS
DO N
OT O
VERF
ILL
NOT
FOR
LIQU
IDS
BOX MUS
T BE
SEC
URELY
CLOSE
D WHE
N AT
MAX
IMUM
3/4 FUL
L OR, AT
MAN
UFAC
TURE
R’S FILL
LINE
YELL
OW S
HARP
SBI
N OR
BOX
WIT
HPU
RPLE
LID
NE
EDLE
S, SYR
INGES
,SH
ARP INST
RUMEN
TSAN
D BR
OKE
N GLA
SSCO
NTAM
INATED
WITH
CYTO
TOXIC/CY
TOSTA
TIC MED
ICINES
OR
OTH
ER TOXIC
PHAR
MAC
EUTICA
LPR
ODU
CTS
DO N
OT O
VERF
ILL
NOT
FOR
LIQU
IDS
BOX MUS
T BE
SEC
URELY
CLOSE
D WHE
N AT
MAX
IMUM
3/4 FUL
L OR, AT
MAN
UFAC
TURE
R’S FILL
LINE
YELL
OW R
IGID
BIN
OR B
OX W
ITH
PURP
LE L
ID
NON-SH
ARPS
HEALTH
CARE
WAS
TECO
NTAM
INATED
WITH
CYTO
TOXIC/CY
TOSTA
TIC MED
ICINES
OR
OTH
ER TOXIC
PHAR
MAC
EUTICA
LPR
ODU
CTS
SEE NO
TE REG
ARDING
LIQUIDS
BEL
OW
DO N
OT O
VERF
ILL
BOX MUS
T BE
SEC
URELY
CLOSE
D WHE
N AT
MAX
IMUM
3/4 FUL
L OR, AT
MAN
UFAC
TURE
R’S FILL
LINE
YELL
OW R
IGID
BIN
OR B
OX W
ITH
BLAC
K LI
D
PLAC
ENTAS (SEE
NOTE
BEL
OW RE
ABSO
RBEN
TMATER
IAL)
LA
RGE AN
ATOMICAL
BODY
PAR
TS
BS
E/TS
E RE
LATE
DBL
OOD OR TISS
UE
CONT
AMINATED
LARG
E METAL
OBJEC
TS(SEE
6.4.1.1.4)
DO N
OT O
VERF
ILL
BOX MUS
T BE
SEC
URELY
CLOSE
D WHE
N AT
MAX
IMUM
3/4 FUL
L OR, AT
MAN
UFAC
TURE
R’S FILL
LINE
46
47
APPENDIX BExample of Waste Transfer Form (WTF) and European Waste Catalogue List (EWC)
48
49
50
European Waste Catalogue and Hazardous Waste List –1 January 2002
18 WASTES FROM HUMAN OR ANIMAL HEALTH CARE AND/ ORRELATED RESEARCH (except kitchen and restaurant wastes notarising from immediate health care)
18 01 Wastes from natal care, diagnosis, treatment or prevention of diseasesin 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* wastes whose collection and disposal is subject to special requirements inorder to prevent infection
18 01 04 wastes whose collection and disposal is not subject to special requirementsin order to prevent infection (for example dressings, plaster casts, linen,disposable clothing, and diapers)
18 01 06* chemicals consisting of or containing dangerous substances
18 01 07 chemicals other than those mentioned 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
18 02 wastes from research, diagnosis, treatment or prevention of diseaseinvolving animals
18 02 01 sharps except (18 02 02)
18 02 02* wastes whose collection and disposal is subject to special requirements inorder to prevent infection
18 02 03 wastes whose collection and disposal is not subject to special requirementsin order to prevent infection
18 02 05* chemicals consisting of or containing dangerous substances
18 02 06 chemicals other than those mentioned in 18 02 05
18 02 07* cytotoxic and cytostatic medicines
18 02 08 medicines other than those mentioned in 18 02 07
* Asterisk beside number denotes hazardous wastes
51
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