Waste Management Awareness Handbook 1

HEALTH SERVICE EXECUTIVE

Waste Management Awareness Handbook

2014

Storage Ca

G

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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, Irelandnationaltfs@dublincity.ie

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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