Waste within healthcare facilities Handling and disposal ...€¦ · DRS 209: 2020 iii ©RSB 2020 -...

ICS 13.030.30

Reference number

RS 209: 2020

© RSB 2020

RWANDA STANDARD

RS

209

Second edition

2020-mm-dd

Waste within healthcare facilities — Handling and disposal — Code of practice

DRS 209: 2020

©RSB 2020 - All rights reserved ii

In order to match with technological development and to keep continuous progress in industries, standards are subject to periodic review. Users shall ascertain that they are in possession of the latest edition

© RSB 2020

All rights reserved. Unless otherwise specified, no part of this publication may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying and microfilm, without prior written permission from RSB.

Requests for permission to reproduce this document should be addressed to:

Rwanda Standards Board

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Tel. +250 788303492

Toll Free: 3250

E-mail: [email protected]

Website: www.RSB.gov.rw

ePortal: www.portal.RSB.gov.rw

mailto:[email protected]

http://www.rsb.gov.rw/

http://www.portal.rsb.gov.rw/

DRS 209: 2020

iii ©RSB 2020 - All rights reserved

Contents Page

1 Scope ...................................................................................................................................................... 1

2 Normative references ............................................................................................................................ 1

3 Terms and definitions ........................................................................................................................... 1

4 Symbols (and abbreviated terms) ........................................................................................................ 8

5 Occupational hazards and health risks ............................................................................................... 8

6 General provisions ................................................................................................................................ 9 6.1 segregation of wastes. .......................................................................................................................... 9 6.2 In-house control .................................................................................................................................. 10 6.3 Closure and bagging of waste-holding plastic bags ....................................................................... 11 6.4 Intermediate and final storage areas ................................................................................................. 11 6.5 Movement of waste ............................................................................................................................. 12 6.6 Disposal ................................................................................................................................................ 12 6.7 Maintenance and cleaning operations .............................................................................................. 13 6.8 Spill or accident clean ups ................................................................................................................. 14

7 Human/animal anatomical waste ....................................................................................................... 14 7.1 Composition ......................................................................................................................................... 14 7.2 Subcategories ...................................................................................................................................... 15 7.3 Human anatomical waste ................................................................................................................... 15 7.4 Animal anatomical waste .................................................................................................................... 16

8 Infectious non anatomical waste ....................................................................................................... 18 8.1 Composition ......................................................................................................................................... 18 8.2 Containment ......................................................................................................................................... 18 8.3 Collection ............................................................................................................................................. 19 8.4 Final storage areas .............................................................................................................................. 19 8.5 Disposal ................................................................................................................................................ 19

9 Sharps and similar waste ................................................................................................................... 20 9.1 Composition ......................................................................................................................................... 20 9.2 Containment ......................................................................................................................................... 20 9.3 Collection ............................................................................................................................................. 20 9.4 Disposal ................................................................................................................................................ 20

10 Chemical/pharmaceutical waste ........................................................................................................ 21 10.1 Chemical waste .................................................................................................................................... 21 10.2 Hazardous chemicals .......................................................................................................................... 22 10.3 Pharmaceutical waste ......................................................................................................................... 22

11 Pressurized container waste .............................................................................................................. 26 11.1 Containment ......................................................................................................................................... 26 11.2 Collection ............................................................................................................................................. 26 11.3 Disposal ................................................................................................................................................ 26

12 General waste ...................................................................................................................................... 26 12.1 Characteristics ..................................................................................................................................... 26 12.2 Containment ......................................................................................................................................... 26 12.3 Collection and disposal ...................................................................................................................... 27 12.4 Kitchen waste ...................................................................................................................................... 27

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12.5 Non-clinical glass waste (Containment and disposal).................................................................... 27

13 Movement of waste to final disposal site ......................................................................................... 27 13.1 General ................................................................................................................................................. 27 13.2 Movement ............................................................................................................................................ 27 13.3 General and decontaminated waste ................................................................................................. 28

14 Best environmental practices concerning health-care waste management ................................ 28 14.1 General ................................................................................................................................................. 28 14.2 Health-care waste management ........................................................................................................ 28 14.3 Training of personnel ......................................................................................................................... 29 14.4 Collection at the site of waste generation ........................................................................................ 29 14.5 Transportation to the intermediate storage area ............................................................................. 29 14.6 Best Available Techniques (BATs) for the incineration of health-care waste .............................. 30

Annex A (informative) Waste disposal methods ......................................................................................... 33

DRS 209: 2020

v ©RSB 2020 - All rights reserved

Foreword

Rwanda Standards are prepared by Technical Committees and approved by Rwanda Standards Board (RSB) Board of Directors in accordance with the procedures of RSB, in compliance with Annex 3 of the WTO/TBT agreement on the preparation, adoption and application of standards.

The main task of technical committees is to prepare national standards. Final Draft Rwanda Standards adopted by Technical committees are ratified by members of RSB Board of Directors for publication and gazettment as Rwanda Standards.

RS 209 was prepared by Technical Committee RSB/TC 013, Water and Sanitation.

In the preparation of this standard, reference was made to the following standard:

1) MS 615: 2005, Waste within healthcare Handling and disposal practice facilities — Code of practice

The assistance derived from the above source is hereby acknowledged with thanks.

This second edition cancels and replaces the first edition RS 209: 2014 which has been technically revised.

Committee membership

The following organizations were represented on the Technical Committee on Water and Sanitation (RSB/TC 013) in the preparation of this standard.

Ministry of Emergency Management (MINEMA)

Ministry of Trade and Industry (MINICOM)

Ruliba Clays

Paragraph of participantsRwanda Development Board (RDB)

Rwanda Mines, Petroleum and Gas Board (RMB)

Rwanda Polytechnic (RP)

Rwanda Utility Regulatory Authority (RURA)

Shine Engineers Multisectoral Company Ltd (SEMC)

Standards for Sustainability (SFS)

DRS 209: 2020

©RSB 2020 - All rights reserved vi

University of Rwanda- College of Science and Technology (UR-CST)

Rwanda Standards Board (RSB) – Secretariat

DRS 209: 2020

1 ©RSB 2020 - All rights reserved

Waste within health care facilities — Handling and disposal — Code of practice

1 Scope

1.1 This standard develops criteria for segregation, collection, movement, storage and on-site disposal of waste within healthcare units, biological research facilities, and veterinary facilities.

1.2 It also covers disposal of waste materials after removal from site of health care facility, the special precautions which may apply to infectious substances (or the transportation thereof), and efficiency of incinerators.

1.3 This standard does not cover the disposal of e-wastes (Covered by RS 276-1 and RS 276-2), radioactive wastes and the design of landfill dedicated to special wastes from healthcare facilities

2 Normative references

The following documents are referred to in the text in such a way that some or all of their content constitutes requirements of this document. For dated references, only the edition cited applies. For undated references, the latest edition of the referenced document (including any amendments) applies.

RS 181: 2013 Solid waste handling, transportation and disposal – Code of practice

3 Terms and definitions

For the purposes of this standard, the following terms and definitions apply

3.1

chemical waste

waste comprises discarded solid, liquid and gaseous chemicals e.g. from diagnostic or experimental work or from cleaning, housekeeping or disinfected procedures. Chemical waste may be hazardous or non hazardous. For the purposes of choosing the most appropriate waste-handling method, hazardous chemical waste is considered to be waste that is:

a) toxic;

b) corrosive (acids of pH < 2.0 and bases of pH > 12.0;

c) inflammable;

d) reactive (explosive, water reactive, shock sensitive);

e) genotoxic (carcinogenic, mutagenic, teratogenic or otherwise capable of altering genetic material).

©RSB 2020 - All rights reserved 2

NOTE Non-hazardous chemical waste consists of chemical other than those described above such as sugars, amino

acids and certain organic salts.

3.2

clinical glass

glass possibly contaminated with blood and body fluids or chemicals e.g. blood collection tubes, laboratory glass, medication vials

3.3

collection

accumulation of waste from several primary or intermediate storage sites for movement to a waste holding area or from several waste holding areas for movement to a final storage area

3.4

colour coding

application of indelible colour to a container in order to identify the category of waste for which it is to be used

3.5

container

any receptacle for the storage of wastes. Containers can be classified into two subgroups

3.5.1

reusable waste container

waste container that is:

a) reusable;

b) fabricated of metal or rigid plastics;

c) with high resistance to burning, impact and corrosion;

d) suitable for the waste it is to contain;

e) colour-coded or identified according to the type of waste for which it is intended by one of the following methods:

1) if the container is made of plastics, the plastics may be dyed in the appropriate colour; and

2) a band of colour not less than 50 mm in width may be applied to the container.

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3.5.2

single-use waste container

A waste container that can be any of the following:

a) sharps container;

b) waste-holding plastic bag;

c) cardboard container; or

d) specialized container.

3.5.3

“sharps” container

A container that:

a) is steady enough to resist puncture under siege conditions and to the point of disposal;

b) is clearly identified as containing sharps e.g. by the use of the word “Sharps” or symbol recognized by the facility;

c) has lids capable of being tightly secured; and

d) if used for containing cytotoxic waste, has cytotoxic symbol displayed clearly and visibly.

3.5.4

cardboard container

container made from cardboard and that is:

a) colour coded or identified according to the type of waste for which it is intended (see Table 1).

b) rigid; and

c) leak resistant.

3.5.5

specialized containers

specialized containers are colour-coded or identified according to the type of waste for which they are intended (e.g. paint cans)


3.6

cytotoxic

having a deleterious effect upon cells commonly used in reference to pharmaceuticals used in the treatment of cancer e.g. antineoplastics chemotherapy

3.7

disposal

removal of waste from the site of health care facility and its final destruction, or the onsite incineration of waste

3.8

general waste

waste that has not been included in the other waste categories and does not pose a disease-related risk or threat to people or the environment. The general waste category includes:

a) office waste;

b) kitchen waste;

c) non-clinical glass waste; and

d) all other similar wastes.

3.9

hazardous waste

any waste or combination of wastes which pose a substantial present or potential hazard to human health or living organisms because they are lethal, non degradable and persistent in nature and requires special precaution in its storage, collection transportation, treatment and disposal. Hazardous waste includes explosives, flammables, volatile, radioactive, toxic and pathological waste

3.10

human/animal anatomical waste

3.10.1 waste consisting of:

a) tissues;

b) organs;

c) body parts;

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d) products of conception; and

e) animal carcasses.

3.10.2 This waste category is divided into the subcategories of:

a) human anatomical waste;

b) infectious animal anatomical waste; or

c) non-infectious animal anatomical waste.

NOTE The following are considered to be non-anatomical wastes:

a) blood and body fluids;

b) extracted teeth;

c) nail clippings; and

d) hair.

3.11

health care facilities

all places (sites) where professional health services are dispensed to human patients or biological research is carried out and includes inter alia, clinics, hospitals, rehabilitation centres, sick bays (old age homes), day units, clinics (mobile and stationery), veterinary facilities

3.12

infectious non-anatomical waste

any waste contaminated with viable microorganisms capable of transmitting, and reasonably likely to transmit disease. This includes:

a) all microbiology lab wastes that have not been decontaminated;

b) waste from surgeries and autopsies performed on patients with infectious diseases; and

c) all wastes contaminated with a causative agent from patients designated as requiring specific hospital communicable diseases protocols.


3.13

movement

transfer of waste materials between storage areas within the health care facility, or to the final disposal site away from the health care facility

3.14

non-clinical glass

glass from maintenance and kitchen areas e.g. broken windowpanes and discarded glass bottles

3.15

pharmaceutical waste

Pharmaceutical products such as drugs and medicinal chemicals that are no longer usable in patient treatment such as those that have been returned from patient care areas, have become out-dated or contaminated or have been stored improperly, or are no longer required

3.16

pressurized container waste

Consists of aerosol cans or disposable compressed gas containers that may explode if incinerated or accidentally punctured

3.17

refrigerated storage

storage of waste at a temperature of 4 °C or lower

3.18

segregation

separation of waste according to classification prior to storage

3.19

“sharps”

waste including but not limited to:

a) needles,

b) syringes;

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c) blades;

d) clinical glass; and

e) any other clinical items capable of causing a cut or puncture.

3.20

soiled utility room

intermediate storage room within the facility where waste from the patients’ bedside is temporarily stored

3.21

storage

accumulation of waste after segregation in a specified container in a predetermined location

3.22

storage areas

3.22.1

final storage area

area of the facility where waste is stored just before being disposed of

3.22.2

incinerator

appliance capable of withstanding heat, and designed to efficiently destroy, by combustion, solid, semi-solid, or liquid waste at specific conditions, such that the residue contains little or non-combustible material

3.22.3

intermediate storage area

area of the facility where waste is stored following collection from primary storage area and before being removed to final storage area. This includes the means by which the waste is transported

3.22.4

primary storage area

area of the facility where waste originates


3.22.5

system

waste management system belonging to the health care facility

3.23

waste holding

storage of waste collected from all primary storage areas such as laboratory wing, operating rooms, or patient rooms

4 Symbols (and abbreviated terms)

UNEP United Nations Environment Programme

TEQ Toxic Equivalency

SNCR Selective Non Catalytic Reduction

BAT Best Available Technology

SCR Selective Catalytic Reduction

HCl Hydrogen chloride

PDRSD/F Polychlorinated dibenzo-p-dioxins/dibenzofurans

HF Hydrogen fluoride

SO2 Sulphur dioxide

NO Nitrogen oxide compounds

5 Occupational hazards and health risks

5.1 To minimize the occupational health risk associated with handling and disposal of health care waste, occupational health care programmes shall:

a) provide for routine medical check-up for personnel handling waste and periodic review of the medical records;

b) include written procedures to handle and report sharps injuries sustained while engaged in waste disposal;

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c) introduce safe or less hazardous substitutes for chemical agents with exposure hazards (substance distribution inventories are helpful in finding out what agents are actually in use).

d) require closed storage for volatile agents’ traces of which, or brief exposure to which, are a health hazard;

e) require use of proper venting and exhausting in accordance with the established principles of occupational hygiene;

f) provide appropriate personal protective equipment with disinfections and disposal arrangements for workers involved in various stages of waste handling and disposal;

g) include an assessment waste management procedures on a regular basis, to assure compliance with this standard and all applicable regulations;

h) include a training programme for all persons handling wastes; and

i) include appropriate protective equipment and washing facilities.

5.2 Health facilities shall have (freely available to all personnel concerned) written policies and procedures, which include requirements for at least:

a) the cautionary labelling of the containers of hazardous materials;

b) material safety data sheets;

c) appropriate worker training for each system element;

d) locations of particular waste containers;

e) protection of proprietary information; and

f) when applicable, compliance with relevant national and local regulations

6 General provisions

6.1 segregation of wastes.

6.1.1 Waste shall be segregated according to the following categories that are detailed in Table 1:


Table 1 ━ Summary of colour coding/labelling requirements

1 2 3

Waste category Waste sub-category Colour-coding/labelling

Human/animal anatomical waste Human anatomical Red

Infectious animal anatomical Orange, Red

Non-infectious animal anatomical Blue

Infectious non-anatomical waste Yellow

Sharps and similar waste Sharps or recognized symbol

Chemical/pharmaceutical waste Chemical waste

Black, Dark Green, or recognized

coding

Pharmaceutical waste excluding

cytotoxic pharmaceutical waste

Cytotoxic hazard symbol.

Radioactive waste Radiation hazard symbol

Pressurized container waste Black or Dark Green

General waste Office waste

Kitchen waste, non-clinical glass

waste

Non-clinical non-anatomical waste

Black or Dark Green

Blue, or Green

Blue Black or Dark Green

6.1.2 All wastes should be handled so as to ensure that it is segregated at source, contained in packaging that holds the contents to the point of disposal, and disposed in a manner that is practical and efficient yet minimizes any hazard. By minimizing the handling of waste, fewer people are be exposed to it. Potentially offensive unrefrigerated waste shall be timeously removed.

6.1.4 It is recommended that plastics materials that are to be included in the stream of waste to be incinerated be non-halogenated. Materials bearing heavy metals should not be used. The most commonly used Plastics; Polyvinyl Chloride (PVC) yields hydrogen chloride upon incineration.

Examples Non-halogenated plastics include polystyrene, polyesters and polyolefins such as polyethylene and

polypropylene.

6.2 In-house control

6.2.1 Each generator/originator of biohazardous waste shall prepare, maintain and implement a written plan to minimize, identify and handle all waste generated within the facility and shall provide a training programme for all staff to familiarize them with:

a) procedures for the segregation, collection, storage, labelling and movement of waste specified by this standard;

b) personal hygiene, especially hand washing; and

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c) the hazards of those materials to which workers may be exposed. This training shall be continuously assessed and reinforced.

6.2.2 The in-house control of wastes produced by health care facilities should be managed in accordance with 6.2 of this standard, under the supervision of the facility’s infection control committee or a designated department.

6.2.3 This written plan shall be reviewed periodically to ascertain its effectiveness.

6.2.4 An inspection programme shall be established to ensure that the procedures specified by this standard are followed.

6.2.5 It is the responsibility of the waste generator to indicate disposal instructions and assist in the best practicable disposal of such waste.

6.3 Closure and bagging of waste-holding plastic bags

6.3.1 Bags containing waste, no matter how they are closed shall be such that their contents are prevented from escaping.

6.3.2 A single bag is normally adequate, if it is impervious and sturdy (not easily penetrated) and if the articles can be placed in the bag without contaminating the outside of the bag otherwise, double bagging shall be used.

6.4 Intermediate and final storage areas

6.4.1 All waste-storage areas shall meet the requirements of the local authority regulations.

6.4.2 Intermediate and final storage areas shall:

a) be totally closed;

b) be separated from supply rooms or food preparation areas;

c) have access restricted to authorized personnel only; and

d) have access restricted to authorized personnel only.

6.4.3 Health care facilities that refrigerate stored waste shall use:

a) lockable, closed storage facility; and

b) lockable, domestic-type freezer unit that is dedicated to the accumulation of waste for disposal. This waste shall be stored at a temperature of 4 °C or lower with freezing being preferred method of storage.

6.4.4 Storage facilities should be reasonably sized for the predicted storage needs.


6.4.5 Health care facilities shall prepare a contingency plan for dealing with the storage of refrigerated waste in the event of excess waste being produced, incineration facilities becoming inoperative or refrigeration/freezing facilities becoming inoperative.

6.4.6 Health care facilities shall prepare a contingency plan to deal with the disposal of waste in the event of a disruption of disposal services.

6.4.7 Users of this standard shall refer to local authority regulations for information regarding the ventilation of waste-storage areas.

6.5 Movement of waste

6.5.1 Manual handling of waste materials shall be minimized;

6.5.2 Carts used for carrying waste shall:

a) be capable of containing the waste;

b) be designed to prevent spills;

c) be constructed of materials that permit affective cleaning and disinfections; and

d) be used solely for the transportation of waste.

NOTE Open carts may be used to transfer waste contained within waste containers.

6.5.3 Waste containers shall be moved only when properly closed.

6.5.4 Specific routes for the movement of wastes shall be planned in order to minimize its passage through patient care areas and other clean areas.

6.5.5 Infection waste shall have specially designed movement procedures that completely eliminate contact with unprotected skin of the handler. These procedures shall be written and implemented by specially trained personnel and shall be reviewed periodically to align them with local, national or international regulations.

6.5.6 A regularly scheduled cleaning programme should be established for waste disposal chutes.

6.6 Disposal

6.6.1 The healthcare facility shall dispose wastes in accordance with national regulations.

6.6.2 Handling and disposal of general wastes shall be in accordance with RS 181.

6.6.3 Waste disposal chutes/conveyors shall be avoided but if they are provided, shall be used for general waste purposes only.

DRS 209: 2020


6.7 Maintenance and cleaning operations

6.7.1 Protective apparel

6.7.1.1 The following protective apparel shall be worn, as necessary, by any personnel engaged in cleaning of reusable waste containers, waste-movement carts or final storage area:

a) waste-resistant overalls;

b) heavy-duty water proof gloves;

c) rubber boots;

d) protective goggles or face shield; and

e) appropriate respiratory equipment to protect them from gases and odours.

6.7.1.2 When not in use, protective apparel shall be stored in an area designated for this purpose.

6.7.2 Reusable waste containers and waste movement carts

6.7.2.1 These shall be thoroughly cleaned in accordance with facility’s established procedures.

6.7.2.2 The frequency or cleaning operations shall be in accordance with facility’s established procedures.

6.7.2.3 Reusable waste containers and waste movement carts shall be thoroughly cleaned before any maintenance work is performed on them.

6.7.2.4 Reusable waste containers shall be inspected for holes or leaks every time they are emptied and their colour coding renewed if necessary.

6.7.3 waste holding plastic container

Plastic bag used as a container and that shall be:

a) steady enough to resist puncture, leaking and braking under individual usage conditions and to the point of disposal., except where;

b) colour coded or identified according to the type of waste for which it is intended.

6.7.4 Storage sites

Floors, walls and ceilings of intermediate and final storage area shall be thoroughly cleaned in accordance with the facility’s established procedures.


6.8 Spill or accident clean ups

6.8.1 Health care facilities shall have a documented policy and procedure for managing spills of hazardous substances.

6.8.2 The procedure for managing a soil shall include the following:

a) all staff shall be trained and educated on method for the containment and isolation of each type of spill shall be prepared;

b) persons shall have specific management training in the management of spills;

c) information concerning individual substances and their clean up shall be readily accessible to all staff and available on 24 h basis.

d) proper equipment shall be available for:

1) spill clean-up; and

2) the protection of employees.

e) the procedures for proper disposal of waste spills according to the waste management policy of the facility shall be prepared;

f) the procedures for each type of spill shall be documented and made available in the area where the spill is likely to occur;

g) all incidents shall be documented for the purpose record keeping;

h) any employee exposed to a spill shall be treated and monitored by the facility; and

i) if necessary, evacuation and internal disaster plans shall be implemented.

7 Human/animal anatomical waste

7.1 Composition

Human and animal anatomical waste consists the following:

a) tissues;

b) organs;

c) body parts;

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d) products of conceptions; and

e) animal carcasses.

NOTE The following are considered to be non-anatomical wastes:

a) blood and body fluids;

b) extracted teeth;

c) nail clippings; and

d) hair.

7.2 Subcategories

The human/animal anatomical waste category shall be subdivided into:

a) human anatomical waste;

b) infectious animal anatomical waste; and

c) non-infectious animal anatomical waste.

7.3 Human anatomical waste

7.3.1 Containment

7.3.1.1 Human anatomical waste shall be placed within a waste container that is colour-coded orange.

7.3.1.2 When human anatomical waste is being packed, handlers of waste shall wear:

a) a gown;

b) disposable gloves; and

c) any other protective equipment.

7.3.2 Collection

7.3.2.1 Waste containers shall be moved in accordance with the requirements given in 6.5.1

7.3.2.2 Human anatomical waste shall be collected and moved to its final designated area by the most direct route possible avoiding patient care areas. This waste shall not be combined with other waste during its collection.


7.3.3 Final storage area

7.3.3.1 Human anatomical waste shall be segregated stored and refrigerated at a temperature lower than 4 °C or preferably frozen.

7.3.3.2 For ease of handling, for transportation and disposal, human anatomical waste shall be stored in containers that are:

a) colour coded red (see Table 1)

b) rigid; and

c) leak proof.

7.3.3.3 The recommended maximum storage time for human anatomical waste in intermediate storage areas is 1 week if waste is refrigerated.

7.3.3.4 Health care facilities shall prepare a policy for the maximum storage time of frozen human anatomical wastes based on the facilities, storage capacity and appropriate regulations and legislation.

7.3.3.5 Final storage area shall meet requirements given in 6.4.2

7.3.3.6 Final storage areas shall be thoroughly cleaned on regular basis.

7.3.4 Disposal

Human anatomical waste shall be incinerated.

7.4 Animal anatomical waste

7.4.1 Containment

7.4.1.1 Infectious animal anatomical waste shall be placed within a waste container:

a) that is colour coded orange or red;

b) the infectious animal anatomical waste may be placed within a waste container that is colour coded red, provided that the infectious animal anatomical waste and human anatomical waste are not intermixed within the same waste container,

7.4.1.2 Human anatomical waste is treated with respect. For this reason, human anatomical waste and animal anatomical waste are placed within separate waste containers. The issue of whether to incinerate human and infectious animal anatomical wastes together or separately is decided by the institution in accordance with the national regulations.

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7.4.1.3 Non-infectious animal anatomical waste shall be placed within a waste container that is colour coded blue.

7.4.1.4 The handling and disposal of infectious animal anatomical waste shall be in accordance with local authority regulations and appropriate standards; handlers of this waste shall wear:

a) a gown;


c) other protective equipment.

7.4.2 Collection

7.4.2.1 Waste containers shall be moved in accordance with requirements given in 6.5.3;

7.4.2.2 Animal anatomical waste shall be collected and moved to its final destination by the most direct route avoiding patient care areas. This waste shall not be combined with other waste during its collection.

7.4.3 Final storage area

7.4.3.1 Infectious animal anatomical waste shall be segregated, stored and refrigerated at a temperature lower than 4°C or preferably be frozen.

7.4.3.2 For ease of handling transportation and disposal of infectious animal anatomical waste shall be stored in containers that are:

a) colour-coded orange or red

b) rigid; and

c) leak proof.

7.4.3.3 For ease of handling, transportation and disposal, non-infectious animal anatomical waste shall be stored in containers that are:

a) colour-coded blue;

b) rigid; and

c) leak proof.

7.4.3.4 The recommended maximum storage time for animal anatomical storage waste in intermediate storage areas is 1 week if the waste is refrigerated.


7.4.3.5 Health care facilities shall prepare a policy for the maximum storage time of frozen animal anatomical wastes, based on the facility’s storage capacity and appropriate regulations and legislation.

7.4.3.6 Final storage areas shall meet the requirements given in 6.4.2.

7.4.3.7 Final storage areas shall be routinely decontaminated on a regular schedule decided upon by the facility infection control committee or designated department or designated responsible person.

7.4.4 Disposal

7.4.4.1 Infectious animal anatomical waste shall be incinerated appropriately.

7.4.4.2 Non-infectious animal anatomical waste shall be:

a) incinerated (on-site incineration is the preferred method of disposal);

b) transported to a designated landfill site for burial in accordance with local authority regulations; and

c) removed by an appropriate disposal company in accordance with local authority regulations.

8 Infectious non anatomical waste

8.1 Composition

Infectious non-anatomical waste includes:

a) all microbiology laboratory wastes that have not been decontaminated;

b) waste from surgeries and autopsies performed on patients with infectious diseases; and

c) all wastes contaminated with a causative agent from patients designated as requiring specific hospital communicable diseases protocols.

NOTE 1 The policy of universal precautions dictates that blood and tissue from all patients be handled in a safe manner, thereby removing the need for patients to be identified as requiring blood precautions. In enforcing BSI (Body

Substance Isolation), all specific communicable disease protocols except for respiratory isolation, are withdrawn. In this way, all patients who in the past would have been subject to blood precautions, enteric precautions, etc., are now treated

identically.

NOTE 2 In order to afford users of this standard the flexibility to establish their own policies and procedures, infectious

non-anatomical waste has been defined in such a way as to give guidance to those facilities requiring it, while not

restricting others from introducing the policies of universal precautions and BSI.

8.2 Containment

8.2.1 Infectious non-anatomical waste shall be placed within a waste container that is colour-coded yellow.

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8.2.2 Infectious liquids shall be:

a) contained in sealed, single-use containers before being placed within a waste container that is colourcoded yellow (see Table 1); or

b) where this means of containment is considered inappropriate, the disposal of such liquids into sanitary sewers shall conform to local authority by-laws.

8.2.3 When infectious non-anatomical waste is being packed, the handlers of the waste shall wear:

a) a gown;


c) other protective equipment.

8.3 Collection

Waste containers shall be moved in accordance with the requirements of 6.5.3

8.4 Final storage areas

8.4.1 Final storage area shall meet requirements of 6.4.2

8.4.2 For ease of handling for transportation and disposal, infectious non-anatomical waste may be stored in containers that are:

a) colour coded yellow (see Table 1);

b) rigid; and

c) leak proof.

8.5 Disposal

8.5.1 The preferred method of disposal of infectious non-anatomical waste is on site incineration. Acceptable alternatives are:

a) off site incineration

b) autoclaving and then handling the decontaminated waste as general waste;

c) disposal into sanitary sewers; and

d) other treatment technologies deemed acceptable to the regulatory authority.


8.5.2 In all cases, disposal shall be in accordance with national and local authority regulations.

9 Sharps and similar waste

9.1 Composition

Sharps and similar wastes include:

a) needles;

b) syringes;

c) blades;

d) clinical glass; and

e) any other clinical items capable of causing a cut or puncture.

9.2 Containment

9.2.1 container specified in 4.5;

9.2.2 Sharps containers should be so located as to permit the safe and convenient disposal of sharps.

9.2.3 The recapping of needles is not recommended. Needless shall not be clipped, bent or broken.

9.3 Collection

9.3.1 Before a sharp container is moved the lids shall be securely in place.

9.3.2 Sharps containers shall be three-quarter filled since overfilling may pose a hazard to those persons using and discarding the containers.

9.3.4 Sharps containers shall be removed to a point of use when they are suitably full.

9.3.5 Sharps containers shall be moved in accordance with the requirements of 6.5.3

9.4 Disposal

9.4.1 Filled sharps containers shall be treated or handled for disposal by any of the following methods. The preferred method is the on-site incineration. Other methods outlined below may be chosen for healthcare facilities, based on the individual facility’s experience and local conditions. In all cases, disposal shall comply with national and local authority regulations:

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9.4.1.1 On-site incineration; incineration decontaminates and renders sharps unusable. The sharps containers shall be made of a material suitable for incinerations.

NOTE Removal and handling of the ash from the incineration may pose a physical hazard to personnel through

scraps and puncture of wounds from the remaining portion of sharps.

9.4.1.2 Off-site incineration; off-site incineration has the same benefits and risks outlined in 9.4.1.1 above.

NOTE Additional exposure risk is incurred through increased handling in transportation and exposure to the environment

in a transportation accident causing container rupture.

9.4.1.3 Landfill; authorities having jurisdiction over landfill sites may allow burial of sharps containers with compacted or uncompacted waste, although this method is not a recommended practice.

9.4.1.4 In addition to transportation risks, if the security of the container; transportation or landfill sites were to fail, waste handlers and scavengers risk transmission of infection by inoculation with unknown consequences.

9.4.2 New technology; the above methods take into account existing technology and handling methods. New handling and disposal methods may be considered by facilities as they arise.

NOTE Autoclaving of filled sharps containers before final disposal is not recommended because it can result in

incomplete decontamination of contents

10 Chemical/pharmaceutical waste

10.1 Chemical waste

Chemical waste comprises discarded solid, liquid and gaseous chemicals, e.g. from diagnostic and experimental work, or from cleaning, housekeeping or disinfecting procedures. Chemical wastes may be hazardous or non-hazardous. For the purposes of choosing the most appropriate waste-handling method, hazardous chemical waste is considered to e-waste that is:

a) toxic;

b) corrosive (acids of pH > 2.0 and bases of pH >12.0);

c) flammable;

d) reactive (explosive, water reactive, shock sensitive); or

e) genotoxic (carcinogenic, mutagenic, teratogenic or otherwise capable of altering genetic material).

NOTE Non-hazardous chemical wastes consist of chemicals other than those described above, such as sugars, amino

acids, and certain organic and inorganic salts.


10.2 Hazardous chemicals

10.2.1 General

10.2.1.1 Expert advice shall be obtained prior to disposal of hazardous chemicals. Chemical waste shall be segregated to avoid chemical reactions; e.g. bases shall not be contained together with acids.

10.2.1.2 Suitable methods for chemical deactivation shall be sought using appropriate references.

10.2.1.3 Disposal of hazardous chemicals shall be performed only by qualified personnel. Individuals responsible for handling and disposal of hazardous chemicals shall have received appropriate training and education.

10.2.1.4 In consideration of the fact that a chemical spill or accident may occur, the requirements of 6.8 shall be met.

10.2.2 Disposal

Healthcare facilities shall comply with national standards concerning the disposal of hazardous wastes.

10.3 Pharmaceutical waste

10.3.1 Composition

10.3.1.1 Pharmaceutical waste comprises pharmaceutical products such as drugs and medicinal chemicals that:

a) are no longer usable in patient treatment and have been returned from patient care areas, have become outdated or contaminated have been stored improperly; or

b) are no longer required.

NOTE Items contaminated with pharmaceuticals do not normally pose a threat. However, those contaminated with

catatonics and radiopharmaceuticals are considered to be cytotoxic and radiopharmaceutical wastes respectively.

10.3.1.2 All pharmaceuticals can be abused or misused. Therefore, appropriate disposal precautions should be practiced for all pharmaceuticals.

10.3.2 Basic safety guidelines

10.3.2.1 Written policies or procedures shall be developed to deal with the following aspects as they pertain to pharmaceuticals:

a) storage;

b) preparation;

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c) labelling products removed from original containers;

d) use of safety equipment;

e) emergency procedures for treating accidental contact and spills; and

f) disposal.

10.3.2.2 These policies or procedures shall be reviewed annually and revised as necessary to reflect current approved standards and legislation. These policies and procedures shall be developed in consultation with local authorities, Rwanda Bureau of Standards and any other relevant authorities.

10.3.3 Basic waste disposal guidelines

10.3.3.1 The amount of pharmaceutical waste generated shall be minimized by careful preplanning. Provision for the disposal of waste shall be considered before a material is purchased or is produced within the pharmacy. Waste shall be minimized by the following preplanning steps:

a) quantities of materials purchased shall reflect the needs;

b) quantities of materials with special disposal requirements, e.g. Chemicals, cytotoxics and biological shall be purchased in quantities to match the immediate needs;

c) non-hazardous materials shall be substituted for hazardous ones, when appropriate; and

d) materials shall be recovered for reuse, when appropriate.

10.3.3.2 Appropriate precautions in packaging products for transport shall be taken to prevent handlers from accidental exposure due to breakage. For example, the use of sealable plastics bags helps to contain spills.

10.3.3.3 Transportation of packages containing hazardous products shall be labelled to indicate the hazards involved and precautions to be taken in the event of breakage. Transportation methods used shall reflect the hazards involved.

10.3.4 Handling and disposal of pharmaceuticals other than cytotoxics

10.3.4.1 Pharmaceuticals shall be disposed of in such a manner that they can be reused. Once rendered unusable, pharmaceutical waste other than cytotoxic pharmaceutical waste shall be placed within a waste container that is:

a) Colour-coded black or dark green, and

b) clearly identified as containing pharmaceutical waste utilizing a coding system recognized by the facility.

NOTE For specific recommendations regarding the handling and disposal of:


a) antibiotics and antiseptics; and

b) narcotics and other controlled drugs, users of the standard should refer to local authority regulations.

10.3.4.2 Biologicals, such as live attenuated vaccines shall be handled and disposed of in accordance with annex A.

NOTE Some biological may require inactivation prior to handling for disposal.

10.3.4.3 Radiopharmaceuticals shall be handled in accordance with the relevant laws

10.3.5 Handling and disposal of cytotoxic pharmaceuticals

10.3.5.1 Cytotoxic pharmaceutical waste shall be placed within a waste container that clearly and visibly displays the toxic hazard symbol as below together with the world cytotoxic printed boldly directly beneath the symbol in letters at least 7 mm high.

10.3.5.2 Protective equipment and clothing shall be worn to help prevent exposure of unprotected skin to drug, splashing of the drug into eyes or inhalation of powders or aerosols. Recommended safety apparel includes:

a) a long-sleeved, water-repellent disposable protective garment, preferably with a solid front and tight fitting cuffs and neck;

b) disposable latex gloves. Gloves should be changed as required;

c) eye protection, e;g. safety glasses, goggles or full-face masks; and

d) respiratory protection, e.g. disposable dust and mist respirator mask (not surgical mask).

10.3.5.3 Cytotoxic pharmaceutical waste and associated contaminated materials, e.g. needles, syringes, tubing, containers, preparation materials, vials and ampoules shall be separated from general waste and discarded into designated cytotoxic waste containers. Sharp objects contaminated with cytotoxics, such as needles, broken glass, etc., shall be placed into designated cytotoxic sharp containers.

10.3.5.4 The sharp containers shall be labelled with the toxic hazard symbol as in Annex A. Containers selected shall be compatible with and appropriate to the type of waste they are to contain. Where practical, the same type of container should be used throughout the facility. Standardization of containers fosters greater use and enhance identifiability among users. Sharp containers shall include the following features:

a) a fill line;

b) unauthorized withdraw prevention

c) handles; and

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d) a wall bracket and lock.

10.3.5.4 Care shall be taken to prevent penetration and leakage. Excess cytotoxic fluids shall be placed in sealed containers; the original container is acceptable.

NOTE Prior to the cytotoxic waste containers being used an absorbent material may be at the bottom of the waste

containers to absorb excess fluids.

10.3.5.5 Cytotoxic pharmaceutical wastes that can be incinerated without causing dangerous off gassing shall be incinerated unless incineration as a disposal means is not available.

10.3.5.6 If incineration is not available chemical deactivation shall be used for some cytotoxic pharmaceuticals. Suitable methods for chemical deactivation shall be used for some cytotoxic pharmaceuticals. Suitable methods for chemical deactivation should be sought direct from the manufacturer. These procedures shall be performed in a biological containment cabinet complying with the compulsory specifications for using appropriate precautions; protective equipment for visual and respiratory protection shall also be worn.

10.3.5.7 Users of this standard should refer to appropriate national or international standards for information regarding the installation and field-testing of biological containment cabinets.

10.3.5.8 Disposal of small amounts of cytotoxic pharmaceuticals into landfill sites or into municipal sanitary sewer may be permissible in some areas. Local authorities shall be consulted if either of these methods is to be used.

10.3.5.9 The term “small amount” is used in a descriptive sense. Local authorities state their own criteria for what constitutes a small amount, based on factors such as mass, volume and concentration. These criteria shall be applied when small amounts are being disposed of.

10.3.5.10 After agreement has been obtained from the distributing agent, consideration shall be given to returning, intact, pharmaceutical products such as unreconstituted or unopened vials, ampoules or bottles to the distributing agent who may be the pharmaceutical manufacturer or the laboratory in which they were prepared.

10.3.5.11 In the handling of urine and other exert from patients who have received cytotoxic pharmaceuticals within the previous 48 h, latex gloves shall be worn. Contaminated garments and liner shall be treated as isolation linen and washed separately.

10.3.5.12 Personnel cleaning up cytotoxic spill shall use full protective equipment and clothing such as gowns, double gloves, eye protection and respiratory protection.

a) the spill shall be contained and wiped up using absorbent powders or papers or both;

b) the area shall be washed with a detergent followed by 70 % alcohol (aseptic areas) or water (non-aseptic areas) and then dried; and

c) all contaminated materials shall be discarded into designated cytotoxic waste containers.


11 Pressurized container waste

11.1 Containment

Pressurized container waste shall be placed within a waste container that is colour-coded black or dark green.

11.2 Collection

11.2.1 Pressurized container waste shall not be incinerated or autoclaved.

11.2.2 Refillable compressed gas cylinders shall be returned to the manufacturer or distributor.

11.3 Disposal

Pressurized container waste shall be disposed of with the general waste or as otherwise directed by the local authority regulations.

12 General waste

12.1 Characteristics

General waste consists of waste that:

a) has not been included in the other waste categories and

b) does not pose a disease-related risk or threat to people or to the environment. The general waste category includes:

1) office waste;

2) kitchen waste;

3) non-clinical glass waste;

4) non-infectious non-anatomical waste, e.g. blood and body fluids, facial tissues, disposable drapes, diapers, dressings from non-infected wounds, and decontaminated waste; and

5) all other similar wastes.

12.2 Containment

Solid general waste shall be placed within a waste container that is colour-coded black.

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12.3 Collection and disposal

12.3.1 Except for kitchen waste (see Table 1) and non-clinical glass waste (table1); solid general waste requires no special measures and can safely be dealt with in the same manner as general municipal waste.

12.3.2 The disposal of liquid waste into sanitary sewers shall comply with municipal sewerage by laws and national regulations and legislation.

12.4 Kitchen waste

Kitchen waste shall be handled, stored and disposed of in accordance with national regulations governing food premises. Public health authorities shall be consulted regarding the applicable regulations.

12.5 Non-clinical glass waste (Containment and disposal)

Non-clinical glass shall be placed within a container suitable for the purpose. The waste shall then be handled stored, and disposed of in a safe manner that protects the handler and any other persons within such vicinity

NOTE In many guidelines, all waste contaminated with blood or a body fluid is classified as infectious waste. This enormously increases the volume of waste requiring expensive handling and disposal. Identical items are disposed of from

homes without special handling or decontamination.

13 Movement of waste to final disposal site

13.1 General

Waste within healthcare facilities is sometimes disposed of in municipal sites and/or landfills. This entails movement of waste beyond the boundaries of the facility. It is important that such transportation of waste be carefully designed.

13.2 Movement

13.2.1 Transportation of waste shall be done only by vehicles designated for this purpose.

13.2.2 Each healthcare facility shall design a disposal schedule that is capable of prevention over accumulation of waste. All the waste for collection designated place without any spillage or overflow, before agreed collection time.

13.2.3 The black plastic bags shall have their mouths tightly closed and the bins shall have the lids firmly secured to avoid odours.

13.2.4 The vehicle used for transportation of waste shall be properly loaded with waste so as to avoid dispersal of the healthcare facility and the local authority where the local authority’s vehicles are used. It shall be the sole responsibility of the healthcare facility when the facility utilizes its own vehicles for such duties.


13.3 General and decontaminated waste

13.3.1 Only general waste and waste that has been properly decontaminated can be transported beyond the boundaries of the facility.

13.3.2 In case of accidental-in transit-dispersal of waste, the transporter shall immediately recollect the waste and clean-up the area.

13.3.3 The waste shall be disposed of as general municipal waste.

14 Best environmental practices concerning health-care waste management

14.1 General

14.1.1 In order to ensure an efficient and state of the art incineration of waste a number of practices prior to the combustion of waste itself is considered necessary.

14.1.2 These practices are not directly linked to the reduction and avoidance of unintentionally produced Persistent Organic Pollutants (POPs) but represent general principles of health-care waste management which in consequence can influence the generation of waste fractions and which contribute to the safety of the personnel, the public and the environment.

14.2 Health-care waste management

The establishment of healthcare waste management involves to:

a) characterize the nature and amount of the different waste fractions;

b) identify options to avoid or reduce waste generation (package sizes, stock keeping, evaluate work processes, reuse of equipment where feasible);

c) draw up a list of rules how to handle the waste;

d) specify the suitable containers for collection, storage and transport;

e) lay down the responsibilities of the personnel;

f) describe the appropriate treatment options for the different waste fractions;

g) provide for proper documentation and control of the waste disposal;

h) describe the transportation of the waste fraction to the final disposal location and the type of final treatment, and

i) calculate the costs for the different activities.

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14.3 Training of personnel

The personnel shall get thorough instructions about:

a) risks connected with health-care waste;

b) classification and codes of the different waste fractions and their classification criteria; c) costs of waste treatment;

c) illustration of the waste management from generation to disposal;

d) responsibilities; and

e) effects of mistakes and mismanagement.

14.4 Collection at the site of waste generation

14.4.1 The following shall be provided at the site of waste generation:

a) small bins for the disposal of the different waste fractions at suitable places;

b) proper packaging of the waste: Bags/containers for infectious waste and sharps shall be puncture resistant and leak proof. Either solid drums or bags which are placed within a rigid or semi-rigid container having a capacity of 30 L - 80 L shall be used. The containers may be recyclable (stainless steel) or single use (thick cardboard or rigid polyethylene). Plastic materials containing chlorine shall be avoided if incineration takes place. Full containers shall have a locking or sealing device.

14.4.2 Containers shall be property labelled as infectious, cytotoxic etc, waste.

14.4.3 The personnel at the site of waste generation shall ensure that there is no overloading of waste containers.

14.4.4 Highly infectious waste shall, whenever possible, be sterilized immediately by autoclaving. It therefore needs to be packaged in bags that are compatible with the proposed treatment process.

14.5 Transportation to the intermediate storage area

14.5.1 Once the primary containers are full they shall be taken to an intermediate storage area.

14.5.2 The facility shall have designated areas for storage, and cleaning/washing/disinfection of the containers where access is only allowed for authorized personnel.

14.5.3 Personnel handling the waste shall wear protective clothing (gloves, shoes) during collection, transportation and storage).

14.5.4 The personnel handling the waste shall ensure:


a) clear transport routes and times;

b) no comprimation of waste containing sharps; and

c) no manual sorting of infectious waste fractions.

14.6 Best Available Techniques (BATs) for the incineration of health-care waste

14.6.1 Incineration is an important method for the treatment and decontamination of biomedical and healthcare waster. This sub-clause gives guidance on the incineration of the following (mostly) hazardous waste fractions: infectious health-care waste, biological health-care waste and sharps.

14.6.2 Incineration is a high-temperature (850 °C – 1 100 °C) dry oxidation process that reduces organic and combustible waste to inorganic, incombustible matter and results in a very significant reduction of waste volume and weight.

14.6.3 Semi-pyrolysis is a process of smouldering where thermal conversion occurs in an oxygen deficient atmosphere at a temperature between 500 °C and 600 °C.

14.6.4 The incineration/pyrolysis shall be carried out in appropriate plants. The system shall be designed to cope with the specific characteristics of hazardous health-care waste (high water content, high plastic content).

14.6.5 As the following technologies are rather sophisticated only hazardous, waste fractions should be burned in these plants. Other health-care waste which is similar to municipal waste should be segregated in advance and be subjected to different waste treatment technologies. On-site facilities (i.e. in the hospital) are usually equipped with incinerators up to a capacity of 1 ton/day.

14.6.6 An incineration plant basically shall consist of the following units:

a) furnace or kiln;

b) afterburning chamber;

c) dry, wet or catalytic flue gas cleaning devices; and

d) waste water treatment plant.

14.6.7 Simplified flow scheme of an incinerator (see Figure 1).

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Figure 1 — Simplified flow scheme of an incinerator

14.6.8 The following firing technologies are adequate options for the thermal treatment of health-care waste:

a) degassing and/or gasification of wastes (pyrolysis);

b) rotary kiln; and

c) grate specially adapted for health-care waste.

14.6.9 If infectious waste is not burned immediately (during 48 h) it shall be deposited in a cooled storage room (10 °C max). Working and storage areas should be designed to facilitate disinfection.

14.6.10 Flue gas cleaning.

14.6.10.1 Flue gases from incinerators contain fly ash (particulates) composed of heavy metals, dioxins, furans, thermally resistant organic compounds, and gases such as nitrogen oxides, sulphur oxides carbon oxides and hydrogen halides. Flue gases resulting from uncontrolled batch mode (no flue gas cleaning) shall contain around 2000 ng TEQ/m3 (source: UNEP Dioxin and Furan Toolkit).

Flue gas cleaning

Furnace (plus after burning chamber)

Wastewater treatment

Exhaust gas

Ash

Wastewater

Flue gas

Heat recovery

Wastewater

Waste discharge

Sludges (require treatment

Ash (to disposal and stabilization)

Air

Waste


14.6.10.2 The following gas cleaning measures have to be combined in a suitable manner to ensure the application of BAT:

a) Separation of dust and non-volatile heavy metals; Fabric fitters, electrostatic precipitators and file wet scrubbers are used for dust separation. Pre-cleaning of flue gases can be done with cyclones that are efficient for separation of larger particles;

b) HCl, HF, SO2, and Hg removal; the removal of acid components and Hg can be reached by different dry or wet adsorption methods (adsorption on activated coke or lime) as well as by scrubbing (1 – or 2 – stage wet scrubbing);

c) NOx removal; primary measures consist in the use of low-NOx burners, staged combustion and recirculation of the flue gas; secondary measures are SNCR and SCR.

d) The reduction of organic emissions; and PDRSD/F can be performed by primary measures (such as limitation of the de-novo synthesis, optimized combustion) and secondary measures like dust separation, activated coke filter, flow injection with activated coke/furnace coke and lime hydrate, catalytic oxidation.

14.6.10.3 Due to the high investment and operational costs of the above equipment an economical plant operation seems often impossible. Therefore; centralized units preferred to decentralize on-site treatment of the health-care waste. Health-care waste incineration lines operated on the same site as other or municipal waste incineration will result in synergy effects and provide economic viability.

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Annex A (informative)

Waste disposal methods

Waste Category Examples Disposal

Method

Special

considerations Symbol

Non-fluid biohazardous

clinical waste

Gloves, Sponges,

Dressings,

Sanitary pads, Surgical drapes soiled or soaked with

blood, body fluids, or

secretions.

Red Bag with Biohazard

symbol.

Incineration.

Container ¾ full for

disposal.

Empty ash in pit

latrine.

Biohazardous

fluid waste

Blood, blood products, body

fluids, dialysis waste.

Dispose into

sluice.

Sharps

Needles,

scalpels, blades,

razors, other

sharps, clinical

glass.

designated,

puncture resistant,

sharps containers

Incineration.

Container ¾ full for

disposal.

Empty ash in pit

latrine.

Isolation waste

Lassa virus disease

Marburg virus disease

Ebola virus disease.

*NB: any isolation waste

not associated with viral

haemorrhagic fevers is

disposed of as biohazardous

waste.

Incineration.

Contact national

health authority.


Laboratory waste (highly

infectious)

Cultures

and stocks

Diagnostic specimens

Vaccines.

Incineration. Seal bag when ¾ full

and remove.

Anatomical

waste/ Pathological

waste

Tissues,

organs, body parts,

foetuses, placentas,

surgical

wastes, etc.

Incineration.

Seal bag

when ¾ full

and remove.

Animal waste

From research

laboratory. Incineration.

Seal bag

when ¾ full

and remove.

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Food waste

Milk, food, meat, fish, chicken,

vegetables, etc.

Incineration

landfill.

or When ¾ full, seal bag and

Take to

disposal site.

Domestic waste

Empty bulk

cartons

Food containers

Food wrappers,

etc.

Incineration

landfill or Place

separately from

food.

When ¾ full seal and

dispose of.

Cytotoxic waste Cytotoxic waste requires

incineration at 1100oC.

This must be carried out by a

licensed

contractor

Waste within healthcare facilities Handling and disposal ...€¦ · DRS 209: 2020 iii ©RSB 2020 -...

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