Best Practice: Infection Control - Disposal of Clinical Waste
October 24 2019
Clinical waste consists of waste that has come from healthcare activities and can pose a risk to public health or the environment if not disposed of properly. It must be handled and collected under controlled conditions and should not be disposed of with any other wastes.
What is clinical waste and the types of waste?
Most of the waste that is produced by healthcare practices is classified either as non-hazardous or hazardous clinical waste and will need disposing of in the correct manner.
Offensive Clinical Waste
This is classed as waste that is non-hazardous but may still have an offensive odour or be unpleasant in any way. They can usually be disposed of by incineration or deep landfill disposal.
Examples include:
- Nappies
- feminine hygiene products
- used but uncontaminated PPE (has not been in contact with an infected patient)
- incontinence waste.
This is non-infectious waste and does not require specialist treatment or disposal.
Potentially Hazardous Clinical Waste
Examples of potentially hazardous clinical waste include:
- Human or animal tissue
- Bodily fluids
- Excretions
- Drugs
- Pharmaceutical products
- Swabs or dressings
- Syringes or needles
It is essentially any waste that has come from medical, dental, nursing, veterinary or pharmaceutical practices. This also includes investigations, treatments, teaching, research or the collection of blood for transfusion. Hazardous clinical waste is any waste that will cause infection if it comes in contact with someone.
Waste medicines, such as drugs that have gone past their sell-by date, are normally classified as to whether or not they are considered to be cytotoxic or cytostatic. This means they are of the following:
- They are acutely toxic
- They have carcinogenic properties
- They are mutagenic
- Can be toxic to pregnant people
Clinical waste regulations
In the United Kingdom, there is legislation in place to ensure that clinical waste is managed and disposed of safely and properly. This helps to protect the environment and make sure it remains free from any harm. These legal obligations have been made so that organisations can provide advice and recommendations to make certain that clinical waste is handled, disposed of and transported in a safe and effective way.
All clinical waste handling and disposals must comply with the following regulations:
- The Environmental Protection Act 1990 - including the Duty of Care Regulations
- The Controlled Waste Regulations 2012
- The Hazardous Waste Directive 2011
- The Carriage of Dangerous Goods Regulations
Under the main legislation act of clinical waste disposal - Environmental Protection Act 1990 - all producers of waste have a Duty of Care to ensure that the waste is managed properly. It states that it is “unlawful to deposit, recover or dispose of controlled clinical waste management licences or in a way that causes pollution of the environment or harm to human health.”
Some clinical waste is classified as special waste and is subject to the Hazardous Waste (England & Wales) Regulations 2005 and the Special Waste Amendment (Scotland) Regulations 2004.
Correct disposal
This table acts as a guide regarding the correct disposal of clinical waste, detailing the type of clinical waste bin to use.
| Type of clinical waste bin | Contents |
|---|---|
| 60 litre rigid container ‘orange lid’ burn bin (Rigid container) | This should contain infectious or potentially infectious clinical waste that has been contaminated by bodily fluids such as blood. |
| Various sized ‘orange lid’ sharps bin | This is for laboratory clinical sharps that have been contaminated with human tissue.This bin must then be placed inside a red lidded burn bin for proper disposal. |
| Various sized ‘purple lid’ sharps bin | This is for cytotoxic and Cytostatic sharps and plasticware that has been contaminated with either phenol, chloroform or formamide. |
| 30 litre rigid container ‘purple lid’ burn bin | This is for clinical waste that has been contaminated with cytotoxic and cytostatic material. |
| 60 litre rigid ‘yellow lid’ burn bin | This is for any laboratory clinical waste that isn't suitable for any sort of heat treatment. Must not be used for sharps. |
| 60 litre rigid container ‘red lid’ burn bin | This is for: ● Human anatomical waste ● Human tissue waste ● Animal anatomical waste - to be also put in green freezer bags (see below for more) |
| Green freezer bags | This is for any animal anatomical waste that is most likely to undergo putrefaction. It should be placed in these bags and labeled before it is frozen. Paper tissues that have been contaminated with animal tissue or fluids also needs to be placed within the bag. You shouldn’t put anything in the bag. Do not place the lids on these bins. You should place these bags in the bins that are in the freezer to give waste shape when it is frozen. |
How to dispose of clinical waste properly
The correct disposal of clinical waste is an essential part of health and safety, infection control and over all good hygiene. The types of waste are categorised as:
- Sharps waste
- Clinical waste
- General waste
Each of which must be disposed of immediately after being used.
Sharps waste must be disposed of in designated sharps bins and these bins should never be used for the disposal of any other type of waste - this is because it will increase the risk of needlestick injury, as well as leading to an unnecessary increase in waste disposal costings. Sharps bins ensure safety is maintained at all times and each bin is colour coded to ensure that they are being used correctly.
Clinical waste includes contaminated materials such as swabs, gloves, catheters etc. and yellow clinical waste bags are available for this type of waste. You should never dispose of general waste in these bags.
General waste such as be disposed of in general waste bins/bags and under no circumstances should other materials, such as sharps or clinical waste, be disposed of in general waste bins.
Each container is labeled and indicates what type of disposal is required, in order to meet certain guidelines and make sure that they are used in a correct manner. There are instructions on each label, as well details on keeping the contents and those using it safely.
Containers need to be positioned correctly, using either a bracket or a tray. The containers should never be overfilled and should only ever reach up to the safe fill line when it is applicable. When the waste inside reaches the line it should be locked (details of how to do this are shown on the back) and then disposed of in a safe way. Care must be taken at all times when handling all Sharps and Clinical containers.