HEALTH CARE WASTES & MANAGEMENT 7 CATEGORIES OF HEALTH CARE WASTES

HEALTH CARE WASTES INFECTIOUS WASTES

− Refers to all solid or liquid wastes generated by any − All wastes suspected to contain pathogens or toxins
of the following activities: in sufficient concentration that may cause disease
▪ Diagnosis, treatment and immunization of to a susceptible host.
humans − BIN: Strong leak-proof bin with cover labelled
▪ Research pertaining to diagnosis, treatment, “Infectious” with biohazard symbol.
and immunization of humans − LINER: Yellow plastic that can withstand
▪ Research using laboratory animals geared autoclaving with 0.009 mm thickness & labelled
towards improvement of human health “Infectious Waste” with a tag indicating source and
▪ Production and testing of biological products weight of waste & date of collection; may or may not
▪ The activities performed by a health care facility have biohazard symbol.
that generates wastes − It includes discarded materials or equipment used
for diagnosis, treatment, and management of
HEALTH CARE WASTE GENERATORS patients with infectious diseases. Examples include
− All health care facilities, institutions, business discarded microbial cultures, solid wastes with
establishments, and other spaces where health infections such as dressings, sputum cups, urine
care services are offered with activities or work containers, and blood bags, liquid wastes with
processes that generate health care wastes. infections such as blood, urine, vomitus, and other
body secretions, and food wastes (liquid or solid)
FACILITIES coming from patients with highly infectious
− Hospitals and medical centers diseases.
− Infirmaries
− Birthing homes PATHOLOGICAL AND ANATOMICAL WASTE
− Clinics and other health-related facilities − Refers to tissue sections and body fluids or organs
▪ Medical derived from biopsies, autopsies, or surgical
▪ Ambulatory procedures sent to the laboratory for examination.
▪ Dialysis − BIN: Strong leak-proof bin with cover labelled
▪ Health care centers and dispensaries “Pathological/ Anatomical Waste” with biohazard
▪ Surgical symbol.
▪ Alternative medicine − LINER: Yellow plastic that can withstand
▪ Dental autoclaving with 0.009 mm thickness & labelled
▪ Veterinary “Pathological/Anatomical Waste” with a tag
− Laboratories and research centers indicating the source and weight of waste & date of
▪ Medical and biomedical laboratories collection. Biohazard symbol is optional.
▪ Medical research centers − Examples include internal organs and tissues used
▪ Blood banks and blood collection services for histopathological examinations. Anatomical
▪ Dental prosthetic laboratories waste is a subgroup of pathological waste that
▪ Nuclear medicine laboratories refers to recognizable body parts usually from
▪ Biotechnology laboratories amputation procedures.
▪ Animal research and testing
▪ Drug testing laboratories SHARPS
▪ HIV testing laboratories − Refer to waste item that can cause cuts, pricks, or
− Drug manufacturers punctured wounds. They are considered the most
− Mortuary and autopsy centers dangerous health care waste because of their
− Institutions potential to cause both injury and infection.
▪ Drug rehabilitation centers − BIN: Puncture-proof container with wide mouth and
▪ Training centers for embalmers cover labelled “Sharps” with biohazard symbol.
▪ Medical technology internship centers − LINER: Not applicable (red)
▪ Schools of Radiologic technology − Examples include used syringes in phlebotomy,
▪ Medical schools blood lancets, surgical knives, and broken
▪ Nursing homes glasswares.
▪ Dental schools
CHEMICAL WASTE IMPACT OF HEALTH CARE WASTES
− Refers to discarded chemicals generated during
disinfection and sterilization procedures; also ▪ Humans are at risk of being injured/infected
includes wastes with high content of heavy metals (sharps-inflicted injuries)
and their derivatives. ▪ Toxic exposure (pharmaceutical products)
▪ Toxic ▪ Flammable ▪ Chemical burns
▪ Corrosive ▪ Reactive ▪ Air pollution
− BIN: Labelled “Chemical Waste”; for liquid chemical ▪ Thermal injuries
waste, inside the bin is a disposal bottle made of ▪ Radiation burns
amber-colored glass with at least 4 liters capacity ▪ Wastes ended up in sea off Mactan Island
that is strong, chemical-resistant, and leak proof.
− LINER: Yellow with black band plastic with 0.009 LEGISLATION, POLICIES, & GUIDELINES
mm thickness and labelled “Chemical Waste” with a GOVERNING HCW
tag indicating source and weight of waste and date
of collection.
A. INTERNATIONAL AGREEMENTS:
PHARMACEUTICAL WASTE ▪ The Montreal Protocol on substances that
− Refers to expired, spilt, and contaminated deplete the ozone layer
pharmaceutical products, drugs, and vaccines. ▪ The Basel Convention on the control of the
− BIN: Strong leak-proof bin with cover labelled transboundary movements of hazardous wastes
“Pharmaceutical Waste” for expired drugs and drug and their disposal
containers and “Cytotoxic Waste” for cytotoxic, ▪ The United Nations framework convention on
genotoxic, and antineoplastic waste. climate change
− LINER: Yellow with black band plastic with 0.009 ▪ The Stockholm Convention on persistent
mm thickness and labelled “Pharmaceutical Waste” organic pollutants
with a tag indicating source and weight of waste and ▪ The ASEAN Framework agreement on the
date of collection. facilitation of goods transit

RADIOACTIVE WASTE B. NATIONAL LAWS & POLICIES ON HCW

− Refers to waste exposed to radionuclides including MANAGEMENT:
radioactive diagnostic materials or radiotherapeutic ▪ RA No. 4226
materials. ▪ RA No. 6969
▪ cobalt (Co 90) ▪ RA No. 8749
▪ technetium (99 Tc) ▪ RA No. 9003
▪ iodine (131 I) ▪ RA No. 9275
▪ iridium (192 Ir) ▪ DOH “Manual on HCW Management”
▪ Irradiated blood products
GREEN PROCUREMENT POLICY
− BIN: Radiation proof repositories, leakproof, and
▪ An approach in minimizing wastes
lead-lined container labelled with the name of
▪ Involves 2 aspects: WASTE PREVENTION &
radionuclide and date of deposition with radioactive
WASTE REDUCTION
symbol.
− LINER: Orange plastic with 0.009 mm thickness Health Care Waste Management Hierarchy
and labelled “Radioactive” with a tag indicating
name of radionuclide and date of deposition.

NON-HAZARDOUS OR GENERAL WASTE

− Refers to wastes that have not been in contact with
communicable or infectious agents, hazardous
chemicals, or radioactive substances, and do not
pose a hazard.
▪ Recyclable
▪ Biodegradable
▪ Non-recyclable/non-biodegradable
− BIN: Optional recycle symbol for recyclable non-
hazardous wastes; varying sizes depending on the
volume of waste.
− LINER: Black or colorless plastic for non-
biodegradable and green for biodegradable with
0.009 mm thickness with a tag indicating source,
weight of waste, and date of collection.
 TREATMENT OF HCW DISPOSAL OF HCW

1. PYROLYSIS LANDFILL
− Thermal decomposition of HCW in the absence − Engineered site designed to keep waste isolated
of supplied molecular oxygen in the destruction from the environment
chamber where the waste is converted into SAFE BURIAL
gaseous, liquid or solid form and are disposed − For healthcare facilities in far areas with no
in a landfill. access to landfill
2. AUTOCLAVE USE OF SEPTIC OR CONCREATE VAULTS
− Use of steam sterilization set at 121°C with a − Recommended for sharps and syringes
pressure of 15 psi for 15-30 minutes. A color
changing tapes can be used to check the KEY POINTS
validity of sterilization. ▪ Health care wastes are by-products of the
3. MICROWAV activities performed by a health care facility.
− Use of moist heat to 100°C (237.6°F) for 30 ▪ Health care facilities generate large amounts of
minutes; destroys microorganisms irreversibly wastes which can be harmful to patients, health
coagulates and denatures enzymes and personnel, the general population, and the
structural proteins. environment.
4. CHEMICAL DISINFECTION ▪ There are seven categories of health care wastes
− Application of chemicals (sodium hypochlorite, with designated colors, labels, markings, and
hydrogen peroxide, peroxyacetic acid, heated specifications for their disposal.
alkali) ▪ There must be a proper procedure for the
5. BIOLOGICAL PROCESS generation, segregation, collection, storage,
− Uses enzyme mixture where the by-product is transport, treatment, and disposal of health care
placed in an extruder to remove water for wastes.
wastewater disposal. ▪ The proper management of health care wastes
6. ENCAPSULATION should focus primarily on waste minimization.
− Involves the filling of containers with waste, ▪ The success of health care waste management
adding and immobilizing material, and sealing systems depends on the adherence of all the
the containers. Disposal is done thru a landfill. personnel of a health care facility on the existing
7. INERTIZATION laws, guidelines and policies regarding health care
− Useful in pharmaceutical waste that involves wastes.
mixing of waste with cement and other
substances before disposal.