Public Health Agency

Waste Management

Key Points

Healthcare waste (also known as clinical waste) may prove hazardous to those that come into contact with it and are subject to stringent controls.

The term ‘hazardous waste’ is used in England, Wales and Northern Ireland to describe waste with hazardous characteristics in line with the List of Wastes (LoW) regulations, which transpose the European Waste Catalogue (EWC) into domestic legislation and provide codes for all hazardous and non-hazardous wastes.

All healthcare organisations should have a waste policy which specifies how an organisation manages its waste and identifies who is responsible for this within the organisation

Introduction

The management of healthcare waste is an essential part of ensuring that healthcare activities do not pose a risk or potential risk of infection and are securely managed (Health Technical Memorandum 07-01). The HTM 07-01 is a UK-wide guideline which provides a framework for best practice waste management; it covers a range of waste streams produced directly from healthcare activities and provides practical advice for all those involved in the management of healthcare waste.

Although the HTM 07-01 is relevant to all four UK countries, some countries have adopted the guidance to suit their devolved health systems and therefore differences do exist with respect to some practices and the colour coding of waste containers.

The safe management of healthcare waste is the responsibility of all healthcare professionals and all staff must understand how waste should be classified, segregated and stored prior to collection or disposal (RCN, 2014).

The HTM 07-01 guidance covers a range of waste streams produced directly from healthcare activities. The guidance provides practical advice for those involved in the management of healthcare waste and is applicable to anyone who comes into contact with or manages healthcare waste. The following table, taken from the guidance, provides an overview for example roles and most relevant chapters. Local arrangements should also be considered.

Who should use this guidance?

Which chapters are most relevant?

Directors/senior management

Chapter 3 – ‘Legislation and healthcare waste’

Chapter 6 – ‘Managing compliance’

Waste managers/transport managers

All chapters

Estate managers

All chapters

Environmental/sustainability managers

All chapters

Procurements/purchasing

Chapter 3 – ‘Legislation and healthcare waste’,

Chapter 4 – ‘Healthcare waste definitions and classifications’, Chapter 5 – ‘Waste minimisation, segregation, colour-coding and storage’

Housekeepers and porters

Chapter 4 – ‘Healthcare waste definitions and classifications’

Chapter 5 – ‘Waste minimisation, segregation, colour-coding and storage’

Chapter 6 – ‘Managing compliance’

Chapter 7 – ‘Transport packaging and operations’

Cleaning staff

Chapter 4 – ‘Healthcare waste definitions and classifications’, Chapter 5 – ‘Waste minimisation, segregation, colour-coding and storage’

Nursing staff and doctors and support teams

Chapter 3 – ‘Legislation and healthcare waste’

Chapter 4 – ‘Healthcare waste definitions and classifications’ Chapter 5 – ‘Waste minimisation, segregation, colour-coding and storage’

Chapter 6 – ‘Managing compliance’

Infection prevention and control staff

Chapter 3 – ‘Legislation and healthcare waste’

Chapter 4 – ‘Healthcare waste definitions and classifications’ Chapter 5 – ‘Waste minimisation, segregation,colour-coding and storage’

Chapter 6 – ‘Managing compliance’

Waste contractors and consultants

All chapters

The following diagram, taken from the HTM 07-01, provides a summary of the key sections of the guidance with a brief overview:

Key Sections

The full HTM 07-01 guidance can be found at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/167976/HTM_07-01_Final.pdf

Segregation of waste

Segregation of waste is essential for compliance with waste regulations. To ensure effective segregation, appropriate colour coding of waste containers should be used. The HTM 07-01: Safe management of healthcare waste guidance provides colour coding for waste containers which can be quickly used to identify the types of waste which should be disposed into them.

However there has been a Northern Ireland Amendment to this – Safe management of healthcare waste 7658:2.0: Northern Ireland:

Waste information

Notes

  1. The use of Black/Orange for offensive/hygiene waste was chosen as these colours denote that the waste is of a non-infectious nature but contains materials that derive from a healthcare setting that need to be treated differently from standard Domestic waste
  2. The colour ‘red’ is new to the colour coding system in this edition. Care should be taken when ordering red containers to ensure that they can be clearly differentiated from orange. The colour coding could be agreed as part of a contact
  3. Cytotoxic and Cytostatic Wastes have a recognised label placed onto the rigid container to differentiate from other pharmaceutical waste products. This label should be available to all departments that produce Cytotoxic/Cytostatic Waste
  4. The colour ‘brown’ denotes compostable or food waste, the receptacles or sacks should be biodegradable as agreed as part of a contract specification

Sharps

Sharps found in the healthcare setting include hypodermic syringe needles, suture needles and scalpels. All sharps should be disposed of in a suitable container:

Sharps information

In practice, most healthcare organisations/facilities use purple lidded sharps receptacles for cytotoxic/cytostatic sharps and yellow or orange lidded sharps receptacles for all other sharps.

The Procurement and Logistic Service (PaLS) healthcare waste segregation poster for N. Ireland can be found here (insert link to poster)

References

Department of Health (2013) Health Technical Memorandum 07-01: Safe management of healthcare waste. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/167976/HTM_07-01_Final.pdf

Royal College of Nursing (2014) The management of waste from health, social and personal care. Available at: https://www2.rcn.org.uk/__data/assets/pdf_file/0003/572079/RCN_waste_guidance_2014.pdf