Clinical Waste Management
What Is Clinical Waste?
- Any waste consisting wholly or partly of human or animal tissue, blood or other body fluids, excretions, drugs or other pharmaceutical products, swabs or dressings, or syringes, needles or other sharp instruments, being waste which unless rendered safe may prove hazardous to any person coming into contact with it; and
- Any waste arising from medical, nursing, dental, veterinary, pharmaceutical or similar practices, investigation, treatment, care, teaching or research, or the collection of blood for transfusion, being waste which may cause infection to any person coming into contact with it.
In addition some clinical waste, by virtue of its properties, is classified as special waste and is therefore subject to the Hazardous Waste (England & Wales) Regulations 2005 and the Special Waste Amendment (Scotland) Regulations 2004.
The packaging and storage of clinical waste is particularly important. Sharps (spent needles, etc.) must be put into secure rigid containers. Other clinical waste should be placed into yellow plastic clinical waste bags. All clinical waste should be stored in a secure, locked container.
Clinical waste must be disposed of at a facility licensed to take clinical waste. In the majority of cases this will mean disposal by incineration although some clinical wastes can be successfully sterilised at specially designed facilities.
Documentation for disposal must comply with controlled waste and hazardous/special waste requirements if appropriate as outlined in previous sections.
Be In The Know
Most frequent questions and answers
The majority of all clinical waste is incinerated, which is one of many waste-to-energy technologies available today. This is a waste treatment process that employs very high temperatures, resulting in the combustion of organic substances found in clinical waste materials.
During the thermal treatment, the incinerated materials are turned into nothing but gas, ash & heat. The high-temperature heat generated through incineration can then however be recycled as heat energy. The incineration process is also proven to reduce the mass of the original waste by more than 80%, as well as the volume of the waste by over 95%, leaving only a fraction of waste to ends up in a landfill site.
- Keep waste to a minimum by doing everything you reasonably can to prevent, reuse, recycle or recover waste (in that order)
- Sort and store waste safely and securely
- Complete a waste transfer note for each load of waste that leaves your premises
- Check if your waste carrier is registered to dispose of waste
- Not allow the waste carrier to dispose of your waste illegally (and report them to crimestoppers if they do)
You can seek advice from a specialist waste contractor if you’re not sure whether it’s hazardous or not.
For more information, contact the Environment Agency.
Telephone: 03708 506 506
Minicom: 03702 422 549
Monday to Friday, 8am to 6pm
In most cases you can check the waste code or codes associated with your type of waste – it’ll have an asterisk if it’s hazardous.
Some waste may have both hazardous and non-hazardous entries, depending on whether it contains dangerous substances at or above certain levels.
In these cases, you must determine the waste’s composition and assess if it has hazardous properties or components before you can classify it – check the manufacturers’ product safety data sheets for this information.
Many products include orange and black danger symbols or red and white hazard. Epictograms to indicate they’re hazardous.
Your description must include:
- the waste classification code, also referred to as LoW (List of Waste) or EWC (European Waste Catalogue) code – you can find some common classification codes in parts 2 to 6 of this guide
- whether it’s hazardous
- the type of premises or business where the waste was produced
- the name of the substance or substances
- the process that produced the waste
- a chemical and physical analysis
- any special problems, requirements or knowledge related to the waste
Where there is the presence of clinical waste, there will be a warning sign making you aware.
Warning signs may vary.
As part of a general safety policy required under S 2(3) of the Health and Safety at Work etc. Act 1974, all organisations should have clearly defined strategies for the segregation, storage, transport and disposal of clinical waste. Clinical waste is defined as controlled waste, so the provisions of the EPA 90 including the Duty of Care apply.
What Is Personal Protective Equipment (PPE)?
The following are common items of ppe that you’ll find in most health care settings and care homes:
- Disposable gloves
- Disposable plastic aprons.
There are other items of ppe that you may be asked to use on occasion in your workplace – you will be advised about this by your manager or supervisor.
Disposable gloves should only be worn if you’re performing or assisting in a procedure that involves a risk of contact with body fluids, broken skin, dirty instruments and harmful substances such as chemicals and disinfectants. Gloves should not be routinely used or put on ‘just in case’. This is dangerous for the patient/client as you will not be able to wash your hands when you are wearing gloves. Gloves need to be used in specific circumstances only. This includes procedures that involve:
- A risk of being splashed by body fluids (blood, saliva, sputum, vomit, urine or faeces, for instance)
- Contact with the patient’s/client’s eyes, nose, ears, lips, mouth or genital area, or any instruments that have been in contact with these
- Contact with an open wound or cut
- Handling potentially harmful substances, such as disinfectants.
Note that disposable gloves are not necessary for many parts of routine day-to-day care, like helping a patient/client to wash and dress or bed-making.
The gloves should:
- Fit you comfortably (not be too tight or too loose)
- Be changed between patients/clients and between different tasks with the same patient/client
- Never be washed or reused.
When you’ve finished the procedure, you should take the gloves off, avoiding touching the outer surfaces (which are likely to be contaminated with germs), and dispose of them in the correct waste-disposal system. You must then perform hand hygiene. You can read the rcn guide on glove use and the prevention of contact dermatitis (a skin condition that can arise if gloves are used incorrectly over time).
Some gloves have a substance called ‘latex’ that can cause serious allergies. If you know you have an allergy to latex, you must tell your employer so that alternative gloves can be supplied. You will also be told when particular patient/clients have latex allergies and mustn’t have contact with latex gloves. Some nursing staff experience sore hands as a result of their job, usually caused by a mixture of things such as wet work (bathing, washing patients), using wipes and alcohol hand gel, wearing gloves and not drying their hands properly. If you have sore hands you should tell your manager and report it to you occupational health department or lead.
These aren’t needed to carry out many normal aspects of day-to-day care with patients/clients, such as helping them to go for short walks, but you will need one when you are:
- Performing or assisting in a procedure that might involve splashing of body fluids
- Performing or helping the patient/client with personal hygiene tasks
- Carrying out cleaning and tidying tasks in the patient’s/client’s living space, such as bed-making.
You must always perform hand hygiene before putting a disposable gown on and after taking it off and placing it in the correct clinical waste bin.
Note that different organisations have different-coloured aprons for different tasks – you should always check your workplace’s local policy.
Applying, removing and disposing of ppe
As we’ve mentioned, ppe will only protect you and others if you know how to put it on and take it off correctly and dispose of it safely. The following gives you some general guidance, but specific ppe items vary. Your employer and registered staff in your area will be able to advise you.
- Select correct glove size and type.
- Perform hand hygiene.
- Pull to cover wrists.
- Grasp the outside of the glove with the opposite gloved hand and peel off.
- Hold the removed glove in the gloved hand.
- Slot your finger under the lip of the remaining glove and peel it off, taking care not to touch the contaminated outer surface.
- Dispose of the gloves in the clinical waste bin.
- Perform hand hygiene.
Aprons must always be changed after you finish care activities with each person.
Pull the apron over your head and fasten at the back of your waist.
- Unfasten (or break) the ties.
- Pull the apron away from your neck and shoulders, lifting it over your head and taking care to touch the inside only, not the contaminated outer side.
- Fold or roll the apron into a bundle with the inner side outermost.
- Dispose of the apron in the clinical waste bin.
- Perform hand hygiene.
Supporting document created by the NHS on Standard Operating Procedure for Clinical and Offensive Waste