Classification of Medical Waste

Does every facility have the same classification scheme? No. In fact it’s better if they don’t. The classification scheme can follow regulatory categories (hazardous, radioactive) but large facilities usually have more categories than that. The waste manager determines which categories are appropriate.

Waste management is difficult partly because the waste is heterogeneous. Variety increases costs for collection, storage, treatment, and disposal. Segregation, one of the principles of medical waste management, is important, and having different categories supports segregation, but there is a trade-off as more categories increase complexity.

Richness is a simple count of the number of different types. The boundaries of different types of waste are not straightforward necessarily, but are drawn from a combination of judgment calls (from experienced engineers/waste managers), formal regulations, and industry norms. Types of treatment may inform waste categories, but should not dictate categories by themselves. Ways to characterize waste include:

  • Presence of listed constituents per RCRA
  • Characteristics that meet RCRA
  • Presence of radioactive materials/criteria for radioactive waste
  • Nature of infectious material
  • Physiological source (blood, lymph, flesh)
  • Clinical source (operating room, intensive care unit)

So richness is just a count of different types. One facility may produce four categories of waste, and another six categories. The second facility is more rich in waste. The word “rich” implies that richer is better than less rich, and in the field of ecology this is generally true. But it is not true in the field of waste management. Richness makes things more complicated and expensive.

We can get a more nuanced characteristic of waste diversity if we factor in the amounts of each type of waste. The Shannon Index, borrowed from information science, takes into account variety (richness) and quantities (however measured) to come up with a measure of diversity. Also called the Shannon Wiener index.and Shannon-Weaver index. Related measures include Renys entropy and the Simpson Index.

How useful are these indices in waste management? For day-to-day activities, not useful. But for long-term planning, strategic planning, it can possibly be of use, especially when comparing situations at different facilities. Or in planning locations of facilities. If you can put operations in locations such that the diversity index is lower, all other things being equal, you win.

A set of waste streams with high richness but low diversity can be said to be even. Evenness is neither good nor bad from a waste management standpoint.