Hospital Waste Management


Recycling

Hospitals are usually large enough that a recycling system is economically beneficial. There is nothing special about the healthcare industry in this respect; wherever people work there is usually a lot of waste that can be recycled. Look at your local ordinances and options. You can probably get recyclable materials hauled away cheaper than it would cost to put them in the MSW stream. Recycle companies have rules about what they will accept and you want to follow their rules. Set up your waste management plan, including containers and instructions for facility personnel, to segregate waste materials that can be recycled.

Hospitals usually find they can recycle

  • Paper (including white office paper, computer printer paper, newspapers, magazines, and cardboard boxes)
  • Shipping pallets
  • Hard plastic items including polyethylene terephthalate beverage bottles, and High-density polyethylene (HDPE) containers for saline solutions and irrigation fluids.
  • Polystyrene packaging materials
  • Metals (including aluminium beverage cans and other metal containers)
  • Glass, and construction and demolition debris
  • Computer equipment and printer cartridges

Collection of Waste in Hospitals

What color system do you use?

Why types of containers do you employ? Bags, bins, etc. How and when are the bins washed?

What is the material flow of waste through the system?

Who (job title?) collects the waste from the examination rooms, operating theaters, patient rooms, radiology lab, etc, and brings them to storage? Make sure you state only a limited number of people are authorized to do this task. How are these employees trained?

How often do you empty waste containers (of all categories)? How often do your waste disposal companies come to transport the waste away?

Storage of Medical Waste in Hospitals

Although waste can be collected in plastic bags, storage for more than a day is usually in sturdy containers made of plastic or metal. See our page on storage of medical waste.

How clean are hospitals? Pretty darn clean. The average household has more bacteria per square foot than a hospital does. Hospitals have a more diverse population of pathogens because they have so many more residents. Most hospital areas have hard surface flors (not carpet) and they are washed with a disinfectant periodically. (This is not the same as saying the floors are disinfected but they are cleaned better than most buildings.) You want the storage area to be ventilated and pest-free and you want to take precautions against odors.

On-site Treatment

In decades past every hospital had an incinerator onsite. Incineration can be an excellent method for treating medical waste but for various economic and social reasons, few hospitals in the US now have one. If you have one at your hospital, you save on disposal costs. But you also have the headache of incinerator operation, with an EPA permit for emissions, handling and disposal of ash, cost to run the incinerator (fuel and labor), training for staff, and emergency equipment associated with operating the unit.

Most hospitals now ship their waste that will be incinerated off-site. Central incinerators service multiple hospitals can be more efficient and generate economies of scale that individual incinerators cannot. Sometimes hospitals chains will have a disposal unit, or hospitals will form a partnership to operate the incinerator. Other models include incinerators run by independent waste companies that accept fees from waste generators. Long-term contracts are generally used as they reduce risk for everyone.

Autoclaving: Hospitals use autoclaves to sterilize medical equipment. They often have separate autoclaves for deactivating biohazardous waste.

See our page on treatment for other methods of treatment. Sometimes treatment happens at the hospital and sometimes it happens at an external TSDF (treatment, storage, and disposal facility.)

Solidification/encapsulation

Hospitals may have absorbents to make sludges or slurries more solid and less likely to spill. This type of absorbent is probably not sufficient for immobilizing waste for disposal in a landfill. Subsequent treatment usually happens at an off-site treatment facility.

The hospital waste management plan

All hospitals, even the smallest, should have a waste management plan. There is no standard plan you can adopt. You can copy elements of plans for other locations and organizations, but you must tailor them to your own situation. No two hospitals are exactly the same. If you hire a consultant who has written plans for other hospitals, he or she will probably largely copy an old plan. But it can’t be an exact copy because other hospitals don’t have your waste production details and your facility layout.

Elements you need in your plan:

Facility description - physical and geographical description. Plan of buildings.

Operational description - what kind of hospital it is, how many beds, how many operating theaters, size of emergency room, maternity ward, special focuses.

Potential accidents and known risks - as related to waste. Of course there are many hazards in a hospital;

Categories of waste you use in your inventory and management system. Estimate of monthly and/or annual production of waste in total and by category.

Methods of collecting and segregating waste - types of standard collection bins and containers, schedule for emptying them, where waste is sorted and staging areas during the collection process, if any.

How and where waste is stored on site prior to disposal. - physical description of the rooms, description of the storage containers and pallets, how long waste typcially resides on site before disposal.

Inventory and tracking system for waste. - bar codes, reports, etc.

Any treatment on site.

Plans for turning over waste to disposal companies. How often this will happen? What is the schedule for shipments? Note that under RCRA hazardous waste shipments must meet criteria for manifests.

Maximum quantity of waste that will be stored on site, broken down by category.

Contact people. Names and phone numbers of waste management personnel.

  • The waste manager, if there is one (and there should be one in a big facility)
  • The facilities manager
  • The environmental manager
  • Occupational safety manager
  • Infection control manager

Who gets a copy?

Ideally, you should be open about giving the plan to anyone who wants it. But that is up to you. There is no legal requirement that you give the plan to anyone.

More on waste management plans.

Success? YES!

The good news is that hospital waste management programs are effective. The CDC says it does not know of a situation in which waste leaving a hospital has “caused disease in either the health-care setting or the general community.”