Medical Waste Reduction

Reducing production of waste is - other things being equal - almost always a good idea. It saves money on treatment and disposal costs and it reduces liability risk.

Clinics and centers can reduce their waste costs by choosing wisely in purchasing and by proper inventory management. It takes some thought, but (1) picking supplies that produce a less hazardous waste product and (2) using as much as possible (preferably all) or the material in a container benefits your overall waste management profile.

The 1984 amendment to RCRA made waste minimization “the nation's preferred hazardous waste management practice.”

The 1990 Pollution Prevention Act says "the national policy of the United States that pollution should be prevented or reduced at the source whenever feasible".

There is little the government can do to force producers to minimize waste, but the entire waste management community agrees reducing production of waste is an admirable goal. You can reduce waste in many ways. Techniques such as product substitution, and process substitution can reduce the quantity of end waste and often the toxicity of the waste. Of course, blindly cutting waste production is not always a good idea. There are diminishing returns after a while, and competing demands (e.g. the need for patient care), means isn’t always preferable to cut waste.

Getting Started

One great way to start is with how you bring materials into your facility. Some organizations have adopted an environmentally preferable purchasing (EPP) philosophy.

This means choosing items likely to generate low quantities of final waste when they leave the building, and that are less likely to include, release, or cause generation of hazardous materials.

Some EPP and inventory management tactics include:

  • Rotate chemical stock to keep chemicals from becoming outdated.
  • Order smallest container of material necessary for use.
  • Review your inventory periodically to remove unwanted or unusable chemical stocks.
  • Only purchase gas cylinders from manufactures who will accept the return of the partially used or empty cylinders.
  • Returning unopened pharmaceuticals to the supplier.

Polyethylene, polypropylene and polyethylene terephthalate (PET) are easily recycled plastics. Polyvinyl chloride (PVC) is the most problematic of the common plastics. It is sometimes difficult to choose the best EPP products, and few organizations make it their only decision criteria (cost still counts). But over time you may be able to reduce the negative impact your organization has on the environment and build a more sustainable operation. Actions like buying recycled paper where it can be used contribute to EPP. Adopting life-cycle thinking in evaluation of major purchases also could be a goal. Also, over time you can push your suppliers to be more economical in use of packaging material.

Often the facility's waste management plan has a section describing waste minimization goals. Possible good ones:

  • Increased use of recycled paper (specify percentage)
  • Material reduction goals and objectives. Set targets for reducing the amount of each waste sent to landfill.
  • Waste per patient/bed/etc.
  • Specify waste treatment areas, storage areas, and transport modes, including what materials are being segregated on site for reuse or recycling.
  • Personnel training plan and how personnel about and training to support and encourage participation from everyone on site.

Resource: World Health Organization publication on Waste minimization, recycling, and reuse.