Topic 3 Healthcarewm

TOPIC 3
COLLECTION, SEGREGATION,
TRANSPORT,
TREATMENT & DISPOSAL
METHODS
Sadat International, Inc.

Engineering and Environmental Services Sadat Associates, Inc.
TOPIC 3 – COLLECTION through DISPOSAL

• Classification
• Segregation
• Minimization
• Collection
• Basic Questions
• Key Points
• General Principles
• Minimum Approach
• Enhancements
• Contingency Measures

CLASSIFICATION
Types of waste from a health-care facility:
• Regular garbage (non-risk waste)
• Hazardous healthcare waste
– Biohazardous waste or infectious waste
(includes sharps and pathological or
anatomic waste)
– Hazardous chemical and radioactive waste
(also includes pharmaceutical waste)
CLASSIFICATION
cont’d
Category Examples
Sharps Hypodermic needles, syringes, suture needles, scalpel and other blades,
lancets, saws, knives, broken or unbroken glass, vials, tubes, pipettes, etc.
Cultures and Stocks Human and animal cell cultures, stocks of etiologic agents, discarded live
and attenuated vaccine or serum, culture dishes and other devices used to
transfer, inoculate or mix cell cultures
Human Blood, Free-flowing blood or blood components, semen, vaginal secretions,

cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, pertitoneal
Blood Products, and fluid, amniotic fluid, saliva in dental procedures, and body fluids contaminated
Body Fluids with blood; materials saturated or dripping with liquid blood and body fluids
Pathological Waste Tissues, organs, anatomical waste (recognizable body parts except teeth)
removed during surgery, autopsy or other procedures
Selected Isolation Swabs, excreta, soiled dressings, drainage sets, items saturated or dripping
with human blood, etc. from patients infected with highly communicable
Waste diseases
SEGREGATION
• Separation of healthcare waste from non-
healthcare waste at or near the point of
generation.
• Maintaining the separation during
storage, transport, until treatment.


SEGREGATION
cont’d
• Assess the appropriate number of containers:
– Too many yellow bags or too few black bags
Æ over classification
– Too few yellow bags or too many black bags
Æ insufficient segregation
• Have both containers yellow black
side by side in areas where both types of
waste are generated.
• Monitoring and evaluation.
• Staff training.
Two containers as viewed from
Note : Yellow or red bags are used. above
MINIMIZATION:
Cost Reduction Strategies
• Reduction, to the greatest extent

possible, of waste that is destined
for ultimate disposal.


MINIMIZATION:
cont’d
Techniques
– Segregation
– Source Reduction
• Inventory control
• Employing reusable products
– Recovery and Reuse
• Silver recovery from photographic chemicals
MINIMIZATION:
cont’d
Techniques, cont’d
– Recycling
• Recycling office paper, newspapers,
aluminum cans, glass bottles, used beds,
construction debris, etc.
– Composting
• Composting organic food and yard waste.

WASTE COLLECTION: Types of Wastes
TYPE OF SPECIFICATIONS FOR EXAMPLES
WASTE CONTAINER OR BAG
Sharps - Container should be puncture-resistant, - Empty bleach bottle with a

leak-proof on the sides and bottom, and biohazard label
durable. - Thick rigid puncture-resistant
- Container should have the biohazard label. cardboard box with a biohazard
- Container should be closable if used to label
transport sharps waste. - Rigid plastic container with a
biohazard label
Non-sharps - Plastic bag should be leak-proof; designed - Plastic bag placed in a yellow
to prevent ripping, tearing, or bursting under painted garbage can or bin with the
biomedical normal use. The plastic bag should be placed biohazard label
solid and inside a rigid container. - Yellow plastic bags should be
semi-liquid - Rigid container should be leak-proof, used as soon as they are available
durable, labeled with the biohazard symbol,
waste and colour-coded.
Non-sharps - Container should be leak-proof and durable. - Bottles, vials, plastic containers,
- Container should be marked with the canisters, pails
biomedical biohazard label if it will be used to transport
liquid waste waste.
- Container should be designed such that it
can be transported without spillage.

WASTE COLLECTION
cont’d
Sharps
Any sharp instrument or object including needles,
syringes, blades, lancets, broken glass, pipettes, etc.
• Sharps should be disposed of in puncture-resistant sharps
containers.
• Sharps containers should be readily accessible in areas
where sharps are used.
• Sharps containers should only be filled up to 3/4ths full.


WASTE COLLECTION
cont’d
RECAPPING SHOULD BE
DISCOURAGED BUT IF USED,
FOLLOW ONE-HAND RULE
1. Place the cap on a flat surface and remove your hand.
2. With one hand, hold the syringe and use the needle to
“scoop up” the cap.
3. After the cap slides over and covers the needle completely,
use the other hand to secure the cap on the needle hub;
handle the cap only at its bottom portion.

WASTE COLLECTION
cont’d
Color Coding
TYPE OF WASTE COLOR
Healthcare Waste Yellow / Red
Regular Garbage Black
Yellow / Red = Hazardous Healthcare Waste Black = garbage


WASTE COLLECTION:
cont’d WHAT GOES WHERE?
Yellow / Sharps Black
Red bag container bag
Blood-saturated gauze
Empty IV bag
Used hypodermic needle
Suction canister with body fluids
Bandage with a little dried blood
IV tube containing fluid blood
Thermometer
Dirty glove
Soiled disposable diaper
WASTE COLLECTION:
cont’d WHAT GOES WHERE? cont’d
yellow Sharps Black
bag container bag
Expired medicine (tablets)
Broken pipette
Patient’s empty juice bottle
Lancet
Skin tag removed from patient
Culture dish
Cotton swab with a little alcohol
Blood-covered surgical gown
Disposable tongue depressor after use
with a sick patient

WASTE COLLECTION:
cont’d WHAT GOES WHERE? cont’d
Lollipop
Spoon
Tongue depressor

WASTE COLLECTION:
cont’d
LABELING
All containers of health care waste
should have the
International Biohazard Label


WASTE COLLECTION
cont’d COLOUR CODING & LABELING
• Interim
– Plastic bag with Biohazard sticker on red background
inside a yellow painted bin with biohazard sticker.
– Bleach bottle with Biohazard sticker on a red
background for blood collection tubes.
– Thick cardboard box with Biohazard sticker on red
background and “Caution: Sharps” marking for
sharps, or rigid plastic sharps containers.

WASTE COLLECTION
cont’d COLOUR CODING & LABELING
• Long-Term
– Yellow plastic bag with Biohazard

label inside bins.
– Yellow colored rigid plastic sharps

containers with Biohazard label and
marking for Sharps.
Questions and Comments by Audience

BASIC QUESTIONS
• Who is in charge of the removal of segregated
hazardous HCW & its disposal?
• What is the importance & objective of a selected
treatment & disposal option?
• What are the practical arrangements to be put
into place?
• Can the HC establishment work with others to
share the treatment or disposal burden?


BASIC QUESTIONS
cont’d
• What, if any, outside organizations need to be

involved?
• Will the HCW disposal system be in operation when
waste segregation begins in medical areas?
• Can the private sector provide well managed collection,
transport, treatment & disposal services for hazardous
HCW at an affordable price?
• Can the HC establishment pay for municipal SW
collection & disposal services?
KEY POINTS
• Simple treatment / disposal of HCW is better
for public health than doing nothing.
• Burial of hazardous HCW:
– Minimal treatment/disposal
– On-site safe burial: easier to control – favored in lower
income areas, small HC establishments, crisis
• Enhanced treatment/disposal:
– Pathogen destruction more efficient & in a more
environmentally beneficial manner
– More costly & complex
– Realistic if affordable and can be maintained locally

GENERAL PRINCIPLES
• On-site transport
– Porters transfer segregated HCW to separate central storage
points
– Protective gloves, goggles & overalls
– Use separate central storage points
– Transport by trolley: less risky than manual carrying
• Covered trolleys: 2-wheeled 240-liter plastic bins
• Open trolley
– Central storage of bags with HCW & used sharps containers
in a secure compound: tolerable
– There should be 2 separate central storage areas on-site:
• Hazardous HCW
• General waste
GENERAL PRINCIPLES
cont’d
• On-site transport, cont’d
• Use fully enclosed, wheeled carts
– If not available, make sure all waste
containers and bags are well sealed
and secured to prevent spillage
• Healthcare waste carts should only be used for
healthcare waste
• Carts should be cleaned and disinfected routinely
• Waste transporters should use gloves


GENERAL PRINCIPLES
cont’d
• Storage areas should be:
– Protected from water, wind, and rain;
– Protected from rodents, insects, and other animals;
– Located away from patients and the public;
– An enclosure that can be locked when not in use;
– Accessible only to authorized personnel;
– Kept clean, free at all times of debris and standing water;
– Disinfected weekly and whenever a spill occurs.
• Waste that can decompose and smell should not be
stored longer than 1 day (warm weather) to 2 days
(cool weather).
GENERAL PRINCIPLES
cont’d
• On-site treatment & disposal
– Basic disposal: burial in a dug pit covered with earth.
Risk of groundwater pollution / scavenging
– Basic treatment step before disposal: chemical disinfection.
Open burning grounds: unacceptable
– Intermediate incineration technology for lower-income
countries & non-urban locations
– Advanced waste treatment systems for on-site treatment:
recommended for a group of local/regional HC
establishments due to capital investments & operation costs:
• High temperature double chamber incineration
• Wet thermal disinfection
• Microwave technology

GENERAL PRINCIPLES
cont’d
• Transportation off-site
– Tractor/trailer/small truck: sufficient if site is nearby
– Protective gloves, goggles & overalls to transport staff
– There should be 2 separate central storage areas on-site:
• hazardous HCW
• general waste
– Use of 2 separate vehicles:
• Pick-up of general waste by vehicles used to collect municipal wastes
• Pick-up of hazardous HCW by special purpose vehicles
– Use of a larger truck if off-site facility is 2 or more kms away

GENERAL PRINCIPLES
cont’d
• Transport outside the facility
– Healthcare waste should be packaged for transport
outside the facility
– Packaging containers should be:
• Rigid
• Leak resistant
• Resistant to tearing or bursting under normal use and
handling
• Sealed to prevent leakage
• Labeled with the facility’s name and address


GENERAL PRINCIPLES
cont’d
• Transport outside the facility, cont’d
– Permits for haulers
• Vehicle has been inspected and is suitable for transport of
healthcare waste
• Hauler is trained in handling, transport, spill clean-up,
incident reporting, contingency plans
– Registration for HCW generators
• Name / contact information

GENERAL PRINCIPLES
cont’d
• Transport outside the facility, cont’d
– Collection Routing and Scheduling

– Waste Tracking System
– Packaging and Transport
Requirements
– Vehicle Markings


GENERAL PRINCIPLES
cont’d
• Off-site treatment & disposal
– Centralized off-site treatment: favored in middle/higher-
income areas
– Advantages of central facilities: share/reduce cost
– Advanced waste treatment systems:
• High temperature (circa 1200 degrees Celsius) double-chamber
incinerators
• Wet thermal disinfection systems (similar to autoclave systems)
• Autoclave technology
• Microwave technology
– Final disposal of residues to landfills

GENERAL PRINCIPLES
cont’d Interim Treatment
APPLICABLE HEATLHCARE TREATMENT METHOD
WASTE
Free-flowing blood and body fluids Sanitary sewer
Cultures On-site autoclave

Body parts (anatomical waste) Interment or cremation
All except cultures and body parts Transport and burial in special
landfill trenches
Healthcare waste from Health On-site burial pits
Centers

GENERAL PRINCIPLES
•Cultures
–Use an on-site autoclave
(minimum 121 C, 30 min)
•Anatomical Waste (large body parts)
–Interment at burial grounds

GENERAL PRINCIPLES
•Other Healthcare Wastes

Sharps, blood-soaked waste or material
dripping with blood or body fluids, small
tissues
–Transport and Burial in Special Landfill
Trenches
–Requires coordination with SWM
–For Health Centers: Small On-Site Burial
Treatment - Interim
Small On-Site Burial Pits
security fence cement or embedded
wire mesh
Earth mound to keep
50 cm of soil cover water out of the pit
2 to 5 meters
soil or soil-lime layer
biomedical waste
1 to 2 meters
NOT DRAWN TO SCALE
Treatment - Interim
Encapsulation With Immobilizing Materials
Cement
Drum
Soil Sharps waste


GENERAL PRINCIPLES
cont’d Long Term Treatment
• Collection, Transport and Treatment at a

Centralized Facility

MINIMUM APPROACH
– Pit on-site
•Liming the waste
•Encapsulation in concrete
•Also to dispose of toxic chemical waste solutions
–Placing sharps in sodium hypochlorite disinfectant solution
prior to disposal by burial/incineration/encapsulation: infective
potential remains
– Open burning – soaking in fuel: in emergency
situations only

MINIMUM APPROACH
cont’d
• Off-site treatment & disposal
–Controlled municipal landfill nearby:
practical option - burial each day beneath 2
meters of partially decomposed municipal
waste
• Low-cost option
• In places where controlled landfilling exist
• In places with no scavenging by people /
animals
ENHANCEMENTS
–Well-constructed single or double chamber incinerators
–Small units with enhanced techniques of treatment can be
installed on site
•Off-site treatment & disposal
–Commonly central systems with shared reliance between:
•Waste generators
•Waste transporters
•Treatment operators
•Landfill disposal operators
–Costs of these systems: higher
–Systems needed in countries with rising national
environmental protection standards & social expectations

ENHANCEMENTS
cont’d
• Systems used in centralized facilities:

–High temperature, double chamber pyrolitic
incineration
–Microwave disinfection
–Steam disinfection including autoclaving
–Dry thermal disinfection

Stockholm Convention on POPs
• Article 5:
Countries have to take measures to further reduce releases of
POPs from unintended production “with the goal of their
continuing minimization and, where feasible, ultimate
elimination.”
• Annex C
– Source with “the potential for comparatively high formation
and release” of dioxins & furans:
Medical Waste Incinerators
– “Priority consideration” should be given to alternative
technologies that avoid formation of dioxins & furans
MEDICAL WASTE INCINERATION (MWI) AND

DIOXINS
– Toronto, Canada: MWI was the largest source of
dioxins (2002)
– Thailand: MWI was the highest source of dioxins of
seven sources tested (2001)
– Europe: 62% of dioxin emissions due to four processes
– one of which is MWI (1999)
– Denmark: MWI is third or fourth largest dioxin source of
16 process categories (1997)
– USA: MWI was third largest source of dioxins,
accounting for 17% of total dioxins (1995)
Best Available Techniques under the
Stockholm Convention
• Incinerator Design
– Single-chamber, drum and brick incinerators are not
BAT
– An incinerator should consist of:
• Furnace or kiln (primary combustion chamber)
• Afterburner chamber (secondary chamber)
• Flue gas cleaning system
• Wastewater treatment if wet flue gas cleaning is used


• BAT air emissions performance level:
– 0.1 nanograms I-TEQ/Normal cubic meter at 11%
oxygen
• BAT wastewater performance level for effluents
from treatment of gas treatment scrubbers:
– 0.1 nanograms I-TEQ/liter
To be achieved by a suitable combination of

primary and secondary measures
• Primary measures
– Introduction of waste at 850ºC or higher in the
primary chamber ; automation to avoid introducing
waste below 850ºC
– Avoidance of temperatures below 850ºC in the
primary chamber and no cold regions
– Auxiliary burners
– Avoidance of starts and stops
– Control of oxygen input

• Primary measures
– Minimum residence time of 2 seconds at 1100ºC in
the secondary chamber after last addition of air and
6% O2 by volume (for waste with >1% halogenated
substances)
– High turbulence of exhaust gases and reduction of
excess air
– On-line monitoring for combustion control (T, oxygen,
carbon monoxide, dust), and regulation from a
central console.
• Secondary measures
– Dedusting
• Fabric filter operating below 260ºC
• Ceramic filter used between 800 to 1000ºC
• Cyclones for pre-cleaning
• Electrostatic precipitators around 450ºC
• High performance adsorption units with activated carbon


• Secondary measures
– Techniques for further emission reduction
• Catalytic oxidation
• Gas quenching
• Catalyst-coated fabric filters
• Different types of wet or dry adsorption systems using
mixtures of activated charcoal, coke, lime and limestone
solutions

• Disposal of Residues (bottom and fly ash)

– Ash should be handled, transported (using covered
hauling) and disposed of in an environmentally
friendly manner
– Disposal in safe dedicated landfills (e.g., landfilling in
double-walled containers, solidification, or thermal
post-treatment)
– Catalytic treatment or vitrification of fabric filter dusts

• Monitoring
– Routine monitoring of: CO, oxygen, particulate
matter, HCl, SO2, NO2, HF, air flows, temperatures,
pressure drops, and pH
– Periodic or semi-continuous measurement of:
polychlorinated dioxins and furans

• General measures
– Operation by trained, qualified personnel
– Use of personal protection equipment
– Periodic maintenance including cleaning of the
combustion chamber and declogging of air flows and
fuel burners
– Auditing and reporting systems
– Routine inspections of the furnace and air pollution
control systems by the regulatory authorities

Resources
• Guidelines on best available techniques and

provisional guidance on best environmental
practices, to be posted on the Stockholm
Convention website
http://www.pops.int/
• Reference document on the best available
techniques for waste incineration: BAT reference
document (BREF), European Commission, 2008;
available in the European IPCC Bureau website
eippcb.jrc.es/pages/FActivities.htm
Stockholm Convention on POPs

• Annex C, Part IV (Definitions):
On best available techniques:
“[Priority consideration should be given to

alternative processes, techniques or practices
that have similar usefulness but which avoid
the formation and release of … [dioxins and
furans].”
Some Trends: Medical Waste Incineration (MWI)
8000 United States
6200 250 219 Canada
6000 200
MWIs
MWIs
4000 150
2400
100 56
2000 50
72
0 0
1988 1997 2006 1995 2003
554 Germany
600 Portugal
50
On-Site MWIs
40
400 40
MWIs
30
200 20
0 10 1
0 0
1984 2002 1995 2004
200
150
Ireland
150
MWIs
100
50
0
0
1990s 2005
Examples of Alternatives
• Low-Heat Thermal Technologies
– Autoclaves or Retorts
– Advanced Autoclaves
– Microwave Units
– Dry Heat Systems
• Chemical
– Non-Chlorine Technologies
Alternative Thermal Technologies
• Autoclaves & advanced autoclaves Resistance to Disinfection
• Other steam-based technologies Microorganism Examples
• Microwave technologies Bacterial spores Geobacillus

stearothermophilus
• Dry heat technologies Mycobacteria M. tuberculosis
Non-lipid or small Polio virus, Hepatitis A

Typical disinfection criteria for medical waste: viruses virus
4 Log reduction or higher of Geobacillus Fungi Aspergillus
stearothermophilus or Bacillus atropheus Vegetative bacteria Staphylococcus,
Pseudomonas
Temp °C Press Spore Kill
(kPa) time (min) Lipid or medium-size HIV, HBV
viruses
116 174 30
118 186 18 Typical standard: 121 ºC for 30 min

121 205 12
Monitoring methods: microbial
125 232 8
inactivation tests, self-contained
132 287 2 biological indicators, color
138 341 1 indicators
Autoclave
Pressure Gauge Air Vacuum
Release Safety Filter

Valve Valve
Jacket
Autoclave Chamber
Charging
Door
Thermocouple
Steam Steam
Steam
Trap
Trap
Drain

Autoclave Examples
Centralized Autoclave Facility,
(2.4 m dia x 9.7 m long)
Small Autoclaves
On-Site Autoclave, 750 lb/hr

Source: Bondtech Corporation, WSF
Large-Scale Post-Treatment Shredder

Advanced Autoclaves: Examples
• Vacuum / steam treatment / shredding / compaction
• Pulse vacuum-steam treatment / drying
• Steam treatment-mixing-fragmenting / drying / shredding
• Stream treatment, fragmenting & mixing / drying
• Internal shredding / steam treatment / cooling / vacuum
• Internal shredding / steam treatment & mixing / drying

Steam treatment-mixing-fragmenting / drying / shredding

Source: Tempico
Advanced Autoclave Example

Source: Hydroclave
Advanced Autoclave Example

Range of capacities:
45 to 180 kg/hr
Process:
- Waste loaded at the top
- Internal shredding
- Steam at 138 C, 3.8 bar
for 10 min
- Cooled to 80 C
- Drained
- Vacuum
- Discharge at
the bottom
Sadat Associates, Inc.
Engineering and Environmental Services
Source: Ecodas
Internal shredding / steam treatment &
mixing / drying

Source: STI Chem-Clav
Internal shredding / steam treatment &

mixing / drying

Source: Anteaus
Microwave Disinfection

Engineering and Environmental Services
Source: Sanitec
Sadat Associates, Inc.
Examples: Small Microwave Units

• Small-scale systems
• Waste heated to 121 – 134C
using microwave generators for
30 minutes
• Optional post-treatment
shredder
Range: 6, 30 & 60
liter capacities
(20-200 kg per 8
hr day)
Range: 60 – 70 liters/cycle
Source: Sintion, Meteka
Chemical: Alkaline Hydrolysis
Process:
- Waste in stainless steel baskets
are lowered into hot alkali
- Heated to 110-115 C for 4-8 hrs
• Designed for tissue waste,

placentas, animal waste, organs
• Also destroys cytotoxic waste
• Range: 19 to 570 liters

14 kg/cycle to 3200 kg/cycle
Source: Waste Reduction by Waste Reduction (WR2)
Tripolia Hospital, Bihar, India

Solar-powered autoclave

Treatment Approaches
• Centralized treatment
• Decentralized (on-site) treatment
• Treatment within clusters
• Mobile treatment

Swiss Red Cross Kyrgyzstan Project

• Pilot project at a 340-bed hospital:
– Segregation: color-coded plastic bags and containers
– 2 BMDi needle cutters provided per hospital unit
– On-site autoclave, mechanical shredder and recycling
• Results
– Significant reduction in infectious waste through segregation
(6000 kg/month Æ 1200 kg/month)
sharps infectious
– Large reduction in hypochlorite costs 3% waste
17%
– Revenues from recycled plastics
– ROI on autoclave: about 2 years
– Anecdotal information:
• Fewer complaints from workers
• Lower needle-stick injuries (no data) 80%
non-infectious
• No complaints from neighbors waste
SRC Kyrgyzstan Project: Sharps
Treat in an Bury in a
Collect on-site pit
BMDI needles autoclave
$25
54 liter
autoclave
$1000
Sharps Needle
30-40%
waste cutter volume
Treat in an reduction
Collect
plastic on-site Shred
syringe autoclave
Recycle at
plastics plant

Solution: St. Stephen’s Hospital, Delhi
Collection in sharps containers
Burial in a concrete sharps pit

Solution: Himalayan Institute Hospital Trust,
Himalayas
Collection in reusable sharps containers,

autoclaving, post-treatment shredding,
gravity separation in water bins, and
recycling of all plastic and metal pieces
Solution: Tata Memorial Hospital, Mumbai
Collection in
color-coded
containers
Waste audit and training
On-site
transport
and
storage On-Site Treatment in a
Hydroclave and Shredder
GEF Medwaste Project
• “Demonstrating and Promoting Best Techniques and Practices for
Reducing Health Care Waste to Avoid Environmental Releases of
Dioxins and Mercury”
• Funded by the Global Environmental Facility (GEF)
• Partners: UNDP, WHO and HCWH; governments and NGOs in
Argentina, India, Latvia, Lebanon, Philippines, Senegal, Tanzania,
Vietnam
• Key components:
– Develop model urban and rural hospitals: demonstrate best
practices and alternative technologies
– Establish national training and certification programs
– Document, promote, and institutionalized management systems
– Disseminate and replicate results regionally & globally
• Project implementation: 2008
GEF Tanzania Component

Objectives
– To design and build affordable,
small and medium-scale technologies
for treating infectious waste
• Electricity, bottled gas, solar energy options
• Autoclavable containers
• Mechanical & electrical shredders or compactors
– To demonstrate fabrication, installation, and use of the
technologies in Tanzania
– To assist in replication in other countries
Waste Management
is a Comprehensive
System
Not a Technology.

Some Resources on Alternative Technologies

• “Safe Management of Bio-medical Sharps Waste in
India: A Report on Alternative Treatment and Non-
Burn Disposal Practices,” SEA-EH-548, WHO
South-East Asia, New Delhi (2005)
• Global Inventory of Alternative Treatment
Technologies (2007), “Non-Incineration Medical
Waste Treatment Technologies” (2001) and “Non-
Incineration Medical Waste Treatment Technologies
in Europe”(2004), HCWH, available in
www.noharm.org
• GEF Medical Waste Project: www.gefmedwaste.org
CONTINGENCY MEASURES
• Spill containment and cleanup

procedures
• Exposure incident procedures


cont’d
• Spill Clean-Up Kit
Disposable gloves, face mask and safety glasses
Small scoop or dust pan and brush, shovel
Absorbent pads or powders
Cleaning rags or paper towel
Chlorine disinfectant (1:10 chlorine)
Germicidal wipes
Extra red bags
First-Aid kit
Biohazard labels Biohazard
Aspirator bottle, spatula or mercury amalgam powder for
mercury spills
cont’d
• Exposure Incident Procedures
–If injured, provide first-aid immediately
–Clean up any spillage following proper procedures
–Provide additional medical attention and prophylaxis
if necessary
–Reporting & record-keeping
•Report incident to Waste Management Officer or
Infection Control Officer
•Maintain records for later evaluation


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TOPIC 3

Sadat International, Inc.

TOPIC 3 – COLLECTION through DISPOSAL

Sadat International, Inc.

Human Blood, Free-flowing blood or blood components, semen, vaginal secretions,

Sadat International, Inc.

TOPIC 3 – COLLECTION through DISPOSAL

• Reduction, to the greatest extent

Sadat International, Inc.

TOPIC 3 – COLLECTION through DISPOSAL

TOPIC 3 – COLLECTION through DISPOSAL

Sharps - Container should be puncture-resistant, - Empty bleach bottle with a

Sadat International, Inc.

Sadat International, Inc.

TOPIC 3 – COLLECTION through DISPOSAL

Sadat International, Inc.

Yellow / Red = Hazardous Healthcare Waste Black = garbage

TOPIC 3 – COLLECTION through DISPOSAL

TOPIC 3 – COLLECTION through DISPOSAL

Sadat International, Inc.

Sadat International, Inc.

TOPIC 3 – COLLECTION through DISPOSAL

Sadat International, Inc.

– Yellow plastic bag with Biohazard

– Yellow colored rigid plastic sharps

Questions and Comments by Audience

Sadat International, Inc.

Sadat International, Inc.

TOPIC 3 – COLLECTION through DISPOSAL

• What, if any, outside organizations need to be

TOPIC 3 – COLLECTION through DISPOSAL

Sadat International, Inc.

TOPIC 3 – COLLECTION through DISPOSAL

TOPIC 3 – COLLECTION through DISPOSAL

Sadat International, Inc.

Sadat International, Inc.

TOPIC 3 – COLLECTION through DISPOSAL

Sadat International, Inc.

– Collection Routing and Scheduling

Sadat International, Inc.

TOPIC 3 – COLLECTION through DISPOSAL

Sadat International, Inc.

Cultures On-site autoclave

TOPIC 3 – COLLECTION through DISPOSAL

Sadat International, Inc.

•Other Healthcare Wastes

Soil Sharps waste

Sadat International, Inc.

TOPIC 3 – COLLECTION through DISPOSAL

• Collection, Transport and Treatment at a

Sadat International, Inc.

TOPIC 3 – COLLECTION through DISPOSAL

TOPIC 3 – COLLECTION through DISPOSAL

• Systems used in centralized facilities:

Sadat International, Inc.

MEDICAL WASTE INCINERATION (MWI) AND

Sadat International, Inc.

Best Available Techniques under the

To be achieved by a suitable combination of

Best Available Techniques under the

Sadat International, Inc.

Best Available Techniques under the