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Whether you run a hospital, GP practice, pharmacy, or laboratory, you deal with healthcare waste.

This includes expired pharmaceuticals, bags and vials containing traces of toxic medications, spilled liquids, and contaminated tissues or body fluids. In addition, those produced in the course of health procedures carried out by patients at home (dialysis, insulin injections, etc.) can be included as medical waste.

About 10-25% of healthcare waste is considered hazardous and can create a variety of health risks. The disposal of pharmaceutical waste and other chemical waste, such as laboratory waste, can be very problematic.

Sanitary waste can be classified into:

• Infectious waste. Any waste suspected of containing pathogens (bacteria, viruses, parasites, or fungi) in sufficient concentration or quantity to cause disease, such as cultures and stocks of infectious agents from laboratory work, surgical and autopsy waste from patients with infectious diseases, waste from infected patients in isolation rooms and infected animals from laboratories.

• Pathological waste. It is made up of tissues, organs, body parts, human fetuses and animal corpses, blood and body fluids. Within this category, recognizable parts of the human or animal body are also called anatomical debris.

• Sharp Objet. These are items that could cause cuts or puncture wounds, including needles, hypodermic needles, scalpels and other blades, knives, infusion sets, saws, broken glass, and nails. Infected or not, these items are generally considered highly hazardous waste.

• Pharmaceutical waste. This includes expired, unused, spoiled, and/or contaminated medicines, medications, and vaccines that are no longer needed and must be disposed of properly. The category also includes discarded items used in the handling of pharmaceutical products, such as bottles or boxes with waste, gloves, masks, connection tubes and medication vials.

• Genotoxic waste. This type of waste is highly dangerous and may have mutagenic or carcinogenic properties. It poses serious security problems, both inside hospitals or doctor’s offices and after its elimination. Genotoxic waste can include certain drugs used in chemotherapy or body fluids that contain chemicals and radioactive residues.

• Chemical waste. Wastes in this category consist of discarded solid, liquid, and gaseous chemicals, for example, from diagnostic and experimental work and from cleaning, cleaning, and disinfecting procedures. Chemical waste is considered hazardous if it is toxic, corrosive, flammable, or reactive in any way.

• Radioactive waste. This includes solid, liquid and gaseous materials contaminated with radionuclides. It occurs as a result of procedures such as in vitro analysis of body tissues and fluids, in vivo organ imaging and tumor localization, and various research and therapeutic practices.

It is important that all healthcare waste is disposed of safely to avoid any potential negative impact on the environment and public safety.

One of the biggest challenges in managing healthcare waste is that this type of waste contains potentially harmful microorganisms that can infect hospital patients, healthcare staff and the general public.

Other potential hazards may include drug-resistant microorganisms spreading from healthcare facilities into the environment. Disposal of untreated sanitary waste in landfills can lead to contamination of drinking, surface and ground water.

For all these reasons, the management of medical waste requires special attention and diligence.

These are the most important steps to follow:

1. Reduce the volume of waste generated and ensure proper segregation of hazardous waste. Waste can be minimized by careful stock keeping. For example, you can keep track of how much of each pharmaceutical is needed and avoid ordering too much. Set up a “first in, first out” system so that packages that are going to expire first are used first. Whenever possible, try to negotiate take-back agreements with suppliers, whereby suppliers accept and dispose of pharmaceuticals that you cannot use. The key to effective healthcare waste management is segregation (separation) and waste identification. Proper handling, treatment, and disposal of hazardous waste by type reduces costs and helps protect public health. Segregation should always be the responsibility of the waste producer, it should be done as close as possible to where the waste is generated, and it should be maintained in storage areas and during transport.

2. Ensure proper transportation of hazardous waste Prior to transportation of waste, shipping documents must be completed, all arrangements must be made between the waste producer, transporter and treatment facility. Vehicles or containers used for the transport of medical waste must not be used for the transport of any other material. They must be kept locked at all times, except when loading and unloading. Articulated or demountable trailers (temperature controlled if required) are particularly suitable as they can easily be left at the waste production site. Other systems can be used, such as large containers or specially designed containers; however, open bins or containers should never be used to transport healthcare waste.

3. Choose a safe and environmentally compatible treatment for hazardous medical waste. In recent years, many waste brokerage companies have sprung up subcontracting their clients’ waste to the lowest bidder, often with no idea whether these contractors are licensed to handle such materials. If in doubt, contact the Environment Agency, who will be able to tell you if the business is properly licensed. In addition to the obvious dangers to human health, as the producer of the waste, it is your legal responsibility to ensure proper disposal and avoid legal action.

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