Handling Proper Garbage Proposal

1. Introduction
Hazardous waste is waste that poses a risk to human health or the environment and requires special disposal techniques to make it harmless or less dangerous.
Commercial waste is all other waste produced such as paper, cardboard, packaging, flowers and tins.
2. Categories of Clinical Waste
Recommendations as to the categorisation of Clinical Waste are as the Health and
Safety Commission “Health Services Advisory Committee (1982)”:-
Group A Waste

Soiled surgical dressings, swabs and all other contaminated waste from treatment areas.

Waste material (other than linen) from cases of infectious disease where assessment indicates risk to staff handling them

All human tissue (whether infected or not), animal carcasses and tissues from laboratories and all related swabs and dressings.
Group B Waste
Discarded syringes, needles, cartridges, broken glass, ampoules, cannulas and any other issued disposal sharp instruments.
Group C Waste
Laboratory and post-mortem room waste other than waste included in Group A
Group D Waste
Certain pharmaceutical and chemical waste including waste dental amalgam containing mercury.
Group E Waste
Used disposable bed-pan liners, urine containers, incontinence pads, stoma bags and GP bowls. 5
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3. Colour Coding and identification for Waste Containers (see pages 10, 11 &
12)
All containers used for clinical and household waste within Hertfordshire Partnership
NHS Trust are to conform to the following colour codes, and be separately identifiable Colour and type of container Type of Waste
Yellow Bag, clearly marked for incineration Group A Wastes, also Group E wastes, if
Macerator method of disposal is unavailable Yellow Plastic Sharps Containers Group B Wastes marked for incineration
Black Plastic Bag General Household Waste, i.e. paper, packaging, dead flowers, office waste, bin contents and all aerosols.
Cardboard Box Glass bottles, jars, broken glass. (Broken glass should be wrapped in paper before placing in the cardboard boxes. This includes empty pharmaceutical containers.) Pressurised containers (medicinal Aerosols) must be placed in yellow bags and marked “Contains aerosols”.
All bags must comply with the British Standard Specification 6642 (1985).
Yellow clinical waste bags must be sealed by tying at the neck of the bag and affixing the identification tag which is available from the Facilities Department at 99 Waverley
Road – telephone number 01727-897797 or fax number 01727-897422
Sharps containers are to comply with BS 7320 (1990) and be of a type approved by the Infection Control Team. All used sharps containers must be incinerated.
Sharp containers for disposal must be properly assembled, sealed and secured, and site details must be entered together with the signature and date of assembly and disposal on the box. They should not be filled more than two-thirds.
The manager will ensure that numeric tracing can identify the point of origin of all yellow bags and sharp containers.
It is the responsibility of the manager to ensure that their department has sufficient supplies of bags and tags. It is strictly forbidden to borrow or use tags issued to another ward, department or site. Staff have been instructed not to collect yellow bags without identification tags. 6
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4. Means of Segregation
Group A Waste to be placed in yellow clinical waste storage container/bag at the point of generation.
The container/bags are to be removed at least daily (or when three-quarters full for a bag or two-thirds full for containers) and to be taken to the Separate Clinical Waste
Storage Area in the vicinity of the ward or department.
It is the responsibility of all staff to ensure that each yellow bag is secured with a separate identification tag.
Group B Waste (i.e. discarded syringes, needles and cartridges, together with broken glass ampoules and any other sharp instruments including plastic sharps) must be placed in the sharps containers. Sharps containers are to be sealed when two-thirds full.
Sealed sharps containers should be tagged with an identification tag. This should then be placed in the storage area.
Group C Waste
Not relevant in Hertfordshire Partnership NHS Trust.
Group D Waste
All group D Waste should be placed in a yellow sharps bin and procedure for the bagging and tagging of clinical waste followed.
Group E Waste
Group E Wastes – bed-pan washers are the normal means of disposal of the contents of bed-pans, urine containers etc. However, there are a small number of macerators. Only when neither washer nor macerator is available (e.g. due to temporary breakdown) may such wastes be disposed of by other routes to the sewer.
Disposable containers, once emptied, are to be dealt with as Group A Wastes.
Household waste should be placed in black plastic bags and separately stored.
Glass and aerosols should be safely wrapped and stored with household waste or boxed prior to disposal.
All medicine aerosols that are no longer required should be sent back to Pharmacies where they will arrange for their safe disposal. 7
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5. Procedures for Handling Household and Clinical Waste.
All staff handling clinical or household waste must wear appropriate and suitable
Personal Protective Equipment (PPE) as supplied.
All bags of waste must not be more than three-quarters full.
Housekeeping will be responsible for transporting waste to the Segregated Storage
Areas, and ensuring that waste is kept segregated in these areas. Managers are responsible for supplying a suitable trolley to transport waste.
6. Clinical and Household Waste Storage Areas and Transportation Containers.
Waste storage areas must be kept locked and secure at all times.
Managers will be responsible for keeping storage areas clean.
Each storage area must be kept clean and checked each day.
7. Pharmacy Services.
A specific procedure detailing the sorting and storage of pharmaceutical waste in the pharmacy should be available. For reasons of security it is required that pharmaceutical waste thus generated remains under the control of the pharmacy.
The pharmacy manager will confirm incineration arrangements with the Waste
Contractor.
Therefore, medicines/drugs, surplus or unused must be returned to the pharmacy for recycling or destruction. Wards and departments are not authorised to dispose of waste medicines/drugs.
Medicines/drugs for disposal by incineration will be packed in accordance with pharmacy procedures and collected and transported as directed by these procedures. Pharmaceutical waste will be collected directly from the pharmacy department by the
Clinical Waste Contractor, the consignment notice system will be operated in all cases. Where specific disposal instructions are sent out with drugs by pharmacy, these instructions must be followed. 8
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8. Cases of Infectious Diseases
Where the assessment indicates a risk of infection to staff, advice can be obtained from the Consultant Microbiologist (Infection Control Doctor) to determine the method of waste disposal and level of supervision required.
9. Cytotoxic Waste Disposal
Parenteral cytotoxic drugs are prepared to individual patient requirements and issued by the pharmacy department.
Where a full dose has been administered to a patient and no spillage has occurred, empty syringes, IV bags, needles, etc., can be disposed of using sharps bins and yellow clinical waste bags as appropriate.
Disposable clothing, towels, etc., which have not been in contact with spillage can disposed of as normal clinical waste.
Where a full dose has not been administered or a spillage has occurred the following procedure must be followed:

Any disposable or non-disposable clothing which has come into contact with cytotoxic spillage must be removed without delay and placed into a cytotoxic waste bag (supplied by pharmacy with the cytotoxic drug).

Should any area of skin be affected by spillage then this must be washed thoroughly before donning clean cloths. An Incident Report Form must be completed. Any staff affected in this way should report immediately to the
Occupational Health Department.
Cytotoxic waste bags are larger than is normally required to allow for the occasional need to dispose of contaminated clothing. Bags should be sealed securely using sellotape and if only a small amount of waste is to be disposed of, the bag should be folded and rolled up in a small package which will provide maximum safety for handling. The label supplied with the cytotoxic bag must be completed in full by the person packaging the waste. The information required will include:

The name of the patient receiving the cytotoxic drugs

The estimated amount of drug within the waste

The name of the person packaging the waste with ward/department and date.
All cytotoxic waste bags must be returned to the pharmacy department, preferably in the blue cytotoxic box (supplied by pharmacy) allowing for size. 9
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All non-parenteral forms of cytotoxic drugs (tablets, capsules, etc) are labelled:
CAUTION
CYTOTOXIC DRUGS
HANDLE WITH GLOVES
DO NOT HANDLE IF PREGNANT
In common with all pharmaceutical preparations, these must be returned to pharmacy for destruction or recycling when they are not wanted on the ward or department. Should staff have any queries regarding the handling or disposal of cytotoxic waste then they should contact the head of pharmacy for advice.
The head of pharmacy services will be responsible for the safe and appropriate disposal of such wastes, using an approved Contractor authorised to handle such waste. The waste will be collected directly from the pharmacy department by the contractor and a consignment notice system will be operated in all cases.
10. Food Waste
Food waste and other refuse must not be allowed to accumulate in any food rooms and kitchens. Food waste me kept in closable containers.
Bins must be kept clean and in sound condition.
Provision must include the frequent removal from the food preparation and service area, at the end of each food service as a minimum.
Areas for indoor storage must be away from food areas.
Liquid food waste such as oil and cleaning chemical must be disposed of safely. It is not acceptable to flush significant quantities into the drain.
When using waste disposal unit it is essential that operators follow the manufacturer’s instructions and arrange for regular servicing.
11. Transport of Clinical Waste
Healthcare workers who transport clinical waste from community visits must use a rigid, lidded box within their car boot to house the yellow clinical waste bags, which must be put in a yellow clinical bin on their return to base. Advice about suitability of boxes can be obtained from the Trust Infection Control Nurses or the Health and
Safety Manager.