Healthcare Waste: Difference between revisions
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[[File:Healthcare waste pic.jpg|280px|left|Picture of Healthcare Waste packaging from Herefordshire CGC report]]__TOC__ | [[File:Healthcare waste pic.jpg|280px|left|Picture of Healthcare Waste packaging from Herefordshire CGC report]]__TOC__ | ||
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==Macro Tonnage== | |||
The macro-level data reported for 2020 by [[DEFRA]]<ref>[https://www.gov.uk/government/statistics/uk-waste-data UK Statistics on Waste July 2020 update]</ref> for tonnage arisings is summarised in the figure below, with a total of 355kt tonnes of Healthcare Waste (and some associated biological waste) arising in the UK, the large majority of which came from the service sector : | |||
==Clinical Waste== | [[File:Helathcare tonnage 2020.png|1000px|center]] | ||
==Overview== | |||
===Clinical Waste=== | |||
'''Clinical Waste''' is [[Healthcare Waste]] that: | '''Clinical Waste''' is [[Healthcare Waste]] that: | ||
*contains viable micro-organisms or their toxins which are known or reliably believed to cause disease in humans or other living organisms | *contains viable micro-organisms or their toxins which are known or reliably believed to cause disease in humans or other living organisms | ||
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*is waste of a similar nature from a non-healthcare activity | *is waste of a similar nature from a non-healthcare activity | ||
==Offensive Waste== | ===Offensive Waste=== | ||
'''Offensive Waste''' is non-infectious waste which is unpleasant and may cause offence to those coming into contact with it. It includes<ref name="Net">[https://www.netregs.org.uk/environmental-topics/waste/managing-waste-materials/offensive-waste/ NetRegs]</ref>: | '''Offensive Waste''' is non-infectious waste which is unpleasant and may cause offence to those coming into contact with it. It includes<ref name="Net">[https://www.netregs.org.uk/environmental-topics/waste/managing-waste-materials/offensive-waste/ NetRegs]</ref>: | ||
*outer dressings and protective clothing e.g. masks, gowns and gloves that are not contaminated with body fluids | *outer dressings and protective clothing e.g. masks, gowns and gloves that are not contaminated with body fluids | ||
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*any waste that is infectious (i.e. a clinical waste) | *any waste that is infectious (i.e. a clinical waste) | ||
==Management of Healthcare Waste== | ===Management of Healthcare Waste=== | ||
The management of Healthcare Wastes is set out in '''Healthcare Technical Memorandum 07-01 - Safe Management of Healthcare Waste'''<ref name='Tech1'>[https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/167976/HTM_07-01_Final.pdf Link to pdf document]</ref> which replaced the Safe Management of Healthcare Waste in 2013 <ref>Published in 2006, this removed the clinical waste classification system categorising into 5 types; A to E</ref>. Management of Healthcare Waste for regulated facilities with an environmental permit is the subject of guidance issued in July 2020 <ref>[https://www.gov.uk/guidance/healthcare-waste-appropriate-measures-for-permitted-facilities Healthcare Waste:Appropriate Measures for Permitted Facilities]</ref> by the [[EA]] which sets out appropriate measures in the following sections: | The management of Healthcare Wastes is set out in '''Healthcare Technical Memorandum 07-01 - Safe Management of Healthcare Waste'''<ref name='Tech1'>[https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/167976/HTM_07-01_Final.pdf Link to pdf document]</ref> which replaced the Safe Management of Healthcare Waste in 2013 <ref>Published in 2006, this removed the clinical waste classification system categorising into 5 types; A to E</ref>. Management of Healthcare Waste for regulated facilities with an environmental permit is the subject of guidance issued in July 2020 <ref>[https://www.gov.uk/guidance/healthcare-waste-appropriate-measures-for-permitted-facilities Healthcare Waste:Appropriate Measures for Permitted Facilities]</ref> by the [[EA]] which sets out appropriate measures in the following sections: | ||
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* Process efficiency appropriate measures | * Process efficiency appropriate measures | ||
==Healthcare Waste | ==Categories of Healthcare Waste (Packaging Colour and Appropriate Waste Management)== | ||
The types of [[Healthcare Waste]] are grouped and designated by packaging colour set out in the table below (can be bag colour or lid colour)<ref>[https://assets.publishing.service.gov.uk/media/5f05a7fae90e0712d0206e88/Types_of_healthcare_waste_table.pdf Types of Healthcare Waste]</ref> <ref name ='Tech1'/>: | The types of [[Healthcare Waste]] are grouped and designated by packaging colour set out in the table below (can be bag colour or lid colour)<ref>[https://assets.publishing.service.gov.uk/media/5f05a7fae90e0712d0206e88/Types_of_healthcare_waste_table.pdf Types of Healthcare Waste]</ref> <ref name ='Tech1'/>: | ||
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With regard to the table above, it can be seen that there are options for '''incineration''' and '''alternative treatment''' and in some specific cases [[landfill]] is acceptable. | With regard to the table above, it can be seen that there are options for '''incineration''' and '''alternative treatment''' and in some specific cases [[landfill]] is acceptable. | ||
===Incineration=== | ===Incineration=== | ||
For [[incineration]], Healthcare Waste will normally be incinerated in | For [[incineration]], Healthcare Waste will normally be incinerated in [[High Temperature and Clinical Waste Incineration]]. The graph below shows the trend for different types of incineration of Healthcare Waste, plus the small amount that was exported for [[R1]] incineration. Some [[Residual Waste EFW]] incinerators are able to dispose of specific Clinical Waste streams, and as a result of the COVID-19 pandemic the [[EA]] published a Regulatory Position Statement (RPS C23) clarifying the circumstances where COVID-19 waste could be [[Incineration|incinerated]] with Municipal Waste Waste ([[MSW]]) until July 2021. <ref>[https://www.gov.uk/government/publications/incinerating-specified-healthcare-wastes-at-a-municipal-waste-incinerator-rps-c23/incinerating-specified-healthcare-wastes-at-a-municipal-waste-incinerator-rps-c23#conditions-you-must-comply-with RPS C23]</ref> | ||
[[File:Clinical Waste Incineration Graph.png|600px|center|Graph of Clinical Waste to Incineration all rights reserved Monksleigh]] | |||
===Alternative Treatment=== | ===Alternative Treatment=== | ||
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Mechanical Treatment is also available as a pre-treatment option for any of the AT's outlined above. By pulverising, shredding, crushing etc the [[Healthcare Waste|waste]] this results in a reduction of the volume of the [[Healthcare Waste|waste]] by 60% plus although it does not kill any pathogens, microorganisms or disinfect equipment<ref>[https://www.malsparo.com/treat2.htm Malsparo]</ref>. | Mechanical Treatment is also available as a pre-treatment option for any of the AT's outlined above. By pulverising, shredding, crushing etc the [[Healthcare Waste|waste]] this results in a reduction of the volume of the [[Healthcare Waste|waste]] by 60% plus although it does not kill any pathogens, microorganisms or disinfect equipment<ref>[https://www.malsparo.com/treat2.htm Malsparo]</ref>. | ||
==NHS Management of Healthcare Waste [[ERIC]]== | |||
The [[wikipedia:National Health Service| NHS]] report their management of Healthcare Waste via the Estates Returns Information Collection ('''[[ERIC]]''') dataset<ref>https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection</ref> which gives a break down the tonnage, management approach, and associated cost of waste - including Healthcare/Clinical Waste. The figure below for the ERIC data over the last four years shows a downward trend for Healthcare Waste going to incineration<ref>The data for 2017 and 2018 is on a different basis within ERIC and represents the total waste sent for incineration, leading to an exaggeration of the drop in incineration in the figure</ref><ref>For the data for 2020/21 the figure produced by Monksleigh adjusts the ERIC data for 4 NHS Trusts that appear to have reported in kg rather than tonnes. This is the subject of a review by NHS Digital as it also impacts the Clinical Waste tonnage treated as a whole by the NHS estate</ref> (against a backdrop of increasing tonnage overall, notwithstanding the impacts of the [[wikipedia: COVID-19|pandemic]], this means increasing tonnage has gone to treatment). The figure also shows that the proportion of waste incinerated from the [[wikipedia:National Health Service| NHS]] has dropped relative to the total Healthcare Waste incinerated - reflecting that non-NHS facilities (such as private hospitals, care homes etc)<ref>https://digital.nhs.uk/services/organisation-data-service/file-downloads/non-nhs-organisations</ref> have relied more heavily on incineration than treatment for the management of their waste over recent years. | |||
[[File:NHS Tonnage Incinerated vs Total.png|500px|center|NHS Clinical Waste Incinerated vs total Clinical Waste Incinerated - all rights reserved Monksleigh Ltd]] | |||
==References== | ==References== | ||
<references /> | <references /> | ||