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Waste

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A Brief History

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The Days of Crown Immunity 1948 - 1991

  • Crown Immunity enabled NHS Hospitals to run without being inspected or prosecuted.

  • During this the NHS was exempt from a multitude of health & safety regulations.

  • In short this was a time of:

    • No sharps containers​

    • No colour coding of bags

    • No duty of care

    • Black bags, hiding a multitude of sins!

    • Burn the lot

  • Onsite incineration, effectively meant unregulated, onsite pollution​

The Environmental Protection Act 1990 

  • This brought about the fundamental structure and authority for waste management and control of emissions into the environment.

  • For the NHS, this meant that any hospitals with their own incinerators, either complied; or be prosecuted.

  • The NHS were given 2 years to get their house in order.

 

1992

  • Most NHS hospitals were outsourcing their clinical waste destruction to compliantly run commercial incinerators.

  • The birth of yellow clinical carts, yellow clinical waste bags and single use hard burn bins (sharps containers).

 

Special Waste Regulations 1996

  • Authorisation, enforcement and prosecution for the incorrect disposal of hazardous and controlled waste became the responsibility of the Environment Agency (EA).

 

Hazardous Waste Regulations 2005

  • NHS Waste Managers start to appear in larger acute hospitals and Trusts, to solely manage waste, its contracts, compliance, training hospital staff and write / implement trust waste management policies.

 

2011

  • The Department of Health issues  the first Safe Management of Healthcare Waste (HTM 07-01), which embraces   best practice waste management principles and ways to improve carbon impacts of managing waste.

 

2012

  • The Controlled Waste Regulations 2012 were born, classifying household, industrial and commercial waste as   controlled waste and subject to the Environmental Protections Act 1990.

"Very interesting! But what I want to know is what goes in what bin?"

Mixed Recycling

What do they look like?

  • Clear / Blue / Green plastic bags

What goes in them?

  • Depends on waste contract

  • Usually clean paper, plastic, card, glass, wrapping and tins.

What doesn't go in them?

  • Usually avoid food, bodily fluids, and drugs

How are they disposed off?

  • Usually go to a Materials Recovery Facility (MRF), where machines sort and recovery items for recycling.

£100-200/Tonne

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Domestic Waste

What do they look like?

  • Clear with domestic written on them / Black

What goes in them?

  • Non clinical, non pharmaceutical domestic waste.

  • Food for example.

 

What doesn't go in them?

  • Clinical, Offensive, Pharmaceutical, Recyclable Waste.

How are they disposed off?

  • Landfill, incinerators, waste to energy.

£100-200/Tonne

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Offensive Waste

What do they look like?

  • Yellow & Black Stripes (Tiger Bins)

 

What goes in them?

  • Soft non-infectious healthcare waste

  • No requirement to disinfect or any further treatment to reduce the number of micro-organisms.

 

How are they disposed off?

  • Deep landfill, incinerators, waste to energy.

£200-300/Tonne

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Orange Clinical Waste

What do they look like?

  • Orange bags

 

What goes in them?

  • Soft wastes contaminated with known infectious clinical waste arising from healthcare activities like infected swabs, dressing and PPE.

 

How are they disposed off?

  • Must undergo treatment or destruction to render safe, such as alternative treatment or high temperature incineration (higher carbon footprint).

£400-600/Tonne

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Yellow Clinical Waste

What do they look like?

  • Yellow bags

 

What goes in them?

  • For the disposal of clinical wastes from specific clinical disciplines, such as infectious waste contaminated with hazardous chemicals, from places like Microbiology, Histopathology and Pathology.

 

How are they disposed off?

  • Must undergo destruction by high temperature incineration (over 1000°C).

  • Not suitable for alternative treatment.

£800-1000/Tonne

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Yellow Sharps Bin with Orange Lid

What do they look like?

  • Yellow plastic bin with orange lid

 

What goes in them?

  • For the disposal of sharps waste where body fluid contamination may or may not occur. Commonly used in Acupuncture Therapies, Theatres, Outpatients, Phlebotomy, Antenatal, Renal Care etc.

 

How are they disposed off?

  • Must undergo treatment or destruction to render safe, such as alternative treatment or high temperature incineration.

£400-600/Tonne

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Yellow Sharps Bin with Yellow Lid

What do they look like?

  • Yellow plastic bin with yellow lid

 

What goes in them?

  • For the disposal of sharps waste where medicinal products (not cytotoxic or cytostatic) have contaminated the syringe and needle (residue content only and fully discharged).

 

How are they disposed off?

  • Must undergo destruction by high temperature incineration (over 1000°C).

£800-1000/Tonne

Yellow Sharps Bin with Purple Lid

What do they look like?

  • Yellow plastic bin with purple lid

 

What goes in them?

  • For the disposal of sharps waste where cytotoxic or cytostatic medications have contaminated the syringe and needle (residue content only and fully discharged).

 

How are they disposed off?

  • Must undergo destruction by high temperature incineration (over 1000°C).

£800-1000/Tonne

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Blue Bodied Pharmaceutical Container

What do they look like?

  • Blue plastic bin with blue lid.

 

What goes in them?

  • For the disposal of creams, solid tablets, pills, medicine vials, ampoules, bottles and giving sets contaminated with pharmaceuticals. No cyto waste.

How are they disposed off?

  • Must undergo destruction by high temperature incineration (over 1000°C).

£800-1000/Tonne

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Yellow Container with Red Lid

What do they look like?

  • Yellow plastic bin with red lid (various sizes)

 

What goes in them?

  • For the disposal of body parts, full blood / plasma bags, recognisable human tissue and bone.

 

How are they disposed off?

  • Must undergo destruction by high temperature incineration (over 1000°C).

£800-1000/Tonne

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"Wow its pretty complicated! No wonder I was confused.."

Waste management really is tricky business and costly too. The NHS spends over 100 million pounds a year getting rid of the stuff! Waste makes up only 0.1% of the breakdown of the NHS carbon footprint, but with COVID-19, this is likely to have increased (SDU, 2016). 

Getting things in the right bin works both ways. Putting an empty plastic soda bottle in an yellow bag has significant cost and environmental implications. That plastic bottle will no longer get recycled and instead will undergo energy intensive high temperature incineration. On the other hand disposing of drug waste in domestic or offensive waste risks water contamination. 

GASP are currently advising in the development of a new government Health Technical Memoranda (HTM) on the management of healthcare waste - keep your eye peeled...

If you would like learn how you can save carbon, money and waste going to landfill, click here.

This page was written by our resident waste manager Neil Allen. Many thanks for his contribution.

If you would like to write for GASP or have any questions on the article, please email us: gaspanaesthesia@gmail.com