Medical Waste

Production

While hospitals and other facilities produce medical waste that can pose a threat of infection, the vast majority of waste volume arising in most healthcare facilities is municipal solid waste, such as paper, plastics, metal, glass, and food waste. In fact, approximately 80 percent of waste arising from these sources and operations is general waste, which is either identical or similar to that generated by hotels, offices, and residential properties. The remaining 20 percent of waste is what may be considered as hazardous materials, which may be infectious, toxic, or radioactive. However, this proportion has been calculated by the Centers for Disease Control and Prevention (CDC) as a significant overestimation of the true volume of medical waste that needs to be treated and disposed of separately. The CDC suggest that as little as 2–3 percent of hospital and healthcare wastes are likely to be medical waste for the purpose of regulation and control.

Risk Factors

Although medical waste constitutes a small fraction of the waste produced by these sources, it is of special regulatory concern because of the potential risks of harm to human health and the environment from pathogens that may be present in the waste or from hazardous chemicals. Poor management of medical waste can expose healthcare workers, waste handlers, patients, and the larger community to infection and toxic effects, as well as cause environmental risks, including pollution and contamination. Other potential infectious risks include the spread of microorganisms from healthcare establishments into the environment. Wastes and byproducts can cause injuries, for example, radiation burns, sharps-inflicted injuries, poisoning, and pollution. These impacts can occur through the release of pharmaceutical products, such as antibiotics and cytotoxic drugs, into wastewater or by the release of toxic elements or compounds, such as mercury or dioxins. Chemicals such as dioxins are often [Page 526]found in the air, water, soil, and living organisms. An unwanted by-product, they are formed when heating processes create certain chemicals like chlorine. Dioxins increase the risk of cancer, although they are also linked to reproductive health, lowering sperm counts, causing behavioral problems, and increasing the incidence of diabetes. In these ways, medical waste poses a significant risk of transmitting infections and contamination.

Waste Management in the European Union

In the European Union (EU), the sustainable management of waste is set out in the Waste Framework Directive (2008/98/EC). This piece of legislation outlines the basic obligations and objectives of member states in relation to waste. It is supplemented by a series of other directives that deal with specific wastes. Under Article 17, member states are required to take the necessary action to ensure that the production, collection, and transportation of hazardous waste, as well as its storage and treatment, are carried out in conditions providing protection for the environment and human health. This must be achieved in a way that minimizes risk to water, air, soil, plants, and animals and prevents nuisance of odor through adequate record keeping. It also requires member states to establish penalties and enforcement provisions in their national legislation to prohibit abandonment, dumping, or uncontrolled management of waste.

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