Infectious Waste

Infectious waste, also known as medical or clinical waste, is produced by healthcare premises such as hospitals, clinics, medical offices, clinical and research laboratories, and nursing homes. Best management practices for infectious waste have been defined by the World Health Organization (WHO) to be adapted according to national and local situations. Many treatment systems are suitable for infectious waste, except encapsulation (which can be used for sharp objects) and inertization to prevent potentially explosive reactions or flammability. Highly infectious waste containing deadly human pathogens should be autoclaved first. As background, healthcare activities produce infectious wastes that lead to adverse health effects and are a risk for patients, healthcare workers, waste handlers, and communities. Used syringes and needles contain residual blood and blood-borne pathogens and may transmit diseases when reused without reprocessing or through accidental needlesticks. Little attention is paid to ensure the budgeting and financing for management of infectious waste.

WHO aims at developing clear guidance, policies, and recommendations for the safety of healthcare workers and the public. The guiding principles of the policy paper on safe healthcare waste management are to prevent the health risk associated with exposure to healthcare workers by promoting sound management policies and to reduce the exposure to toxic pollutants associated with the combustion process through the promotion of appropriate practices. It also acknowledges that until countries in transition and developing countries have access to healthcare waste management options that are safer to the environment and health, incineration may be an acceptable response when used appropriately. Key elements of appropriate operation of incinerators include effective waste reduction and waste segregation, placing incinerators away from populated areas; satisfactorily engineered design; construction following appropriate dimensional plans; proper operation; periodic maintenance; and staff training and management.

Infectious wastes such as used syringes and needles lead to adverse health effects and are a risk for patients, healthcare workers, waste handlers, and communities.

To support implementation, a WHO healthcare waste website (http://www.healthcarewaste.org or http://www.who.int/water_sanitation_health) offers technical options, costing tools, country information, contacts, and 142 reference documents. This includes a practical pocket-size document on managing waste from injection activities, along with [Page 234]two related posters. The posters summarize the strategies proposed for the management of waste from injection activities; a portion of the poster demonstrates on-site and off-site treatments, and another portion shows the use of needle removers, a device not yet approved by WHO because of its potential risk of needlestick injuries for injection providers. Nevertheless, it has added value for preventing needlestick injuries among waste handlers and communities. As of 2010, a study was being conducted in Bangladesh on routine activities, which should soon determine the value of the practices. Meanwhile, WHO has developed prequalification specifications on injection-related equipment, including a needle remover, aimed at providing recommendations for the purchase of equipment, as this equipment has already been introduced by the Ministry of Health in a number of countries (e.g., India). Additionally, recycling or reprocessing plastic syringes into other utensils represents a return value (e.g., in India, where it has been put into practice and is working well).

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