Waste Management Guidelines
The World Health Organization (1999) presents the following summary of recommendations for waste management:
- Prevent and minimize waste production.
- Reuse or recycle the waste to the extent possible
- Treat waste by safe and environmentally sound methods.
- Dispose of the final residues by landfill in confined and carefully designed sites.
These recommendations are discussed in more detail below.
Health Care Waste
The following recommendations to encourage the minimization of health care waste are provided by the World Health Organization (Table 6.1, p. 59).
Source reduction
- Purchasing reductions: selection of supplies that are less wasteful or less hazardous.
- Use of physical rather than chemical cleaning methods (e.g. steam disinfection instead of chemical disinfection).
- Prevention of wastage of products, e.g. in nursing and cleaning activities.
- Centralized purchasing of hazardous chemicals.
- Monitoring of chemical flows within the health facility from receipt as raw materials to disposal as hazardous wastes.
Stock management of chemical and pharmaceutical products
- Frequent ordering of relatively small quantities rather than large amounts at one time (applicable in particular to unstable products).
- Use of the oldest batch of a product first.
- Use of all the contents of each container.
- Checking of the expiry date of all products at the time of delivery.
Recommendations for the Segregation of
Health Care Waste
According to the World Health Organization, “the key to minimization and effective management of health-care waste is segregation (separation) and identification of the waste” (p. 61). Nurses are in a position to ensure this happens and simple practice changes related to the way nurses sort the waste they create can ensure that the various forms of waste are treated and disposed of properly. “The most appropriate way of identifying the categories of health care waste is by sorting the waste into colour-coded plastic bags or containers” (World Health Organization, p. 61). The following table outlines the World Health Organization’s recommended colour coding scheme:
| Type of Waste | Colour of Container and Markings | Type of container |
| Highly infectious waste | Yellow, marked “HIGHLY INFECTIOUS” | Strong, leak-proof plastic bag or container capable of being autoclaved |
| Other infectious waste including pathological and anatomical waste | Yellow | Leak-proof plastic bag or container |
| Sharps | Yelow, marked “SHARPS” | Puncture-proof container |
| Chemical and pharmaceutical waste | Brown | Plastic bag or container |
| Radioactive waste | | Lead box labeled with the radioactive symbol |
| General waste | Black | Plastic bag |
(World Health Organization, p. 62 table 7.1)
Recycling and Reuse of Health Care Waste
The following supplies may be recycled as long as they are separated from other wastes, carefully washed, and undergo thermal or chemical sterilization procedures (World Health Organization):
- Certain sharps including scalpels and hypodermic needles.
- Glass bottles and containers
- Syringes. Plastic syringes and catheters should be discarded.
- Metals
- Paper
- Plastics
- Cardboard
Sewering pharmaceuticals
The following are generally acceptable for sewering:
- Solutions in IV bags containing only : saline solution, lactate, nutrients such as glucose (D5W), vitamins, and added salts such as potassium and/or other electrolytes.
The following wastes are not acceptable for sewering:
- Any hazardous wastes.
- Liquid and solid pharmaceutical wastes, or IV bags containing biologically active materials (e.g., antibiotics, painkillers, and chemotherapy agents) and controlled substances.
(Health Care Without Harm, 2005).
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