BEST PRACTICES

Even when not required by regulators, some best practices associated with clinical waste management include the following:

1. Segregate clinical wastes at the point of generation; do not mix clinical waste with hazardous or radioactive waste. Further segregate wastes into three categories, Sharps, Waste for Incineration and Waste for Other Disposal/treatment options. This will minimise the amount of waste that must be incinerated and possibly keep the incinerator in a lower operating classification minimising the regulatory requirements of the incinerator.
2. Be sure clinical waste is properly bagged and/or containerised as close to its source of generation as possible. This will protect those that transport and handle the waste downstream.
3. Store clinical waste in sturdy 3 mm plastic bags. Bags or other containers should be sturdy and not subject to leakage. Label bags with information identifying the generator, date, and type of waste contained. Use red bags that do not contain toxic metals or toxic inks.
4. Wastes should be stored in areas with adequate ventilation and waste should not be allowed to decay to prevent creation of odors. If necessary, refrigeration may be needed.
5. Areas used to store clinical waste should be durable, impermeable to liquids and easily cleaned and disinfected. The area should be protected from rodents and other vermin that could potentially spread infectious material. The area should be protected from the weather.
6. Waste areas should be clearly marked and secured and controlled to allow access to only authorized personnel.
7. Clearly mark containers as containing medical/infectious waste.
8. For wastes that are autoclaved, maintain a log indicating date, time and material disinfected along with parameters such as temperature, run duration, pressure, etc.
9. Dispose of sharps separately in specified sharps containers. Do not fill containers more than ¾ full
10. Where possible seek environmentally appropriate treatment options. Avoid incineration where possible. Treatment options for clinical waste may include:
    - Chemical treatment - usually used to treat sharps prior to disposal as solid waste. Some infectious fluids can be chemically treated and discharged to a sanitary sewer. Be sure to check with the wastewater treatment plant or local regulators before discharging any wastes to the sanitary sewer system. Chemicals used for treatment can include chlorine solutions, bactericides, fungicides, and may be considered hazardous.
    - In some cases certain biological and infectious fluids can be discharged directly to the sanitary sewer. Check with the wastewater treatment plant to be sure as to what is allowed in your area.
    - Steam sterilisation may be used to treat sharps, pathological wastes, and some animal wastes. Steam sterilisation has the advantage of not producing chemical wastes but usually requires equipment operated by trained personnel.
    - Incineration can be used to treat a large volume of wastes. However incineration requires adherence to special regulations for medical incinerators because of the potential to pollute the air and the ash may need to be managed as hazardous waste if it meets the characteristics of hazardous waste.
11. Review opportunities for waste minimisation. Conduct a waste stream analysis and identify areas where wastes can be minimised or recycled.
12. Educate employees on the importance of following waste minimisation and segregation.