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February 2019

Health care waste: Terminology 101

Written by Nathalie Leblond
Health and Safety, Medical Waste and Waste Disposal

If anyone asked, “do you know the difference between infectious anatomical waste and hazardous chemical waste?” you’d be forgiven for answering “no”. Even those of us who work in the hygiene industry find that the terminology and jargon can get confusing. It doesn’t help that even in our legislation some of the terms are used interchangeably.

The first draft had this article take the form of an alphabetical list, however, I soon realised that grouping the waste categories and sub-categories made for a clearer picture. I hope you’ll agree and find this useful. Here’s my attempt at de-mystifying some of the common jargon we hear when referring to health care waste.

Understanding the difference between hazardous and infectious:

Hazardous waste: This refers to any material or substance that - if handled incorrectly - has the potential to harm people, property and the environment.

Infectious waste: This refers to any material that may contain pathogens (bacteria, viruses, parasites or fungi) in sufficient concentrations to cause disease.

Health care waste and all its different subsections and subclassifications:

Health care waste: This is all waste generated at a health care establishment or facility: defined as anywhere where professional health services are dispensed to human patients, or in which biological research is carried out, such as hospitals, clinics, rehab centres, sick bays, operating theatres, day units, mobile and stationary clinics and doctors rooms.

Health care waste is then subdivided into Health care general waste and Health care risk waste.

Health care general waste: This is non-hazardous waste. A bit of a catchall, the general waste category includes waste that has not been included in any of the other categories and does NOT pose a risk to people or the environment, such as office waste, kitchen waste, non-clinical glass waste and all other, similar waste.

  • Non-clinical glass waste: This is glass waste from maintenance and kitchen areas, such as used glass bottles, broken window panes etc. as long as it's not contaminated with blood or bodily fluids.

Health care risk waste is made up of hazardous and infectious waste components that are capable of producing disease.  Risk waste includes anatomical waste, chemical waste, non-anatomical infectious waste, pharmaceutical waste and sharps waste.

For the purposes of this blog, we are going to concentrate on Health care risk waste and all its sub-categories:

Anatomical waste: This is waste consisting of tissues, organs, body parts, products of conception (foetal or placental tissue) and animal carcasses. This is also sometimes referred to as Pathological waste.  (It does not, however, include hair, nails, and teeth, which fall into the category of Non-anatomical waste).

Anatomical waste is further sub-divided into:

  • Human anatomical waste: human tissues, organs, body parts, products of conception (foetal or placental tissue).
  • Animal anatomical waste: infectious and non-infectious:

Non-anatomical waste: This waste stream is comprised of human blood and bodily fluids, extracted teeth, nail clippings and hair. It is divided into infectious and non-infectious non-anatomical waste.

  • Non-infectious, non-anatomical waste such as hair and nail clippings can be disposed of in the general waste stream.
  • Infectious non-anatomical waste comprises of anything in the non-anatomical waste stream that may have been infected with micro-organisms capable of transmitting disease: for example bloodied linen, bandages, plasters etc

Chemical waste: This is waste that is made up of chemicals to be discarded in solid, liquid or gaseous form. Chemical waste may be hazardous or non-hazardous.  

  • Hazardous chemical waste: This is chemical waste that contains dangerous or polluting chemicals that pose a threat to humans, animals or the environment if disposed of improperly. It includes waste that is considered to be toxic, corrosive, flammable, reactive, explosive, or genotoxic.
  • Reactive chemical waste: This is chemical waste that is explosive, water reactive or shock sensitive.
  • Genotoxic waste: This is hazardous chemical waste that is carcinogenic, mutagenic, teratogenic or otherwise capable of interfering with living cells and altering genetic material or causing genetic damage.
  • Non-hazardous chemical waste: This is chemical waste that consists of chemicals such as sugars, amino acids and certain organic and inorganic salts and poses no risk to humans, animals or the environment.

Pharmaceutical waste: This waste stream is made up of unused drugs, medicines and medicinal chemicals that are no longer usable for patient treatment and have been returned, or have become outdated or contaminated, have been improperly stored, or are no longer required.

Sharps waste: This includes needles, syringes, hypodermic needles, scalpels, blades, clinical glass, pipettes and any other clinical items capable of causing a cut or puncture.

  • Clinical glass: Glass possibly contaminated with blood or bodily fluids or chemicals (for example blood collection tubes, lab glass, medication vials)

Once you have a handle on the different types of Health care waste, you need to work out whether you are a Health care risk waste generator.  Generators fall into 3 categories:

1. Domestic waste generator: This is a household or premise which generates less than one kilogram (1kg) per day of health care risk waste (calculated monthly).

2. Minor waste generator: This is an establishment that generates up to twenty kilograms (20kgs) per day of health risk waste (calculated monthly).

3. Major waste generator: This is an establishment that generates more than twenty kilograms (20kgs) per day of health risk waste (calculated monthly).

Both minor and major waste generators must comply with the guidelines set out in The National Health Act 2003 (Act No 61 of 2003): Regulations relating to health care waste management in health establishments, which include a “duty to dispose of waste safely. No health establishment may manage health care waste in a manner that may pose a risk or hazard to human health and the environment.“

The act goes on to say that health care waste generators are “legally and financially responsible for the safe handling and environmentally sound disposal of the waste they produce” and  “have responsibility for the waste from the point of generation until its final treatment and disposal” (the cradle to grave concept).

In an upcoming blog, we’ll look at what these regulations actually mean for healthcare establishments and how Initial can assist with cradle to grave waste disposal services.

Keep a safe environment by downloading your Waste Disposal Posters - posters that you can place in your organisation to ensure that waste is being correctly disposed.

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Contact Initial today for more information on how we can tailor make our medical waste services for your business, and a free quote.

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Nathalie Leblond

Nathalie Leblond

I joined Rentokil Initial South Africa in 2004 as the PA to the MD, and after 6 months maternity leave I re-joined the Company in 2009 as the Marketing Co-ordinator for Rentokil. I'm now the Marketing Communication Manager for Rentokil Initial. I'm still terrified of cockroaches (Americana's only!) but the rest of the creepy crawlies we deal with don't really bug me (see what I did there?), so I guess I'm in the right industry! I am passionate about what we do here at Rentokil Initial and also write for our Hygiene Blog, which can be found at blog.initial.co.za, and our Ambius blog - https://www.ambius.co.za/blog. Life outside of Rentokil Initial mostly revolves around my daughter, who has just turned twelve, and my husband (who is a bit older). I love living in Cape Town and wouldn't trade living here for anywhere else in the world.

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