12.2 Waste management

Health care waste

Health care waste contains potentially harmful microorganisms that can infect patients, team members and the general public. Other potential hazards may include drug-resistant microorganisms which spread from health facilities into the environment.

Negative health outcomes associated with health care waste and by-products could include:

• sharps-inflicted injuries
• toxic exposure to pharmaceutical products, in particular, antibiotics and cytotoxic drugs released into the surrounding environment
• chemical burns from disinfection solutions, sterilization or waste treatment activities
• air pollution arising as a result of the release of particulate matter during medical waste incineration
• thermal burns from operating autoclaves
• injuries occurring in conjunction with open burning and the operation of medical waste incinerators

Lack of awareness about the health hazards related to health-care waste, inadequate training in proper waste management, absence of waste management and disposal systems, insufficient financial and human resources and the low priority given to the topic are the most common problems connected with health-care waste.

New Zealand Standard NZS 4304:2002 details how health care waste is managed. Management of some hazardous waste will require reference to other sources, for example, National Radiation Laboratory Code or controls under the Hazardous Substances New Organisms Act 1996).  

Health care waste refers to all waste generated by a health care facility and includes ‘non-hazardous’, ‘controlled’ and ‘hazardous’ waste. Non-hazardous waste constitutes the bulk of waste generated and is managed in the same way as household waste. Hazardous waste requires proper handling, storage, transport and disposal to minimise risk to personnel, the public and the environment, and to prevent causing cultural or aesthetic offence.

A fundamental principle of waste management is the minimisation of waste.

Waste Management AS/NZS 4304:2002 requires the waste management policy to include processes on standard precautions and PPE as well as emergency waste management (which may also be included in your pandemic plan).

Health care waste policy

Healthcare waste policy and procedures must include:

• emergency waste management
• a designated waste management officer
• standard precautions
• consideration of Te Tiriti o Waitangi commitments (4.3.8 of the legislation)
• segregation of waste
• waste management procedures
• Reuse and recycle strategies
• practice team members’ roles and responsibilities
• relevant training and frequency of training
• audit to check compliance against the policy
• reflect the organisation’s size and complexity
• a policy and procedure review every two years
• adherence to local council by-law

Puncture resistant sharps containers 

There are a variety of different sharps containers, they are usually yellow, and all must have the biohazard symbol displayed on the outside of the container.

Wall hung sharps containers are to be positioned 1.5 metres from the floor to ensure they are safely out of reach to children. Bench top sharps containers must be in a restricted area, kept at the rear of the bench and not closer than 0.5 metres to the ends of the bench. In both instances, consider nearby chairs or furniture a child could potentially climb on to reach the sharps container.

Disposal of sharps falls into hazardous substances and are to be disposed of by an approved waste contractor.

Training and induction resources

The College has not specified training or frequency of training in favour of practices identifying which training best fits the scope of their individual practices and aligns with the NZ Standards applied to the indicators.

• The College will also accept correctly documented in-house training.
• New team members must be inducted into the practice’s processes of waste management.