What happens to waste? Answers to common questions
Clinical waste
What is clinical waste?
Clinical waste is defined in the Controlled Waste Regulations 1992. It means any waste which consists wholly or partly of:
- human or animal tissue;
- blood or bodily fluids;
- excretions;
- drugs or other pharmaceutical products;
- swabs or dressings; or;
- syringes, needles or other sharp instruments;
which unless rendered safe may prove hazardous to any person coming into contact with it. And:
- any other waste arising from medical, nursing, dental, veterinary, pharmaceutical or similar practice, investigation, treatment, care teaching or research, or the collection of blood for transfusion, being waste which may cause infection to any person coming into contact with it.
What controls are there on the disposal of clinical waste?
Clinical wastes are healthcare wastes that may prove hazardous to those that come into contact with them. There are stringent controls in place to ensure that clinical waste is managed safely and is recovered or disposed of without harming the environment or human health. Under the Environmental Protection Act 1990 it is unlawful to deposit, recover or dispose of controlled (including clinical) waste without a waste management licence, contrary to the conditions of a licence or the terms of an exemption, or in a way which causes pollution of the environment or harm to human health. Contravention of waste controls is a criminal offence. Section 34 of the Act, places people concerned with controlled (including clinical) waste under a duty of care to ensure that the waste is managed properly, recovered or disposed of safely and is only transferred to someone who is authorised to keep it. Householders are exempt for their own household waste.
What about clinical waste produced in a private household?
Hypodermic needles and hazardous clinical wastes should never be disposed of in the domestic waste stream.
If patients are treated in their home by a community nurse or a member of the NHS profession, any waste produced as a result is considered to be the healthcare professional's waste. If the waste is non-hazardous, and as long as it is appropriately bagged and sealed, it is acceptable for the waste to be disposed of with household waste. This is usually the case with sanitary towels, nappies and incontinence pads (known collectively as sanpro waste) which are not considered to be hazardous when they originate from a healthy population. If the waste is classified as hazardous the healthcare professional can remove that waste and transport it in approved containers (i.e. rigid, leak proof, sealed, secured etc) and take it back to the trust base for appropriate disposal. Alternatively, the trust can make arrangements for the disposal of the waste with an appropriate waste contractor for which a charge may be made.
If patients treat themselves in their own home any waste produced as a result is considered to be their own. Only where a particular risk has been identified (based on medical diagnosis) does such waste need to be treated as hazardous clinical waste. In these cases, local authorities are obliged to collect the waste separately when asked to do so by the waste holder, but may make a charge to cover the cost of collection.
In the case of pharmaceuticals the recommended means of disposal is to return them to a pharmacist. If this is not possible then again local authorities are obliged to collect the waste separately when asked to do so by the waste holder, but may make a charge to cover the cost of collection.
Does the quantity of waste produced affect its classification?
Human hygiene or sanpro waste can sometimes be produced in large quantities in places such as schools, nurseries and motorway service areas. Although such wastes from these sources may be non-hazardous, in quantity they can be offensive and cause handling problems. In these cases, where the premises generate more than one standard bag or container of human hygiene waste over the usual collection interval, it is considered appropriate to package it separately from other waste streams.
Are there any special arrangements for hypodermic needles produced in the home?
Sharps bins can be obtained on prescription (FP10 prescription form) and can be returned to your doctor for disposal when full. There is also a duty on local authorities to collect and dispose of household generated waste including clinical/sharps waste from households. However, collection of clinical/sharps waste does not arise until a person requests such a service. Local authorities may then levy a reasonable charge on the waste holder for the collection of that waste. On no account should soft drink cans, plastic bottles or similar containers be used for the disposal of needles, since these could present serious hazards to staff if they were disposed of in domestic waste.
Hazardous Waste Regulations 2005
In July 2005 the Hazardous Waste Regulations replaced the Special Waste Regulations and introduced new definitions of hazardousness for infectious and pharmaceutical wastes. Wastes that contain substances containing viable micro-organisms or their toxins which are known or reliably believed to cause disease in man or other living organisms are hazardous wastes (H9 infectious). Only cytotoxic and cytostatic medicines are hazardous. These are waste medicines possessing hazardous characteristics H6 toxic , H7 carcinogenic, H10 teratogenic or H11 mutagenic.
The Environment Agency is responsible for administering the hazardous waste regime. Guidance on how to assess the hazardous properties of waste can be found in Annex C of the their guidance document WM2:
Page last modified: 11 December 2006
Page published: 24 April 2003