Tips for Minimizing Waste
As much as 80% of the waste produced in healthcare centres is not hazardous but ordinary waste like that from homes and offices. If it is not mixed with more dangerous wastes, much of it can be reused or recycled. This can reduce the amount spent on specialist treatment and disposal, and even produce income from the sale of paper, plastic and other recyclables.
The first step is to put in place a rigorous segregation program. Sorting healthcare waste once it has been mixed is extremely hazardous and should never be attempted.
HCWH-Southeast Asia has been collaborating with hospitals around the Philippines and found it was possible to reuse or recycle numerous products. As well as the well-known recyclables such as paper and glass, markets or secondary uses were found for everything from printer cartridges to used cooking oil cans.
Food waste was either composted for use on the hospital grounds, or sold for animal feed. Hospitals have a dedicated Health Care Waste Management Committee responsible for developing the health care facility's waste management plan which includes policies and guidelines on proper waste management, training and education, and monitoring. The committee schedules a monthly meeting to discuss problems related to waste management and find new ways to recycle and reuse products. Different hospitals found a variety of ways to utilise the money saved or earned from their new waste management practices — in one case there was enough to pay the salary of the waste manager, making the whole system self-sustaining. Read more in the Philippines Best Practices report.
Another important step that healthcare facilities can take is to reduce the number of unnecessary injections. Many patients have an unfounded belief that injections are better than pills. However, the used syringes are capable of spreading infections like HIV and hepatitis. Wherever a treatment can be given orally, that should be the preferred method.
The procurement department should consider the amount and toxicity of waste generated by a specific product before purchasing. For example, products containing PVC, mercury, silver, BPA or other toxic materials should be avoided wherever possible. Reusable — from food ware to those medical devices that can be safely sterilised and reused — should be favoured over disposables. Where the products themselves are equivalent, choosing the one with the lighter or more easily recycled packaging can make a genuine difference to the balance between wastes that the facility has to pay to dispose of and that which it can sell for recycling.
Healthcare facilities should develop procurement policies with waste minimisation in mind. Low-toxicity, low-waste products should be trialled to make sure they are reliable and easy to use, and then added to the purchasing policy through a decision of the waste management committee or other decision-making structure.
Health Waste Assessment Project
In the Philippines, HCWH-Southeast Asia launched its Health Care Waste Assessment Project (HWAP) with the following objectives:
- Draw up baseline data on good health care waste management practices
- Identify the types of health care waste generated per hospital and the total volume of health care wastes generated by the facility/locality
- Draw up existing waste management systems and procedures with particular attention to good practices and problems encountered
- Determine the actual costs of existing waste management systems in the hospitals under study
- Develop a health care waste assessment procedure appropriate in the Philippine health care setting and also for adaptation in other Southeast Asian countries.
The results and recommendations from the health care waste assessment project will be beneficial for the improvement of the health care waste systems and procedures of the hospital/ health care facility under study.
The highlighted good practices of the hospital/ health care facility will hopefully serve as guide or model to other hospitals in the Philippines and in Southeast Asia so that they can adapt and institute the necessary systems and procedures for their health care waste programs.
The result of the study will further refine the health care waste assessment process suitable in the Philippine and Southeast Asia health care settings.
The Health Care Waste Assessment Project employs the following process:
- Stage 1 is gathering of preliminary data which included document review, interview with the hospital administrators and members of the waste management committee and preliminary walk-through in the hospital.
- Stage 2 is a validation of preliminary data gathered from Stage 1 and further validation through focus group discussions.
- Stage 3 is the final validation of data gathered from Stages 1 and 2 through actual walk-through assessments and observing the waste management practices from waste collection, waste segregation, actual weighing of health care wastes, transport and final disposal.
- Stage 4 is the collation and analysis of data gathered from Stages 1 to 3. Collated data are analyzed and initial results are given in the form of case studies to all hospitals.
- Best Environmental Practices and Alternative Technologies for Medical Waste Management (pdf)
Discusses impacts of medical waste incineration and alternatives for the developing world
- Best Practices in Health Care Waste Management: Examples from Four Philippine Hospitals (pdf)
- Contamination of Chicken Eggs near Indian Hospital by Dioxins, PCBs and Hexachlorobenzene (pdf)
- Eleven Recommendations for Improving Health Care Waste Management (pdf)
- For Proper Disposal: A Global Inventory of Alternative Medical Waste Treatment Technologies (pdf)
- GEF/UNDP Project: Demonstrating and Promoting Best Techniques and Practices for Reducing Healthcare Waste to Avoid Environmental Releases of Dioxins and Mercury (pdf)
- Health Effects of Waste Incinerators (pdf) British Society for Ecological Medicine report
- Health Care Waste Assessment Project: A Partnership Between the Local Government Unit of Baguio, Tertiary Hospitals in Baguio City and Health Care Without Harm-Southeast Asia (pdf)
- Health Care Waste Assessment Tools (pdf)
- Incineration and Human Health: State of Knowledge of the Impacts of Waste Incinerators on Human Health (pdf)
- Non-Incineration Medical Waste Treatment Technologies in Europe (2004 version, pdf)
- Promoting Best Practices to Reduce Health Care Waste and Avoid Dioxin and Mercury Releases (pdf)
- Understanding and Simplifying Bio-Medical Waste Management (pdf)
Toxics Link Training Manual for Trainers
- WHO: Safe Health-Care Waste Management Policy Paper (pdf)
- WHO: Safe Management of Wastes from Healthcare Activities (pdf)