I: INTRODUCTION - Anatomical waste is a subgroup of

pathological waste. This type of waste

It is commonly acknowledged that hospitals and other health refers to recognizable human body
care institutions are waste producers and that 30 to 37% of wastes parts.
generated from these institutions are most hazardous and  Amputated body parts like limbs, fingers, toes, etc.
potentially dangerous of all wastes arising in the community. As the
volume and complexity of these wastes increase, resulting from the 4. PHARMACEUTICAL WASTE
increased utilization by the people of these health care services, the - Pharmaceutical wastes includes
risk of transmitting diseases through unsatisfactory collection, expired, spilt, and contaminated
handling storage treatment transport and disposal practices also pharmaceutical products, drugs,
increases. vaccines and sera that are no longer
In line with this awareness, there is a need to improve and required and need to be disposed of
impose stricter control over the disposal of wastes generated within appropriately. This category also
our hospital in order to minimize the risks and health hazards include discarded items used in
imposed particularly to our staff, personnel and patients and to the handling pharmaceuticals such as
community in general. This can be achieved by the reduction of bottles or boxes with residues, gloves,
wastes and by using enforceable codes, guidelines and instructions masks, connective tubing and drug
for all aspects of our health care waste management plan. vials.

II: OBJECTIVES
5. CHEMICAL WASTES
1. Clear definition of hazardous wastes, its various categories - Chemical wastes consist of discarded
and the hazard/risk involved. solid, liquid and gaseous chemicals used
2. Application of concepts that can minimize risk to patients, in diagnostic and in cleaning,
healthcare workers and the environment. housekeeping and disinfecting
3. Installation of appropriate monitoring system to ensure procedures. Chemical waste from
enforcement of guidelines and policies. hospitals can be hazardous or non-
4. To review policies and guidelines as needed to adapt to hazardous.
new technologies and trends.
5.A. HAZARDOUS CHEMICAL WASTES
III: CATEGORIES OF HOSPITAL WASTES
1. TOXIC – chemicals have the capacity to harm biological
A. HAZARDOUS WASTES tissues.
2. CORROSIVE – chemicals that cans cause severe burns to
1. INFECTIOUS WASTES skin and other biological tissues including the eyes and
- These are wastes that are most likely to lungs.
contain pathogens (bacteria, viruses, 3. FLAMMABLE – chemicals that can ignite or burn easily in
parasites, fungi, etc.) in sufficient normal working temperatures.
concentration or quantity to cause 4. RADIOACTIVE – chemicals that can react by themselves
diseases in susceptible hosts. when exposed to heat, pressure, shock friction or by
 cultures and stock of infectious agents from laboratory contact with air or water.
works, wastes from surgeries and autopsies (e.g. tissues or
materials or equipment that have been in contact with 5.B. NON-HAZARDOUS CHEMICALS WASTES
human blood or other body fluids.)
 wastes consist of chemicals with none of the above
 wastes from infected patients in isolation wards (excreta, properties
dressings from infectious wounds, clothes soiled with  sugar, amino acids and certain organic and inorganic salts.
human blood or other body fluids)
B. NON-HAZARDOUS OR GENERAL WASTES.
 wastes that have been in contact with infected patients - This includes all the wastes that have
undergoing hemodialysis or any other instruments or not been infected like general office
materials that has been in contact with infected person. waste, packaging, leftover food, x-ray
plates and nonhazardous
2. SHARPS pharmaceutical wastes. They are
- Sharps are considered as the most comparable to domestic wastes, which
hazardous waste generated in hospitals does not pose special handling
and must be managed with utmost problems or hazard to human health or
care. This is because of the double to environment. They comprise around
danger it poses. It can cause injuries 70% of the generated wastes in any
through accidental pricks, cuts or hospitals. General wastes shall be dealt
punctures. Aside from this, one can with by the municipal waste disposal
also be infected with a pathogen system.
through these injuries. Whether or not
they are infected, such items are B.1 RECYCLABLE WASTES
usually considered as highly hazardous  paper products
wastes.  aluminum such as in beverage cans, food cans, etc
 pressurized gas containers such as in disinfectants sprays,
 Examples of sharps include needles, syringes, oxygen tanks.
scalpels, saws, blades, broken glass, infusion  plastics such as in water bottles, soft drinks, containers etc
sets, knives nails and any other items that can  glass
cause a cut or puncture wounds.  wood
 durable goods used in furniture’s, bedframes, curtains
3. PATHOLOGICAL AND ANATOMICAL WASTES  electronic devices such as computer equipment, printer
cartridges, toners
- Pathological wastes refer to tissue
sections and body materials derived B.2 BIODEGREDABLE WASTES
from biopsies or surgical procedures  leftover food of patients with non-communicable disease
that are examined in the laboratory.  garden wastes such as cut grasses or tree trimmings
 Placenta, internal organs, tissues used for diagnostic
procedures such as biopsy, blood and fetus.
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 B.3 NON-RECYCLABLES/NON-BIODEGRADABLE WASTES
 includes all the non-hazardous or general wastes that do
not belong to the previous two categories.
IV: PRETREATMENT OF WASTES
- Infectious and pathological wastes and
sharps are soaked in 1% chlorine prior
to their proper disposal. It must be
noted that no infectious waste is to be
collected or disposed without prior
application of the pre-treatment
process or disinfection as it may pose
potential health hazard to others
(garbage collectors, scavengers, etc.).
V: SORTING, SEGREGATING AND COLOR CODING
The effective management of healthcare waste considers the basic
elements of waste minimization, segregation and proper
identification of the waste materials. Appropriate handling,
treatment and disposal of waste by type reduce cost and do much to
protect public health. Segregation at source shall always be the
responsibility of the waste generator.
Segregation is the process of separating different types of waste
at the point of generation until its final disposal.
Hazardous waste generated requires special treatment methods
for the safety of health workers, patient’s visitors and the general
public.
To improve segregation efficiency and minimize incorrect use of
bins, proper placement, labeling of waste bins and use of color
coded plastic liner must be implemented.
The purpose of color coding is to make it easier for health care
worker to puts the waste into correct bins and maintain segregation
during collections, storage, transport, treatment and disposal.
Color coded covered storage bins should be situated in strategic
areas and or lined with corresponding color coded plastic bags:
1. RED – sharps (puncture proof plastic container with cover)
and pressurized containers.
2. YELLOW – infectious and pathological wastes
3. BLACK – non-infectious, non-biodegradable waste
4. GREEN – non-infectious biodegradable waste
5. YELLOW WITH BLACK BAND – chemical and
pharmaceutical wastes.
VI: COLLECTION AND TRANSPORT SYSTEM
The selected appropriate collection system should be implemented
in a sanitary manner without creating nuisance or pollution to the
public.
a. Collection system route
1. Planning the logical route should avoid routing the
collected packaging type hospital waste on congested
areas.
2. Collection system route must be laid out from the farthest
point of the designated transfer station on disposal area,
and as collection progresses towards the collection storage
area.
3. Routes drawn shall be practicable, compact and must
consider the logical progression of hospital waste
production throughout the area.
4. Revised routing plan should be established in cases and
circumstances that may arise in the original plan.
b. Scheduling
1. Preparation of a collection schedule by route or zone.
2. Assignment of responsible personnel by zone or area.
3. Provision of collection schedule to municipal collection
service.
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c. Collection system frequency
1. The recommended frequency of collecting hospital waste
on a room to room basis shall be at least once every shift
or as often as necessary.
2. The time of collection waste regardless of any category
shall be made at the end of every shift.
3. All receptacles and area designated as collection shall be
covered throughout the day.
d. Collection storage / transfer station
1. The hospital waste management shall assist the
maintenance personnel in the following activity:
2. Inspect and supervise the construction of a collection,
storage/transport status within the hospital compound in
which all packaged – type hospital waste is disposed or
stored prior to collection by municipality collection service.
3. Determine the capacity of transfer station to be built
based on the waste generated by the hospital.
4. Locate hospital transfer station within the hospital
compound and shall conform with the following site
criteria:
 it must be located as nears as possible to the center of
waste production on the collection area which it serves.
 It must be accessible to municipal service.
 It must be located where there is minimum public
objection for the transfer operation of the municipal
collection service.
 When transfer station is not available within the hospital
compound, an arrangement with municipal collection
service must be provided in transferring or disposing of
hospital waste to disposal site.
VII: DISPOSAL SYSTEM
Non-hazardous or general waste in black and green plastic
containers are collected from different collection points and
transported to the transfer station located at the west side of the
hospital where they are ultimately collected by the city garbage
collection team.
Pre-treated infectious waste in closed containers from the
laboratory collected in yellow plastic bags is likewise transported to
the transfer station. (refer to laboratory manual for further details)
Pre-treated pathological wastes containing body parts, human
fetuses and sharps in puncture proof containers are placed in septic
vaults located at the west side of the hospital. (refer to OR/DR
manual for details)
Pre-treated blood and body fluids, hazardous chemical rendered
less hazardous buy dilution with other base or acids or adequate
amount of water are drained directly into sinks followed by proper
rising. (refer to laboratory manual for details).
Expired and spoiled drugs / medicines are regularly collected by
our pharmacists and are disposed directly to the sink after proper
handling and documentation. (refer to pharmacy manual for
details).
Sharps are disposed after pre-treatment awhile empty medicine
bottles and vials are being collected by the janitorial for manually
grinding and placed in septic vaults while part of it are being
collected by the central supply room personnel for use of laboratory
and ward as specimen bottles.
Empty IVF bottles (glass) are also being collected by the central
supply room personnel for use as drainage bottle for CTT and at
dietary department as osteorized feeding container.
Pressurized containers like oxygen tanks are returned to the
suppliers for refill. Light weight pressurized containers are crushed
before disposal together with the general waste.
X-rays hazardous wastes are collected into converted plastic
containers and collected buy a private person for recycling. (see
radiology dept. manuals for details.)
 VIII: REDUCTION OF OUR HOSPTAL WASTES
Our generated hospital waste is further sorted into
biodegradable and non-biodegradable, recyclable wastes.
Biodegradable wastes liked food leftovers coming from the
dietary dept., patients and personnel are collected in covered plastic
pails and utilized as food for domestic animals.
Non-biodegradables and recyclable wastes like empty plastic, IVF
containers, etc, are likewise collected and sold to junk shops.
Recycling of hospital forms and reduction of size of forms are being
reported in order to reduce the consumption of the precious
resources and to protect the environment from the frequent cutting
of trees utilized in paper making.
IX: TRAINING COMPONENT
When job performances is judged and found to be below
standard, there’s is a need for a training to improve and change job
performances. There is a need to improve and change performance
when:
a. The staff/personnel do not know how to do all or part of
his /her current job.
b. The staff/personnel are given news task requiring news
knowledge, skills or attitudes.
c. The staff/personnel are given an entirely new job requiring
news knowledge, skills or attitudes.
Training hospital Staff / personnel Program
1. Hospital waste management for hospital administrative
and department heads
2. Storage, pre-treatment and disposal of hospital dangerous
wastes for housekeeping and maintenance of technical
staff / personnel.
3. Operation and maintenance of hospital waste disposal
facilities for plant operation and maintenance of technical
staff/personnel.
4. Development of IEC (information, education,
communication) materials on hospital waste management
for hospital retraining staff/personnel.
IEC support service
1. Continuous Health Education campaign to personnel
concerned and to the public as well.
2. IEC materials development reproduction and
dissemination.
3. Head/chief of hospital or duly authorized representatives
follows up of sanitary conditions.
4. Institutional reforms promoting a repeated integrated
approach including changes in procedures, attitudes and
behaviors and the full participation of woman at all levels
in sector institutions should be encouraged.
X: ADMINSTRATIVE COMPONENT
A. Organization and functions
The entire organizational structure and services of a hospital must
be responsible in the proper storage, collection and disposal of
wastes generated by hospital. However, there are certain services
or units in the hospital that usually have more responsibility like the
office of the chief of hospital or director of hospital, housekeeping
services, maintenance and ground services and the motor pool
services.
Duties and responsibilities of the chief/director of hospital or head
of health care facility.
a. Plans program me for hospital waste management
activities with the head of sections/services directly
involved in the implementation scheme and with the
assistance of the provincial sanitary engineer.
b. Prepares and requests the necessary budget of the
program from authorities concerned.
c. Established good working relations with all the medical
sections/services for their full participation in the planning
and implementation stage of the program.
d. Establishes good working relations with related agencies
by proper referral, consultation and cooperating system
concerning waste management.
e. Carries all routine inspections in relation to activities of the
shoptalk waste management program.
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f. Attend to complaints in legal matters regarding existing
and unforeseen problems arising from the implementation
of the program.
Duties and responsibilities of the housekeeping services
a. Maintain cleanliness, orderliness of the hospital premises
for aesthetic reasons.
b. Assists in the preparation stages of planning the hospital
waste management program.
c. Initiate a sanitary manner of implementing the pre-
treatment processes, appropriate collection
system/processes and disposal of hospital waste either
buy individual group or municipal system.
d. Maintain a good working relationship with all the hospital
personnel constantly for their support and full
participation in implanting the programme.
Duties and responsibilities of the maintenance and group services
a. Assists in the proper pre-treatment, collection and
disposal of hospital wastes.
b. Carries out directly at the activities related to the
operation and maintenance of pre-treatment, collection
and disposal facilities as soon as possible the importance
of drainage system and plumbing facilities of the shoptalk.
c. Attends immediately to problems arising from the
repair/installation of waste equipment.
B. Planning the hospital waste management programme
A five year programmer plan should be prepared by the hospital.
From this five year plan, an annual plan is formulated. This program
me plan should be incorporated into the hospital development plan
and be provided with budget. Planning should be a collaborative
effort to all responsible staff of the hospital.
The content of the plan should include among others:
a. The situation, a description of the hospital waste
management situation; the hospital areas that generate
waste, their type and hos stored, collected and disposed.
Issues and problems are the products of these situational
analyses.
b. The objective of the plan: which could be divided into
general and specific objectives? The objectives are
addressed to the identified problems.
c. The strategies: these are the ways and means by which the
objectives can be attained.
d. The activities and targets: each strategy are translated into
activities and corresponding targets.
e. Resource requirements: the resources that are required of
implementation the program plan must be identifies with
correspond budget. This can be done by identifying what
resources are needed for every activity and estimate the
cost for each resource need per activity.
C. Recording and Reporting
Recording
The hospital management is required to establish proper
recording on waste management activities and maintain it by
upgrading all exciting record. Appropriate records shall form the
basis upon which financial and operational contents may be
developed.
The following are the guidelines for classification of records and
files.
a. Work plan
1. five year plans
2 annual work plan
3monthly work plan and/or quarterly work plan
4weekly work plan
 b. Major activities
1 storage
2 collection
3transportaion with requirements
4 disposal
c.Reports
1 daily work sheet
2 quarterly report

d. Administrative matter
1 personnel
2 supplies and equipment
3 miscellaneous

f. Reporting
Appropriate report forms shall be devolved and made available for
authorities concerned.

-END-

“Hospital waste management is a constant challenge to maintain

cleanliness, proper disposal of waste materials and to reduce
public health hazard and promote a healthy environment.”

Reference:

Hazardous Material and Waste Management Plan Manual June 4,

2010
Healthcare Waste Management Manual; 3rd Edition
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