The 10 categories of HCRW

The 10-25% hazardous fraction of HCW are usually classified into the following waste groups. To get detailed information about each category, click on the title.

Are considered as infectious waste, all wastes that are susceptible to contain pathogens (or their toxins) in sufficient concentration to cause diseases to a potential host. Examples of infectious waste include discarded materials or equipment, used for the diagnosis, treatment and prevention of disease that has been in contact with body fluids (dressings, swabs, nappies, blood bags…). This category also includes liquid waste such as faeces, urine, blood or other body secretions (such as sputum or lung secretions).

Pathological waste consists in organs, tissues, body parts or fluids such as blood. Even if pathological waste may contain healthy body parts, it has to be considered as infectious waste for precautionary reasons.

Anatomical waste is a sub-group of pathological waste and consists in recognisable human body parts, whether they may be infected or not. Following the precautionary principal, anatomical waste is always considered as potential infectious waste.

Pharmaceutical waste includes expired, unused, spilt and contaminated pharmaceutical products, drugs and vaccines. In this category are also included discarded items used in the handling of pharmaceuticals like bottles, vials, connecting tubing. Since the Ministry of Health has taken specific measures to reduce the wastage of drugs, HCFs should deal only with small quantities of pharmaceutical waste.

This category also includes all the drugs and equipment used for the mixing and administration of cytotoxic drugs. Cytotoxic drugs or genotoxic drugs are drugs that have the ability to reduce/stop the growth of certain living cells and are used in chemotherapy for cancer. Cytotoxic waste is dealt with under a separate heading.

Chemical waste consists of discarded chemicals (solid, liquid or gaseous) that are generated during disinfecting procedures or cleaning processes. They may be hazardous (toxic, corrosive, flammable…) and must be used and disposed of according to the specification formulated on each container. Nevertheless non-explosive residues or small quantities of outdated products may be treated together with infectious waste.

Waste with high contents of heavy metals and derivatives are potentially highly toxic (e.g. cadmium or mercury from thermometers or manometers). They are considered as a sub-group of chemical waste but should be treated specifically.

Pressurised containers consist of full or emptied containers or aerosol cans with pressurised liquids, gas or powdered materials.

The last four categories (7-10) are considered as highly hazardous and therefore require special attention.

Sharps are items that can cause cuts or puncture wounds (needle stick injuries for instance). Whether they are infected or not, they are considered as highly dangerous and potentially infectious waste. They must be segregated, packed and handled specifically within the HCFs to ensure the safety of the medical and ancillary staff.

Highly infectious waste consists in microbial cultures and stocks of highly infectious agents from Medical Analysis Laboratories. They also include body fluids of patients with highly infectious diseases.

Genotoxic waste derives from drugs generally used in oncology or radiotherapy units that have a high hazardous mutagenic or cytotoxic effect. Faeces, vomit or urine from patients treated with cytotoxic drugs or chemicals should be considered as genotoxic. In specialised cancer hospitals, their proper treatment or disposal raises serious safety problems.

Radioactive waste includes liquids, gas and solids contaminated with radionuclides whose ionizing radiations have genotoxic effects. The ionizing radiations of interest in medicine include X- and g-rays as well as a- and b- particles. An important difference between these types of radiations is that X-rays are emitted from X-ray tubes only when generating equipment is switched on whereas g-rays, a- and b- particles emit radiations continuously.

The type of radioactive material used in HCF results in low level radioactive waste. It concerns mainly therapeutic and imaging investigation activities where Cobalt 60Co, Technetium 99mTc, iodine 131I and iridium 192Ir are most commonly used.

With the noticeable exception of Cobalt 60Co, their half-life is reasonably short (6 hours for 99mTc, 8 days for 131I and 74 days for 192Ir) and the concentrations used remain low. A proper storage with an appropriate retention time is sufficient to prevent radioactivity to spillage in the environment.

Information about possible treatment options for each category can be found in the ressources section under the treatment options chapter.