The management of healthcare waste in emergencies

Special care must be taken with refuse from a field hospital or health centre. The main categories of waste of concern in such situations are: infectious waste; sharps and pathological waste. These wastes must be handled, stored treated and disposed of properly to reduce public health risks.

In the case of small health centres, particularly in rural areas, well-managed on-site burial may be appropriate. In larger centres producing a significant quantity of sharps and infected waste, more sophisticated technology will be required. When healthcare facilities (HCFs) operate diagnostic laboratory services, radiological diagnosis and treatment facilities, pharmacies, etc., waste management is a specialized activity requiring trained and well-equipped staff.

Waste management during triage and classification of victims

Triage and classification of victims generate potentially infectious waste. Since this is a rapid response activity, it is highly recommended that all wastes generated during this stage, without exception, are stored in containers, preferably in red bags, that are properly labelled as "bio-contaminated waste". Direct contact with such wastes must be avoided.

Waste management during medical activities

Management will be similar for permanent (existing hospitals and health centres) and provisional (field hospitals) health facilities.

Wastes should be properly segregated at the point of generation according to their type: [read more…]

  • Infectious non-sharp waste;
  • sharps;
  • chemical wastes (drugs, chemical solutions, etc.);
  • non infectious, common wastes (paper, cardboard, etc.)

Infectious non-sharp waste should be disposed of in washable PVC containers with a capacity of 40–50 litres. Cardboard containers lined with a plastic bag are also an option.

Sharps must be collected in safety boxes or other puncture proof containers such as plastic bottles when no other options are available.

Non-infectious waste can be disposed of with the other general household waste by the municipal waste-collection service, if one can ensure it doesn't contain any hazardous materials.

To avoid potential confusion, colour codes should be used whenever possible:

  • yellow or red for infectious wastes and sharps;
  • black for common wastes.

Collection should be carried out daily, especially in warm climate areas. Internal transport should be done using a cart or trolley. The personnel assigned to handle medical waste should be properly trained and should wear protective equipment (gloves and boots are minimum requirements).

Treatment should be done according to the type of waste. Infectious non-sharp waste as well as sharps should either be disposed of in protected pits or incinerated. Existing functioning nearby waste treatment facilities (autoclaves / incinerators) should be used but only if safe means of transport can be ensured. If not possible, simple, short term solutions such as the "de Montfort" Mark 7 incinerators can be used.

For the rehabilitation and reconstruction phases after the emergency, long term environmentally friendly options should be selected. In general, non-burn technologies such as autoclaving should be preferred to incineration technologies.