WHAT IS INFECTIOUS MEDICAL WASTE?

Potentially infectious medical waste is waste from healthcare, diagnosis, follow-up and preventive, curative or palliative treatment activities. Potentially infectious biomedical waste is a natural by-product of both human and veterinary medicine.

THE DEFINITION OF INFECTIONS MEDICAL WASTE

The World Health Organisation defines infectious medical waste as “waste contaminated with blood and other bodily fluids (e.g. from discarded diagnostic samples), cultures and stocks of infectious agents from laboratory work, or waste from patients with infections (e.g. swabs, bandages and disposable medical devices)”.

The following items can be considered

AS POTENTIALLY INFECTIOUS BIOMEDICAL WASTE:

  • Any sharp materials, e.g. needles, blades, catheters, razors and scalpels, from the first time that they are used.
  • Any blood products for therapeutic use which have not been fully used-up or are non-compliant (expiry date has passed, etc.), e.g. bags for liquids, blood sample tubes, aspiration bottles, spittoons, drains,
  • Small-scale healthcare equipment known as “soft waste”, e.g. pipes, probes, compresses, dressings and cannulas,

Infectious medical waste comes mainly from the following three sources:

  • 90% of potentially infectious clinical waste comes from the activities of healthcare facilities (hospitals, the pharmaceutical industry and research and teaching facilities),
  • 7% comes from small-scale operators. To be more precise, this is potentially infectious clinical waste produced by health professionals in private practice and by medical analysis laboratories.
  • Finally, 3% comes from households and from people who are self-medicating.

THE OBLIGATION TO TREAT POTENTIALLY INFECTIOUS CLINICAL WASTE

Taking a preventive approach to the health risk involved in handling potentially infectious healthcare waste, it is regulated by laws in most countries. World Health Organisation (WHO) insists upon the collection and treatment of potentially infectious clinical waste either at an accredited sorting centre or in situ.

In order to be totally safe, the clinical waste must be managed by adhering to best practices, which include allocating the various responsibilities and ensuring the availability of sufficient human and material resources to handle the risk-free separation, recycling and disposal of this waste. Most of the waste generated at healthcare facilities is ordinary and non-infectious (e.g. packaging, food waste, disposable paper towels). This waste must be separated from any which is infectious and thrown into clearly identified bins, in sealed bags, and disposed of as ordinary municipal waste. Any infectious waste generated when looking after patients – including waste from patients who have been confirmed to have COVID-19 – such as sharps, bandages, and anatomical and infectious waste, must be collected in totally safe way in clearly identified lined containers or sharps boxes. This waste must be treated – preferably in situ – and then disposed of in a totally safe way. The methods to be used where possible are high-temperature treatment, dual chamber incineration or autoclaving. If the waste is taken off-site, it is essential to be fully aware of where and how it will be treated and disposed of.

On-site treatment

FOR SOLID POTENTIALLY INFECTIOUS CLINICAL WASTE

The organisation can take a preventive and environmentally-friendly approach by collecting and neutralising any potentially infectious clinical waste right there on its production site. To be more specific, this is a kind of pre-treatment designed to remove the waste’s infection potential. The neutralised infectious medical waste is then sent on to the household waste circuit. This method offers a twofold advantage:

It limits the spreading of infectious diseases as a result of the storage and transportation of hazardous waste, and it can also reduce the facility’s carbon footprint and impact upon the environment (zero CO2 emissions, lower power consumption, no use of water and chemical products, etc.)

Sterigerms® offers this solution through two mobile units – the Sterigerms® ST12L and the Sterigerms® ST60L.

THE MEDICAL RISK INHERENT IN POTENTIALLY INFECTIOUS CLINICAL WASTE

Potentially infectious clinical waste varies according to its properties and presents a multiple risk, i.e. both in microbiological terms and because of its transmissibility. Indeed, it is likely to:

Contain infectious agents, tissues or biological fluids, and be made up of sharp objects.

In fact it is these latter that are the most dangerous as they come directly into contact with the blood.

THE RISK OF TRANSMISSIBILITY

Potentially infectious clinical waste also presents a risk of transmissibility of infectious or viral diseases (antibiotic-resistant bacteria, hepatitis B and C, or HIV). This can be inoculated by an accidental skin puncture when giving a treatment, with a needle used on a sick patient or through direct contact with potentially infectious clinical waste. For example, when a member of staff handles this kind of clinical waste – a collector which is not properly sealed or has been perforated, the cap is missing from a needle, the lid has come away from the collector, etc.

THE MICROBIOLOGICAL RISK

Biomedical waste may possibly contain a variable quantity of potentially dangerous microorganisms. Whether or not these microorganisms are present depends on a number of factors:

  • The patient’s infection status,
  • The infectious agents’ ability to survive in the outside environment,
  • Their pathogenicity,
  • The minimal infective dose (MID),
  • And also the infectious agents’ mode of transmission.

CONTROLLING RISKS RELATING TO POTENTIALLY INFECTIOUS CLINICAL WASTE

The organisation can adopt preventive and protective measures from the production right through to the treatment of potentially infectious clinical waste in such a way as to avoid any risk of contamination by this clinical waste.

PREVENTIVE MEASURES

In order to reduce the risk of exposure to infectious diseases effectively, the healthcare or research facility can come up with prevention measures – for instance, it can raise staff awareness about the following subjects:

  • Good practices for the collection and treatment of potentially infectious clinical waste – providing suitable containers, rules on the filling and sealing of collectors, voluntarily depositing at a collection point, prohibited measures,
  • Steps the facility can take in order to dispose of clinical waste include maximum storage times for the various different types of potentially infectious clinical waste, collection intervals, collection points, proof of traceability and conservation time,

PROTECTIVE MEASURES

Healthcare or analytical facility can use new medical device models with the aim of reducing the severity of the consequences of any exposure to an infectious agent. These latter are recommended by the WHO and are automatically fitted with protective systems designed to allow totally safe treatment, such as a retractable lancet, flexible perforating device, locking the syringe piston after use, retracting the needle at the end of the injection, etc.