Healthcare Waste Report - Environment Health

Italy
An Italian Hospital located in Rome has been
chosen as an example of well-integrated waste
management and disposal of medical wastes.
The hospital is specialized in the neuro-motor
rehabilitation of patients suffering from
different diseases (strokes, amputations,
paraplegia, etc.). The hospital produces
roughly 42 kg/day per 1.260 kg/month. The
waste originating from the activities of the
hospital can be classified as special (those from
long-term stay) and hazardous (those from
research laboratories) but it also includes
municipal waste not coming from medical
activities. More generally, waste originated
from medical activities are divided into:
Non Hazardous Medical Waste
Non Infectious Hazardous Medical Waste
Infectious Hazardous Medical Waste
Medical Waste similar to Municipal Waste
Medical Waste Requiring Special
Management Systems
Recovery
The hospital produces many items that can be
recycled, reused or recovered, such as:
Glass containers for medicines, food,
drinks, infusion solutions without cannulas
or needles visibly not contaminated with
blood, not radioactive and not coming
from patients in infective isolation
Other waste for packing in glass, paper and
cardboard, plastic or metal excluding the
hazardous ones (e.g. empty medicine boxes,
magazines and newspapers, residues
administrative activities, paper bags)
Non hazardous metal waste (All these wastes are
sent to dedicated and authorized recovery plants)
Gardening waste
Waste originating from the preparation of meals
Non-delivered radiological fixing liquids
Mineral, vegetal and fat oils
Exhausted batteries
Toners of photocopy and fax machines,
laser printers
Mercury
Films and photographic sheets
The Centre Hospitalier in Roubaix,
France
The capacity of the Centre Hospitalier in
Roubaix is 2000 beds, with the generation of
1 ton of waste (all types of waste) per bed
annually. The composition of the waste in the
hospital is as follows.
Hazardous medical waste - 15% (3% of
which are anatomical parts and cytostatics,
the rest is infectious waste)
Non-infectious waste - 85% comprising of
special industrial waste 2%, ordinary
industrial waste 3%, 80% similar to
household waste of which 45% is recyclable
Before 1993, the hospital in Roubaix
incinerated its waste without much segregation
in an on-site incinerator. In 1993, it was
decided to shut down the incinerator, and look
for other disposal methods. It was decided to
pre-sort waste at the source and to treat its
infectious part using a non-burn method
based on hot steam. In August 1993, the
hospital bought a shredding, steam treatment
and drying technology. According to the
hospital, the system was chosen because it
decontaminates infectious waste using a
steam-based process at 138°C, and the
internal shredder reduces the initial volume of
waste by 80%. Collection and sorting waste at
source was adopted to avoid professional risks
for staff at the hospital and for workers that
collect waste. This also reduces transport costs.
The cost objectives have been met. The
annual global cost of waste management at
the hospital has been reduced by 30%.
As mentioned in the earlier section of this
chapter, it is wiser to learn from the
experiences of others, not only the good
practices but also the dreadful examples. The
objective of providing this bad example in the
Box (right) is only with idea of bringing to
limelight a possible issue that other countries
might have to confront if due care is not given
to the proper and safe disposal of healthcare
waste.
115 HEALTHCARE WASTE IN ASIA: INTUITIONS & INSIGHTS