National Norms and Standards relating to Environmental Health

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Alternative emergency collection, treatment and disposal of health care risk waste shall beagreed upon between the health care risk waste facility and the waste managementcontractor; The location of temporary and central health care risk waste storage areas; and The collection points, routes and times of the HCRW from the temporary HCRW storageareas.2.10 CLASSIFICATION OF HEALTH CARE RISK WASTEEHPs should monitor HCRW to ensure that they are classified as follows:a) All health care waste must be classified in accordance with SANS 10228, and furtherclassified/divided in accordance with the hazard and risk involved. According to technical guidelineson environmentally sound management of biomedical and health care waste provided by theconference of parties to the Basel convention on the control of transboundary movements ofhazardous waste and their disposal, health care waste is classified as follows:• Category A: Health care general waste e.g. office waste, food or garden waste• Category B: Biomedical and health care waste requiring special attention includes Human anatomical wastes such as human body parts, organs and tissues; Pharmaceutical waste such as , cytotoxic pharmaceutical waste, expired pharmaceuticals, andwastes containing heavy metal and non hazardous pharmaceutical waste such cough syrups; Waste sharps such as needles, scalpel blades• Category C: Infectious and highly infectious waste.Infectious waste include , discarded materials (disposable gloves, line, aprons) and equipmentscontaminated with blood and other body fluids from patients with hazardous communicable diseasesand from patients with blood borne infections undergoing haemodialysis. Highly infectious wasteinclude microbiological waste with any kind multiple pathogens and laboratory waste such as cultureswith viable biological agents• Category D: Other hazardous waste includes chemical waste such as empty aerosol cans, heavymetal waste and discarded chemical disinfectants• Category E: Radioactive waste includes liquids, gases, solids contaminated with radionuclide’swhose ionizing radiation have genotoxic effects2.11 SEGREGATION OF WASTE AT A HEALTH CARE FACILITYSegregation refers to the separation of waste into different types of recyclable, reusable and disposablewastes. Segregation is one of the most important steps to successively manage HCRW.a) An EHP should conduct audits in a health facility to monitor waste segregation practices and ensurethat acceptable methods are adopted.b) In accordance with the NEMA: Waste Act, waste generators must reduce adopt methods andpractices to reduce the generation of waste where possible, and segregate waste with the aim ofminimization (reuse, reduce, recycle and recover).c) Health care waste must be segregated correctly at the point of generation, and be containerized andcorrect liners used.d) All workers/employees shall be trained in the correct identification and segregation of the wastegenerated.e) An EHP should monitor the collection of waste in a health facility to ensure that the facility containersused for the storage of waste complies with the following requirements waste:• Waste containers are SABS approved;• General waste is stored in plastic bags with thickness of 80µm or more, or approved refusereceptacles or bulk steel containers for the storage of any generated building waste or garden waste• Health care risk waste containers are labeled with colour codes and the international biohazardsymbol for health care risk waste as per (SANS 10248-1:2008 Annexure F- extract) as follows:Table 1:Waste Waste sub-category Colour coding LabellingHuman or animal Infectious human RED • Marked “infectious waste”DOH. Norms and standards for environmental health in South Africa Feb 2013 126
anatomical waste anatomical • Have the appropriateinternational infectious hazardlabel.Infectious animal ORANGE • Marked “infectious waste”anatomical• Have appropriate internationalNon infectious animalanatomicalinfectious hazard labelBLUE • Marked non infectious animalanatomical waste• No hazard labelinfectious non anatomicalwasteNone RED • Have appropriate international“infectious hazard” labelSharps None YELLOW, • Marked with the words• “Danger contaminated sharps”.• Have appropriate internationalinfectious hazard labelChemical waste includingpharmaceutical wasteChemicalpharmaceuticalCytotoxicpharmaceuticalorDARK GREEN • Have appropriate internationalhazard label.• Marked with words - e.g.pharmaceutical waste-liquid or• Pharmaceutical waste-solid.• For flammable liquids or solids,e.g. chlorinated organic solventwaste and a bold warning ‘“HIGHLY FLAMMABLE” or“FLAMMABLE”• For oxidizing substances ororganic peroxides ; e.g. “Oxidizing chemical waste” or “organic peroxide waste”DARK GREEN • Cytotoxic or genotoxiccontaminated sharps marked “Cytotoxic sharps” or “ Genotoxicsharps”• Cytotoxic and genotoxicpharmaceutical waste marked“Cytotoxic waste” or “Genotoxicwaste”• Cytotoxic hazard label.• (SANS 10248-1:2008Annexure E- extractRadioactive waste None No colour coding • Have the appropriateinternational radiation hazardlabel.• The name and contact numberof the radiation officer, foremergency purposes.General wasteBlack, beige, whiteor transparentpackaging can beused.• Marked general waste.• No hazard label.• The thickness of the plastic bags used as standalone containers is 80µm or more;• Plastic bags used as liners which form an integral part of a rigid container have a thickness of 60µmor more;• All health care risk waste containers clearly indicate the contents e.g. pharmaceutical waste,infectious waste, etc; andDOH. Norms and standards for environmental health in South Africa Feb 2013 127
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No. 36849 GOVERNMENT GAZETTE, 20 SE
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AcknowledgementsDrafting Team (Nati
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Preamble by Director-GeneralThe Nat
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POLICY AND LEGISLATIVE FRAMEWORKThe
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1. Introduction1.1 Policy contextOn
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5. Monitoring and enforcing complia
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BACKGROUNDHealth surveillance of pr
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h) Adequate and potable water avail
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a) Entrance and exit control must b
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• Storage of unsafe, toxic, dange
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(i) For children between 0-24 month
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• The health certificate holder,
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a) Separate storage facilities must
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2.4 Inspections should include an a
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g) Adequate facilities must be prov
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d) Corridors must be at least 1.8m
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1. NORMS1.1 Schools to be operated
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• A cardiopulmonary mouthpiece pr
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a) All circumcisions must be conduc
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) Toilets, wash hand basins and bat
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• Liquid soap;• First aid instr
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h) A daily record must be kept on t
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t) A separate room or area with sep
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h) An adequate number of purpose-ma
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c) Health care facilities should ha
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a) All facilities used in connectio
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5. General hygiene requirementsa) T
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1.1 The premises operated under a v
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5. Environmental health should cond
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d) The use of non-waterborne sanita
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so many kgs of manure is produced p
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a) On any residential premises, onl
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n) A rodent-proof storeroom must be
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d) Pets must be vaccinated against
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1.3 The premises in compliance with
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2.1 Environmental health inspection
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2.1 Environmental health inspection
Page 75 and 76: 1) Responsibility of management1.1.
Page 77 and 78: that all possible health impacts of
Page 79 and 80: BACKGROUNDThe Scope of Profession o
Page 81 and 82: a) An Integrated Disease Surveillan
Page 83 and 84: a) All food onboard must be stored
Page 85 and 86: 3. Waste managementa) The managemen
Page 87 and 88: c) Documents outlining prevention,
Page 89 and 90: Chapter 3HEALTH RELATED WATER QUALI
Page 91 and 92: d) The catchment (rivers, treatment
Page 93 and 94: f) Ensuring monitoring of effective
Page 95 and 96: SECTION 4:WATER QUALITY MONITORING
Page 97 and 98: water world etc)1. In the event of
Page 99 and 100: Step 2: if water is obtained from t
Page 101 and 102: • Of the time frame, if any, with
Page 103 and 104: 3. Household grey-water (generated
Page 105 and 106: SECTION 14:MONITORING OF DRINKING W
Page 107 and 108: contamination (e.g. from birds and
Page 109 and 110: SECTION 21: COMPLIANCE ENFORCEMENT6
Page 111 and 112: DEFINITION OF APPLICABLE TERMSThe f
Page 113 and 114: BACKGROUNDWaste management is the c
Page 115 and 116: • Provides municipal health servi
Page 117 and 118: a) The premises used for recycling
Page 119 and 120: SECTION 4: COLLECTION OF GENERAL WA
Page 121 and 122: SECTION 7: CLASSIFICATION, PACKAGIN
Page 123 and 124: • The spillage area shall be mark
Page 125: • Elbow length heavy duty gloves,
Page 129 and 130: • Waste oxidizing substances and
Page 131 and 132: Sharps container 90 days Cool room
Page 133 and 134: Relationships between transboundary
Page 135 and 136: Chapter 5HAZARDOUS SUBSTANCES AND C
Page 137 and 138: 3. The premises used in connection
Page 139 and 140: d) In addition, all hazardous subst
Page 141 and 142: 4. Guidelines for Drinking Water Qu
Page 143 and 144: for conducting monitoring.7. Analyz
Page 145 and 146: Bacterial infectionsCholeraCampylob
Page 147: paralytic aspeticmeningitis. The re
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National Norms and Standards relating to Environmental Health

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