Clinical Waste Management

DEFINITION OF CLINICAL WASTE

Clinical waste is any waste which consists wholly or partly of:

Human or animal tissue

Blood or other body fluids

Excretions (saliva, sweat)

Drugs or other pharmaceutical products

Swabs or dressings

Syringes, needles or other sharp instruments

DEFINITION BY WORLD HEALTH ORGANIZATION

(WHO)

Substances which unless rendered safe may prove hazardous to any

person coming in contact with it and any other waste arising from

medical, nursing, dental, veterinary, pharmaceutical or similar

practice, investigation, treatment, care, teaching or research, or the

other collection of blood for transfusion, which may cause infection

to any person coming into contact with it

TYPES OF CLINICAL WASTE

1) TYPE A

Wastes that comes from human body such as blood, pus, swab,

biopsy and human organ

2) TYPE B

Sharp instrument such as syringes, needles, glass, scalpel

blades, etc

3) TYPE C

Residual that comes from laboratory such as from haematology,

microbiology and forensic practice

4) TYPE D

Pharmaceutical waste such as medicines, vaccines and others

TYPE A

TYPE C

TYPE B

TYPE D

CLINICAL WASTE MANAGEMENT AT COMMUNITY

CLINIC, HEALTH CLINIC, AND DISTRICT HOSPITAL

1

• All the clinical waste are separated from general waste into yellow bin and sharp bin

2

• Clinical waste from community and health clinic will be collected at the district hospital

3

• Clinical waste will be collected according to the schedule. Plastic bags will be sealed by one way seal

4

• Collector will fill the clinical waste record sheet and paste it on the surface of plastic bag, and then put into wheeled bin

5

• Clinical waste then being weighed at Clinical Storage Facility, watched by hospital representative, then consignment note filled

6

• Then clinical waste will be transported to the inceneration sites according to the schedule

Collection

Weight and store

Consignment notes

Transportation

Incineration

At the fixed time and

frequency.

Plastic bags are tied properly

Sign the “clinical waste

record sheet”

Paste it on the collected

plastic bags

Put the bags in the wheeled

garbage bin.

Collection

Weight and store

Consignment notes

Transportation

Incineration

Clinical wastes are weigh in

clinical waste storage facility

Supervised by appointed

hospital personnel

Consignment note is filled

Collection

Weight and store

Consignment notes

Transportation

Incineration

Copy 1 : Waste Generator

Copy 2 : Contractor

Copy 3 : Jabatan Alam Sekitar

Copy 4 : Transporter

Copy 5 : Waste producer

Copy 6 : Jabatan Alam Sekitar

Copy 7 : Incinerator Plant

Collection

Weight and store

Consignment notes

Transportation

Incineration

According to planned

schedule

Special transportation

Special route

Collection

Weight and store

Consignment notes

Transportation

Incineration

INCINERATOR

Temperature:

20000C

Companies involved:

Central & northern regions

Radicare Sdn Bhd

Southern regions

Pantai Medivest Sdn Bhd

THE IMPORTANCE OF PROPER HANDLING &

MANAGEMENT OF CLINICAL WASTE

To avoid injury – needle prick injury

To avoid pollution of the environment – water and soil

To avoid spreading of infection to the community – HIV and

Hepatitis B

COMMON HEALTH HAZARDS ASSOCIATED WITH

CLINICAL WASTE

1) To the community – occurs in 3 ways

Accidental exposure from contact with waste at municipal

disposal bins

Exposure to chemical or biological contaminants in water

Exposure to chemical pollutants (eg: mercury) from incineration

of the waste

Chemicals leakage ++ residues (drugs, antibiotics, heavy metals, disinfectant, antiseptic)

Discharged into sewage system – contaminate ground water

Poisoning, injuries & burns

2) To the workers

Healthcare workers – needle prick injury by sharp objects such as

contaminated needle

Risk of transmission of HIV/ AIDS as well as Hepatitis B and C

ENVIRONMENTAL LAW

1) Environmental Quality Act 1974

Empowered the Department of Environment (DOE)

to control and prevent pollution

to protect and enhance the quality of the environment.

PART IVA – CONTROL OF SCHEDULED WASTES (Section 34B)

Prohibition against placing, deposit, etc of scheduled wastes.

Person should not:

Place, deposit or dispose of, or cause or permit to place except at

prescribed premises only, any scheduled wastes on land or into

Malaysia.

Receive or send or cause or permit to be received or sent any

scheduled wastes in or out Malaysia.

Transit or cause or permit the transit scheduled wastes without

any prior written approval by Director General.

Any person who are guilty under this section should be

liable to fine not exceeding RM500,000 or to imprisonment

for a period not exceeding 5 years or both

2) Environmental Quality (Schedule Waste) Regulation 1989

A set of regulations dealing with hazardous waste management

which regulate the storage, transport, treatment and disposal of

hazardous wastes was enforced since May 1989:

Environmental Quality (Scheduled Wastes) Regulations, 2005 (to

replaced the Environmental Quality (Scheduled Wastes)

Regulations 1989)

Environmental Quality (Prescribed Premises) (Scheduled Wastes

Treatment and Disposal Facilities) Regulations, 1989

Environmental Quality (Prescribed Premises) (Scheduled Wastes

Treatment and Disposal Facilities) Order, 1989

The regulations among other things specify the following

requirements:

Scheduled wastes shall as far as practicable, before disposal, be

rendered innocuous.

Generation of scheduled wastes shall be reduced using the best

practicable means.

Scheduled wastes may be stored, recovered and treated within

the premises of a waste generator.

Use of durable waste containers with clear labels. Storage of

wastes shall be proper and adequate.

Waste generators to notify the DOE of any scheduled wastes

generated and keep up -to-date inventory of scheduled waste

generated, treated and disposed of.

Incineration, disposal, off site storage and off-site treatment shall

only be carried out at prescribed premises licensed by the DOE.

Waste generators shall conform to the requirements of the

consignment note system when transporting wastes to ensure it

reaches the approved destination and are carried out by licensed

transporter.

Waste generators shall provide information to a transporter

regarding the nature of the wastes transported and action to be

taken in case of accidents

HEALTH PROMOTION ACTIVITIES

Campaign once a month on each group of waste and the waste to

manage it.

Enhancing the knowledge of all key players involved in clinical

waste management, dissemination of technical and scientific

information by doing talk and practical.

Spot check to make sure clinical waste are handle safely.

Effective confinement and safe handling.

Store waste in a designated area and must away from drains and

watercourses as possible.

Label storage areas according to the different types of wastes