Abstract
The need for a new definition of infectious healthcare waste in the UK was identified through a review of current regulatory and management regimes and comparisons with International and European approaches. The philosophy of current infectious waste management has been examined and the underlying principles and concepts identified by reference to five assumptions: 1. People receiving healthcare in hospital produce infectious waste; 2. The majority of infectious healthcare waste is produced in hospitals; 3. People living in their own homes do not produce infectious waste; 4. The risks posed are directly proportionate to the hazard; and 5. Clinical waste (infectious waste) poses a greater risk of infection than Household Waste. These five assumptions were examined in relation to healthcare waste characteristics and production trends by reference to published papers, published data and a questionnaire survey of community healthcare waste producers. The five assumptions were shown to be incorrect and two new assumptions were identified: 1. Infectious waste is produced both within and out-with healthcare premises; and 2. The infectious nature of the waste can be determined by a three step assessment methodology described as ‘TOP’ focusing on the type of waste, the likely outcome and the infection pathway. Forthcoming regulatory changes were reviewed, focusing on the UK implementation of the Hazardous Waste Directive (91/689/EEC) and the European Agreement Concerning the International Carriage of Dangerous Goods by Road (ADR 2005). The need to align the definitions used in forthcoming and current regulation concerned with health and safety, waste and transport has been identified. A new approach to the management of infectious healthcare waste in the UK has been proposed, taking into consideration the regulatory requirements for both hazard and risk assessment, providing a practical classification for infectious waste for UK healthcare practitioners. In addition, a UK best practice colour coding system has been developed based on waste classification and the treatment/disposal requirements of components of the healthcare waste stream. Both the new approach to classification and the colour coding segregation system were subject to extensive peer review and the findings of this dissertation will be incorporated into a UK Joint Agency guidance document titled: ‘Safe Management of Healthcare Waste’, due to be published in 2006.