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  1. 1. OXFAM – TBN 18 (V1 – 21/05/08)Hazardous WastesThis Technical Brief looks the handling and storage of Hazardous wastes such as hospital waste, industrialwastes, chemical, asbestos, batteries, gas canisters and other such waste. Oxfam staff would generally beunlikely to be involved in final disposal of hazardous wastes. • High heave metal content (batteries, brokenWhat are Hazardous thermometers, blood pressure gauges)wastes? In most emergency situations the predominant types of medical waste are infectious waste, pathological wasteHazardous wastes are likely to include asbestos, and sharps.batteries, gas canisters, hospital wastes, industrialwastes, oils, chemical wastes, pesticides, fungicides, etc. Medical/clinical waste poses significant risks to health,Hazardous wastes from all sources can cause serious the most obvious the transmission of diseases throughhealth risks through uncontrolled containment and contact with infected waste items such as needles,handling. discarded dressings, human tissues or fluids. AdditionalOften emergency clean-up work is undertaken by risks include disease transmission through vector andvolunteers and local residents who are unaware of the pollution of the surrounding environment, including waterhazards associated with different wastes and may be pollution. There are also risks associated with handlingunable to identify hazardous materials. It’s important that radioactive or toxic wastes.where Oxfam staff and volunteers are involved inemergency clean-up that they are made aware of the Asbestos wasteshazards associated with various wastes and are able to Asbestos is a naturally occurring mineral that hasidentify hazardous wastes and know how to appropriate excellent tensile strength properties, a poor conductor ofhandle and storage of such wastes. heat, is relatively resistant to chemical attack and is non-Hazardous wastes should be separated, handled and biodegradable. As a result of these properties asbestos isdisposed of separately from normal municipal solid widely used throughout the world, particularly in buildingwaste. and as an insulating material. However, damage toGenerally speaking Oxfam is unlikely to deal with most asbestos containing materials can result in the release ofhazardous wastes, other than those contained within small asbestos fibres, which can cause serious lunggeneral waste on a routine basis, but it is possible from disease. There is no minimum threshold or safe level oftime to time the Oxfam public health staff will need to exposure to asbestos fibre.deal with such materials. There main types of asbestos are white, blue and brown asbestos. White asbestos is the most commonly usedMedical wastes form of asbestos.Medical wastes typically constitute only 10 to 25% of Asbestos can be found in many common building andhealth care generated waste. The remaining non-clinical insulation materials including:waste includes office and kitchen waste. The medicalwaste presents the greatest risk to health. Medical waste • Boiler and heating vessels and insulationcan be further divided into the following: • Cement pipes • Infectious waste (lab cultures, wastes from isolation wards, tissues, used dressings) • Clutch, brake and transmission components • Pathological waste (body parts, human foetuses, • Conduits for electrical wires placentas, blood and other body fluids) • Pharmaceutical waste (unwanted drugs, expired • Pipe covering and insulation covering drugs) • Roof sheets and roofing products • Chemical waste (chemicals from diagnostic work, cleaning materials) • Duct and home insulation • Sharps (needles, blades and broken glass) • Fire protection panels • Radioactive waste (radioactive substances from • Furnace insulating pads radiotherapy and lab work) • Sheet vinyl and floor tiles and underlay • Pressurised waste (gas cylinders, cartridges and aerosol cans) • Partition walling and plasters.OXFAM Technical Brief – Hazardous Wastes 1
  2. 2. OXFAM – TBN 18 (V1 – 21/05/08)Separation of Hazardous RisksWastes Hazardous wastes cause direct risk to health and the environment through contact directly or through indirectWhere hazardous wastes are identified it is important contact resulting from release into the environmentthat they are kept separate from normal municipal waste affecting soil, groundwater and air.and stored in appropriate labelled sealed containers untilthey can be properly disposed of. For example, hospital Hazardous waste should not be mixed with other waste,waste should be separated into sealed containers for should not be burnt and should not be piled up in ansharps, swabs and other blood-contaminated materials uncontrolled manner.and for medicine, which required disposal. These Hazardous waste should be separated from each othercontainers should appropriately labelled, including a and from general municipal waste.suitable hazard warning label and if possible thesecontainers should be different colours depending upon All hazardous wastes should be handled with great care.what they are storing. Different hazardous wastes will require specific measures to be taken to reduce the risk to those handling them.Labelling of hazardous wastes should include the For example, when handling asbestos particular carecontents, e.g. hospital sharps, and the date the container should be taken to ensure that it is not broken orwas filled and sealed. It should also include an fractured to prevent spreading of fibres.appropriate hazard-warning label. Greatest risk from hazardous waste will be to thoseHazardous wastes should be handled with great care. creating the wastes, those handling the wastes and thoseAdvice should be sought from those familiar and disposing the waste. Oxfam staff are only likely to beexperienced in handling such wastes wherever possible. involved with the handling and storing of hazardousWhere this is not possible and the waste needs to be wastes and on very rate occasions disposing thesemoved extreme care should be taken. Hazardous wastes (such as with some medical wastes).wastes should only be moved if there is animmediate threat to human health. Others who are at risk from hazardous wastes are wasteWhere existing containers are leaking and no longer pickers who are involved with the collection anddeemed to be safe, waste should not be transferred out separation of general waste where hazardous wastesof one container into another as this could create greater may be contained within.health and environmental risk than leaving the wastes inthe poor quality containers. Instead the waste togetherwith its existing container should wherever possible How to Minimise Risk fromcontained within a bund. Handling Hazardous WastesAppropriately contained and labelled hazardous wasteshould be stock-piled/stored in flat areas protected bybund walls and tarpaulin. Effort should be made to The location of hazardous materials should be identifiedensure that the storage area is protected from rainwater. and a risk assessment carried out to establish theThe storage area should be secured to prevent animals, particular risks associated with the particular wasteschildren, etc entering and accessing the area. identified. It is important that the people involved with waste clean- ups are adequately informed of the risks and methods of Photo: Examples of Storage of Hazardous Wastes best practice in handling wastes. They should be made (Note: containers are labelled and stored under cover. aware of the particular risks associated with hazardous The storage area would also benefit from a concrete slab wastes and how to identify them. and cut off drainage) It is important the disturbance of all types of hazardous wastes is kept to a minimum. This will reduce the risk of the release of hazardous material into the broader environment, by preventing dust, providing containment for leaks, etc. Minimise the extent to which people have contact with the hazardous wastes is also very important. Hazard wastes should not be moved unless there is an immediate risk to public health or the environment. Where hazardous need to handled and contained, it is vital that those handling the waste are provided with appropriate personal protective equipment. A minimum will be heavy-duty gloves, safety glasses, overalls (preferably disposable), dust mask, appropriate to the waste being handled (care should be taken when handling asbestos that a mask sufficient to block asbestos fibres is used).OXFAM Technical Brief – Hazardous Wastes 2
  3. 3. OXFAM – TBN 18 (V1 – 21/05/08)The waste management system used should be designed Good access to the storage area would be preferable toto minimise contact with hazardous wastes. For example, ease the transportation of the waste to the temporaryreduce double handling, provision of good storage storage area and also transportation to the final disposalfacilities, effective transportation, etc.) site.Hazardous wastes must not be burnt under any Photo: Examples of Labelling of Hazardouscircumstances (the only exception to this would be some (Medical) Wastemedical wastes but only under controlled and appropriateincineration methods).Risks of indirect contact with hazardous wastes can bereduced by appropriately containing the wastes in sealeddrums, which are appropriately labelled. Vector controlshould be applied, such as covering waste and containingwithin strong vector resistant drums. Water sourcesshould be protected from contamination from hazardouswastes. Good hygiene practice should be implemented bythose handling and dealing with the wastes, such ashand washing and not taking contaminated personalprotective equipment home.Separation of HazardousWastesHazard wastes should be sorted from the general wasteand stored separated in order to prevent contamination Separated hazardous wastes should be stored in sealedwith normal waste. Hazardous wastes should be containers appropriately labelled including a hazard-separated by chemical and physical properties. Many warning label. Labels should include content and datewastes change over time so on-going monitoring should placed in drum.take place. A register should be kept of all waste stored.Separation of medical wastes The relevant government body (Ministry or DepartmentMedical wastes can be easily separated at source by for Environment) should be informed about the location,providing a minimum of three separate segregated kind and amount of hazard waste being stored.containers. One for general waste, one for infectious andpathogenic waste, and the third for sharps. Other Waste Guideseparate containers can be provided if additional disposal materialoptions for example, placentas that are disposed of Asbestos • Separate from general wasteseparately from infectious waste in for example a • Do NOT crushplacenta pit. • Must use personal protectiveA minimum of three separate containers should be equipmentprovided at each treatment, diagnosis and consultation • When working with asbestos ensurearea, such as wards, laboratories, immunisation points, that is kept wet to prevent dustetc. to enable appropriate disposal options to be • Store in a safe and protected areaundertaken for each type of waste. • Store in sealed and labelled drums or strong plastic bagsStorage of Hazardous • Do NOT burnWastes Waste oil • Collect and store in sealed drums on bunded hard standingA storage area should be identified for hazardous wastes, • Take care of leaky drumsso that they can be stored safety whilst final disposal • Do NOT burnoptions are being identified. The storage area should beon solid impermeable ground (preferably concrete), Clinical waste • Collect and store in sealed drumssheltered from rainwater where possible and bunded. appropriately labelledThe storage area should be secure, fenced withappropriate signage. This could include a specifically • Do NOT burn uncontrolledidentified structurally sound building. Heavy • Store in drums on a safe siteThe storage site should be located away from water contaminatedsources, water holes and land depressions (a minimum soildistance of 150m) and located away from heat sources.Additionally, the storage site should not be on thehighest point.OXFAM Technical Brief – Hazardous Wastes 3
  4. 4. OXFAM – TBN 18 (V1 – 21/05/08)Storage of medical wastes Health and SafetyAs with other hazardous waste all containers should have Education, training and awareness raising of dangers oflids and should be watertight. Where possible, containers hazardous wastes should be provided to all thoseshould be the same colour for each type of medical handling hazardous wastes and others who are likely towaste. If this is not possible, same colour labels for same come in contact with such wastes (waste-pickers,type medical wastes should be used. scavengers, children, etc.)Containers for needles should be designed appropriately Handling of hazardous wastes should always beto eliminate further handling of the needles. A simple undertaken with great care. Protective clothing andsharp container can be made from empty pharmaceutical equipment must be obligatory. As a minimum this shouldcontainers with the lid glued or taped shut. A small include overalls, gloves, mask and helmet. This personaltriangular slot cut in the lid will enable used syringes to protective equipment should remain stored in anbe dropped into the container and the syringe pulled allocated area when not in use or be disposal. Under noaway without the need to handle the used needle. circumstance should personal protective equipment usedWHO/UNICEF have approved a cardboard sharps box, for dealing with hazardous waste be taken home.which can be obtained from UNICEF or other medical Appropriate equipment should be provided to collect,agencies. load and transport waste. Where ever possible equipmentSharps boxes must be sealed and stored securely to should be used to reduce direct contact of workers withprevent theft or harm to waste-pickers or scavengers. hazardous wastes. Washing facilities must be provided for workers. Workers Photo: WHO/UNICEF sharps container should be aware that they need to wash before eating, (courtesy of WHO Europe) drinking or smoking and before returning home. Those handling hazardous wastes should be appropriately immunised such as for tetanus, Hepatitis B, etc. Additionally access to appropriate healthcare facilities should be available. People not involved with cleaning up the hazardous waste should be kept out of the clean-up operational area. Suitable hazard warning labels should be provided to mark out the operations area. Handling Asbestos Particular measures need to be undertaken when handling asbestos. These include: Personal protection clothing must be worn, and this must include an appropriate mask/respirator, with a filter sufficient for handling asbestos materials.Disposal Options Keep the material wet to prevent dust. Keep handling of asbestos containing materials to aFinal disposal of hazardous wastes should be undertaken minimum. Asbestos structures should be dismantled asby the appropriate authorities in an approved manner by gently as possible. If it is necessary to move, saw orproperly trained personnel only. This may include break up such materials, the materials should bedisposal at appropriately designed and management thoroughly wet to reduce the amount of airborne fibressanitary landfill. and dust.Oxfam staff should not attempt to dispose of Cleaning of surfaces contaminated with asbestoshazard wastes. containing material should be cleaned using wetThe responsibility for the disposal of medical wastes methods. Under no circumstances should dusting orshould be clearly defined and should remain with the sweeping or use of a vacuum cleaner be undertaken toorganisation managing the facility. Oxfam are unlikely to ensure against dust and fibres in the air.be involved. However, if disposal is observed not to be Asbestos should be stored in strong sealed drums orundertaken safely Oxfam can offer assistance. plastic sacks such that dust cannot be released.Medical wastes can be incinerated but only inappropriately designed incinerators, which are properly Handling Oilmanaged and operated. Incineration of sharps, for Particular measures, which should be undertaken whenexample, must be in excess of 1000°C, also toxic fumes handling oil and similar products, include:can be emitted from incinerating expired medicines.Ineffective incineration may not remove all hazards and • Personal protection clothing must be worn.may cause air pollution. MSF provide detailed design • Containers should never be filled to the top toguidance on medical waste incinerators (Ref: MSF Health allow expansion of the oil.care waste management manual and the De Montfortmedical waste incinerator. • Keep different types of oil separate, e.g. machine oil, hydraulic oil.http://www.mw-incinerator.info/en/101_welcome.html )OXFAM Technical Brief – Hazardous Wastes 4
  5. 5. OXFAM – TBN 18 (V1 – 21/05/08) Further informationPhoto: an example of a De Montfort medical Emergency Sanitation – Assessment and Programmewaste incineration Design (Chapter 8, Waste management at medical centres), Peter Harvey, Sohrab Baghri & Bob Reed, WEDC, 2002. Asbestos – hazards and safe practice for clean-up after tsunami - WHO Waste management aspects after tsunami disaster – A guideline for solid waste management activities during clean up and reconstruction – Ministry of Environment and Construction, Republic of Maldives MSF Public Health Engineering in Emergency Situations MSF draft Health Care Waste Management manuals Additional Support / ExpertSphere standards AdvicePages 84 & 85 of SPHERE, section 5 – Solid Waste Disaster Waste Recovery (DWR)Management, refers to the separation of and separate Website: www.disasterwaste.orgdisposal of medical wastes. Martin BjerregaardMedical wastes are separated and disposed of separately martin@disasterwaste.organd there is a correctly designed, constructed and tel: +44 7971 49 29 57operated pit, or incinerator with a deep ash pit, withinthe boundaries of each health facility (see guidance notes Helen Meekings3 and 6) helenmeekings@yahoo.comThere are no contaminated or dangerous medical wastes tel: +44 7919 447737(needles, glass, dressings, drugs, etc.) at any time inliving areas or public spaces (see guidance note 3).Guidance Note 3.Medical waste: poor management of health-care wasteexposes the community, health-care workers and wastehandlers to infections, toxic effects and injuries. In adisaster situation the most hazardous types of waste arelikely to be infectious sharps and non-sharps (wounddressings, blood-stained cloth and organic matter such asplacentas, etc.). The different types of waste should beseparated at source. Non-infectious waste (paper, plasticwrappings, food waste, etc.) can be disposed of as solidwaste. Contaminated sharps, especially used needles andsyringes, should be placed in a safety box directly afteruse. Safety boxes and other infectious waste can bedisposed of on-site by burial, incineration or other safemethods.Guidance Note 6.Staff welfare: all solid waste management staff whocollect, transport or dispose of waste should be providedwith protective clothing, at minimum gloves and ideallyoveralls, boots and protective masks. Water and soapshould be available for hand and face washing. Staff whocome into contact with medical waste should be informedof the correct methods of storage, transport and disposaland the risks associated with improper management ofthe waste.OXFAM Technical Brief – Hazardous Wastes 5