Wherever you work, there will be a policy and system for sorting out different types of waste that result from providing care to patients/clients. The most common type of waste is household or ‘domestic waste’. It is also common to generate offensive, clinical and other waste, such as sharps (needles, broken glass and such like). There are different ‘waste streams’ for different types of waste, and it’s important to understand the importance of segregating waste in line with its correct category and how this is managed where you work.
‘Waste streams’ are likely to include:
- ‘Domestic waste’ – this is like household waste and is disposed in landfill sites or by recycling
- ‘Offensive waste’ (sometimes referred to as ‘hygiene waste’) – waste that is non-infectious but may cause offence due to the presence of recognisable health care waste items, body fluids or odour; it is different to ‘clinical waste’
- ‘Clinical waste’ – this kind of waste comes from health care activities that pose a risk of infection or other hazard and includes items contaminated by body fluids, sharps and pieces of personal protective equipment (PPE) (disposable gloves, disposable aprons and masks); clinical waste is incinerated
- ‘Hazardous waste’ (known as ‘special waste’ in Scotland) – this covers a wide range of substances, including some kinds of batteries; special measures may have to be taken to ensure safe disposal.
It’s very important that you know about the waste streams in your place of work and follow them – it’s your responsibility to separate items and dispose of them in the correct waste stream. You are the waste producer, as the waste has arisen as a result of your work. Placing items into the wrong waste streams might put your organisation at risk of breaching the law or pose a risk to waste handlers.
It’s important to remember that even when waste is offensive (that is, it contains urine or soiled items), it doesn’t necessarily mean it is infected. The actual amount of truly infectious waste produced by health care is small. Never be tempted to place items in the clinical waste stream ‘just in case’ – this is both costly and unnecessary.
Most waste streams follow a colour-coded system with different-coloured bags and containers for different kinds of waste. It’s vital that you get to know this colour-coding system and recognise the right containers for the right waste.
The following example shows colour-coded segregation proposed in the safe management of health care waste manual for the health care sector in England. You must check what colour codes are used in your organisation.
Yellow: Infectious waste for incineration
Waste which is contaminated with bodily fluids that may pose a potential infection risk or includes medicines or chemicals.
Yellow bag, rigid yellow-lidded container or sharps receptacles.
- infectious waste contaminated with chemicals
- chemically contaminated samples and diagnostic kits
- laboratory specimens.
Orange: Infectious waste which can be sent for treatment to render it safe prior to disposal.
Waste contaminated with bodily fluids which may pose a potential infection risk.
Orange bag , orange-lidded, rigid yellow sharps receptacles.
- protective clothing (for example, gloves or aprons).
Purple: Cytotoxic or cytostatic medicine waste must be incinerated at an authorised facility.
Waste consisting of, or contaminated with, cytotoxic and/or cytostatic medicines.
Yellow/purple bag, purple bag, rigid yellow purple-lidded medicine container or rigid yellow purple-lidded sharps receptacles.
- medicine containers with residues of cytotoxic or cytostatic medicines
- used sharps or item e.g. swabs from treatment using cytotoxic or cytostatic medicines.
Tiger: Offensive/hygiene waste which may be sent for energy recovery at ‘energy from waste’ facilities.
Health care waste classified as non-hazardous, ie where the waste does not pose an infection risk.
Yellow and black striped bag.
- stoma or catheter bags
- incontinence pads
- hygiene waste
- gloves, aprons, maternity waste with no infection risk
Red: Anatomical waste sent for incineration at a suitably authorised facility.
- recognisable body parts
Blue: Non-hazardous medicinal waste for incineration at a suitably authorised facility.
Blue-lidded, rigid yellow receptacles.
- unused non-cytotoxic/cytostatic medicines in original packaging
- part empty containers containing residues of non-cytotoxic/cytostatic medicines
- empty medicine bottles.
Black: Domestic/municipal waste to be sent to energy from waste facilities or landfill.
Items which you would find in the normal household waste stream.
Usually a black bag.
You’ll find special rigid containers for disposal of sharps in your workplace. Safe disposal of sharps is especially important because of the dual risk sharps pose – they can not only cause injury, but can also spread infection. Again, your organisation will have a strict policy on disposal of sharps that you must follow.
Health care organisations will also have strict policies on the segregation of bed linen (there will be a special ‘stream’ for linen that is classified as infected) and for dealing with spillages of harmful substances like the chemicals used in some procedures.
Take time to get to know the colour-coding system in your place of work and make sure you apply it all the time, every time in your daily practice. And remember to follow the rules of standard infection control precautions when dealing with waste, particularly focusing on the use of personal protective equipment and hand hygiene.
For more information, look at the RCN guidance on waste management [PDF file 1.67MB] [How to accessPDF files] .