Hospital Toxic Waste
Hospital waste is considered dangerous because it may possess pathogenic agents and can cause undesirable effects on human health and the environment. Hospital, or any healthcare waste, should be handled, treated or disposed of correctly, otherwise it can spread disease, poisoning people, livestock, wild animals, plants and entire ecosystems.
 A Bigger Problem Today
In recent years, medical waste disposal has become a bigger problem with the advent of disposable needles, syringes, and other similar items. This type of waste has a bad effect on the environment as it contaminates the land, air and water resources. More and more hospitals are making efforts to “green” their buildings and operations. Sustainable practices are emerging, taking into account a wide range of issues such as building design, energy usage, environmentally preferable purchasing, green cleaning, sustainable foods etc.
Opting for multiple-use instead of single-use devices and items with least packaging will decrease the solid waste stream in a hospital. Such purchases take care of the ecological health as much as that of the patients.
 Did You Know?
- Hospital waste that has been improperly disposed of, can cause the spread of infectious and dangerous diseases.
- According to a UN report, when the December 2005 tsunami hit the long, remote shoreline of Somalia, it broke rusting barrels of hazardous hospital illegally dumped in the war-racked country during the early 1990s! Today, many Somalis are sick with symptoms consistent with radiation sickness, respiratory infections, mouth ulcers and bleeding, abdominal haemorrhages and unusual skin infections.
 Different Types of Wastes
Categories of hospital waste as classified by the World Health Organization (WHO) are:
- General waste, including material such as packaging or unwanted paper. This waste is generally harmless and does not need special handling
- Infectious waste, which includes material which contain sufficient concentrations or quantities of pathogen capable of causing diseases when exposed, such as tissues/swabs; materials or equipment that have been in contact with infected patients; human excretions such as pus, feces and vomit from patients without highly infectious diseases; wash water etc.
- Sharps, which are disposable needles, syringes, saws, blades, broken glasses, nails etc. Sharp objects can easily cut or injure a handler. Used hypodermic needles are the most common and dangerous, as they are often contaminated with highly infectious blood.
- Pathological waste, which includes tissues, organs, body parts, human flesh, fetuses, blood and body fluids.
- Pharmaceutical waste, like drugs and chemicals which are no longer used, outdated or contaminated.
- Chemicals, such as unwanted disinfectants, solvents, film developer, laboratory reagents are items which fall under this category of waste containing purified chemical substances that are toxic.
Certain chemicals and pharmaceuticals are safe in small quantities, but may be highly hazardous in large quantities. These are --
- Genotoxic waste, like chemotherapy drugs which contain substances which can cause mutations, birth defects and cancer.
- Radioactive waste, contaminated with radioactive substances used in diagnosis and treatment of diseases like toxic goiter.
- Other waste from the offices, kitchens, rooms, including bed linen, utensils, paper etc.
Refer to Best Management Practices for Hospital Waste for more.
 Disease Transmission
The most immediate threat from infectious hospital waste is transmission of diseases. This threat is also the greatest. Extreme care should be taken to destroy the pathogenic organisms, otherwise dangerous quantities of microscopic disease-causing agents—viruses, bacteria, parasites or fungi—will remain in the waste. These agents can enter the body through punctures and other breaks in the skin, mucous membranes in the mouth, by inhalation, swallowing or transmission by a vector organism.
Direct contact with the waste poses the greatest risk. People with the maximum risk of direct contact are healthcare workers, cleaning staff, patients, visitors, waste collectors, disposal site staff, waste pickers, drug addicts and those who knowingly or unknowingly use “recycled” contaminated syringes and needles.
Though common threats from sharps are physical hazards of cuts and punctures, sharps which are infectious waste pose a much greater threat. Primarily healthcare workers, waste handlers, waste pickers, drug addicts, and others who handle sharps, run the risk of being infected with HIV/AIDS and hepatitis B and C viruses through pricks or reuse of syringes/needles. There are also devastating effects if water supply gets contaminated by untreated hospital and healthcare waste. If infectious stools or bodily fluids are not treated before being disposed of, they can create and extend epidemics.
 Chemical and Toxic Threats
Large quantities of hazardous chemical wastes can poison, burn or damage the skin and flesh of people who touch, inhale or are in close proximity to them as they can be toxic, corrosive, flammable, reactive, and/or explosive.
Disposal of large quantities of such waste in unlined landfills, especially unlined pits, may contaminate ground and surface water. And if this water is for drinking, bathing and cooking, it can be more damaging, even to plants and animals in the local ecosystem. Burning or incinerating healthcare waste, while often a better option than disposal in an unlined pit, may create additional problems.
Burning or incineration of hospital waste may produce toxic air pollutants such as acid gases, Nitrogen Oxides (NOx), particulates, dioxins and heavy metals and distribute them over a wide area. Dioxins are not biodegradable and have cancer-causing agents. Toxic materials such as mercury and cadmium cause birth defects in even small quantities.
Mercury is a known toxic material that builds up in body tissue. Mercury exposure can lead to learning disabilities and damage to the heart and blood vessels in unborn fetuses and young children. In adults, exposure to mercury may result in problems in the cardiovascular and central nervous systems.
A large portion of hospital waste is infectious and potentially dangerous. They include items such as hypodermic needles, body parts and fluids, diapers, laboratory cultures, etc. Because of the nature of such waste many hospitals burn the waste to render it harmless, rather than to bury it in landfills. The incineration of hospital waste produces acids (hydrochloric acid, hydrofluoric acid, sulphur dioxide, nitrogen oxides), heavy metals, dioxins, furans and dust.
Once this discharge is airborne, it can foul the air and end up in waterways. The leftover incinerator ash is usually sent to local landfills, where the pollutants can seep into soils and groundwater if not properly contained.
 Alternative Disposal Methods
Hospitals don’t need to burn as much waste as they often do. They can take steps to reduce the need to burn waste and expose our communities to toxic air pollution.
These steps include:
- Waste Reduction and Recycling: One way to reduce the need to burn hazardous waste is by reducing waste generation. Much of the waste which is burned can be recycled and remade into new items instead.
- Autoclaving: Some waste can be superheated and sterilized so it can be harmlessly buried in landfills. Switching to an on-site autoclave saves 50%.
- Using Nontoxic Equipment Alternatives: Many medical items are available which do not contain dioxin and mercury. For example, hospitals can use thermometers that contain no mercury and non-PVC plastic items that contain no dioxin or chlorine. Use of such items will reduce much of the toxic materials from incinerator emissions.
- Medical Waste Incineration