August 29, 2022

Frequently Asked Questions about Segregating Medical Waste

A healthcare facility generates many types of waste, such as non-anatomical waste, anatomical waste, cytotoxic waste, and sharps waste, that must be separate from other waste streams. As a waste generator, a healthcare organization is responsible for adequately sorting the waste it produces and preparing it for disposal. Everyone working in your organization must recognize the different waste types and throw them away in the appropriate containers. There can be safety, compliance, and financial consequences if you fall short in these areas.

Correctly segregating waste can be challenging due to varying rules and regulations and the rapid pace of healthcare delivery. There are Canada-wide guidelines for the management of specific waste types, such as the Canadian Council of Ministers of the Environment (CCME) Guidelines for the Management of Biomedical Waste in Canada. However, these must be adopted by provincial legislation or municipal by-laws to be enforceable. Local by-laws may be more stringent than the guidelines recommended by the CCME. In addition, some healthcare facilities may have disposal policies that are even more stringent than regulations. Sometimes, a healthcare worker must quickly decide where to put waste, and if they don’t fully understand the regulations, and their facility’s policies, they can make a mistake. The following are answers to some frequently asked questions that can help clarify how to segregate different waste streams appropriately.

The Government of Canada defines Biomedical Waste as “waste generated in human and animal health care facilities, medical or veterinary research and training facilities, clinical testing or research laboratories, as well as vaccine production facilities. Biomedical waste is segregated from the general waste stream as it requires decontamination prior to disposal.” The CCME categorizes biomedical waste into five types: human anatomical waste, animal waste, microbiology laboratory waste, human blood and body fluid waste, and sharps waste.

Although it’s important to know what biomedical waste is, it’s also critical to understand what it isn’t. Just because an item is soiled does not necessarily mean it should be considered biomedical waste. For example, the following should be considered general waste: soiled dressings; sponges; surgery drapes; lavage tubes; casts; catheters; disposable pads; disposable gloves; specimen containers; lab coats and aprons; and dialysis wastes such as tubing, filters, towels, and disposable sheets.

Biomedical waste does not include waste that is from animal husbandry, household in origin, controlled under the Health of Animals Act (HAA), or generated in the food production, general business maintenance, and office administration activities of those facilities to which this definition applies.

Non-anatomical waste generated from procedures, including any items saturated with blood or other potentially infectious materials (OPIM), such as bandages, gauze, or personal protective equipment (PPE) should be disposed of safely in yellow bags, placed in marked containers, and stored for pickup.

Anatomical waste such as human or animal tissues, organs or other body parts, other than teeth, hair or nails; and animal bedding or carcasses, should be packaged separately for pickup in red bags and placed in containers marked for incineration only.

Anything that could puncture the skin when handled should go in a puncture-resistant sharps container.

Although throwing everything in yellow and red bags or sharps containers may be tempting because these receptacles are usually the most accessible waste containers in a healthcare organization, this would be an expensive strategy. The cost of treating and disposing of biomedical waste is much higher than the cost of treating and disposing of general trash. And according to the World Health Organization, 85% of the waste generated by a healthcare organization is non-hazardous waste comparable to domestic waste. So, if a healthcare entity opts to put all its waste in yellow or red bags, it will pay premium prices unnecessarily, wasting organizational resources for no added benefit. With this approach, there is also a risk that something inappropriate could end up in the bags or sharps container, such as cytotoxic waste or pharmaceutical waste.

Pharmaceutical waste refers to medications that are no longer needed or can no longer be used, such as expired, contaminated, or partially administered items. This waste can be classified as either hazardous or non-hazardous.

Health Canada through the Controlled Drugs and Substances Act (CDSA) regulates controlled drugs and opioids while the Provincial Ministries of the Environment all have regulations on pharmaceutical waste disposal. These regulations specify how pharmaceutical waste must be classified and disposed of based on prescribed criteria and procedures.

Other agencies that regulate pharmaceutical waste disposal include Transport Canada, which covers how drug waste should be transported to waste management facilities, and Environment Canada.

Cytotoxic waste is medical waste that has come into contact with cytotoxic agents used in chemotherapy, including empty chemo drug vials, syringes and needles, spill kits, IV tubing and bags, contaminated gloves and gowns, and materials from spill cleanups. This waste should be properly segregated, packaged in red bags, and labelled for safe pickup and disposal. However, full chemo drug vials and unused chemo drugs and pharmaceutical waste need to be handled and packaged accordingly.

Before a medical waste company like Stericycle can retrieve waste containers for disposal, healthcare organizations must package the bags or containers appropriately, including per applicable Transport Canada requirements. Once a bag is full, it should be sealed to secure the contents. After securing the bag, it can be placed in the transport container. Bags should not be visible once the outer transport container is closed. The outer container should have appropriate labelling that meets federal, provincial, and local requirements.

Waste segregation can be complicated, and it helps to work with a knowledgeable waste management expert to help you make sure that your organization is consistently following the correct processes. Learn more about how Stericycle can help with your medical waste segregation and management efforts.

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