With an aim to ensure quick and better management of clinical/medical waste, the Ministry of Health on Oman has appointed 28 health safety and environment officers.

Dr Issa Said al Shuaili, head of occupational health section in the department of environmental and occupational health, MoH, said, “This is a new concept. We have appointed qualified professionals who will ensure proper disposal of medical waste.”

The officers will be posted at the Khoula Hospital, Al Nadah, The Royal Hospital and other hospitals across various governorates.

“They will supervise the medical waste management programme and conduct risk assessment. They will also check infection rate in the hospitals,” added Dr Shuaili.

These professionals will be given a comprehensive training by experts from April 6 to 17 on infection control and health safety. They will also be told about the guidelines set up by the World Health Organization (WHO).


What a great idea. Twenty eight inspectors will really make a difference. Can we have some too?





Ozone treatment of clinical wastes has been and gone over the years, several times over.

Never quite sparking great excitement, and always under a cloud of suspicion by regulators ozone treatment plant in their various formats have always struggled.

Now, Colorado is adopting what it describes as a “Greener Method” of Medical Waste Processing. Perhaps the “Green” soubriquet will help its future acceptance



The news services have picked up a story to be aired in Channel 4 based on the claims of a mother who lost her pregnancy between 6 and 13 weeks.

Regrettable as that is – and we cannot fail to recognise the distress to the lady involved and others in her situation – there will be a disposal issue that must be addressed.

What to do with a blob of tissue? A formal burial with religious service or secular equivalent? Take it home and bury it in the garden? A simple woodland burial perhaps? And what about a memorial? Costly in a cemetery, and all too often decorated in the various momentous, so may say ‘tat’ that often decorated the graves of the newborn, or a DIY equivalent in a garden or parkland? And what about rules and regulations, that might restrict or forbid such approaches, causing further upset when rules are applied?

The reality is that, for late pregnancy losses, staff are trained to discuss, sympathetically, the options for disposal. Where possible, parents can be given a little time to consider their options and choice, but storage is an issue and storage facilities are costly so a hospital may push for an early decision or expect that a foetus is transferred to an undertaker.

For early pregnancy losses, those blobs of tissue that require disposal, there is still the same need for sympathy and compassion. However, it becomes more a matter of disposal and, within the relevant legal framework, disposal as clinical waste is the generally appropriate option. This necessitates disposal by incineration.

But one mum has complained, though she is not the first to do so. Aghast at the reality that an alleged 15,000 aborted foetuses are incinerated as clinical wastes the press has picked up the story, and a ‘celebrity mum’ has jumped on the bandwagon.

There are rules, and those rules are complex and convoluted. However, they refer really to the disposal of a rather more mature foetus and not the blob of tissue arising from loss of a pregnancy at just 6 weeks. However, the Human Tissue Act complicates matters and their is often no discretion.

The costs to NHS service providers will escalate dramatically if formal cremation if demanded for all aborted foetuses. Cremator capacity will be stretched and inevitably multiple foetuses will be cremated together. That too will then generate complain, indignancy and uproar.

This is, potentially, a no-win situation. Further discussion and debate will become heated, and is so doing will increase the distress of many would-be parents. Compassion is essential, but perhaps that might best be directed at a more pragmatic, less emotional, approach to management of these tissue remnants. Midwives and hospital/community Trusts will bear the brunt, emotionally and in cost. In the meantime, the disposal contractors will be painted as villain of the piece in a truly no-win situation.

Perhaps inevitably, the Addenbrooke’s incinerator is in the headlines, and has immediately take on that role as villain. “Aborted babies used to heat hospitals” scream the headlines., prompting the Department of Health to act and prohibit the practice. The problem now moves to local authorities, who will want neither the responsibility nor the cost, or to the parents most of whom will want to mourn in the own way but otherwise move on, without the cost of an undertaker.

What a mess.



Yesterday, and for the second time recently, I became aware of a research laboratory using ethidium bromide (EtBr) to stain electrophoresis gels.

Nothing unusual in that, except that each lab admitted discarding its EtBr waste comprising the gels, all consumables and towels used to wipe down equipment and workspace surfaces, and gloves, into a clinical waste sack for disposal. The expectation was that since “these wastes are incinerated”, all would be well.

One of the labs was about to changing from yellow to orange sacks as their previously large stock was running low and they had found that orange sacks could be ordered internally, saving money compared with a one-off external purchase.

EtBr fluoresces nicely but in neither case were checks made of the outgoing waste sacks to ensure that they were free from external contamination. That alone was a significant error, and sat uncomfortably against the diligent checks of all workplace surfaces to ensure that the lab was free from contamination. Perhaps others don’t matter quite so much, and their health and safety is optional?

Ethidium bromide is a nasty chemical. It is a potent mutagen intercalates double stranded DNA, that is it inserts itself between the double strands of DNA, deforming that DNA. It is assumed that it is the subsequent metabolites of ethidium bromide that actually cause the damage. It is readily absorded through skin and becomes fixed in the underlying tissues where it can induce tumour formation.

In most jurisdictions, EtBr can be poured down the sink for disposal, and low level solid wastes can be discarded without specific restriction. However, most reputable laboratories and many local policies dictate that even low level EtBr waste is managed as hazardous chemical waste. There is unlikely ever to be any risk of infection, so disposal as or with clinical wastes in entirely inappropriate, no matter how convenient this may be.

Chemical waste disposal may be expensive, but is necessary and appropriate for EtBr wastes. The Environment Agency would do well to issue a specific guidance note or reminder about this, to ensure correct classification and ensure proper packaging and handling of these wastes, and subsequent disposal in an appropriate facility. This will ensure that all those coming into contact with the wastes as they pass along the [presently and inappropriate] disposal chain are not exposed to EtBr residues.



All credit to those involved in the delivery of healthcare waste training in Lahore. Addressing a two-day training workshop on hospital waste management for health managers, nurses and sanitary inspectors of government hospitals, Adviser to the CM on Health Khawaja Salman Rafique said that hospital waste was causing dangerous diseases. He said all stakeholders should adopt a consolidated strategy for tackling with the problem.

The photo shows source segregation Lahore-style. With critical shortages of funds and a greater importance on recovery of material resources, this is about as good as it gets. The latex gloves are a great leap forward as previously not gloves would have been used, or expected to be used. They simply would not have been available, and would cost far too much.

Soap and water will be in short supply, or non-existent. Training is just beginning, though training, supervision and support of those working further along the disposal change is unlikely to exist.

But its a start, and an important start, to introduce training like this even where the circumstances are so poor and the challenge faced by trainers so great.

Good luck to them all, their work is invaluable.




Two yellow clinical waste sacks have been found on a north London street, by the look of it conveniently (?) left next to an already overflowing waste bin.

Clinical waste sack, north London

Noting that it has happened before, A resident has spotted them, and quite responsibly reported the find to the appropriate Council contractor. I wonder how long ’till they get removed, and whether any attempt will be made to address the issues involved in this waste being inappropriately dumped?

That’s not such an easy task – identify the producer, explain how the wastes should be categorised and packaged (is yellow really appropriate), make arrangements for appropriate container supply and uplift at an agreed frequency, interim storage arrangements, costs, talking with GP and hospital teams, and community nurses, to make sure their advice is up to scratch,  etc, etc, etc. That’s much more than throwing into the back of a truck in the hope it doesn’t happen again, or worse to threaten some penalty to a householder struggling with home treatment, without dealing adequately with the underlying issues.

A 16 month old toddler has died after overdosing on iron tablets he thought were ‘Mummy’s sweets’ after his sister climbed onto the bathroom sink to reach them.

When children are in the house, ALL tablets and capsules etc are dangerous and should be kept under lock and key to prevent accidental poisoning.

For adults, the additional risks of stockpiling old and unwanted medicinal products, whether prescription drugs or not, include unwanted adverse effects from deteriorating and out-of-date medicines, and in a few of intentional self-harm.

Though limits on prescriptions should alleviate the latter, GPs and others have repeatedly blamed patients for asking for a prescription, and then for repeat prescriptions, without a hint of irony since it is their own responsibility, not the patient’s, to assess each request and prescribe accordingly. Regrettably, that takes just a little too much time and effort.

And our concern, of disposal of these unwanted products that accumulate in a kitchen or bathroom cupboard, is to ensure environmentally sound disposal. That cannot happen if unwanted pharmaceuticals are thrown into a black sack or poured down the toilet.

Until the Environment Agency awake from their slumbers and address this issue, instead of fussing about an occasional blister pack that the might observe in an orange sack, the better and safer this will be. Lower NHS costs, fewer accidental overdoses, less intentional self-harm, and far lower environmental impact from inappropriate disposal.

There is a GP surgery or clinic, or a family pharmacy in every High Street and shopping precinct, and in every large supermarket. The opportunities to operate a properly funded and effective take-back scheme are there, but need purpose and negotiation, and a willingness to make an effort at least to initiate those negotiations and drive them forward in a positive and encouraging way. Regrettably, that isn’t the way of the Environment Agency, but why not?

see also Prescription drug residues in natural water sources

and Cutting medicines waste through prescription control

and Wales urges patients to avoid prescription waste

and Presciption numbers rocket to new high

and Drug residues from wastes – the impact on the environment?

and http://www.ianblenkharn.com/?s=prescription





We at the Clinical Waste Discussion Forum and at Blenkharn Environmental have always promoted the use of cable ties to fasten clinical and other healthcare waste sacks.

Toothed or serrated tags make certain that a the gathered neck of a waste sack or bag is held firmly without damage, though most people will find that the smooth tags of ties work equally well and do not slip provided the sack is not overfilled.

This is always preferable to tying the neck in a ‘bunny ears’ knot which requires some compression by – hopefully – gloved hands and too often by unprotected forearms also.

Since waste tracking is important, to provide feedback in the event of any problems, and for the increasingly popular unit charging, an effective identification system per sack can be invaluable. This allows unit or ward-by-ward charging, and effective measurement of waste outputs by location and/or type, providing information that can be invaluable in resource planning.

RFID devices can be attached to bulk containers but in many locations these may be shared between users and this approach lacks detail and specificity and can fail to provide the required information.

Step in the cable tie. We have been promoting it – without any commercial link or undertaking as this is the Clinical Waste Discussion Forum – for a long time. It’s just a good idea.

One company is now marketing numbered cable or sack ties specifically for use with clinical wastes. In an array of colour codes and overprinted with the producer (Trust) name and a unique sequential numeric codes, and complimented by a software suite to permit allocation and tracking of numbered tags, the system seems [almost] ideal.

Better still is the use of tags with an additional machine readable barcode print which may appear along the loose end of the tag or on a flattened extension. Electrical suppliers and asset management service providers use them. So why not for clinical wastes?

Such a system provides a better closure suitable also for tracking of sharps containers, with a simple and straightforward tracking system that can be enhanced with machine readability using a simple handheld barcode reader. This might be used to trace wastes across a single site, or by roundsmen collecting smalls from multiple sites, where uplift and recording can be made far more efficient and speedy.




A local Stoke newspaper is reporting that plans to use a warehouse for the storage of clinical waste have been submitted, a move that will without doubt lead to much concern and criticism.

Energy Plant UK Ltd has lodged a planning application to change the use of the former HW Plastics distribution centre in Sir Stanley Matthews Way, Trentham Lakes.

According to the plans, a quarter of the building would be turned into a waste storage and handling area. The remaining three-quarters would be used as a waste processing area, which will be the subject of a future planning application.

Stoke-based Energy Plant UK eventually hopes to use the site to produce energy from waste materials, with 10 full-time workers employed on the site.

Good idea, and presumably based upon some sound estimate of need. But why claim warehouse storage?  Isn’t that misleading?

Planners at Stoke-on-Trent City Council are due to make a decision on the proposals by May 19.




The Philippines Manual on Healthcare Waste Management, 3rd edition, published in 2011 contains a wealth of practical and regulatory information. It is a great credit to its authors.

Obviously applicable to waste generation, segregation, collection and disposal activities in the Philippines, it additionally provides a counterpoint to other guides and policy documents including the excellent ICRC manual, and our own HTM 07-01.

see also ICRC Clinical waste management guide


It is reported in today’s BMJ that there is a further increase in drug abuse found among some sportsmen and women, and those using gyms and bodybuilding facilities.

Steroid abuse is now rife in certain sections, to build muscle and promote what is seen as a ‘perfect’ body shape, and to enhance sexual ability (allegedly!).

Now the breast cancer drug Tamoxifen is being used to reduce breast overgrowth in those artificially pumped up and muscle-bound devotees.

Tamoxifen is a prescription-only medicine but it’s active substance is found in a specific ‘artificial supplement’ and a high purity product is now flooding the UK market. As popular as so many other legal highs, and as yet unregulated, this is causing all sorts of health problems in users. But it will also add to the troubles for those managing waste disposal from gyms and sports clubs. Sharps use is at an all time high and many gym operators now have sharps bins mounted in their toilets. These will inevitably contain much drug residue, be it a POM or an illegally imported and unregistered POM-equivalent. And now yet more of these pharmacologically active herbal supplements.

Tamoxifen, a selective oestrogen receptor modulator, is not quite a cytotoxic drug substance though it has many similar properties and should be handled, and disposed, with great care.



SEPA have updated and expanded their guidance surrounding the management of clinical waste.

On this page, they aim to provide access to guidance and best practice for those involved in the management of clinical wastes.




A green box marked ‘Property of NHS suppliers’, dumped by fly-tippers on some Radcliffe wasteland close to residential properties, sparked concerns of clinical wastes when spotted by residents.

Flytipping NHS box

The box appears typical of those used extensively by individual hospitals and Trusts, and by NHS supplies.

A Cross Lane resident said the site is frequently blighted by discarded rubbish but he had never before seen anything identified as belonging to the NHS left there.

Bury Council sent workers to attend the patch of land, close to Cross Lane, who confirmed the green crate was empty and the rubbish was mainly domestic waste.

A spokesman for the local Pennine Acute Hospitals NHS Trust said green storage crates, identical to the one pictured, have not been used by the NHS for a decade.

Though that might be an explanation based less on accuracy and more of defence since it is common to find these boxes used throughout all hospitals where they serve a useful purpose, for storage and goods movement. However, it is equally likely that these bins find their way out of the hospital to find a new life in lofts and cupboards, and in the garden shed!

It’s a similar problem with waste sacks. Black sacks disappear regularly. Of more concern is the pilfering of orange, yellow and Tiger bags for domestic use. Placed out for collection as domestic waste overflow, or simply by those too tight fisted to buy their own, this creates huge problems for community waste collection teams.

Regrettably, it’s invariably an inside job. GP clinic employees and hospital staff regularly pilfer these waste sacks intended for clinical and for sanitary/offensive wastes, and as we have noted many times previously their appearance outside houses owes more to pilfering that to domiciliary clinical waste production.




The Chartered Institution of Wastes Management (CIWM) has published new guidance on healthcare waste audits intended for use with large healthcare waste producers in England.

New guidance on waste auditing for large healthcare producers has been published today by the Chartered Institution of Wastes Management (CIWM). Prepared by the Institution’s Healthcare Waste Special Interest Group, the document is designed to provide simple and concise guidance on pre-acceptance waste audits, as required by the Environmental Permitting (England & Wales) Regulations.

Pre-acceptance waste audits are required to ensure that healthcare wastes are sent for the correct treatment and disposal, and robust auditing and reporting practices are essential to ensure compliance. Good auditing, however, also brings other benefits, including potentially significant cost savings and carbon footprint reductions that can be realised by efficient and appropriate segregation of higher and lower risk healthcare waste streams. The Royal College of Nursing has estimated that there is the potential for annual savings of approximately £5.5 million for the NHS if just 20% of incorrectly classified infectious waste were to be reclassified as offensive waste with lower associated waste management costs.

The new guidance has had input from a range of healthcare waste experts including practitioners, academics, and consultants.

Mat Crocker, Head of Illegals & Waste for the Environment Agency, says: “It is essential that producers of waste correctly segregate and describe their waste to ensure that it is managed correctly and gets to the right place. This guidance for producers of healthcare waste sets out how waste audits can help producers both to fulfil their requirements and to enable their waste management contractor to comply with their legal obligations. The Environment Agency welcomes this publication and the work that CIWM has put into its production.”

The guidance has also been endorsed by the Cambridge University Hospitals NHS Foundation Trust. Victoria Sawford, Environmental Services Manager for the Trust, says: “I believe this will be a very useful tool, especially for those who are new to the waste management sector. It not only highlights the legal requirements but also provides a step-by-step approach to the audit methodology, as well as enabling the user to make an informed decision with regards to the packaging, collection, storage, transportation and disposal routes for the various waste types produced within the healthcare environment.”

Pre-acceptance waste audits: a guidance document for large healthcare waste producers in England is available as a downloadable PDF from the CIWM website and can be found here.




The Environment Agency is consulting on “Small clinical waste treatment units: standard rules and risk assessment”

We, the Environment Agency, have developed a new standard rules permit for small clinical waste treatment units. We are asking for your views on these rules and our identification of the risks associated with this activity.

This is the ninth consultation on sets of standard rules and associated risk assessments.

It is obviously important that all of those who might be affected by these proposals, either directly or indirectly, review the documentation and submit their responses, whether positive or negative.

Who knows, they might actually take heed of those comments. Just don’t bank on it!



The consultation period runs from 17/01/14 10:00 to 11/04/14 10:00




The West Middlesex Hospital infection control standards are not up to scratch, say CQC inspectors.

Inspectors from the health watchdog the Care Quality Commission visited the hospital, in Twickenham Road, Isleworth, unannounced in November last year.

Among other problems, they found bins overflowing with healthcare waste, staff failing to wear the necessary protective gear and shoddy record-keeping of how and when wards had been cleaned.

Problems with clinical waste management, at ward level and beyond, always seem to trip up those organisation where standards of hygiene and infection prevention practise slip, and are almost always instantly visible.

A slightly black mark for the West Middlesex University Hospital. Unsurprisingly, they are not alone.



There are several teaching aids and guides applicable to the management of healthcare wastes, mostly focussed on source segregation.

beyond poster s and labels, these training aids are actually few and far between. They can assist in teaching activities – of waste producers, waste handlers etc – and in raising performance, improving standards of safety, and compliance with regulatory requirements. Several companies place their teaching aids into the public domain, in part as a generous gift to others and, inevitably, as part of their marketing activity.

Users must be aware of the sometimes significant differences in regulation that may affect the suitability of training aids that might not translate from one location to another. However, there is always something to learn.

A particularly impressive training package can be found at http://quizlet.com/33679033/info

Teach, learn, improve, comply







“St. Elizabeth Hospital in Belleville, Illinois is to pay a $10,000 state fine for allegedly failing to properly store hazardous waste and for other violations.

“The fine stems from an inspection of the Belleville hospital in Sept. 2011 by the Illinois Environmental Protection Agency. The violations allegedly occurred in 2009, 2010 and 2011.

“The inspectors allegedly found 178 one-gallon plastic bottles containing spent solvents used to “de-water” human tissue were not labelled within the hospital’s hazardous waste cage.

“The hospital also allegedly did not have a plan in case a fire or other disaster unexpectedly released hazardous waste.

“Other alleged violations include failing to:

  • Maintain aisle space in the hazardous waste cage in the hospital’s basement
  • Conduct weekly inspections
  • File necessary waste reports to state officials
  • Ensure all employees complete training in hazardous waste management
  • Maintain spill control equipment



This is one of a small number of fines issued to hospitals for failure to manage their wastes properly – fewer still in the UK, where the Environment Agency prefer to chase waste management companies while ignoring that many, perhaps most, of the infringements that arise, or errors in waste segregation, classification, packaging, storage etc are the responsibility of the producer and not the carrier.

The standards of clinical waste management and storage in UK hospitals has been a matter of repeated audit, in 2005/6 and in 2006/7 with little improvement noted between those dates. I sometimes doubt if anybody really cares.


Standards of clinical waste management in UK hospitalsJournal of Hospital Infection 2006; 62: 300-303

Standards of clinical waste management in hospitals – a second look. Public Health 2007; 121: 540-545


“More than a dozen cleaners at Cheltenham General Hospital say they have been left severely traumatised after they were stabbed by hypodermic needles in the last 12 months.

“At least 13 members of staff at the hospital have reported being pierced by used syringes in the last year due to “improper disposal” by medical teams.

“The “domestic assistants” have condemned “poor practices” by the hospital’s doctors and nurses which they say are putting the health of the cleaning teams at risk.

“Cheltenham General Hospital has admitted liability for seven cases of piercing by hypodermic needles and one case of contributory negligence.

Regrettably, there is no mention of intervention by any of the various regulators that might step up to the plate here, either HSE or CQC, perhaps even the Environment Agency.

One can only hope that the costs of a private compensation claim has been sufficient to drive a sustained improvement in disposal practise.

Although sharps injury rates are highest among frontline healthcare professionals, we should remind ourselves that a US study comparing injury rates with employment statistics revealed an overall rate of injury among support staff 10x greater than that for nurses, and 30–40x  greater than for clinicians (Leigh et al. Characteristics of persons and jobs with needlestick injuries in a national data set. Am J Infect Contr 2008; 36(6): 414–20).

I guess that the cleaners at Cheltenham General Hospital found that out the hard way.



This sounds exciting. What is being done to reduce the production of clinical wastes? What is being done differently, or not being done at all?

There are perhaps many ways to reduce clinical waste outputs. Some are promoted in schemes such as this one, others presented as more scientific study. One common theme is reclassification, rendering claims for real reduction little more than smoke and mirrors. Continue reading “US Hospital takes steps to reduce medical waste” »

Clinical wastes and indeed just about all other waste streams are managed poorly right across the Indian sub-continent.

A good friend living and working in Goa tells tales of almost daily waste mismanagement, waste-related crime and, more often than not, relatively simple problems that can have far reaching consequences solely due to lack of joined-up waste management systems.

A report from Kerela, of clinical wastes dumped at the roadside, is typical. Wastes have been bagged but dumped, or perhaps dropped accidentally, at the roadside, creating a problem for those using the road, and those tasked with the clean-up. But the TV news report shows much of the wastes smoke stained but essentially unburned.  Has someone tried to do the right thing, but been thwarted by a fundamental lack of resources?



Alongside the revelation of radioactive wastes of hospital origin having been deposited in N Ireland landfill, and the many incidents and irregularities in clinical waste disposal South of the border, there are reports of landfill problems elsewhere.

In Greece, the department of the Attica Regional Authority responsible for managing the Fylis landfill northwest of Athens suggested on Wednesday that more than 20 tons of hazardous medical waste has made its way to the dump since late November.

The announcement came after the fourth discovery in just 10 days of hospital waste at the capital’s biggest landfill. The waste, which included used gauze, tubes and IV drips, was brought to the landfill in dump trucks doing their regular rounds, suggesting that hospitals around Athens are using municipal bins to dispose of hazardous waste. Continue reading “More landfill discoveries” »


Recent history tells of many ‘surprises’ hidden in the landfill sites of N Ireland, and indeed elsewhere in Ireland.

In some circumstances, perhaps healthcare wastes have been the least of the problems, but it has become clear that many thousands of tonnes of healthcare wastes have been deposited illegally, both north and south of the border.

The latest revelation is of possibly substantial quantities of radioactive wastes, from hospitals and universities, deposited in sites at Duncrue Street in north Belfast and at Culmore Point outside Londonderry.

Previously confidential British government files from 1983 released in Belfast confirm the secret dumping of radioactive waste in the early 1980s.

A memo in the file revealed that solid radioactive waste had been buried at two local authority disposal sites during the period 1977-82. These were at Duncrue Street in north Belfast and at Culmore Point outside Londonderry. At Duncrue Street, the memo noted, “a number of controlled burials of hospital/university waste of short half-life together with small amounts of industrial waste were arranged”.

The total activity disposed of was approximately 180 millicuries, of which the bulk comprised radioactive iodine with a half-life of less than two months. At Culmore Point, two consignments of hospital waste had been disposed of by controlled burial.

With such modest quantities of short half-life materials the residual risk is negligible. However, it is clear that this should not have happened, nor should it have been followed by an official silence – dare we say, a ‘cover-up’? –



It seems most unlikely. A fake clinical waste operating plant? What was it? What did it pretend to be?

Amusing perhaps, but the reality seems far more sinister. In fact, the story relates to an unlicensed clinical (biomedical) waste plant operating at Samurou Makha Leikai in Imphal West which is in Manipur state in northeastern India. There, local officials from the Manipur Pollution Control Board (MPCB) unearthed a scam operation that was purporting to be a regular clinical waste disposal facility. In reality, there was no treatment facility at all, but instead a recovery and recycling operation that processed unsterilized syringes and other items for reuse.

The MPCB staff should be praised for identifying and putting a halt to this operation, for which the owner has been summoned. No doubt many lives have been saved by the elimination of unsafe injection equipment and other healthcare items. The regulation of clinical or biomedical (medical or healthcare) waste facilities has an importance that far outweighs the immediate box-ticking approach, extending as in this case to significant and wide ranging public health protection and crime prevention.



Sixty-nine thousand tonnes of medical waste were collected in Turkey in 2012, according to Waste Statistics Of Health Institutions of the Turkish Statistics Institute (TurkStat).

In the report, posted on TurkStat’s website on Friday, the Waste Statistics of Health covered 1,449 health institutions, which were in operation by the end of 2012.

All of them indicated that the medical waste was collected separately within their institutions.

According to the data, the medical waste collected separately, 46% was disposed of in controlled landfill sites after sterilization and 28% without sterilization; 16% was disposed of in municipal dumping sites after sterilization and 1% without sterilization, and 8% was incinerated.

TurkStats data shows that 41% of total medical waste was collected in three metropolitan cities.

Out of the total medical waste, 22% was collected from health institutions in Istanbul, 11% in Ankara, and 8% in Izmir.

The Table footnote is particularly interesting, showing a huge reduction in the amount of healthcare waste burned in open pits of buried (hopefully in sanitary landfill, but there is no evidence for this). That is a commendable improvement, but one must wonder how much waste is simply not recorded here, arising in centres outside the three main metropolitan cities and thus officially “off the radar”?




Is it possible? Can the Environment Agency really do the job with less Red Tape, or will it be an exercise in smoke and mirrors?

The Government’s Red Tape Challenge claimed that it is burdensome for some small businesses to fill in Waste Transfer Notes. In consequence, the Government is proposing greater flexibility around Waste Transfer Notes as well as making two minor amendments to legislation relating to waste carrier registration and enforcement 


This should be a step in the right direction, but it would be hugely out of character despite plans to streamline services and slash budgets with the lass of 1,400 jobs.

How long before inspectors are charged with the task of direct income generation through a model of FFI similar to that recently implemented by HSE?

Any bets?




So, an interesting product development, ‘The Flip’, from Wybone had recently caught my eye.

Intended to extend the value of waste sack holders, these flexible and wipe-able magnetic covers sit neatly onto the upper and outer surface of a sack holder lid to identify the intended waste stream, be it intended for orange or yellow sacks, or tiger stripe etc.

This is a clever idea that can save money and supports improvement in source segregation, though it would be better still if it was over-printed with some indication, as text or pictograms, of the wastes intended for disposal within. Continue reading ““Flip your clinical waste stream”” »

Dealing with waste pharmaceuticals is currently something of a hot issue, for wards and clinics, for patients in their own home, for manufacturers and pharmacists, and others, and for all of those others working at the farthest end of the disposal chain.

When pharmaceutical wastes enter the disposal chain, waste processing is expected to satisfactorily destroy or otherwise minimise any likely adverse environmental impact. Dispersal and dilution and a disposal option simply will not do. Instead, the environment agency continues with its policy – something of a one-man policy – to demand ever more complex assessments of waste treatment technologies.

Regrettably, the scientific integrity that underpins those Environment Agency demands is paper thin. This has been adequately discussed on the Clinical Waste Discussion Forum on previous occasions. In summary, there is little understanding of the impact of native drug or of its perhaps many and varied thermal degradation products, nor of the other thermal degradation products of each and every compound present in waste, including the very bag or box into which it has been placed. Continue reading “Dealing with pharmaceutical residues” »

Clinical Waste Discussion Forum tops 1,000

Some of our visitors may have noticed already, but just a few days ago we topped 1,000 posted since restructuring of the Clinical Waste Discussion Forum in September 2010.

Some funny; some deadly serious. Most posts have been informative, inquiring, instructive, questioning and challenging, reporting on issues central to the safe management of clinical wastes. Some have concerned regulatory of business issues, others more practical matters, to share best practice, news, views and opinions.

There have even been a few posts to pass the time over coffee or use as a training aid.

In addition to this, as some of our regular and long-standing visitors will be aware, the Archive section containing and additional 1,500+ posts. This goes way back to September 2006. Though it contains much in the way of news information contemporaneous to the date of posting, this remains a valuable archive of information that might provide the answer you are looking for.

Regrettably, the Archive section of the Clinical Waste Discussion Forum is not included in the site search system, and now probably never will be. But as just 3 subsections, it is quite easy to search using the Ctrl+F word search function of Internet Explorer or one of the other web browsers.

We have a small number of registered users on the Clinical Waste Discussion Forum, and a modest number of others who choose to leave a comment (only registered users can start their own thread, but anyone can post a comment). Feel free to add your thoughts, comments, suggestions, criticisms etc.

There is always a healthy stream of emails coming to us, referring to issues that have appeared in the Forum or informing us of things that might be helpful or interesting to others. If you want, that’s fine and we will do the rest. But do feel free to engage fully with the Clinical Waste Discussion Forum. It’s here for everyone interested in, concerned about or affected by any aspect of clinical waste generation, packaging, handling, transport and storage, treatment and beyond, covering the entire disposal chain from [before] the point of production to [beyond] final destruction.



A group of Utah doctors have urged boycott of Stericycle Inc in the on-going battle against the company and its incinerator operations in the Salt Lake City region.

Calling for a boycott of a clinical (medical) waste incinerator in an effort to shut it down as the company fights emissions violations and faces a special investigation ordered by the governor.

The Utah Physicians for a Healthy Environment stepped up its campaign against Stericycle Inc. by asking customers to stop doing business with the company’s burn plant in North Salt Lake. The investigation by state health authorities is doing little but delaying action against the company, the group added.



see also Stericycle clients wavering as Utah woes continue

and Campaign ramped up against Stericycle incinerator

and Stericycle clinical waste incinerator violates air quality standards; allegations of cheating

and Stericycle – vitriol and threats continue

and US “Stop Stericycle” campaign spreads to Stericycle suppliers


and more !