Old ideas are often the best, and in the case of clinical waste treatment from sources at University College Hospital London that is undoubtedly true.
Many laboratories produce vast quantities of clinical waste and that tends to be plastics-rich. Moreover, it is rich in just one type of plastic and might be suitable for recovery and recycling.
On-site autoclave treatment of wastes by laboratory staff is the norm, intended to render the wastes safe before they are removed from the lab….and then managed at potentially infections clinical wastes destined for incineration! It is simply ludicrous, and highlights both the inadequacy of current guidelines, and of the architects of those guidelines who fail properly to understand what they are dealing with.
Mitie, the outsourcing firm supporting operations at UCL/UCH, is claiming success in diverting this autoclaved laboratory waste to waste-to-energy incineration rather than the more costly and wasteful clinical waste incineration. Claims of 18% in disposal cost per tonne and reduction in CO2 emissions per tonne by 27% are laudable and worthy of the award for innovative practice in waste management and resource recovery at the 2011 Environmental Excellence Awards, hosted by the Chartered Institution of Waste Management (CIWM) last week. So, it seems that old ideas ARE the best, and can win awards too!
But is this innovative? I have recommended this approach for several years, and several off-shore clients have put it into very successful practice. Various details can be found in the Clinical Waste Discussion Forum archives though some information is commercially privileged and will not appear here.
Regrettably, there is one fly in the ointment though this will generally be an issue for regulators rather than operators. Laboratory autoclaves are not, thus far, tested for performance to the same extent as any clinical waste treatment facility. Autoclave loading may be less than satisfactory, and the various levels of STAATT performance are not guaranteed, or likely, to be achieved.
Does it matter? The answer is both yes and no. Yes it does matter if there is to be a level playing field. Either laboratories confirm to the standards required of clinical waste treatment companies, or the constraints on those companies should be relaxed. On a more scientific foundation, either it matters or it does not.
Fundamentally, it should be a matter for risk assessment. If waste is to be treated and shipped safely in a compactor skip to a recycling facility or waste-to-energy plant then the risk is infinitesimally low and can effectively be discounted. The need for high level STAATT performance is thus unnecessary and unjustifiable.
This is not to say that some performance standard should not be applied, probably to any autoclave used to treat clinical wastes. I have been in discussion for some time to develop using well-established microbiological principles a semi-quantitative test for autoclave performance. Based on spore killing, it will be far less expensive that the techniques proscribed by STATT, but just as effective. The low-cost and technical simplicity may well afford a more frequent test frequency that cannot be a bad thing.
Regulators will be hugely resistant, mostly probably for the simply reason that the idea is not theirs, but that should not matter. Performance testing should be commensurate with the risk for failure. Testing clinical waste treatment facilities with a procedure drawn form that used for the preparation of pharmaceutical drug products, and sterilising clinical wastes to the same sterility assurance level as used for injectable drugs for human administration is a costly and unjustifiable process that has no place in waste management.