It is widely understood that laboratory wastes will be, or should be, autoclaved locally before removal for disposal. It stems from a statement by Chris Collins that “nothing should leave the laboratory unless it has been autoclaved” which appeared in the Howie Report and subsequent safety-related publication  in the mid- to late-80s.

But this aspirational quote never worked. Few laboratories then had sufficient autoclave capacity to achieve this and still few can fulfil this goal.

Some selectivity is practices, with laboratory cultures from microbiology labs autoclaved where possible – and thus not universally – while wastes from other laboratory disciplines are not treated.

These latter wastes, and they exist in substantial quantity, include all of the blood-containing vials submitted for analysis in haematology and biochemistry laboratories. Vacuum-type blood vials are substantially more robust than earlier screw-capped plastic tubes and leakage less frequent though it does occur on occasions. Why then are these laboratory wastes not autoclaved?

The simple answer is that autoclave capacity in laboratories is not available for these extra waste volumes, nor is the necessary manpower. And risks are perhaps low since exposure is unlikely.

Back in the microbiology lab, there are some tough questions to ask. Why autoclave wastes in an autoclave that has not been tested to and does not comply with STAATT performance standards as required of commercial operators? Why no concern about the blow-off of volatile organics? Or of chemical (pharmaceutical) residues in fluids released rom the autoclave chamber and drained from treated wastes at the end of the process (most microbiology wastes have a very high water content comprising in the main the agar jelly on which bugs have grown. This is poured into a drain on cooling but before they set to reduce the nuisance doe to smell and the mess that goes with large volumes of sloppy agar jellies).

Surprisingly, even when wastes are autoclaved first, exceptions are made to this and sharps bins – laboratories produce large quantities of sharps waste – are rarely if ever autoclaved. Almost always, autoclaved wastes are repackaged into yellow – not orange – waste sacks and managed along with other soft clinical wastes from other areas of the hospital. Leaving aside waste classification and colour coding issues that impacts on cost of disposal, the environmental impact of this dual treatment is questionable since energy input is doubled in conflict with general Environment Agency guidance.

The whole situation is something of a mess. It highlights through wide variations in policy and practice the nonsense of a ‘do it if you can but not necessarily’ approach that relies on standards of autoclaved performance that are at best unproven to the standards required of the commercial sector. The fall-back option is not to bother – when the autoclave is not available – and since not all, not even most, laboratory wastes are autoclaved before leaving the lab, why bother at all?

If any other health and safety or waste management process was managed so ‘flexible’ – one might say casual – as this then regulators would step in to offer some rationalisation in approach. This must consider the availability of autoclaves and other demands placed upon them, manpower issues, waste logistics, manpower and storage facilities, and packaging issues, not just an unworkable but ex-Cathedra statement from a single individual within the Environment Agency that is most likely to make a bad situation considerably worse.

But simply pretending that all is well, by re-treating wastes as if the first sterilisation process was or might have been inadequate or because of uncertainty regarding re-classification of those treated wastes as wastes other than clinical wastes, is inadequate.