Scottish Health Technical Note (SHTN) 3: NHSScotland Waste Management Guidance contains the regulatory waste management guidance for NHSScotland including waste classification, segregation, storage, packaging, transport, treatment and disposal.

The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 outline the regulatory requirements for employers and contractors in the healthcare sector in relation to the safe disposal of sharps.

Categories of waste

• Healthcare (including clinical) waste – is produced as a direct result of healthcare activities, for example soiled dressings, sharps.
• Special (or hazardous) waste – arises from the delivery of healthcare in both clinical and non-clinical settings. Special waste includes a range of controlled wastes, defined by legislation, which contain dangerous or hazardous substances for example chemicals, pharmaceuticals.
• Domestic waste – must be segregated at source into:
  • dry recyclates (glass, paper and plastics, metals, cardboard)
  • residual waste (any other domestic waste that cannot be recycled).

Waste streams

• Black – trivial risk
  • Domestic waste or yellow and black stripes (small quantities of hygiene waste).
  • Final disposal to landfill.
  • Clear/opaque receptacles may also be used for domestic waste at care area level.
• Orange, light blue (laboratory) – low risk
  • Orange - consists of items which are contaminated or likely to be contaminated with blood and/or body fluids including saliva. Final disposal following heat disinfection is to landfill.
  • Light blue – laboratory/microbiological waste that must be autoclaved before disposal via the orange stream.

• Yellow– high risk
  • Waste which poses ethical, highly infectious or contamination risks.
  • This includes anatomical and human tissue which is recognisable as body parts, medical devices and sharps waste boxes that have red, purple or blue lids.
  • Disposal is by specialist incineration.

• Red – special waste
  • Chemical waste.

For care/residential homes waste disposal may differ from the categories described above and guidance from local contractors will apply. Refer to SEPA guidance.

Safe waste disposal at care area level

Always dispose of waste:

• immediately and as close to the point of use as possible
• into the correct segregated colour coded UN 3291 approved waste bag (either orange/yellow for healthcare waste or black/clear/opaque for domestic) or container (sharps box)

Liquid waste, for example blood, must be rendered safe by adding a self-setting gel or compound before placing in an orange lidded leak-proof bin.

Waste bags must be no more than 3/4 full or more than 4 kgs in weight and use a ratchet tag/or tape (for healthcare waste bags only) using a ‘swan neck’ to close with the point of origin and date of closure clearly marked on the tape/tag.

Store all waste in a designated, safe, lockable area whilst awaiting uplift. Uplift schedules must be acceptable to the care area and there should be no build-up of waste receptacles.

Sharps boxes must:

• have a dedicated handle
• have a temporary closure mechanism, which must be employed when the box is not in use
• be labelled with date of assembly, point of origin and date of closure.
• be disposed of when the manufacturers’ fill line is reached or following 3 months of assembly (whichever is first)

Local guidance regarding management of waste at care level may be available. 

Resources

Further information can be found in the safe disposal of waste literature review.