Scottish Health Technical Note (SHTN)03-01: NHSScotland Waste Management Guidance contains the regulatory waste management guidance for NHSScotland health and care services including waste classification, categorisation, 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.

Waste regulations require the classification of waste based on hazardous characteristics.

Classification of waste

• Special (hazardous) waste. Special waste includes a range of controlled wastes, defined by legislation, which contain dangerous or hazardous substances.  Examples of special (hazardous) waste resulting from healthcare activities includes sharps, infectious or potentially infectious clinical waste and some pharmaceuticals or medicinal wastes.
• Non-hazardous waste is residual waste produced in both clinical and non-clinical settings which may include dry recyclates (glass, paper and plastics, metals, cardboard), food waste, packaging waste and furniture.

Healthcare waste should be segregated at source into suitable colour-coded and appropriately labelled receptacles across all health and care settings in Scotland.

SHTN 03-01 contains a full colour-coded waste segregation guide which represents NHSScotland accepted best practice and ensures compliance with current regulations. The most frequently used waste streams in health and care settings are summarised below.

Waste streams

• Black (non-hazardous)
  • Residual waste remaining after all source segregated recyclates have been removed.
  • For treatment (which may include recovery of materials), then disposal.
• Orange (infectious), light blue (laboratory) 
  • Orange - consists of infectious or potentially infectious substances or items. Orange lidded leak resistant receptacles may be used for solidified infectious liquids and dialysis waste. Orange bags may be used for items such as PPE, spillage kits, swabs or dressings. Orange lidded sharps box used for sharps disposal only. Consigned to clinical waste treatment facility for treatment and disposal
  • Light blue – laboratory/microbiological waste that must be autoclaved before disposal via the orange stream.

• Yellow, red (infectious)
  • Yellow or red lidded leak resistant receptacles may be used for waste which poses ethical, highly infectious or contamination risks.
  • This includes anatomical and human tissue which is recognisable as body parts but may include other types of waste that require incineration to comply with national or regional policy. Receptacles should be clearly labelled with contents.
  • Yellow stream infectious waste is special (hazardous) waste.
  • Consigned to clinical waste incineration facility for disposal (high temperature incineration). 

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 approved waste bag or container compliant with UN and relevant industry standards.  

Liquid waste, (such as body fluids) that is not suitable for disposal via the toilet or macerator, must be rendered safe by adding a self-setting gel or compound before placing in a rigid leak-resistant receptacle.

Waste bags should not be overfilled and should be securely sealed when 3/4 full (manufacturer’s fill line for sharps boxes) using a closure technique such as a ‘swan neck’ to close with with a plastic tie or tape. The point of origin and date of closure must be clearly marked on the tape/tag or bag.

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 should:

• 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

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.