CLINICAL WASTE
MANAGEMENT
By: NADIRATUL NOZIANA ABD MAJID
EXECUTIVE ENGINEER
AIMS & OBJECTIVE
Provide information on the correct method
of clinical waste management & handling.
To develop awareness so as to appreciate
health , safety and environmental
protection issues relating to clinical
waste.
PMSB VISSION
PMSB WILL PROVIDE QUALITY SERVICE IN THE
HEALTHCARE AND RELATED SERVICE
INDUSTRIES WITH UNSURPASSED DEDICATION
TO CUSTOMER SATISFACTION THROUGH
INNOVATION AND A MOTIVATED, COMMITTED
AND EFFICIENT WORKFORCE WHO TAKE
PRIDE IN THEIR WORK.
PMSB CUSTOMERS
GH
Private
Hosp/Clinics
BIOHAZARD SIGN
LEVEL OF BIOHAZARD
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Level 1 - Varicella, Canine hepatitis
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Level 2 - Hepatitis A, B and C,
Influenza A
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Level 3 - SARS, Yellow fever
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Level 4 - Ebola, Dengue fever
HOSPITAL WASTE CATEGORY
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Clinical waste- scheduled waste
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Radioactive waste- scheduled waste
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Chemical waste- scheduled waste
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Pressurized containers
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General waste
COMPOSITION OF CLINICAL
WASTE
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5% Pathological
3% PVC
30% Plastic other than PVC
32% Paper including wax Paper
10% Hospital dressing
10% Miscellany-flowers, rags etc.
10% Non combustible-glass, sharps,
metal
DEFINITION OF CLINICAL WASTE
Clinical waste - Any waste which consists
wholly or partly of human or animal
tissue, blood or other body fluids,
excretions, drugs or other pharmaceutical
products, swabs or dressings, syringes,
needles or other sharp instruments, being
waste which unless rendered safe may
prove hazardous to any person coming
into contact with it.
DEFINITION OF CLINICAL WASTE
Clinical Waste -Any other waste arising
from medical, nursing, dental, veterinary,
pharmaceutical or similar practice,
investigation, treatment, care, teaching or
research, or the collection of blood for
transfusion, being which may cause
infection to any person coming into
contact with it.
CATEGORY OF
CLINICAL WASTE
Category A
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Blood
Body fluids
excretions
Soiled surgical
dressings
Swabs
Material from
infectious diseases
Category B
Discarded syringes, needles, broken
glass, and other contaminated
disposable sharp instruments
Category C
Lab or post mortem room waste
Category D
Pharmaceutical and
cytotoxic waste
Category E
Used disposal bed pan liners, urine
containers, incontinence and stoma pads
PMSB: CRADLE TO GRAVE SERVICE
Incineration
User Training
Pottering Service
Transport Service
Store Management &
Consumable Supply
CONSUMABLES
Yellow Plastic Bags
Blue Plastic Bags
Cable Ties
CW Label
Bag Holder
Paddle Bin
Sharp Container
Trocar Container
PMSB CONSUMABLES
Consumables are supplied to all hospital
site. They must be used correctly and not
misused.
WASTE SEGREGATION: DOS & DON’TS
Nursing and clinical staff responsibilities:
• Segregation at SOURCE: Clinical Waste
correctly segregated from General Waste.
• ONLY CW is deposited in yellow bags.
• ONLY SHARPS in sharps container.
• Seal bags when 3/4 FULL using cable ties.
Never seal bags by stapling.
WASTE SEGREGATION: DOS & DON’TS
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Waste Cat. A, C, D, & E throw into yellow
bags.
Infectious waste, do prior treatment by
autoclave & throw into blue bags.
Waste Cat. B throw into Sharp containers.
Sharp containers are firmly pressed prior to
disposal.
Don’t force needle/syringes into the sharp
container.
WASTE SEGREGATION
Oops!! I terr..throw
clinical waste into the
black bag….
What should I do?
CLINICAL WASTE GUIDELINE…
If clinical waste and domestic
waste are mixed, it should be
treated as schedule waste…
Clinical Waste + Domestic Waste
Clinical Waste
WASTE SEGREGATION
CLINICAL WASTE GUIDELINE…
• Place contaminated waste bag into
another bag of the correct color
(yellow bag).
• Under no circumstances should
incorrectly segregated waste be taken
out of a waste bag or container once
deposited.
MANUAL HANDLING OF
CLINICAL WASTE BAG
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Check if it is properly sealed.
Check label and ensure it shows the source of
waste.
Pick the bag up by the neck only.
Bags should not be clasped against the body.
Do not attempt to carry too many bags at one
time.
Do not throw or drop the bags.
Do not support the bag from the bottom.
Do not leave the waste unattended.
Conduct spillage clean-up when the need arise.
MANUAL HANDLING OF
SHARP CONTAINERS
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No darting needles into the bin.
Sealed when 3/4 full.
Syringes with attached needles shall be discarded
together. Do not shed needle.
Do not press down the bin lids when closing.
Shake the container gently before closing.
Check if bin is labeled with date and site of origin.
Keep out of reach of children.
Intravascular guidewires, cannulae, blood taking
sets, glass slides, glass dry vials & ampoules shall
be discarded into the correct size containers.
Syringes/needles in yellow bag - Big Mistake…
Result in deadly
consequences!!!
LABELLING
All bag and sharp containers shall be
labeled for identification purpose.
WHY??
Should any problem arise, the waste
can be easily traced.
LABELLING
Labels should have:
• Date waste first generated
• Name, Add & Contact no. of waste
generator
• Marked with biohazard symbol and code
SW404
STORAGE OF CLINICAL WASTE
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Designated area for storage.
Locked & attended at all time.
Separated from general waste store.
Minimum 2 days storage capacity.
Accessible only by authorized person.
Facilities for washing hands made available.
Connected to sewerage system.
PPE made available.
Refrigerated storage required if stored for >24
hours.
Free from vermin, droppings, etc.
Odour control.
Good housekeeping.
STORAGE OF CW- THEN
“Old mortuary house turn
domestic waste store….
Temporarily utilised as
CW storage in 1996”
STORAGE OF CW-NOW
CLINICAL WASTE DISPOSAL
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Landfill
Autoclave (Steam
treatment)
Irradiation
Microwave Treatment
Chemical Disinfection
• Incineration
WHAT IS INCINERATION
Combustion of waste at high
temperature with O2 to produce
inert ash, CO2, H2O and trace
levels of pollutants.
NEED FOR INCINERATION
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Because generation of waste increases daily.
Scarcity of landfill sites.
Sustain clean environment.
Reduces pollution due to open burning.
Ensures total destruction of pathogen & organic
material.
Complies with DOE emission control standard.
CW DISPOSAL-THEN
CW DISPOSAL - NOW
PMSB INCINERATOR PLANT
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Malaysia’s 1st Clinical Waste
Incinerator
Located at Bukit Rambai, Melaka
Operation since October 1996
Stepped hearth technology,
capacity 2 x 250 kg/hr
ISO 9001:2000 (Nov 1997)
ISO 14001:1996 (Dec 2001)
OHSAS 18001:1999 (May 2003)
PLANT PROCESS
Waste Receive
Cold Room
Burning
Bin Washing
Preparing
Clean Bins
Ash Handling
Process Control
Ash Removal
for Disposal
PMSB INCINERATOR PLANT
CLINICAL WASTE
MANAGEMENT IS A
JOINT EFFORT - TO
SUSTAIN GOOD
HEALTH, SAFETY &
ENVIRONMENT….
WRONG PRACTICE
REVISE BACK….
YELLOW BAG
CLINICAL WASTE
CATEGORY….
A?.. B?.. C?.. D?.. E?..
REVISE BACK….
SHARP CONTAINER
CLINICAL WASTE
CATEGORY…
A? ..B?.. C?.. D?.. E?..
SEGREGATION (PENGASINGAN)
Clinical Waste Groups
Group A Wool
 Cotton
 Gloves, Swabs
 Plasters and bandaging
 Soiled surgical dressing
 Materials used to clean spillage.
Group B
Sharps instruments and objects
 Syringes
Group C
Clinical Waste arising from laboratories /
infectious wastes
 Pathology
 Haematology
 Human biopsy
materials
 Human tissues
Yellow Bag
 Blood, Urine,
(Beg Kuning)
Stools
 Organ, Limbs
 Body parts
 Placenta
 Needles
Sharp
 Cartridges
 Scalpel blades Container
(Bekas Tajam)
 Blood
Light Blue Bag
transfusion
(Beg Biru
 Microbiology
Muda)
 Post-mortem
room wastes
SEGREGATION (PENGASINGAN)
Clinical Waste Groups
Group D
Pharmaceutical wastes
 Expired drugs
 Sera
Low level radioactive waste
 X-ray dept.
Group E
 Disposable pads
 Disposable bed -pan liners
 Disposable diapers
Cytotoxic waste
 Treatment of cancer
patient
Sharp Container
(Bekas Tajam)
 Vaccines
 Incontinence pads
 Urine containers
 Stoma bags
Yellow Bag
(Beg Kuning)