UNDP GEF Project on Global Healthcare Waste
INSTRUCTOR GUIDE
MODULE 1: DEFINITION , SOURCES, AND CHARACTERISTICS OF HEALTHCARE WASTE
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UNDP GEF Project on Global Healthcare Waste
MODULE 1: DEFINITION, SOURCES, AND CHARACTERISTICS OF HEALTHCARE WASTE
Estimated Time
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Module Overview
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Learning Objectives
Target Audience
Instructor Preparation
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Lecture: 30 minutes
Activity: 45 minutes
Begin this module with the activity, go through the slides, and then de-brief the
activity at the end
Define healthcare waste
Describe sources and examples of healthcare waste
Describe general characteristics of healthcare waste
Identify where wastes are generated in your facility
Categorize the wastes into two general categories based on whether or not they pose
a risk
Describe general characteristics of the wastes
Administrative personnel
HCWM coordinators
Facility managers
Healthcare professionals
Healthcare waste workers
Facility support staff
Other positions within facility
Make notes pages of PowerPoint slides to hand out to class
Make copies of class exercise for distribution at start of class
Read Chapters 2 and 3 in Blue Book, and other materials included in the References
Find regional and national data to fill in country-specific slides
Make copies of any additional documents/readings that may be handed out to class,
such as those included in the References. Or, you may prove some country specific
data.
Prepare any additional notes to be discussed during the presentation- site or country
specific data you would like to sahre
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UNDP GEF Project on Global Healthcare Waste
Materials Needed
Student Preparation
Review Questions
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Prepare any additional discussion points or review questions
Projector
Student handouts: slides, exercise, homework
Flip chart and marker pens and/or board and chalk
Blue Book Chapter 2, 3
Begin thinking about healthcare waste, what role you play in its generation/removal,
and how it is dealt with in your facility
What do you consider as major or minor sources of healthcare wastes? Give some
examples of healthcare wastes from these sources.
How does your facility deal with the major categories of healthcare wastes (sharps,
chemical, etc.)? Do you know of any interventions that can reduce exposure to
healthcare wastes?
Can you site some examples of mis- management of wastes in your facility? If so, what
can you do about this?
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UNDP GEF Project on Global Healthcare Waste
PRESENTATION
Slide Number/Title
Teacher’s Notes
Slide 1: Title Slide
Slide 2: Module Overview
Slide 3: Learning Objectives
Slide 4: Definition of Healthcare
Waste
Begin this module with the exercise; then proceed with the presentation
Introduce the outline and major points of the presentation
Describe what participants will learn by the end of this module.
Ask participants to define healthcare wastes and identify some sources.
Discuss mismanagement of wastes:
 Lack of segregation
 Re-use of syringes
Much of the general waste is recyclable and the income can significantly subsidize waste
treatment. Do you know of any recycling activities in your country?
Slide 5: General Types of
Healthcare Wastes
Healthcare waste can be:
 Non-hazardous general wastes, comparable to domestic wastes
 Potentially hazardous waste – waste that may have associated health risks
Slide 6: Sources of Healthcare
Wastes
Sources can be major or minor based on volume and type of waste. For example, a dental
clinic may be considered as a minor source of healthcare waste because of the lower
volume of waste generated compared to a hospital. However, the types of waste generated
at a dental clinic are a major hazard and include sharps, blood and mercury.
Slide 7: Other Sources of
Healthcare Wastes
As suggested in previous slide, in addition to volume and type of waste, some “other”
sources may be considered “major” or “minor” depending upon your specific country or
region.
Slide 8: Which Institutions
Generate the Most Amount of
Healthcare Waste?
The bulk of healthcare waste is generally produced by hospitals. Health-related facilities in
the United States can be categorized according to 15 types of sources. Hospitals, which
comprise only 1% of all health-related facilities, account for 71% of the total healthcare
waste generated annually. Doctors’ offices, nursing homes, clinics, and medical labs—
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UNDP GEF Project on Global Healthcare Waste
which together make up 36% of the total facilities—contribute 22% of the healthcare
waste. This pattern is typical of many countries.
Slide 9: Categories of Healthcare
Waste
See Chapter 2 of the WHO Blue Book. These categories will be discussed in greater detail in
a later module.
Slide 10: Examples of Healthcare
Waste
Use the tables on following two slides to introduce some specific waste examples per each
category of waste.
Slide 11: Examples of Healthcare
Waste
Slide 12: General Characteristics
of Healthcare Wastes
Participants should begin thinking of how this information compares with data from their
own facilities. If the data does not exist, they should start thinking of how to gather the
information. By comparison with these average figures, health facilities can begin to
consider if they need to improve their segregation practices. Bulk density values are useful
in estimating the sizes of storage areas or number of containers needed. However, bulk
densities can vary widely depending on the specific component of waste, as shown in the
data below from Canada:
Human anatomical parts - 800-1200 kg/m3
Plastics- 80-2300 kg/m3
Swabs, absorbents - 80-1000 kg/m3
Alcohol, disinfectants - 800-1000 kg/m3
Animal infected anatomical parts - 500-1300 kg/m3
Glass - 2800-3600 kg/m3
Bedding, shavings, paper, fecal matter - 320-730 kg/m3
Gauze, pads, swabs, garments, paper, cellulose - 80-1000 kg/m3
Plastics, PVC, syringes - 80-2300 kg/m3
Sharps, needles - 7200-8000 kg/m3
Fluid, residuals - 990-1010 kg/m3
Slide 13: General Characteristics
of Healthcare Wastes
Since the bulk of healthcare waste is general (non-hazardous) waste, and most of the waste
is paper, plastic, glass, and metal, participants should think of the possibility of recycling
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UNDP GEF Project on Global Healthcare Waste
general waste to minimize the impact on the environment.
Reference:
GEF Project-Green Hospitals.
http://noharm.org/lib/downloads/waste/Best_Practices_Waste_Mgmt_Philippines.pdf
Slide 14: Country-specific HCW
Generation
Slide 15: Country-specific
Sources and Other
Characteristics
Slide 16: Discussion
References (in order as they
appear in slides)
Instructor may include some regional and national data here and in the following slide.
• What are the key sources of healthcare wastes in your country?
• Has any baseline analysis of heathcare waste generation been conducted in your
country? If so, present that data here.
• What are major sources (by volume, and hazard)?
• Graphs and pictures will help.
Go over major points and review questions.
Blue Book, chapter 2, 3
GEF Project-Green Hospitals.
http://noharm.org/lib/downloads/waste/Best_Practices_Waste_Mgmt_Philippines.pdf
Kwakye G, Pronovost PJ, Makary MA. Commentary: A call to go green in health care by
reprocessing medical equipment. Acad Med. 2010;85(3):398–400
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UNDP GEF Project on Global Healthcare Waste
ACTIVITY: MODULE 1: EXERCISE (45 MINUTES)
The purpose of this exercise is to have participants start thinking about healthcare waste, the scope of healthcare waste in
their facilities, and characterizing the waste.
Instructor: Break class into groups of three or more, and distribute exercise at beginning of class. You may group participants
by facility, department, or job type. Participants will complete the activity in groups and record their answers in the table
provided. Instructor should record participant/group responses on a wipe board, flip chart, or transparency, categorize their
responses. Use the table provided to record the answers.
Instructor will go over the responses, once again, during the de-brief.
Module 1 Exercise: Characterizing healthcare wastes.
Instructor should describe the module overview and objectives and then ask participants to categorize the types of healthcare
wastes in their facilities, by location.
1. Think about the sources and locations of healthcare wastes in your facility
2. Try to categorize the waste by two general types based on whether or not they pose hazards.
3. Complete the following table for locations of hazardous wastes in your facility.
De-brief
Instructor will discuss advantages of characterizing healthcare waste and how it relates to the rest of the course.
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UNDP GEF Project on Global Healthcare Waste
TABLE: CHARACTERIZE HAZARDS BY LOCATION IN YOUR FACILITY
Location of hazardous wastes in your facility
Biological agents
Chemical/
Pharmaceutical
Infectious/Sharps
Genotoxic/Cytotoxic Any other hazardous substance
agents
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