Compass Medical Waste Services

What is HCRW?

Two main categories:

  1. Health Care GENERAL Waste (HCGW) 84%

For example, flowers, papers, leftover food, etc.

Recycling greatly reduces the impact of this waste stream, for e.g cardboard boxes.


     2.  Health Care RISK Waste (HCRW) 16%

For example, any waste that is a hazard to human  health or the environment. Also called Medical Waste/Biohazardous waste.

HCRW is broken down into 9 different waste streams.


The Nine Streams Of Health Care Risk Waste

  1. Infectious Waste: ‘Red bag waste’ gloves, bandages, etc
  2. Sharps: Needles, scalpels, blades, infusion sets, etc
  3. Anatomical Waste: Placentas, amputations, etc
  4. Pharmaceutical Waste: Expired drugs
  5. Cytotoxic Waste: Cancer treatment
  6. Radioactive Waste: Waste from X-ray Departments
  7. Hazardous Chemical Waste: Formaldehyde
  8. Heavy Metal Waste: Mercury, Cadmium, Lead
  9. Pressurized Containers: Gas cylinders
  10. Health Care General Waste


Mixing of waste is unacceptable

Infectious Waste

Also referred to as ‘red bag waste’, ‘general medical waste’ or ‘soft waste’.

The largest component (90%) of HCRW, consisting of soft materials that could transmit infectious agents for e.g. gloves, bandages, nappies, dressings, swabs, etc. 



Single use and reusable containers are available for the containerization of infectious waste. The containers must be lined with a red bag prior to use, and sealed with a cable tie once ¾ full. Bags must not be stapled or taped closed. Both containers must be labelled correctly with the recognised and infectious sign, and should be predominantly red. The red bags are the primary container and MUST ALWAYS be placed into a secondary container for transportation.

All patients should be informed on admission that only HCRW must be disposed of into the red bag. The RUC (reusable container) must be filled to capacity as it isn’t cost effective for the healthcare facility to send half filled RUCs for treatment of the waste and disinfection of the RUC. It is the generator’s legal responsibility to ensure that the waste is correctly segregated at source and packaged correctly for transportation.

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Sharps Waste

Any object capable of causing a cut or puncture for example, needles, scalpel blades, empty ampoules, broken glass, amnio hooks, etc. Is approximately 5% of HCRW. This is a highly hazardous waste stream, even if the sharps are not infectious as they are capable of causing a sharp injury



Health care staff (Dr’s & nurses) are at the highest risk of obtaining a NSI when handling the sharps for example, during the administration of injections, taking bloods, etc, and also when sharps are not correctly segregated and containerized. 

Containers must be a rigid, puncture proof container that is yellow. The lid on a single use container must always be on securely before use and the containers must not be overfilled, always sealed at the ¾ mark. The needle must not be removed from syringes due to the increase of NSI, and as a rule the needles must never be re-sheathed. Only sharps are to be placed in containers due to costs. Should be secured to the wall or trolley by use of brackets and kept upright during use, placed as near as possible to the point of generation.

Health care staff are at highest risk of obtaining a NSI when handling sharps (E.g. During administration of injections, taking bloods, etc - also when sharps are not correctly segregated and containerized). 

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Anatomical Waste

This waste consists of tissues, organs, nonviable foetus, amputations, etc. 

Single use (disposable) containers only to be used, must be red in colour, and are called Speci bins. For larger tissue like amputations, the 50 lt. or 142 lt. cardboard box sets can be used. The body tissue should be double bagged, sealed and placed into the cardboard box sets, the box set must be marked ‘Anatomical waste’



An anatomical register should be kept by the Health Facility. Speci bins should be kept in the freezer or mortuary until collected, under supervision, and the register must be signed. Ideally, only one specimen should be placed per container, each placenta should have its own speci bin, and each speci bin should be labelled with the patient’s details/patient’s sticker. 

  • Single use containers are to be used for anatomical waste
  • Clean freezer used storage for anatomical waste
  • Anatomical waste is carefully handed over
  • The anatomical waste is scanned by Barcode tracking system
  • Large amputations are double bagged
  • Box with large amputation is correctly sealed


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Pharmaceutical Waste

This is expired, unused drugs and vaccines.



The green container with the ‘toxic substance’ label must be used and special precautions are to be taken to prevent the theft and illegal distribution of this waste stream. 

Scheduled drugs must be strictly controlled.
Schedule 1 – 4: Drugs can be disposed of together in one container
Schedule 5 – 6: Need special permission prior to disposal

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Cytotoxic Waste

Cytotoxic medications are therapeutic agents used in the treatment of cancer, this is highly hazardous waste. It includes any residual Cytotoxic medication that remains following patient treatment and any materials or equipment contaminated by Cytotoxic drugs for example, IV drip sets, gloves, ampoules, vials, etc. Cytotoxic waste may sometimes also include patient’s vomit, urine and faeces depending on the excretion time of the drug. For example, Methotrexate is present in the urine for 3 days post treatment.



Sharps that are contaminated with cytotoxic material must be placed into a single use yellow Sharps container labelled with a cytotoxic sticker. Other material contaminated, for example gloves, cotton wool swabs, dressing, etc. should be contained in a rigid proof green pharmaceutical container and labelled with the cytotoxic sticker. Containers must be sealed at ¾ full and the disposal of this waste is through incineration at very high temperatures. Non-burn technology may not treat cytotoxic waste.

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Chemical Waste

Hazardous chemical waste consists of discarded/unusable solid, liquid and gaseous products from diagnostic and experimental work, cleaning, housekeeping and disinfecting procedures. For example, Formaldehyde, gluteraldehyde, pesticides, etc. 



The international colour coding for chemical waste is dark green and all chemical waste must be labelled with the label for the class of hazardous waste, e.g. explosives, flammable, corrosive. The disposal depends on the nature of the hazard presented by the waste (flammable, corrosive, etc). 

We do NOT accept chemical waste, to dispose of this waste a chemical waste disposal specialist needs to be contacted.

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Radioactive Waste

There are many uses of radiation in medicine, the most well known is the use of X-rays to foresee whether bones are broken. Within radiology, we find more specialized areas like mammography, CT scans etc, and nuclear medicine. A common example of nuclear medicine is the use of radioactive iodine to treat thyroid problems, including thyroid cancer. 



Radioactive waste is a highly specialized waste stream, governed by the Nuclear Energy Act 46 of 1999. Waste from an X-ray dept is considered inactive or low level radioactive waste. This low level waste may be collected in red liners for HCRW (less than 74 Becquerel’s). Any waste arising from a procedure that has a high-level activity (nuclear medicine) will need to be disposed of by a registered radioactive company.

We only accept low level radioactive waste (less than 74 Becquerel’s).

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Heavy Metal Waste

Mercury is the most common waste in this category, found in thermometers, blood pressure gauges, fluorescent tubes, etc. The best way to deal with Mercury is to move towards a Mercury free hospital. Protective gloves and masks must be worn when cleaning up a Mercury spill. A syringe is a very effective means of ‘sucking’ up the Mercury spillage. 



This waste must never be incinerated because of the risk of atmospheric pollution, and it must never be disposed of in general landfill sites as it may pollute the ground water. It must be sent to a HAZARDOUS waste facility where it is encapsulated in concrete before burial.

We do NOT accept any heavy metal waste, to dispose of this waste a landfill specialist needs to be contacted.

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Pressurized Containers

Many gases, for example, anaesthetic gases, ethylene oxide, oxygen and compressed air are stored in pressurized containers. Air fresheners, insect repellents are stored in aerosol cans.



Most pressurized containers are reusable. Aerosol cans are not reusable and need to be disposed of, once empty they can be disposed of with the HCGW NOT HCRW.

HCRW service providers are NOT permitted to accept pressurized containers as they can cause an explosion at the treatment facility.

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Health Care General Waste

A black bag or clear bag is used for Health Care General Waste. Most hospitals prefer to use clear or transparent bags as this enables the waste handlers to see if any HCRW has been mixed in with the HCGW and it is recommended that facilities initiate recycling projects of the HCGW.

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You do not inherit the earth from your parents, you borrow it from your children