HCRW Container Compliance

The disease-causing potential of healthcare risk waste (HCRW) is considered greatest at the point of generation and naturally tapers off after that point. Therefore, risk to the general public of disease caused by exposure to HCRW is likely to be much lower than risk to the healthcare workers. 

Improper management of discarded needles and other sharps can pose a health risk to the public and waste workers. Used needles can transmit serious diseases, such as the human immunodeficiency virus (HIV) and hepatitis.

Implementing special handling and specific safety procedures for waste handlers to follow, for the containment and segregation of HCRW at the point of generation, helps protect healthcare workers and the public from exposure to infectious materials. Proper management at generating sites expedites the transfer and treatment of HCRW. The quality of handling is affected by the design of HCRW containers.

Segregation

Segregation is the separation of healthcare risk waste into designated categories. It is also the initial and crucial point in the waste handling process that determines the amount of waste and type of treatment process to which it will be subjected in the ensuing waste management process.

Containment

The structures that are used for the containment of HCRW can reduce the probability of transmission of infection. In addition, proper containment of HCRW protects workers from physical injury and greatly expedites the waste handling process.

Guidelines on correct containment and HCRW management:

• Clearly marked, easily accessible containers for each type of waste will encourage optimal segregation.
• The use of colour on a container serves to identify the category of waste that it contains.
• The containers should be located in the immediate area of use.
  
• These containers can include single use and reusables within the scope of hospital infection policy and liability concerns.
  
• Too many containers can confuse and discourage healthcare personnel in attempting to properly segregate the various wastes. Too few containers may result in all waste being designated for a costly and more involved process necessary for only certain types of waste.Routinely replacing the containers helps ensure that they do not become overfilled. 
• Sealing all bags by lapping the gathered open end and binding with tape or a closing device (e.g. cable ties) so that that no liquid can leak.
  
• If containers are to be reused, ensure they are thoroughly washed and decontaminated by an approved method each time they are emptied. Include agitation (scrubbing) in the cleaning process to remove any visible solid residue, followed by disinfection.
  
• Select packaging material appropriate for the type of waste and treatment process. Use packaging that maintains its integrity during storage and transport.
  
• Clinical glass should be placed in rigid, leakproof containers to protect it from breakage.
  
• Use plastic bags that are impervious to moisture, puncture resistant, and distinctive in colour. 
• Reusable containers should be constructed using heavy walled plastic. These containers are not to be used for any other purpose, unless they have been properly disinfected and have the HCRW symbols and labels removed.

For more detailed information on the correct management of HCRW one can obtain copies of the following applicable SANS codes:

SANS 10248

SANS 452

SANS 10229-1

The selection of containers, their availability and careful use is critically important to ensure both safety and minimal impact on the environment.