Wasting healthcare risk waste away

The South African waste management industry is changing as new legislation is promulgated, especially in the healthcare risk waste industry. We conduct a Q&A with Vishika Singh, compliance manager at Compass Medical Waste Services – one of South Africa’s largest healthcare risk waste service providers.

What should people consider when dealing with healthcare risk waste?

They need to remember that it is hazardous and can be detrimental to people’s health and/or the environment and must therefore be managed accordingly.

The generators of healthcare risk waste need to ensure that:

• There are sufficient and relevant containers for this waste stream;

• The waste is segregated correctly;

• There is a central storage area (CSA) to cater for the volume of waste that is generated;

• The CSA is accessible to their healthcare risk service provider (waste collection and disposal company), to ensure that the waste goes directly into the collection vehicle;

• Their healthcare risk waste service provider has barcoded containers so that they can track the cradle-to-grave process of the waste collection and disposal; and

• They understand their legal responsibilities with regard to the disposal of this waste stream and employ the services of a reputable service provider, so as not to compromise their reputation.

What challenges are associated with healthcare risk waste disposal?

Healthcare risk waste disposal is often viewed as a “grudge” expense. Companies are driven by the bottom line rather than considering compliance and the environment. Being compliant with the laws and requirements that regulate the disposal of healthcare risk waste, and being environmentally proactive is expensive.

Every aspect of the industry is regulated – from the bags/liners and containers that the waste goes into, to the personal protective equipment (PPE) worn by staff, the vehicles used to transport the waste, the treatment and disposal processes, the effluent from treatment plants and the washing and decontaminating of the vehicles and reusable containers.

There is also a common perception that there is a lot of money to be made from healthcare risk waste collection and disposal, and that anyone can do it. As a result, illegal dumping is rife.

Some businesses tender for healthcare risk waste collection and disposal, but do not always have the expertise or knowledge of the legislation governing this industry. They also do not have the capacity to cope when the customer’s requirements increase.

You need to have a plan in place for additional waste collection and disposal. This should include the availability of containers in stock, extra vehicles, additional staff and treatment capacity to cope with the amount of waste generated.

As legislation changes on an ongoing basis, it is a challenge to keep abreast of the latest rules and regulations. This is why comprehensive training is essential.

How do you overcome these hurdles?

We regularly educate and train our customers and staff on the rules and regulations governing our industry.

We ensure that we have plans in place for increased waste generation – we have our own treatment facilities (which are based in KwaZulu-Natal, the Eastern Cape and Gauteng) and have extensive product stock in each region.

We also have a sales executive assigned to each customer to assist with whatever queries they may have.

Why is healthcare risk waste training so important?

The management of healthcare risk waste does not form part of the normal training curricula of nurses and doctors. It is, therefore, essential that they are educated on the correct way to handle and dispose of the waste.

Contracted cleaners who work in the healthcare facilities (hospitals) also need to be aware of the potential hazards of healthcare risk waste.

The biggest challenge is that often the healthcare workers do not realise the impact the waste (generated by their facilities) has on the public and the environment.

An injury or incident arising from healthcare risk waste often results in long-term consequences from a health and financial point of view. One needle stick injury can cost up to R8 000, for example, and the treatment takes a minimum of six months. Prevention of the mismanagement of healthcare risk waste is the message we highlight to our customers and their staff.

How much, and what type of, waste do you remove per annum?

Currently, between 25 000 and 30 000 t is being collected and disposed through our services per annum.

We collect and treat the infectious and sharps waste, which forms 93 percent of the total healthcare risk waste stream. We also collect pharmaceutical and anatomical waste, which we transport to licensed third parties for disposal.

What do you do with the waste after it has been removed?

The sharps and infectious waste is treated by our Bondtech autoclaves, then shredded and landfilled at permitted landfill sites. Autoclaving is a non-burn technology that utilises live steam and pressure to “sterilise” the healthcare risk waste.

Anatomical and pharmaceutical waste is incinerated by third-party incinerator operators. Low-scheduled pharmaceutical waste can also be destroyed and landfilled in permitted hazardous landfill sites.

Are there any exciting new developments/trends within the healthcare risk waste disposal industry?

There is a possibility of converting the treated waste into pellets/energy. This is something we plan to investigate as this would tie in with our mission to be environmentally sustainable.

How will healthcare risk waste disposal/services change in the future?

We hope that the authorities will continue to take a “no-tolerance” approach to the incorrect segregation and disposal of healthcare risk waste. We also hope that the generators of the waste will select their service providers based on compliance and service and not just price, and that tenders will be fair and transparent in this regard.