1. storage and External Transportation

2. Place ready storage for hazardous waste
Central hazardous
material storage
Internal transport
External Transport
Hazardous material centre
Supplier
Internal transport
Bringing together of the waste streams
Interim storage
Placing ready for external disposal
Disposal
Recycling
Consumer = Waste generator
External
transport
De-central
collection Points
Internal transport
Place ready
storage

3. General aspects of waste contracting
Ideas of the hospital:
To get rid of the waste in an easy way.
To get the service as cheap as possible.
To give away the responsibility for the waste management, treatment and disposal.
To avoid problems with the government and the public.
Ideas of the contracting company:
To make profit!
To transport, treat and dispose of the waste in an accepted way as cheap as possible
Easy and smooth collection, operation and disposal
To avoid problems with the government and the public

4. Understanding of hospitals
Main cost of the hospital:
Contracting costs
Internal transportation cost including packing material
Cost for the interim waste storage
Cost of the waste management
Ideal contracts for a hospital:
Medium term contracts
Price, based on the weight of generated waste
High frequent pick up on fixed times
Complete take over of the responsibilities by the contractor

5. Storage Requirements Requirements:
Totally enclosed area, separate from other waste storage areas
Identifying as infectious waste area by the use of the biohazard symbol
Easily accessible for collection vehicles (carts)
Easily to disinfect
Not connected to the normal sewage system
Inaccessible also for birds and insects
Good lighting and ventilation
Situated close to supply of cleaning equipment, protective clothing and waste bags or containers.
Periodically cleaning and disinfection after prior consultation with the infection control committee

6. Sample: Interim storage for infectious waste
Lockable door
Hazard sign
Easy to clean surfaces
The storage place should be refrigerated, signed, lockable, easy to clean and not accessible for any stranger or animal. Further it is not connected with the sewage and has a good lightening and ventilation

7. Some details of the interim storage
UN-approved
containers
for infectious
waste
Sterilizeable
transport carts
Tiled room, easy to disinfect
Temperature: 5-7°C

8. Solution for storage places
Waste container as interim storage
If a suitable storage place is not available, large waste container can be a solution. This containers will be filled by the hospital and regularly exchanged against clean and empty once by the disposal company.
Specifications:
Lockable
Signed
Water proof
UV and chemical resistant
Easy to clean and disinfect
Max. storage 24 hours
Should stand at a special place

9. Chemical Waste : Storage
Requirements:
Impermeable hard standing base with good drainage
Additional liquid and chemical proof chemical sump without drainage
Sub dividable in different sections
Fitted with a lock to prevent access by unauthorised persons
Lightening and very good ventilation (explosion proof !!!)

10. Chemical waste : Interim storage
Separate from other buildings, in a lockable, special designed storage, chemical waste can be stored until the disposal
The storage place fulfills the require-ments of the local law and is equipped with all necessary safety equipment

11. Interim storage of hazardous waste
Waste with same risks are stored together like inflammable solvents, water pollutant chemicals, halogen chemicals, etc.

12. Sample: interim storage for chemical waste
Sample of an interim storage for chemical waste:
Necessary safety equipment
Different sections
Chemical waste is packed in suitable packing
Additional liquid and chemical proof chemical sump without drainage
All waste is labelled

13. External transport of hazardous waste
Central hazardous
material storage
Internal transport
External Transport
Hazardous material centre
Supplier
Internal transport
Transport corresponding with UN standards
Documentation of the responsibilities
Record keeping of waste amounts
Disposal
Recycling
Consumer = Waste generator
External
transport
De-central
collection Points
Internal transport
Place ready storage

14. Why we set up of a waste manifest?
The waste manifest
Why we set up of a waste manifest?
To be able to trace the waste during the complete disposal chain
To be able to monitor the correct transportation and treatment
To document the correct treatment
To control the production of hazardous waste in the country

15. Documentation of the transport
Tracing System
For the monitoring of the waste streams, a tracing system must be followed, e.g.:
Authority
Notification - Generator
1. Original - Transport
2. Copy – (Generator)
3. Original - Treatment
4. Copy – (Transport)
5. Copy – (Treatment)
6. Copy – (Generator) 1 2 3 4 5 6

16. Record keeping:
Sample consignment note: (from the United Kingdom for the carriage & disposal of hazardous waste)
Producer certificate
Description of the waste
Carriers collection certificate
Producers collection certificate
Disposers certificate

17. Transport of hazardous waste
External Transportation:
Periodically or on request, a governmental licensed disposal company comes and takes the waste to the treatment plants.
The hazardous waste must be transported according to the applicable laws.
The carrier must endorse the receive of the quantity and quality of the waste and will be responsible for the waste after signing.
After treatment, the carrier will inform the generator about the disposal in accordance with the regulations

18. The “Hospital Waste Officer”
The hospital waste officer is the head of the waste management in the hospitals. He is responsible for the supervision of the introduced waste management, introducing of new methods and for the training of the employees.

19. Basis Information: Hospital waste manual
Documentation:
Waste regulations
Waste management plan
Waste Organisation - Waste Management Organisation - Description of relevant positions
Hospital waste guide - Waste data sheets
Process Organisation - Process instructions - Task- and responsibility matrix
Standardized forms
Waste and accidents records

20. The Hospital waste guide
In the guide, the staff can find information how to manage and handle generated Hospital waste
Waste definitions
Receptacles
Collection
Record keeping
Organisation
Disposal