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  5. Wsd The New Frontier for Medical Waste ...

Wsd The New Frontier for Medical Waste Treatment

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The issue of medical waste is increasingly relevant: the recent Covid-19 pandemic with its resulting economic consequences has underlined how crucial it is to have integrated and definitive solutions. Hospitals and private healthcare facilities of all sizes are faced with complex and costly procedures for medical waste management. The storage, transport, and treatment of infectious hospital waste constitute one the highest costs for the healthcare industry, both economically/financially and from an environmental standpoint. We are talking about a production of 144 thousand tons of waste per year in Italy alone. Following the Covid-19 pandemic, medical waste increased by 40% in 2020, up to 300 thousand tons/year. This growth is related to a higher number of hospital admissions and the use of PPEs, which has increased exponentially for well-known reasons. 

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Medical waste, and specifically infectious medical waste, has become a global emergency.

Most countries are developing new rules and guidelines to reduce the cost and environmental impact of infectious waste, paying special attention to the United Nations’ Sustainable Development Guidelines (SDGs).

Generally, new legislation has the following objectives:

TREATING WASTE AT THE SOURCE (AN EXAMPLE OF THIS IS THE EU WASTE MANAGEMENT LEGISLATION: “PROXIMITY: WASTE SHOULD BE DISPOSED OF AS CLOSE TO THE SOURCE AS POSSIBLE”).

REDUCE WASTE VOLUMES TO LIMIT POLLUTION DUE TO TRANSPORTATION.
ADOPT ALL MEASURES TO PROMOTE RECYCLING AND REUSE OF PRESENT OR FUTURE WASTE (END OF WASTE).

The cumulative effect of these guidelines is pushing legislators to promote on-site medical waste sterilization and treatment.

Cisa Group is leading the field with the invention of a Waste Sterile Department (WSD®), which is based on and adapts the principle of the CSSD , from which the new technology for medical waste treatment is directly derived.

UE: WASTE MANAGEMENT LEGISLATION:
“Proximity: waste should be disposed of as close to the source as possible”.
IT: THE CONVERSION LAW DECREE NO.40/2020
Nell’art.30 Bis e il successivo decreto-legge 76/2020, nell’art.63 Bis, stabiliscono che i rifuti sanitari a solo rischio infettivo assoggettati a procedimento di sterilizzazione secondo i dettami del DPR n.254, presso le strutture sanitarie pubbliche e private sono sottoposti al regime giuridico dei rifiuti urbani.
UK: HEALTH TECHNICALMEMORANDUM 07-01 INFECTUOUTS WASTE - YELLOW STREAM: 5.31
5.31
Infectious waste known or suspected to be contaminated with pathogens classified in Category A in the Carriage Regulations should be treated on- site prior to removal to a disposal facility; on-site treatment may include autoclaving in purpose-built autoclave facilities before being transported.

5.34
Wherever possible, Category A infectious substances (including waste) should be treated on- site (using an autoclave or equivalent).

The Italian legislature has recently introduced the Simplification for Medical Waste Management., and many other countries are introducing similar regulations.

The Italian Converted Into Law Decree 40/2020, in Art.30 Bis and the subsequent Italian Legislative Decree 76/2020, in Art.63 Bis, establish that medical waste at infectious risk only, subjected to sterilization procedures according to the provisions of Presidential Decree 254 “Medical Waste”, at public and private healthcare facilities, falls under the legal status of urban waste.

The concept of simplification for medical waste management is an important innovation: it means that medical waste, properly sterilized, can be disposed of as undifferentiated waste: without having to be sent to the incinerator, it can be treated as mixed municipal waste according to EWC 20 03 01.

In order to implement this smart management of infectious medical waste, the institution must equip itself with appropriate technology. Cisa WSD® allows for the application of this procedure in full compliance with regulations, with safe and environmentally friendly results.

CRITICAL ISSUES AND RISKS FOR HEALTHCARE INSTITUTIONS, OPERATORS AND THE ENVIRONMENT  

There are many critical issues related to the management of infectious hospital waste.
The storage, transport and treatment of medical waste have a huge environmental impact.

1. CRITICAL ISSUES RELATED TO THE TRANSPORT OF MEDICAL WASTE
CO2 emissions due to an overwhelming number of transports* of medical waste to incinerators result in a logistical and economic burden and have a major impact on the environment and health of all of us.
*In Italy, there were an estimated 200,000 special transports per year before the Covid-19 pandemic.
2. OVERALL COST OF OPERATION
Management of infectious medical waste is a high cost item. The possibility of reducing the costs related to hospital waste management directly concerns Healthcare Managers and Hospitals. It is estimated that approximately 25% of all medical waste is hazardous infectious waste, which accounts for over 40% of the global hospital waste cost.
3. CRITICAL ISSUES RELATED TO THE STORAGE OF INFECTIOUS MEDICAL WASTE
The storage and handling of infectious waste are among the most serious hidden hazards in the management of a hospital. When this activity is delegated outside of the hospital facility, hazardous waste must be moved from the hospital warehouse to trucks under strict supervision. This is a high-risk process, which must be carried out following certain procedures in order to protect the health and safety of the healthcare workers involved. Cisa Waste’s solutions for the treatment of medical waste provide maximum protection for the people involved, the facility and the environment, ensuring a safe, economical and sustainable management.
  • Lower waste volumes
  • Waste can be treated as mixed municipal solid waste
  • Up to 30 days of storage time
4. RESPONSIBILITY OF THE PRODUCER IN THE MANAGEMENT OF INFECTIOUS MEDICAL WASTE
The responsibility of the producer is another sensitive issue related to the storage and treatment of infectious hospital waste. Waste legislation is quite complex in many cases, but on this issue it is clear and specific: hospitals and healthcare facilities are to be considered waste producers, with specific obligations and duties. The responsibility of the Institution or facility does not cease with the transfer to the disposal operator. In Italy, various laws and rulings reaffirm the principle of the waste chain: “the accountability and cooperation of all parties involved, in whatever capacity, not only in the waste management cycle, but also of the goods from which waste originates”. The authority/facility can therefore also be held co-responsible for disposal after the transfer. (Legislative Decree no. 152/2006, Ruling of the Criminal Court of Cassation April 10, 2012, n. 13363). The UK Environment Protection Act 1990 states that all waste producers have a Duty of Care to ensure the proper management of waste, “… the responsibility to take all reasonable steps to ensure that when transferring waste to another waste holder, the waste is properly managed throughout its entire journey to disposal or recovery”. Environment Agency Statutory Guidance.