1. UNEP Healthcare Waste: Basic Data and generation rates Surya Prakash CHANDAK Senior Programme Officer United Nations Environment Programme Division of Technology, Industry and Economics International Environmental Technology Centre (UNEP DTIE IETC)

2. UNEP International Environmental Technology Centre2 Structure of Presentation Sources of healthcare waste Material constituents of healthcare waste Characterization of healthcare waste Classification of healthcare waste Generation rates of healthcare waste

3. 3 Sources of healthcare waste Hospitals, medical centers, and polyclinics Clinics, diagnostic facilities, dialysis centers and other specialized outpatient treatment facilities Primary health centers, rural health stations, basic health units, or health posts Maternity centers or birthing facilities Physicians offices Dental clinics and offices Medical laboratories, biomedical laboratories and research centers, biotechnology laboratories, nuclear medicine laboratories Blood banks, blood collection centers, and blood transfusion centers Nursing homes for the elderly, long-term residential care facilities for the chronically ill, and hospices for the terminally ill Pharmacies and dispensaries, drug stores, pharmaceutical manufacturing facilities Alternative medicine treatment facilities (e.g., acupuncture centers) Veterinary hospitals, veterinarians clinics, and veterinary offices Animal research and testing centers, and animal quarantine stations Home health care settings Health facilities, infirmaries, clinics, or health stations in colleges and universities, childrens schools and summer camps, military establishments, police stations, prisons, and commercial or industrial establishments Emergency service facilities (ambulance stations, paramedic units, rescue operations) Coroners or medical examiners facilities, forensic pathology or autopsy laboratories, and crime laboratories Drug addiction rehabilitation centers Funeral homes and mortuaries Tattoo and cosmetic ear piercing establishments

4. UNEP International Environmental Technology Centre4 Sources of healthcare waste contd. The bulk of healthcare waste is generally produced by hospitals. Health-related facilities in the United States can be categorized according to 15 types of sources. Hospitals, which comprise only 1% of all health-related facilities, account for 71% of the total healthcare waste generated annually. Doctors offices, nursing homes, clinics, and medical labswhich together make up 36% of the total facilitiescontribute 22% of the healthcare waste

5. UNEP International Environmental Technology Centre5 Sources of healthcare waste contd.

6. UNEP International Environmental Technology Centre Material Constituents of healthcare waste 6 Average Material Constituents of Healthcare Waste JordanPeruTurkeyTaiwanKuwaitItaly Constituent% % % % % % Paper38Mixed Paper cardboard 22 5 Paper carton 16 5 Paper34Paper cardboard 24 8 Paper34 Plastic27Plastic12Plastic41Plastic26Plastic18Plastic46 Glass10Glass8 7 7 10Glass8 Metals5 2 4 9 0. 4 Food17Food15Food12 Textiles11Cotton/gauze18Textiles10Textiles9 11 Placenta8Anatomical0. 1 Garbage9Others35Other3 3 8Liquids12

7. UNEP International Environmental Technology Centre7 Average Material Constituents of healthcare waste Average material constituents of healthcare waste, excluding food waste is given below: Material ConstituentsComposition Range (weight %) Paper/carton15-40 Plastics10-60 Glass5-10 Metal1-10 Cloth/cotton/gauze10-25 Other5-25

8. UNEP International Environmental Technology Centre8 Characterization of healthcare waste Important parameters for characterization of healthcare waste: Moisture Content – varies widely 15-50% Incombustibles – 8-20% Heating Value – 14.8 MJ/KG- 16.5 MJ/KG Chemical Composition – importance of chlorine Bulk Density – 100-200 KG/m 3

9. UNEP International Environmental Technology Centre Classification of healthcare waste Major Classification of healthcare waste: Sharps Infectious Pathological Pharmaceutical Chemical Radioactive Non-risk general 9

10. UNEP International Environmental Technology Centre Healthcare waste generation rates Factors affecting the rate of waste generation in healthcare facilities Level of activity (often measured in terms of the number of occupied beds plus number of outpatients per day, total number of patients per day, and/or number of staff Type of department (e.g. General ward, surgical theatre, office,) Type or level of facility (e.g. clinic, provincial hospital etc.) Location (rural or urban) Regulations or policies on waste classification Segregation practices Temporal variations (week day vs. weekend, seasonal) Level of development of country 10

11. UNEP International Environmental Technology Centre Healthcare waste generation rates contd. Total and infectious healthcare waste generation by type of facility –Low income countries –Middle income countries –High income countries Total and infectious healthcare waste generation by number of hospital beds –Low income countries –Middle income countries –High income countries 11

12. UNEP International Environmental Technology Centre Healthcare waste generation rates contd. Average waste generation by type of facility 12 FacilityTotal healthcare waste generation rate Infectious healthcare waste generation rate Hospital2 kg/bed-day0.5 kg/bed-day Clinic0.02 kg/patient- day 0.007 kg/patient- day Maternity Centre5 kg/patient-day3 kg/patient-day Clinical Laboratory 0.06 kg/test-day0.02 kg/test-day Basic Health Unit0.04 kg/patient- day 0.01 kg/patient- day

13. UNEP International Environmental Technology Centre13 THANK YOU For further information: http://www.unep.org/ietc/