Waste

EMTs are responsible for the safe management and disposal of health waste generated at their facilities. Safe health-care waste management involves multiple steps: minimization, segregation, collection, storage, treatment and final disposal.

EMTs should be familiar with and adhere to national and WHO waste management policy, regulations, procedures and approval processes.88 Waste management procedures must be well-documented and supported by appropriate equipment and evidence of staff training. Of particular importance is safe disposal of infectious medical waste and waste liquids, sharps, discarded medications and chemicals. Whenever possible, minimize the amount of waste produced and if practicable and safe, consider waste products that can be recycled for reusage. To reduce impact on health and the environment waste that cannot be recycled must be treated with the least harmful options, including treatment or disposal.

1. Development of SOPs for waste management. These should cover the entire cycle and be available to staff, including those recruited locally, in written and visual form.
2. Training all staff in waste management practice with specialized training for staff responsible for the collection, treatment and disposal of waste.
3. Provision of PPE for staff responsible for the handling of waste.
4. Organize segregation and separate storage, collection, and disposal of health-care waste, at least into the four major categories of general, sharps, infectious waste and other hazardous waste.
5. Determine a safe designated waste storage area within the EMT site and consider a minimum 2-day containment capacity for waste production.
6. Planning of waste treatment in accordance with local and international laws and regulations.
7. Implement an infectious waste treatment technology based on incineration or non-incineration.
8. Waste management plan foresees that waste pits be constructed in accordance with existing national and international standards and will be operated, maintained and decommissioned safely.

WHO recommends vaccination of all health-care waste handlers for hepatitis B and tetanus.

• Provide sharps containers that meet WHO standards in all areas where sharps are used.
• Ensure that the equipment used for transport of waste is spill and puncture proof, easy to clean and disinfected daily.
• Designated waste storage sites should be protected and fenced from water/rain and pests and with an appropriate mechanism to prevent access to unauthorized staff and the local population.