Strategies to reduce risks of cross-contamination when managing hospital waste

Q&A with Nigel Green, Senior Environmental Scientist from the Department of Natural Resources, Environment, The Arts and Sport.
Hospital Waste Management Australian Healthcare Week 2011

Health IQ: Now, what legislation governs the aspects of clinical and related waste in the territory and are there any potential conflicts?

Nigel Green: Well, that’s a good question, because at the moment, this very little targets per se, it’s covered under the Waste Management Pollution Control Act as a listed waste under schedule 2 of the regulations. But in terms of our interests, our interest are quite minimal in the sense that we monitor any movements of medical related waste and we do have some governance over where the waste can be disposed of, how it can be disposed of and that, but we’re looking for more of it, we’ve taken up under the Health Act, which will look of course at the human implications. So that’s still on my understanding still being reviewed to a certain extent.

Health IQ: In order to reduce the risk of cross contamination of waste, what strategies do you have in place and how they work, and do you have any metrics on them?

Nigel Green: The metrics are quite broad-brush, most ways we’re divided between what’s happening in the remote, and what’s happening in the arterial townships such as Daly, Katherine, Alice, Tennant, that sort of thing. In those remote areas, basically a lot of waste, it’s quite minimal of course, you would not expect too much medical waste, but what does happen is, it tends to get burnt, their device is called turbo burners that the Department of Health looked into some time ago and they’re quite good if they maintain properly and can’t get rid of it. That of course doesn’t cover those waste that are declared that they cannot be burnt and they have to be shipped back here to RDH, for collection and ultimate shipment down south for appropriate disposal down there. Because we don’t have the facilities here. Here, we have an autoclave at Darwin and Alice Springs, and that deals with most waste, which, after maceration go to landfill. Although in RDH there are issues with source segregation and that caused some problems periodically.

Health IQ: Now, what is it do you have in auditing this waste stream?

Nigel Green: Again, the urban areas are fairly good in the sense that we have a waste manifest system with the transporters and that, and we can keep fairly good taps – generically anyway – on those medical waste that are being moved around from clinics and that are brought in to RDH or into others. But in remote areas, there’s very little information that we have. We are trying to improve that to licensing of landfills with the population of a thousand or more; trying to get stats in that sense from those communities. But it is difficult, and with high turnovers of staffing and poor resourcing; it does cause some problems.

Health IQ: What advice can you give to clinics especially those in remote and rural locations who are looking for best practice advice waste management and the prospect of recycling?

Nigel Green: The simplest solution to that is to pick up the phone – we’re always on the end and we can answer most queries around medical-related waste, and if we can’t we have colleagues in the States who can. So it’s really not that difficult, if you’re really up against the wall and don’t know what to do with a particular waste stream then give us a call, we’re in general phone directories, but you should be able to get us through the government switch number as well.

Nigel Green is presenting at the Hospital Waste Management in February 2011. This event forms part of the Australian Healthcare Week a series of events for healthcare practitioners. You can call Judy on 02-9229-1000.

Health IQ asks Nigel: Can you tell us a bit about yourself?

I started off in the UK working for consultancies, looking into landfill issues, landfill design, waste management, hazardous waste; and then I came to the territory back in 1990 and I’ve stayed here and I’ve done a variety of roles. I’ve done noise as well as waste, and looking at the environmental assessment issues. I’m trying to work as much as I can with remote communities because they have the most problems that I can see given their remoteness and lack of skilled offices out there. So I’ve come to this point where I’m a bit of a jack of all the trades and master of none.