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The Controlled Waste Regulations 1992 (SI 1992 No 588) provide a definition of clinical waste.

The criteria for decision are:

Could the waste be hazardous to any person coming into contact with it?

If so does it consist wholly or partly of

human or animal tissue,
blood or other body fluids,
excretions,
drugs or other pharmaceutical products,
swabs or dressings,
syringes, needles or other sharp instruments

Could the waste cause infection in any person coming into contact with it

If so did it arise from:

Medical, nursing, dental, veterinary, pharmaceutical or similar practice, from investigation, treatment, care, teaching or research or the collection of blood for transfusion.

If waste fits any of the criteria laid out in a.) or b.) above then it is clinical waste.

It is essential to remember that clinical waste may also be hazardous/special waste

The legislation relating to the transport of dangerous goods also applies to clinical waste. It provides a different definition based on 'infectious substances' and uses the term 'healthcare risk waste' as a description of waste that is dangerous for carriage. Specific items that this applies to and that may be relevant to the HFE sector include: infectious biological waste (e.g. tissue and blood); swabs or dressings from hospitals, clinics and labs; infectious waste likely to be contaminated with pathogens from risk groups 2, 3 or 4 (see below); contaminated sharps and instruments. The definition does NOT apply to nappies, sanitary protection etc if it has not arisen from health care or medical treatment or to waste that has been treated to render it non-infectious.

The Advisory Committee on Dangerous Pathogens document 'Categorisation of biological agents according to hazard and categories of containment' sets out hazard groups and provides a list of agents that are included in each group. Broad definitions for the groups are given as:

Hazard Risk Group 1: A biological agent unlikely to cause human disease.

Hazard Risk Group 2: A biological agent that can cause human disease and may be a hazard to employees; it is unlikely to spread to the community and there is usually effective prophylaxis or effective treatment available.

Hazard Risk Group 3: A biological agent that can cause severe human disease and presents a serious hazard to employees; it may present a risk of spreading to the community, but there is usually effective prophylaxis or treatment available.

Hazard Risk Group 4: A biological agent that causes severe human disease and is a serious hazard to employees; it is likely to spread to the community and there is usually no effective prophylaxis or treatment available.

The Health Services Advisory Committee has also designated five categories of Clinical Waste many of which may arise in the HFE sector. These are:

Group A - includes identifiable human tissues (e.g. limbs); blood; animal carcases and tissues from veterinary centres, hospitals or laboratories; soiled dressings, swabs etc

Group B - sharps

Group C - microbiological cultures and potentially infected waste from pathology units

Group D - Drugs and pharmaceuticals

Group E - Items used to dispose of body secretions (other than those in Group A) e.g. incontinence pads.

Procedures for dealing with clinical waste that may be hazardous cannot easily be generalised and individual inspectors from the enforcing authorities have differing views on the need to autoclave or decontaminate the waste prior to incineration. Each type of waste should therefore be assessed on a case-by-case basis after consultation with the local inspector for your enforcing authority.

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