Material and Waste Streams
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Health care produces a diverse set of wastes that require management. An important starting point is to assess what types of waste a typical healthcare facility produces and begin to understand who is responsible for tracking and managing each waste stream. The next stage will involve determining the volumes of each waste generated and the associated costs. It is not strange in health care to find that multiple people—or no one—has historically been responsible for tracking a particular waste stream. Job turnover, and people wearing multiple “hats” sometimes leads to a gap.
Additionally, it is not uncommon to find that different departments manage the costs associated with different waste streams and no one department has ever taken the time or responsibility to add up the various waste streams cross-department to get a clear understanding of how much total waste is generated and how much is spent on waste removal. The amount and costs for each waste stream is dependent on current environmental programs, regional regulations and hauling fees. This early assessment is an opportunity to identify these gaps. Only through capturing details on the types, amounts and associated costs for material removal, can one set goals and track performance.
These are the major categories of waste typically found in an acute-care hospital setting.
Click on each type of waste to learn more about appropriate management and reduction strategies.
- Regulated Medical Waste (RMW) – This waste stream is also called potentially infectious material, red bag waste or biohazardous waste. RMW is regulated state-by-state, but also falls under OSHA’s Bloodborne Pathogen Standard.The typical cost range for this waste is $0.20 - $0.50 per pound.
- Hazardous Waste – Hazardous waste is defined and regulated by the US Environmental Protection Agency (EPA) and is either a “listed” waste or meets the characteristics of a hazardous waste. Individual states may have stricter regulations than the EPA, so management requirements can vary state-to-state. The costs vary, depending on the material but common RCRA hazardous wastes include hazardous pharmaceuticals, bulk chemotherapeutic agents, mercury, xylene and other solvents, some paints, aerosol cans etc. The typical cost range for this waste is $1.70 - $2.00 per pound.
- Construction & Demolition Debris (C&D) – This waste stream is comprised of bulky material generated during construction and renovation projects including ceiling tiles, plumbing fixtures, carpeting, concrete, bricks, fill dirt, etc. Recycling of C&D waste is a common consideration in new construction and renovation projects, as it can qualify the organization for points under LEED certification or the Green Guide for Healthcare. C&D waste is unique in that the totals are not typically included in the determination of total waste generated at a facility, as it can dramatically skew baseline data with its large volume and immense weight. In the Practice Greenhealth framework, C&D waste is still measured, but is tracked separately from the other waste streams mentioned.
- Solid Waste – This waste stream is also called municipal waste, black bag, clear bag, or non-regulated medical waste. This is general trash, similar to what you would find in a hotel but with more plastics and packaging. The typical cost range for this waste is $ 0.03 - $ 0.08 per pound.
- Beneficial Reuse & Donation – This waste stream is comprised of supplies and equipment that can no longer be used by a particular department onsite but canbe reused elsewhere, whether in a different department, in the community or at another facility or clinic locally or overseas. Many hospitals have active donation programs to developing countries. Important to consider in these reuse and donation decisions is the appropriateness of the material for its end donation site. Disposal of this material can often be free while also saving money through avoided waste disposal fees.
- Food – According to the EPA, the United States spends about one billion dollars a year just to dispose of food waste. In September of 2015, the U.S. EPA and the USDA made a joint announcement, setting a goal of 50 percent food waste reduction by 2030.
- Composting – This waste stream is primarily comprised of food and landscaping waste—material that will breakdown naturally in short periods of time under the proper temperature and pressure conditions, such as grass, weed clippings, tree limbs and branches, waste from vegetable produce, bread and grains, and paper products such as napkins or paper plates. One hospital found that 23% of its total waste stream was food waste. Organizations are finding ways to compost this material—either onsite or using an offsite contractor. Diverting this waste from solid waste can significantly reduce waste disposal costs.
- Universal Waste – EPA has designated via its Universal Waste Rule that certain hazardous wastes—when sent for recycling, may be managed under a less stringent set of regulations and do not have to be counted toward total hazardous waste volumes that determine generator status. Universal waste rules were developed to encourage recycling of these materials. Materials eligible to be handled as Universal Waste include:
- Pharmaceutical Waste – Some pharmaceutical waste is considered RCRA hazardous while a large majority may not require handling as hazardous waste but should receive special disposal considerations, including controlled substances. As regulatory scrutiny of pharmaceutical waste increases, it is critical for healthcare organizations to understand the appropriate management and disposal methods. Some states also have stricter regulatory guidelines for pharmaceutical disposal including WA, MN, FL and DC. Disposal costs vary depending on the disposal mechanism.
- Recycling – Recyclables are items and materials bound for the waste stream that can be converted into a reusable material.Recyclables in healthcare include the usual suspects found in commercial buildings such as paper, cardboard, beverage and food containers, metal and glass. Additionally, there are a host of healthcare-specific materials that can also be recycled, including HIPAA paper waste, medical plastics, and items that can be reprocessed for reuse rather than disposed of. The typical cost range for this waste stream is $ 0.01 per pound.