In 1992, the Ministry of the Environment and the Ministry of Health with the Ontario Hospital Association, developed a strategy to assist hospitals and other institutions to dispose of biomedical waste in an environmentally safe and economically feasible manner. Less than 10% of the 150,000 tonnes of medical waste requires special handling and treatment before disposal. In 1988, the Laboratory Centre for Disease Control in Ottawa stated that there is no evidence to show that hospital waste is more infectious than residential waste which has not caused disease in the community1.
Given this background, an Environmental Action Committee was formed at The Toronto Hospital in January 1992. This group included representatives from management, unions and the community. Issues dealt with included waste management, waste prevention, waste reduction, and the reuse of disposables. A study was conducted at The Toronto Hospital in October 1992 on the contents of the "yellow bag" waste which was destined for incineration2. The results showed that up to 50% was not biomedical and could have been sent to landfill. The most important method of reducing the volume of biomedical waste is by careful segregation of all waste by Hospital staff.
Information sessions were initially arranged in areas such as the O.R.'s, haemodialysis units, I.C.U.'s, and emergency departments, and later, on a hospital-wide basis. As a result of the extensive educational and informational program which was conducted, significant changes in waste disposal have occurred resulting in a major reduction on the volume of incinerator targeted "yellow bag" waste.
Waste segregation has both an environmental and financial impact. The disposal cost of regular landfill waste is 3.4 cents a pound compared to biomedical which is 55 cents a pound. Another decision by the Ministry of the Environment in Ontario was to approve the disposal of blood products directly into the sewer which has reduced the amount of liquid biomedical waste.
Other programs which have been started at the Hospital include the recycling of fine paper, glass, plastic and aluminum, batteries and polystyrene (plastic utensils and cups), cardboard, scrap metal, and used furniture and equipment.
In this way, The Toronto Hospital has reduced its landfill waste by 25% and are aiming for 50% by the year 2000 in compliance with Ontario's waste reduction targets.
Additional measures to reduce waste are to encourage manufacturers to decrease the packaging of products, as well as to switch from disposables to reusable items.
To make this program work we must all do our part and remember the 3 Rs.
REDUCE, RECYCLE, REUSE
References:
1 Bureau of Communicable Disease Epidemiology. Health Protection Branch and Health Services Directorate. Infection Control Guidelines, 1988.
2 Ortech International Biomedical Waste Audit, 1993.
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