Waste management is an increasingly important issue for healthcare establishments. Public and private hospitals produce 700,000 tonnes of waste per year, representing 3.5% of the national waste production.1Gestion des déchets hospitaliers – Association Nationale des Cadres et Experts Techniques Hospitaliers In this article, Alcimed reviews the definition of hospital waste, the regulatory framework and solutions for reducing waste production.
Hospital waste refers to all waste arising from hospital activities, so it’s not just waste from healthcare activities!
According to the World Health Organization (WHO), only 15% of waste produced by healthcare establishments is considered hazardous, i.e. infectious, chemical or radioactive. The remaining 85% is comparable to our household waste and must therefore be treated as such.1Déchets liés aux soins de santé – Organisation Mondiale de la Santé
Proper waste management reduces the impact on the environment, but also on people’s health.
| Anatomical waste | Human body tissues and organs
Contaminated body fluids and animal carcasses | Sharp objects | Disposable syringes, needles, scalpels, razor blades, etc. |
| Infectious waste | Waste contaminated with blood and other body fluids
Cultures and stocks of infectious agents used in laboratories
Waste from hospitalized patients in isolation and materials | Chemical products | Solvents used in laboratory preparations
Disinfectants and heavy metals in medical devices
Batteries |
| Pharmaceutical products | Expired, unused and contaminated drugs, vaccines and serums | Genotoxic waste | Carcinogenic, mutagenic or teratogenic, e.g. cytotoxic drugs used in cancer treatment, and their metabolites |
| Radioactive waste | Products contaminated by radionuclides, including radioactive diagnostic equipment or radiotherapy equipment | Other waste | Do not present any particular biological, chemical, radioactive or physical hazard |
Figure 1 – Types of hospital waste according to the WHO
In France, the regulatory framework for the environmental aspect of hospital waste management is currently very weak. The law of July 15th 1975, applied nationwide, establishes the “polluter pays” principle: the establishment is responsible for the waste it produces. The law provides no further details.
The French government’s ecological planning for the healthcare system, published in May 2023, is a roadmap designed to guide the healthcare sector towards ecological sobriety. With regard to waste management, it sets the objectives of accelerating waste reduction and recovery by 2030 and optimizing the scope of infectious waste. It also mentions training and raising awareness among all healthcare professionals. However, to date, there is no binding framework to encourage establishments to take these steps.
Reducing the amount of waste produced by healthcare establishments is a major way of reducing their carbon footprint. Today, there are many possible ways of improving this situation. This reduction can be achieved at every stage of a product’s life cycle: purchase, use and post-use. Here are a few examples of actions already implemented in some establishments.
A number of large public health establishments have already incorporated CSR, economic and technological criterias into their product selection process. This may involve taking into account the quantity of packaging when choosing a supplier or giving preference to the purchase of re-sterilizable products whenever possible as this reduces the number of single-use products.
Eco-design in healthcare aims to integrate environmentally-friendly practices into the design, manufacturing and management of healthcare products and services to reduce their ecological footprint while maintaining their effectiveness. For example, some healthcare establishments regularly re-evaluate the contents of care kits. This is done to reduce or increase the quantity of a given medical device or drug according to their actual use.
“Green Bloc” is an initiative followed by many hospitals to make operating theatres eco-responsible. This approach is based on the principle that since operating theatres are the biggest producers of waste, they must regularly review their sorting procedures and identify sources of waste.
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Reuse is another way of reducing the amount of waste produced. For example, sheets and textiles are commonly reused in hospitals, but this can be extended to other products such as office supplies, packaging, etc.
Recycling is at the heart of waste management. Numerous initiatives are being implemented by healthcare establishments, including the opening of new channels, the setting up of partnerships with service providers to recover certain types of waste, and the recovery of obsolete or unusable products by suppliers. For example, many suppliers recover transport pallets after use.
The introduction of new reuse or recycling practices must be accompanied by training of all staff, to encourage them to adopt these new practices and avoid sorting errors.
All these solutions require considerable financial resources, but they also generate significant savings through their ability to reduce the amount of waste produced. For example, it costs between 500 and 1000 euros to treat one tonne of infectious waste, whereas one tonne of household and similar waste costs 150 to 200 euros.2Référentiel national des coûts de gestion du service public d’élimination des déchets en 2007-2008 – Ademe
Hospital waste management is a major environmental and financial challenge for healthcare establishments. Today, there are numerous solutions for optimizing hospital waste management. Alcimed can support you in your efforts to improve waste management, take stock of the situation and train healthcare staff. Do not hesitate to contact our team.
About the author,
Océane, Consultant in Alcimed’s Innovation and Public Policy team in France
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