Health care waste management resources

Health Care Without Harm and HECAF360 developed six tracking tools for health care facilities to understand and control their waste management. Each tracker is specially designed for a different stage of the waste management process, and they may be filled in by different people playing different roles in the system. Optimized for daily data entry, the tracker produces clear summary tables and graphs that a waste manager, waste management committee, or facility director can quickly view to assess system performance and make informed decisions. Learn more.

Learn about the different available technologies to treat health care waste in this section.

Health Care Without Harm and HECAF360 partnered in a health care waste management project in Kathmandu, Nepal, funded by the German Corporation for International Cooperation (GIZ). The goal of the project is to strengthen health care waste management at the project hospitals, help build capacity for monitoring and reporting of health care waste management. and share learning and innovations arising from the project. This brochure was designed to introduce staff at the hospitals to health care waste management, and its importance for both institutions and communities. [English] [Nepali]

Protection without pollution: COVID-19 waste-reduction strategies: As the worldwide COVID-19 vaccination campaign ramped up, Health Care Without Harm responded to the need to safely manage the waste from vaccinations. This briefing covers not only how to manage used syringes but also how to avoid overusing protective equipment such as gloves.

1. Guidance for sustainable glove purchasing: As health care facilities rethink their purchasing and supply chains in the wake of COVID-19, this guidance can serve as a roadmap for advancing sustainable options [English] [Spanish] [Portuguese]
2. Guidance for immunization waste management: The huge need for masks, gloves, and other personal protective equipment, millions of COVID-19 tests, and lifesaving hospital treatment for victims of the disease has, in many cases, led to an increase in health care waste. This guidance provides recommendations on how to better manage and safely dispose of waste associated with immunization. [English] [Spanish] [Portuguese]
3. Guidance for Personal Protective Equipment for immunizations practices: This document is for health professionals who are using PPE as they administer vaccinations. It will help vaccine administers ensure infection prevention while reducing unnecessary product use and waste. [English] [Spanish] [Portuguese]

Health Care Without Harm and the World Bank published in 2021 a briefing aimed at urban authorities, including those responsible for general waste disposal, addresses all aspects of the issue from how to reduce PPE waste to the potential for recycling vaccination waste, and turning it instead into a resource. Lean more.

The IGES Centre Collaborating with UNEP on Environmental Technologies (CCET) published a case study report on safe and sustainable management of Health Care Waste, based on a project at Tribhuvan University Teaching Hospital (TUTH), one of the biggest hospitals in Nepal, in collaboration with Health Care Without Harm, HECAF360 and WHO Nepal. The case study is supported by the United Nations Environment Programme – International Environmental Technology Centre (UNEP-IETC) with financial assistance from the Ministry of the Environment, Japan (MOEJ). Learn more

The United Nations Development Programme (UNDP) in partnership with the World Health Organizations (WHO) and Health Care Without Harm, developed and implemented the project called Reducing UPOPs and mercury releases from the health sector in Africa. This 4-year initiative led to the implementation of best environmental practices, the establishment of non-burn health care waste treatment technologies, and the introduction of mercury-free medical devices in four sub-Saharan African countries: Ghana, Madagascar, Tanzania, and Zambia. All the resources, guidelines, and best practices produced during this project are available on the Green Healthcare Waste site.

In collaboration with the Plastic Solutions Fund, this Health Care Without Harm Asia report follows up on the previous year’s plastics waste audit report, providing tools for others to conduct their own audits and take action to reduce plastic pollution. Learn more.

Health Care Without Harm Southeast Asia conducted audits of plastic waste at five hospitals in the Philippines and Indonesia. The report breaks down the amounts of medical and non-medical plastic waste, and provides recommendations for the methods to reduce plastic pollution from healthcare. Learn more.

Accessible to members of the Global Green and Healthy Hospitals network, the GGHH Waste Guidance document sets out ways to meet the target of reducing, managing and treating waste in the most sustainable way considering that the different situations found in different countries will mean there is no perfect solution that will suit all circumstances. Learn more.

Also called “blue book”, this comprehensive, yet concise, handbook is oriented towards practical management of health care waste in local facilities. It provides guidelines for the responsible national and local administrators, and the guidelines complement and supplement those produced in different regions in the past. Learn more.

In 2011, the UN Human Rights Council Special Rapporteur invited Health Care Without Harm to provide input about the way in which improper medical waste management might harm human rights. The following report, and input from other agencies including WHO, led to a final report recommending more support for medical waste management and the substitution of incineration wherever possible. Learn more.

• Chemical waste management: Guidelines for chemical waste management in a safe and environmentally sound manner that complies with all applicable federal, state, and local regulations.
• Facility health care Waste management plan: This document describes what is required when developing the health care facility’s waste management plan.
• Facility waste management oversight committee: This document describes what is required when developing the health care facility’s waste management plan.
• Health care waste management audit procedures: This document is intended to provide information on how to appropriately audit laboratory waste management systems.
• Health care waste management budget planning: This document provides guidance to help develop a health care facility budget for and allocate resources to the facility’s health care waste management (HCWM) plan. It describes the steps required to develop a budget for the facility’s HCWM plan, highlights key principles to consider, and describes costing tools.
• Health care waste management prophylaxis: This document provides guidance for directors and managers of health care facilities on ensuring that workers and medical waste handlers avoid disease resulting from exposure to infectious medical waste and performing appropriate postexposure management.
• Health care waste management training: This document is intended to provide health facilities with guidelines about designing and conducting staff training on health care waste management (HCWM).
• Health care waste management worker PPE: This document is intended to provide laboratories and health care facilities with information about personal protective equipment (PPE) for health care waste management (HCWM) workers who handle infectious waste and other health care waste. This document also provides guidance to health facility management in choosing appropriate PPE for their HCMW workers and establishing proper procedures for PPE use.
• Management of offsite infectious waste transportation, treatment, and disposal service provider: This guideline provides the key considerations for selecting and managing an off-site provider of infectious medical waste disposal services.
• Model HCWM systems for each facility type: This document provides guidance on waste treatment requirements for the range of facilities.
• On-site handling of health care waste: This document is intended to provide laboratories and health care facilities with information about how to appropriately classify, segregate, collect and store their infectious waste.
• On-site treatment and disposal of blood transfusion: The purpose of this document is to provide guidance on disposal of blood transfusion products —such as whole blood and plasma, blood containers, and blood bags — for blood transfusion facilities located in developing countries.
• Sanitary sewer disposal of liquid laboratory waste: This document provides guidance and procedures to laboratory directors and laboratory staff on the proper disposal of liquid waste from laboratory activities to a sanitary sewer.
• Waste minimization and recycling of infectious waste: This document is intended to provide hospitals, laboratories and other health facilities with information about how to reduce or minimize the amount of infectious waste they produce and how to recycle it, if possible.

• Autoclave maintenance log.
• Autoclave operation log.
• Autoclave validation and challenge test log.
• Chemical treatment log.
• Department training record.
• Employee training record.
• Incident log.
• Incident reporting form.
• Training program attendance log.
• Waste receipt log.

• Audit checklist: autoclave operation.
• Audit checklist: incinerator operation.
• Inspection checklist: housekeeping/waste handler.
• Inspection checklist: laboratory waste management.
• Inspection checklist: supervisor/matron.
• Inspection checklist: waste holding and storage.

• Technical specifications: Ash pits.
• Technical specifications: Biogas digesters.
• Technical specifications: Organic waste.
• Technical specifications: Placenta pit.

• Autoclave inspection and routine maintenance.
• Autoclave operation.
• Autoclave validation and challenge testing.
• Biological spill clean-up.
• Chemical decontamination of laboratory wastes.
• Disposal of filled blood bags by autoclaving.
• On-site handling and transport of infectious waste for housekeeping staff.
• Shredder or grinder maintenance checks.