Clinical wastes in the community

1. Ian BlenkharnEnvironmental & Healthcare Microbiologyhtpp://www.ianblenkharn.comHealthcare & related wastes in the community- how others see us, and we see othersAnd some who may not see again! http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

2. Clinical wastes in the community • care homes, clinics, schools, dentists, pharmacists, alternate practitioners, piercers, tattooists • domiciliary care & minor self-care • drug abuse • sex industry • trauma or violence • fly-tipping etc An audit of service standards evidenced by information on web sites http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

3. Clinical wastes in the community 271 LA web sites CW collections, domestic premises 131 in-house service 123 by contractor 8 collect soft waste only 5 no service 25 refer to hospital/GP 7 refer to Yellow Pages 6 not stated 115 Supplies provide sacks 31 provide sharps box 16 no box provided, or FP10 11 http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

4. Clinical wastes in the community Service standards frequency 3x week … monthly time of collection 7am … 6pm contact details / enquires 87 waste to doorstep / kerbside / agreed location 29 multi-occupancy properties 2 bulk storage facilities 3 discrete confidential service 14 regular staff; staff ID; liaison with carer(s) use green bin; wrap soft waste in paper, put in black sack; sharps to glass jar or drinks can; take filled sharps box to GP; separate request for every collection; charge for yellow sacks; contact by email, on-line form or letter only http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

5. Clinical wastes in the community Retrieval of drug litter etc • 271 LA web sites • needle retrieval service 130 (48%) • Service located by search • needle(s) 48 • syringe(s) 86 • fly tipping 16 • environment 19 • general 102 • Service limits • public areas only 68 • private land 8 • not stated 195 http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

6. Retrieval of drug litter etc Contact information dedicated phone 68 24 hour phone 27 on-line form / email 6 office hours only 244 freephone 1 switchboard 169 Response time urgent/prompt 13 24/7 6 2 – 4 hours 7 within 24 hours 7 not stated 238 Clinical wastes in the community http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

7. Clinical wastes in the community Retrieval of drug litter etc • Safety information • do not touch 42 • pick up 14 • do not cover 14 • cover 11 • general safety advice 18 • conditional/incomplete advice 51 • no information 118 handle only in an emergency; bulldog clip; wear gloves; put in bottle/can; wrap in paper; take to Police, GP, Pharmacy; send for free leaflet; 0870 number drugs/AIDS awareness links; drugs agencies links; emergency healthcare advice http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

8. Recycling of domestic wastes • HSE Guidance to Cut Recycling Vehicle Incidents • 4 September 2006 - In a bid to cut the injuries and deaths from waste and recycling collection vehicles, the Health & Safety Executive launched new guidance, Waste and Recycling Vehicles in Street Collection • 6 deaths since December 2005 - vehicle reversing • reversing aids • banksmen • vehicle safety checks • driver assessment • personal protective equipment (PPE) • supervision and monitoring • responsibilities of individuals • hand washing provision should be provided where there is a risk of contact with corrosives, acids, biohazards, etc http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

9. Recycling of domestic wastes • Food waste - use of bins households surveyed 102 bin inside kitchen 13 bin outside kitchen 49 garage or outhouse 3 remote storage 19 communal storage 18 (8 shared) • Food waste - handwashing no response 13 sometimes 53 / 89 always 24 / 89 never 12 / 89 perhaps more! • Food waste – service standards emptied weekly 61 emptied fortnightly 9 not stated 23 home composting 9 http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

10. Recycling of domestic wastes • Food waste • smell • fly infestation • rodent infestation • But …. • no liners permitted! • infrequent collections • contamination of lid & handle • bin hygiene? • no hand washing http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

11. serious physical injury infection Recycling of domestic wastes • inadequate PPE • training? • supervision? • no handwash! • no bacon butties? • no cigarettes? http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

12. The cost of kerbside recycling? Food? Glass? False alarm? http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

13. Social Role Valorisation… • A scientific explanation of  societal devaluation  of groups & individuals • People who are not valued by society are often surrounded by images of waste • value • prejudice • esteem • devaluation • insult http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

14. …or just plain thoughtless? • Waste containers inappropriately located • Clinical waste containers almost never locked • No excuses, even when space is limited http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

15. In conclusion…. • Need for better care with Hazardous Wastes • safety • service • speed • cooperation & compliance • social issues • Don’t create new hazards from waste • public health & hygiene • advice for users • occupational safety • effective management • H&S legislation • Care, and respect for others • Keep it simple http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

16. Managing wastes in the community • The Laffer curve The Laffer curve predicts that government can maximize tax revenue by setting tax rates at an optimum point Taxes too high  less money in circulation  productivity falls  job losses  less tax collected Arthur Betz Laffer Sr John Maynard Keynes • It’s just the same when managing wastes! Too many rules ) Too many restrictions )  Too little compliance Too many problems ) http://www.ianblenkharn.com home of theClinical Waste Discussion Forum

17. Ian BlenkharnEnvironmental & Healthcare Microbiologyhtpp://www.ianblenkharn.com http://www.ianblenkharn.com home of theClinical Waste Discussion Forum