As Linda D. Lee, DrPH, REM, Director of Operations for Healthcare Solutions at Waste Management, explains, a hospital is like a small city. It generates small amounts of every kind of waste. In order to truly capitalize on organics (food and yard waste), recycling and to minimize hazardous waste, a hospital needs a complete environmental solution for its waste disposal.

Segregating regulated medical waste from solid and recyclable waste reduces costs and environmental footprint.


“You don’t just want to look at medical waste or solid waste,” Dr. Lee says. “You need to look holistically at waste so that your waste management practices fully engage the spectrum across the hospital.”

Recently, Surgical Products spoke with Dr. Lee to learn best-practice approaches to medical waste disposal, and find out what hospitals and surgical facilities can do to reduce their environmental impact in this area.

SP: How can OR staff and hospitals achieve ‘green’ initiatives in disposing of their medical waste?

LL: One of the things Waste Management (WM) does is work with our clients to help them understand what is considered regulated medical waste and what is not. Regulated medical waste (RMW) includes materials that are dripping or soaked in blood or a sharp object such as a syringe, blade or needle. Many times, hospitals in the OR will throw away wrappings that aresterile into a red bag. We help clients reduce RMW by instead putting it into the solid waste stream or the recycling waste stream. In some cases, they have very little medical waste if they apply those principles.

SP: What are some challenges related to disposing of medical waste that are keeping some hospitals from being as green as they could be?

LL: Often, prior practices get in the way of proper disposal methods in hospitals. If someone said, “We’re going to put all Band-Aids into medical waste whether they need to or not,” they would be put there. If someone said, “All products from the OR have to go into a red bag,” then they would. Many hospital practitioners are so busy that they don’t challenge those old assumptions. If we can get to the right champion in the hospital to challenge those old methods, we can be successful in reducing medical waste.

SP: What’s different about medical waste versus waste from other industries? What challenges in terms of disposal does medical waste pose?

LL: The healthcare environment is the only industry that produces regulated medical waste. Every industry can produce cans or solid waste or chemical waste, for example, but only healthcare produces RMW because of the microbiological components or sharps. Due to the challenges of healthcare reform and regulations, waste disposal doesn’t get as much focus. Waste in a hospital is a by-product of the services they provide. I don’t think hospitals spend a lot of time thinking about their waste because they have nursing, doctor and financial shortages. They don’t see the low-hanging fruit from a financial standpoint. It’s a unique waste stream.

SP: What are the financial implications of being green when disposing of medical waste? Do hospitals have to make investments up front to realize cost savings in the long term?

LL: Different waste streams are more or less expensive to dispose of. Generally, RMW or red bag waste is one of the more expensive waste streams. RMW is a small portion of waste they generate. Advances in surgical techniques mean that less blood and body fluids are being produced.

If waste materials aren’t regulated, they can go into recycling, such as plastic bottles used in the OR that only contain saline. However, this requires commitment on the part of the hospital to segregate into the proper waste streams. Due to the stresses on healthcare, people can’t or won’t take the time for segregation. They could save money by looking to minimize RMW and increase recycling and the amount of materials they can keep out of the waste stream.

SP: How do waste disposal practices relate to safety standards in a hospital? Does waste disposal pose a risk to staff safety?

LL: The healthcare environment is busy and robust and, sometimes, practitioners dispose of sharp objects that could puncture a bag in the wrong place. Putting sharps into red bag waste rather than a sharps container can cause a needle stick injury to housekeeping or other staff.

Safety means having good practices and reinforcing them. Making sure the practitioner is putting waste into the right container is really important. If you look at needle stick injuries among healthcare workers, those are indicative of poor handling practices. You need to look at where the injuries are occurring and they usually trace back to poor practices for handling waste.

SP: Does WM have any new initiatives they’re working on related to waste disposal in the healthcare industry that our readers should be aware of?

LL: BD (Becton, Dickinson and Company) and WM are working together on ecoFinity, a life cycle solution for sharps and sharps containers so hospitals disposing of sharps and containers can look for options that fit with their environmental sustainability goals. In traditional disposal, 100 percent of the sharps container and contents, once treated, ends up in the landfill. With eco- Finity, we’re taking 100 percent of the sharps container and sharps and putting them through a recycling process. It offers a cradle-to-cradle solution for the disposal of syringes and containers in the hospital setting. The recycled plastic is pelletized and used to create new sharps containers.

If you think about the number of devices coming out of a 500-bed healthcare facility, that facility generates 50 tons of sharps and associated wastes. If we can keep that out of a landfill and recycle it, hospitals will get a clean sharps container product to avoid healthcare-acquired infections.

You can look at it as a closed loop system. This is a game changer for hospitals looking for green and sustainable opportunities for disposable products.

SP: Why should hospitals and surgical facilities continue to go green? Why is it important to adopt green practices in this industry?

LL: Most hospitals have environmental sustainability missions. In all the healthcare customers I’ve visited, almost every hospital has some level of sustainability initiative: to reduce waste, to improve energy efficiency, to cut costs by purchasing less products, or to find donation options for materials that could be used by developing countries.

Hospitals want to be good community citizens and not cause any problems for the communities where they operate. Financially, it makes sense for hospitals to develop green initiatives. It’s not about just getting waste into the right bucket. It’s about managing materials to produce less of it so there’s less waste going out. Waste is a mass balance. What comes in, goes out.

Furthermore, many hospitals want to be LEED certified and so they’re focused on waste, energy and use of natural resources. When you look at all the mission areas of a hospital, having good practices around disposal is good for the hospital, good for the community and always embraced by the employees.