We read the editorialby Sneyd et al on ‘Anaesthetist and the Environment' with interest. The ClimateChange (Scotland) Act 2009 proposes a 80% reduction in levels of greenhouse gasemissions by 2050 from the levels recorded in 1990; the interim target is areduction of 42% by 2020 [1].
NHS Scotland'senvironmental report for 2008-2009 revealed that carbon dioxide emissionsincreased by 0.53% from the previous year. Clinical waste also increased by1.22 % from the previous year. The cost for the treatment and disposal of allNHS Scotland's waste was £10.2 million, 7.92% more than the previous year. Thecost of disposal of clinical waste rose 8% to £501.14 per tonne, whilstnon-clinical waste increased by 15.04% to £95.61 per tonne [2].
Most hazardousclinical waste is either incinerated or treated then sent to landfill sites.Both of these methods produce green house gases.
We wished to quantifythe amount of potentially recyclable material that was being disposed of in thehazardous clinical waste bags, within our clinical environment, and thusundertook an audit of waste management in our paediatric anaesthetic practice.We collected, segregated and weighed all of the waste material in theanaesthetic rooms and waste bag next to the anaesthetic machine in theatre.Using calibrated weighing scales and fully protective clothing, we separatedthe recyclable waste (plastic, paper, cardboard) from the non-recyclable waste(hazardous clinical waste - including everything contaminated by body fluids),and weighed the separated contents. The waste material was then re-bagged anddisposed of, as originally intended.
20.7 kg of wastematerial was produced from anaesthetising 60 children in 11 anaesthetic roomsover 3 afternoons. Only 28.9% represented hazardous clinical waste. 71.1 % ofwaste was potentially recyclable. It comprised 48.9% plastic and 22.9% paper orcardboard. We did not evaluate sharps and glass waste products, which weredisposed of in sharps bins. Some of the non-clinical waste material that wasfound in hazardous waste bags included polystyrene cups, plastic water bottles,aluminium cans, food material and theatre lists.
Our findings are ofinterest when compared with McGain et al, who carried out a similar audit in aMelbourne Hospital, and found only 40% of total anaesthesia waste to berecyclable [3]. Hutchins and White, also in their audit of anaestheticwaste in a hospital in Brighton, found that about 40 % of this waste waspotentially recyclable [4].
Education is acrucial part of increasing staff awareness regarding appropriate wastemanagement. We questioned twenty-two members of staff about theirknowledge of the national colour-coding for waste management [5]. Onlyfour of these participants had any formal education on waste management, whilsttwenty members of staff claimed to be aware of the national colour codingsystem. However, when asked to identify the colour coding for yellow, orange,pink striped, black/clear, black striped, and radioactive material bags, only44% of answers were correct. All twenty-two participants agreed that they didnot practice colour coded waste segregation, but twenty-one out of thetwenty-two thought that changing their everyday practice would make asignificant difference to waste management and the environment.
Although our auditfocused on one facility over a relatively short period of time, the results maybe indicative of wider failures. Evaluating our practice, increasingstaff awareness and responsibility for waste management may help contribute tothe reduction of green house gas emissions, in addition to reducing the cost ofwaste disposal in the NHS.
Diana Raj
Gersten Jonker
Rosalind Lawson
Royal Hospital forSick Children, Glasgow
E-mail : diana.raj@ukgateway.net
References
1. ClimateChange (Scotland) Act 1990 : accessed on 6th June 2010 at
http://www.opsi.gov.uk/legislation/scotland/acts2009/pdf/asp_20090012_en.pdf.
2. 2008-2009Annual National Environment Report, version 1 December 2009. Health
Facilities Scotland, a division of NHS National ServicesScotland.
3. McGainF, Hendel SA, Story DA. An audit of potentially recyclable waste from
anaestheticpractice. Anaesthesia and Intensive Care 2009; 37: 820-3.
4. HutchinsD, White S. Coming round to recycling. British Medical Journal
2009; 338:746-8.
5. Departmentof Health. Health Technical Memorandum 07-01: Safe Management of
Healthcare Waste. http://www.dh.gov.uk/ (accessed on 06/06/2010).