**7. Highly infectious waste**

Body fluids of patients, with highly infectious diseases, microbial cultures and highly infectious stocks constitute what is named as the highly infectious wastes in the HCW scheme and are generated, mainly, from medical analysis and research laboratory activities.

## **8. Genotoxic/cytotoxic waste**

This group of waste is accumulated from drugs generally used in oncology or radiotherapy units. It has high hazardous mutagenic and/or cytotoxic impacts. Excretions of cytotoxic drug- or chemically treated patients, i.e., faeces, vomit or urine, must be included as genotoxic waste. In specialized cancer treatment facilities, the controlled and proper treatment and safe disposal should be followed strictly to avoid contamination of the surrounding environment.

## **9. Hazardous chemical waste**

Chemical waste covers the discarded chemicals that are collected after the disinfecting procedures or cleaning processes and generated in solid, liquid or gaseous form. They can be hazardous, i.e., toxic, corrosive, flammable, etc., and should be handled, treated and disposed of following the stated issues. Otherwise, the nonexplosive residues or small contents of outdated products can be treated as infectious waste.

Bulk chemotherapy waste is, also, managed as hazardous chemical waste and must be collected in hazardous waste containers. Firm management hierarchy should be applied for treating all bulk chemotherapy agents as hazardous waste when discarded.

## **10. Waste with a high content of heavy metals**

Waste streams that have high concentration of heavy metals and their derivatives pose threats to healthcare facility as potentially highly toxic materials, e.g. cadmium or mercury from thermometers or manometers. They are categorized as a sub-group of chemical waste but should be managed separately.

The improper management of the hazardous healthcare wastes puts the healthcare workers, waste handlers and the community under the threats of infections, toxic impacts and injuries including damage of the environment. It also provides possibility for the segregated disposable medical equipment, to be resoled and reused, before their disinfection and sterilization, which can be a serious source for of epidemic disease for surrounding ecosystem [9].

It is conspicuous that hazardous materials being sold by a store, as pharmaceuticals, are not a hazardous waste until they are become expired. In general, the generator has to clearly decide that the material is a waste. In this trend, materials that can be sent to a reverse distributor must still be managed as a product, till the reverse distributor decides to dispose of the item. Loose pills, partial drug packages without all of the information on them, etc. are counted as waste and must be properly handled by the generator and/or the reverse distributor. In other words, for pharmaceutical products that meet the definition of a hazardous waste, their segregation, sorting, handling, transportation, treatment and final disposal must be carried out under the controlled rules. However, when these drugs are disposed of by the consumer, known as "ultimate user," then they are not counted a hazardous waste, since they are categorized as the exempt household waste. On the other hand, expired or un-needed pharmaceuticals at healthcare facilities, e.g., hospitals, pharmacies, medical centres, clinics, or other places dealing with drugs as business, are required to be managed as hazardous waste.

#### **11. Hazardous waste management hierarchy**

The management of hazardous wastes is a system carried out in sequences aiming at avoiding the escape of the harmful components from the waste to the man's surrounding environment. This hierarchy usually starts with segregation of the hazardous waste and is terminated by its final disposal. The source reduction can be considered as an issue in the HCW management topics even it takes place at every point of any production [10].

**7**

**Figure 1.**

*Diagram for hazardous waste management hierarchy.*

*Introductory Chapter: Hazardous Wastes DOI: http://dx.doi.org/10.5772/intechopen.88600*

ous or non-hazardous wastes in LICs.

The methodology of a proper hazardous waste management hierarchy includes

However, pharmaceutical wastes are considered as a category of the healthcare waste, even though the healthcare professionals, always, do not pay the adequate attention to their proper management. There are a number of misconceptions regarding the proper methods for segregating, handling and treatment and disposing of this waste, markedly, at the low-income countries. It is worth to state that high-income countries (HICs) generate nearly up to 0.5 kg of hazardous waste/ hospital bed/day; on the other hand, low-income countries delivered, only, about 0.2 kg. Even so, it is rare to find the healthcare wastes being separated into hazard-

The main aim for treating/managing hazardous healthcare wastes is to convert it into to less or non-hazardous materials and stabilize their infectious, toxic and/or radioactive components by various techniques of solidification and encapsulation. Many treatment methods have been used for healthcare wastes aiming at minimizing the threats of their hazard components and/or reducing the volume of the waste before disposal. Incineration of waste is the most widely applied technique for treatment of HCWs [11]. To avoid the disadvantages of incineration process, alternative methods have been applied such as pyrolysis [12], microwaving [13],

the upcoming processes in consequences: segregation and sorting, treatment, stabilization and solidification, storage and then final disposal (**Figure 1**). The full goals of this hierarchy, however it performed; when and wherever it carried out, are keeping human and his ecosystem safe, clean and tidy, moreover not burden the

coming generation the hazardous problem due to our achievement.

#### *Introductory Chapter: Hazardous Wastes DOI: http://dx.doi.org/10.5772/intechopen.88600*

*Assessment and Management of Radioactive and Electronic Wastes*

**10. Waste with a high content of heavy metals**

of epidemic disease for surrounding ecosystem [9].

be managed as hazardous waste.

point of any production [10].

**11. Hazardous waste management hierarchy**

sub-group of chemical waste but should be managed separately.

Chemical waste covers the discarded chemicals that are collected after the disinfecting procedures or cleaning processes and generated in solid, liquid or gaseous form. They can be hazardous, i.e., toxic, corrosive, flammable, etc., and should be handled, treated and disposed of following the stated issues. Otherwise, the nonexplosive residues or small contents of outdated products can be treated as

Bulk chemotherapy waste is, also, managed as hazardous chemical waste and must be collected in hazardous waste containers. Firm management hierarchy should be applied for treating all bulk chemotherapy agents as hazardous waste

Waste streams that have high concentration of heavy metals and their derivatives pose threats to healthcare facility as potentially highly toxic materials, e.g. cadmium or mercury from thermometers or manometers. They are categorized as a

The improper management of the hazardous healthcare wastes puts the healthcare workers, waste handlers and the community under the threats of infections, toxic impacts and injuries including damage of the environment. It also provides possibility for the segregated disposable medical equipment, to be resoled and reused, before their disinfection and sterilization, which can be a serious source for

It is conspicuous that hazardous materials being sold by a store, as pharmaceuticals, are not a hazardous waste until they are become expired. In general, the generator has to clearly decide that the material is a waste. In this trend, materials that can be sent to a reverse distributor must still be managed as a product, till the reverse distributor decides to dispose of the item. Loose pills, partial drug packages without all of the information on them, etc. are counted as waste and must be properly handled by the generator and/or the reverse distributor. In other words, for pharmaceutical products that meet the definition of a hazardous waste, their segregation, sorting, handling, transportation, treatment and final disposal must be carried out under the controlled rules. However, when these drugs are disposed of by the consumer, known as "ultimate user," then they are not counted a hazardous waste, since they are categorized as the exempt household waste. On the other hand, expired or un-needed pharmaceuticals at healthcare facilities, e.g., hospitals, pharmacies, medical centres, clinics, or other places dealing with drugs as business, are required to

The management of hazardous wastes is a system carried out in sequences aiming at avoiding the escape of the harmful components from the waste to the man's surrounding environment. This hierarchy usually starts with segregation of the hazardous waste and is terminated by its final disposal. The source reduction can be considered as an issue in the HCW management topics even it takes place at every

**9. Hazardous chemical waste**

infectious waste.

when discarded.

**6**

The methodology of a proper hazardous waste management hierarchy includes the upcoming processes in consequences: segregation and sorting, treatment, stabilization and solidification, storage and then final disposal (**Figure 1**). The full goals of this hierarchy, however it performed; when and wherever it carried out, are keeping human and his ecosystem safe, clean and tidy, moreover not burden the coming generation the hazardous problem due to our achievement.

However, pharmaceutical wastes are considered as a category of the healthcare waste, even though the healthcare professionals, always, do not pay the adequate attention to their proper management. There are a number of misconceptions regarding the proper methods for segregating, handling and treatment and disposing of this waste, markedly, at the low-income countries. It is worth to state that high-income countries (HICs) generate nearly up to 0.5 kg of hazardous waste/ hospital bed/day; on the other hand, low-income countries delivered, only, about 0.2 kg. Even so, it is rare to find the healthcare wastes being separated into hazardous or non-hazardous wastes in LICs.

The main aim for treating/managing hazardous healthcare wastes is to convert it into to less or non-hazardous materials and stabilize their infectious, toxic and/or radioactive components by various techniques of solidification and encapsulation.

Many treatment methods have been used for healthcare wastes aiming at minimizing the threats of their hazard components and/or reducing the volume of the waste before disposal. Incineration of waste is the most widely applied technique for treatment of HCWs [11]. To avoid the disadvantages of incineration process, alternative methods have been applied such as pyrolysis [12], microwaving [13],

**Figure 1.** *Diagram for hazardous waste management hierarchy.*

sterilization [14], steam treatment [15], thermal processing [16], wet oxidation [17] and many others.

The disposal of untreated or treated and solidified healthcare wastes must be undertaken in well-constructed landfills and in proper ways to eliminate the probability of the contamination of drinking, surface and groundwater.
