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many of these facilities receive each day of the week can also present a logistic and scheduling problem for coordinating dock usage during peak periods. The generation of biohazard waste Biohazard waste presents infection and disease issues that must be addressed. These waste streams must be kept separate and clearly identi ed as required by law. The separation of waste and contamination Separating recyclable waste from nonrecyclable waste creates a new process; in conjunction with this, informing patients and visitors of the separation process also creates an additional management concern. Finding appropriate suppliers for waste removal and recycling. Well-established and reliable waste removal and recycling providers are critical for a successful program; when meeting with prospective companies, request a list of references. Delivery systems for waste and recyclable materials Many older facilities utilize trash shoots on upper level oors to transport waste to the lower level for removal. Creating separate processes for recycling requires coordination of processes to minimize contamination and labor costs.
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Identifying wastes with potential to be recycled or reused is an important aspect of sustainable development. Regular monitoring of recycling data enables nancial bene ts to be assessed and also identi es other wastes that could be recycled or reused. The reuse of medical equipment can be high risk, particularly if the procedures applied are not strictly controlled. Materials present in health-care waste that may be suitable for recycling include paper (newspapers, general mixed paper, of ce paper, and data security paper), glass (green, brown, and clear glass), plastic (PET and other plastics), metals (ferrous, aluminum, mixed, and silver), biodegradable food waste, biodegradable groundmaintenance waste, wood, bricks and concrete, soil, oils and greases, residual ashes, electrical and electronic waste, and textiles and printer cartridges. As shown in Table 36.1 the overall recycling rate for healthcare facilities is 18.9 percent. By using best practice 43 percent could be achieved, showing enormous potential for diverting waste away from disposal and using waste as a resource. It is also important to identify some speci c wastes for reuse such as gas bottles, which if not reused and disposed of appropriately are potentially very dangerous. In the case of unsustainable health-care facilities, potentially recyclable materials are not separated. Unsuitable items such as needles and syringes may be sterilized using an autoclave process. This will eliminate the biohazard issues associated with the waste and allow the waste to be recycled or disposed of normally which in turn will generate cost savings. The Lab Depot, Inc. (www. offers several sterilizers that may be used for these purposes. High-level facilities collect all potentially recyclable materials for reprocessing locally into new product.
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An important component of waste minimization in the health-care eld is communication, not only internal, but with patients and visitors. Speci cally, the separation process and location of clearly designated containers must be emphasized. Health-care facilities also present the challenge of available space. Designating dock space and scheduling deliveries becomes crucial. The clear separation of biohazard waste is also necessary and required by law. This must be clearly labeled and the containers must remain closed. Figure 36.1 displays commonly used medical waste separation containers. The World Health Organization (1991 1993) recommended the following colors codes for waste containers:
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Black Standard refuse Yellow Any kind of waste to be disposed of in incinerators Yellow with black margin Waste for incineration though another type of disposal
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is permissible Light blue or transparent Waste for autoclaving Red or white with red border Infectious waste for steam sterilization White Soiled linen
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More than just a full-service hospital, South Bay Medical Center (South Bay) has become a multiservice recycling center and buy-recycled innovator under the enthusiastic direction of Christine Vandoren, director of Materials Management in Central
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