Transport and Disposal of Waste Audit

Standard: Waste Management: storage, handling, sorting of waste carried out in accordance with NZS 4304:2002 and H&D Standard
8134.1.4:2008

Hospital Policy IC.07.05: To protect staff, visitors and patients by ensuring that all waste is identified and segregated into its correct
category, handled safely and disposed of in an environmentally safe manner according to national and international guidelines.

Date:

Audit Objectives:

To determine that staff are complying with the safe transporting and disposing of the infectious and expressible waste in
compliance of NZS 4304:2002 within ------ Hospital

To observe management of waste and look at risk potential and recommend improved practises if appropriate.

To audit in accordance with NZS 4304:2002 to ensure storage of waste and procedures are being adhered to.

Scope: The Standard covers waste management generated in the provision of healthcare Services.

Carried out by: Infection Prevention & Control Coordinator:

Scoring System: NZS 4304:2002 Standard

Interpretation
0= Unacceptable SHALL= Mandatory
1= Acceptable SHOULD= Recommended
N/A =Not Applicable

Infection Prevention Audit NZS 4304:2002 Transport and Disposal of Waste

Standard Standard Compliance Comments Time frame Completed and
Reference for Rectifying Comments
0 1 N/A
3. Categorization of Healthcare Waste
3.1.1 Specific Category Classification- Healthcare waste shall
be categorized as hazardous, controlled or non
hazardous waste in accordance with 3.2 to 3.5
3.2 .1 Hazardous waste classification is the responsibility of
the healthcare facility generating the waste, material
safety data sheets which assist with the categorisation of
3.2.2 waste must be held.
Hazardous waste shall be initially categorised as either
sharps or non sharps, sharps shall be catogorised as
radioactive, cytotoxic, or infectious. Non sharps will be
categorised as in 3.3
3.3 Specific Category classification
a. Infectious,
b. Radioactive
c. Cytotoxic,
d. Other hazardous waste,
e. Body parts
3.3.2
Other Hazardous waste not categorised such waste
must be sub categorised e.g. solvents, chemicals,
3.3.3 medicine, pharmaceuticals

Body parts should be not be categorised as waste but

be disposed of if not claimed by family as per

3.4 Waste meeting the definition for controlled waste given

in Section 2 shall be categorised as controlled waste
3.5.
1 Categorised as
a. Recyclable
b. General waste
2. Recyclables
a. Paper
b. Cardboard
c. Glass
d. Plastics

Infection Prevention Audit NZS 4304:2002 Transport and Disposal of Waste

 e. Metal
f. Composting waste
3. General waste e.g solid waste or
liquid waste for sewer disposal
4. Waste Generators Responsibilities
4.2
a. There is a waste management policy that is reviewed
and audited biannually
b. There is a Body Parts Policy
c. Correct segregation, packaging, labelling and storage of
all healthcare waste.
d. Where applicable pre-treat waste
e. Audit for compliance of transport and disposal
contractors responsibilities and/or Standards.
f. There is a waste tracking system
g. There is a emergency waste management plan
h. Meet requirements of 7.4 if compacting waste.
i. Establish procedures for the correct handling of waste
j. Develop and implement waste management training
programmes.

4.3 Waste Management Policy

1. Reflects companies size and complexity
3. Has a person responsible for policy development
4. Reviews current policy biannually
5. Consults with local authority, transporters and waste
landfill operator to ensure all requirements are met
6. Identify waste categorisation
4.3.7. Incorporates waste minimisation
7.1 Biannual review of waste streams to promote reduced
volumes.
7.2 Carry out Life cycle analysis regularly
7.3 Ensure purchasing consideration is given to waste
generation
4.3.8 Refer to Treaty of Waitangi commitments
4.3.9 There are defined procedures from the point of
generation through to disposal within the organisation
including:-
a. For each category
Segregation
Packaging
Labelling

Infection Prevention Audit NZS 4304:2002 Transport and Disposal of Waste

 Storage
Documentation
Transport
Disposal
b. Protection of Waste Handlers
c. Emergency preparedness
d. Staff Training
e. Compliance with relevant legislation and
Standards
4.3.10 Procedure defines staff responsibilities general &
specific
4.3.11 A waste management officer responsible for
minimisation, handling and disposal of waste, ensure
requirements of Standard are met.
4.3.12 Policy approved by senior management, copies
available for staff.
4.3.13 Policy should specify how training of staff shall be met.
4.3.14 Review Policy Biannually.
4.3.15 Audit compliance of Policy depending on the risk
involved. At least biannually and when there have been
any significant changes. Records must be kept and
results of actions taken. These audits should include,
carrying out a waste analysis, observation, review of
records, assessing transport and disposal facilities, use
of questionnaires surveys, interview staff review incident
forms and complaints.

4.4 A Body parts Policy shall be in place so that body parts

are handled and released or disposed of in a safe and
culturally acceptable manner and in accordance with
relevant legislation.

4.5 Waste segregation should be according to its category

this should be maintained throughout the cycle of the
waste.
Sharps only in sharps bins
Refrigerate in dedicated refrigerator
Radioactive waste stored and segregated in accordance
with National radiation lab Code of safe practice.

4.6 Waste shall be packaged in appropriate containers

4.6.2 Bags sufficient strength o safely contain the waste

Infection Prevention Audit NZS 4304:2002 Transport and Disposal of Waste

 category.
Comply with NZS 7603
Comply with colour coding and marking system
Be filled to not more than 2/3rds full
Allow for secure closure devises when bag is filled
Not to be secured with staples or have sharps protruding
securing devises
4.6.3 Rigid walled containers:-
1. Sharps meet requirements of AS/NZS 4261 and
reusable sharps containers are emptied, cleaned
and disinfected in accordance with AS/NZS 4478
2. Reusable rigid walled containers resistant to
leakage, rupture or corrosion, inspected after each
use.

4.7 All hazardous waste and controlled waste where

appropriate shall be packaged labelled and documented
for transport in accordance with NZS5433
Infectious substances shall be classified as appropriate

4.8
.1 Movement of waste within the premises
a. Waste bags shall be moved only when bags
have been securely closed.
b. Segregation shall be maintained for categories
of waste during transport.
c. Rigid waste containers should be securely
closed during movement.
d. Trolleys should be capable of containing
leakage.
e. Movement of waste through patient treatment
areas should be restricted to times when least
possible people about.
f. Routes should be well lit, easy to traverse and
where possible separate from supply routes.
g. Hazardous and controlled waste in transit shall
not be left unattended in public areas.

4.8.2 Reusable rigid walled containers, trolleys and

vehicles shall be kept clean
4.9 Waste tracking program:-
Complete a dangerous goods declaration or other

Infection Prevention Audit NZS 4304:2002 Transport and Disposal of Waste

 documentation for waste leaving the premises
Receipt of documentation confirming disposal details of
the waste
Requirements for storage documentation
Storage records for 10 years
4.10 Waste Analysis:-
View waste segregation at point of generation
Open a proportion of waste containers to inspect
contents
Weigh or count waste containers
Review records and documentation
Surveys or diaries by generators
4.11 Spillages:-
Spill kits are available for hazardous waste.
Staff are trained in their use.
5 Healthcare Waste Storage
5.2 Hazardous and controlled waste shall be stored in
designated areas, shall not be left unattended or
unsupervised where public may have access to.

5.3 a. Waste holding areas must be secure with restricted

access away from supply rooms or food preparation
areas
b. Vermin proof, easily cleaned impervious wall and
flooring, graded or bunded flooring to a valved sewer
outlet
c. Adequate access and space for movement
d. Adequate lighting for reading of documentation on
containers and for cleaning.
e. Adequate ventilation to remove odours from storage
area, exhaust vents sited to ensure no access to public
areas or buildings
f. Signage- appropriate to category of waste stored
g. Access to materials for managing any spills, suitable
protective clothing and hand washing facilities

Direct access for vehicles removing waste from the

storage area

5.4 Waste water from any cleaning process shall be

discharged into a sump where it shall be treated to the
satisfaction of the relevant control authority

Infection Prevention Audit NZS 4304:2002 Transport and Disposal of Waste

 Cleaning water shall not be discharged into a storm
water drain.

6. Transporters Responsibility
6.1 Transporter shall:-
a. Transport of waste in accordance with the Land
Transport Rule
b. Waste tracking system
c. Emergency waste management plan
d. Store waste in accordance with Section 5
e. Ensure vehicles are fit for purpose.
f. Meet the requirements of 7.4 if waste is compacted
g. Ensure waste is handled in accordance with Section 8
h. Ensure appropriate staff training is implemented

6.2 Vehicle Requirements

.1 Dedicated truck, separate drivers compartment by a
permanent sealed barrier
.2 Mobile phone or two way radio in cab
.3 Automatic reverse lights and sound, lifting equipment
.4 Load compartment design:- sealed body, lockable doors
refrigerate where necessary, walls, ceiling and floor
constructed rigid smooth faced material sealed seams
easily cleaned. Floor bunded to 50mm, easy loading and
emptying without manual handling.
.5 An effective cleaning disinfecting program performed
daily and effluent disposed of in accordance with
regulatory requirements.

6.3 Tracking hazardous and controlled waste:-

a. Treatment and disposal facilities shall return signed
copies of the dangerous goods declaration or other
approved documentation to the generator to
acknowledge receipt of the waste.
b. Intermediate handlers shall sign the dangerous goods
declaration to acknowledge receipt of the waste and
delivery of the waste to the disposal facility
c. Copies of the dangerous goods declaration or other
approved documentation shall be kept for incoming
waste and for shipment of waste from any source.

7. Waste Treatment & Disposal

Infection Prevention Audit NZS 4304:2002 Transport and Disposal of Waste
7.1 Waste treatment reduces the risk of the waste to enable
it to be disposed of as general or lower risk category
waste
7.2 Agencies responsible for waste treatment and disposal
shall
a. Comply with regional and local authority
b. Comply with Any consents held under Resource
Management
c. Implement controls to protect workers
d. Establish a healthcare waste tracking system
e. Maintain an emergency waste management
plan
f. Store waste in accordance with Section 5
g. Ensure waste is handled in accordance with
Section 8
h. Ensure appropriate staff training is implemented
7.3 Pre treatment of waste is done in accordance with
relevant regulatory authorities
7.4 a. Non hazardous waste may be compacted
b. Controlled waste may be compacted providing any
liquid expressed is fully contained or collected as a
hazardous liquid
c. Compactors at the generators facility should be
located at the final storage area before removal for
disposal.
d. Hazardous waste shall not be compacted prior to
disposal
Hazardous waste and controlled waste acceptable to
landfill may be compacted after burial at the landfill.

7.5 Sterilisation of waste through heat application shall

result in a consistent reduction of the waste bioburden
measured by regular testing using B. Stearothermophilis
of 6 Log or greater conducted on a weekly basis.
7.6 Consult Table 2 for Healthcare waste pre treatment and
disposal methods for full Table
Controlled= Pre-treatment-Compaction without liquid,
sterilisation, Grinding, Macerating. Disposal-Incineration,
Sanitary landfill.
Non Hazardous= Solid- Pre-treatment-Compaction.
Disposal-Incineration, Landfill, Sanitary landfill. Liquid-

Infection Prevention Audit NZS 4304:2002 Transport and Disposal of Waste

 Pre-treatment- Trade waste by laws Disposal- Sewer
Infectious= Pre-treatment, Body part solid Nil, Disposal
cremation or burial, Body part liquid pre-treatment-dilute,
Disposal-Sewer
Cytotoxic= Nil Pre-treatment, Disposal Incinerate Sewer
as approved by local authority
Radioactive= in accordance with NRL code.
Other Hazardous Nil Pre-treatment Disposal-
Incineration, Sewer as approved by Local authority,
Recycling for a limited range, Sanitary landfill as
approved by local authority.
8. Waste Handling
8.1 a. Ensure all staff practice Standard Precautions in
the handling of waste.
b. Avoid double handling
c. No manual handling of the contents of
hazardous waste containers
d. Immunization programs are offered to staff
e. PPE must be:-
1. Appropriate,
2. Available
3. Complies with Standards
4. In good working order and checked regularly

f. Procedures are in place for dealing with

incidents involving waste, including a blood and
body fluid policy with
1. Initial First aid treatment
2. Medical follow up
3. Confidential counselling &
4. Record keeping of all such incidents.

9. Emergency Preparedness
9.1 Waste generators, transporters and disposers shall
develop an emergency waste management plan which
shall be reviewed biannually

9.2 The Emergency plan should:-

a. Assess all aspects of waste management
including:-
Spills involving different categories
Road accidents involving waste from the organisation
Infection Prevention Audit NZS 4304:2002 Transport and Disposal of Waste
 Disruption in transport and disposal arrangements
Disruption of waste handling services within the
organisation
Failure of refrigeration or special storage arrangements
Discontinuance of supply of waste containers.
Contamination of low risk waste to higher risk waste
Emergencies that may significantly increase the volume
of waste.
Civil emergency causing wide spread disruption of
services
b. For each situation specified:-
Identify hazard each situation represents
Prepare a contingency plan
Specify person responsible for implementing all parts of
the plan
Sufficient equipment is maintained to implement
contingency procedure
Establish a list of contacts, police, fire service,
hazardous response team, local authorities,
transporters
( Reference must be made to the Fire Safety and
Evacuation of Building Regulations)

9.2.2 Staff handling waste during an emergency or as a result

of an emergency shall have received appropriate
training

9.3 Testing of emergency preparedness of waste

management must be included in any emergency
management exercises undertaken
10. Training
10.1 All new and relieving staff shall be trained in waste
management.

10.2 This shall include:-

a. Risks involved
b. Procedure to follow to minimise risks associated
with waste
c. Their role in waste management within the
organisation
d. Their role in any healthcare waste emergency.
10.3 Content of training:-

Infection Prevention Audit NZS 4304:2002 Transport and Disposal of Waste

 a. Recognizing hazards of healthcare waste
b. Methods for the preventing injury and the
transmission of disease from handling waste.
c. First aid training
d. Safety procedures for dealing with healthcare
waste generated, handled, transported or
disposed of by the organisation.
e. Correctly segregating, handling, moving,
transporting and disposing of the different
categories of waste.
f. Correct use of Personal Protective Equipment.
g. Procedures for action and notification in the
event of an accident or incident.
h. Spill containment and clean up procedures
i. Education on Standard Precautions.
10.4 Records of attendance must be kept of attendance for all
staff and contractors shall be maintained

Infection Prevention Audit NZS 4304:2002 Transport and Disposal of Waste