Persons at risk


All individuals coming into close proximity with hazardous health-care waste are potentially at risk from exposure

to a hazard, including those working within health-care facilities who generate hazardous waste, and those who

either handle such waste or are exposed to it as a consequence of careless actions.

The main groups of people at risk are:

medical doctors, nurses, health-care auxiliaries and hospital maintenance personnel

patients in health-care facilities or receiving home care

visitors to health-care facilities

workers in support services, such as cleaners, people who work in laundries, porters



Safe management of wastes from health-care activities

workers transporting waste to a treatment or disposal facility

workers in waste-management facilities (such as landfills or treatment plants), as well as informal recyclers


The general public could also be at risk whenever hazardous health-care waste is abandoned or disposed of

improperly. The hazards associated with scattered, small sources of health-care waste should not be overlooked.

These sources include pharmaceutical and infectious waste generated by home-based health care, and contaminated

disposable materials such as from home dialysis and used needles from insulin injection, or even illicit intravenous

drug use.



ds from infectious waste and sharps

Infectious waste should always be assumed to potentially contain a variety of pathogenic microorganisms. This

is because the presence or absence of pathogens cannot be determined at the time a waste item is produced and

discarded into a container. Pathogens in infectious waste that is not well managed may enter the human body

through several routes:

through a puncture, abrasion or cut in the skin

through mucous membranes

by inhalation

by ingestion.

The transmission of infection and its control is illustrated by a “chain of infection” diagram (Box 3.1). Each link

in the chain must be present and in the precise sequential order for an infection to occur. Health workers should

understand the significance of each link and the means by which the chain of infection can be interrupted.

Consequently, good health-care waste management can be viewed as an infection-control procedure. It is also

important to note that breaking any link in the chain will prevent infection, although control measures for health-

care waste are most often directed at the “mode of transmission” stage in the chain of infection.

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