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
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
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.