What about anaesthetic waste?

Each operating theatre produces approximately 2300kg of anaesthetic waste and 230kg of sharps waste a year, which is invariably incinerated (at ~£750 per tonne). However, ~40% of anaesthetic waste could be reclassified as domestic waste (disposed of for ~£80 per tonne) or be recycled (potentially earning income of ~£15 per tonne). Furthermore, ~40% of sharps waste comprises inappropriately disposed of packaging, metals, plastic etc. Decreasing solid waste in anaesthetic practice is hampered by convenience, technology, lack of knowledge and statutory regulation. Several strategies (the ‘5R’ approach) may be employed to decrease waste:

  • REDUCE – a key factor is to reduce the amount of waste produced in the first instance, by for instance, decreasing (double, triple or more) packaging;
  • REUSE – more controversially, concerns about sterility demand new solutions rather than continued utilization of single-use equipment;
  • RECYCLE – although there is a carbon cost involved in recycling, non-clinical waste, given the amount of anaesthetic waste produced, there is potential for environmental and financial benefit;
  • RETHINK – for example, redesigning the layout of anaesthetic rooms to encourage de facto waste segregation;
  • RESEARCH – for example, into new methods of packaging and cold sterilisation.

How do I go about solid waste streaming?

Decreasing solid waste disposal in anaesthesia is not straightforward. There is little in the way of accessible knowledge on the subject, and a general (understandable) attitude from hospitals concerned by the possibility of inappropriately disposing of clinical waste, contrary to the Environmental Protection Act and the Control of Substances Hazardous to Health regulations, amongst other legislation. Waste streaming into hazardous and non-hazardous waste is possible at the point of waste creation (in this case the anaesthetic room, during unpackaging), but endorsement is required from several agencies, including theatre managers, estates managers, risk managers, hospital lawyers and clinical staff.

Anaesthetists have to take responsibility for initiating and continuing waste streaming methods, which may involve acting as guarantors for the contents of disposed waste. Audit and pre-planning are important in this instance, and can reassure the Trust about safety concerns, whilst emphasising the environmental and financial benefits of correct segregation.