What is Offensive Waste?

Offensive waste is the term used to describe waste arising from healthcare or related activities that may cause offence to those who come into contact with it, but which does not have any of the hazardous properties associated with clinical waste.

In England and Wales, the following legal definition of offensive waste is provided in the Controlled Waste Regulations 2012:
“offensive waste” means that
a. It is not clinical waste
b. Contains body fluids, secretions or excretions and
c. Falls within code 18 01 04, 18 02 03 or 20 01 99

In practice this means that offensive waste can be any waste arising from healthcare related activities which is not infectious and does not contain medicines, sharps or any other dangerous substance.

The appropriate segregation and management of ‘offensive’ waste remains one of the biggest waste management challenges for the healthcare sector: views on how to best deal with this waste stream vary across the UK, not only amongst the healthcare community which procedures the waste and the contractors who collect it, but between the regulators in each of the UK countries. These inconsistencies exist as a result of legislative, policy and enforcement decisions in each country that have taken differing, often contradictory approaches to achieving the same objectives (those set out in the EU waste framework directive). In very simply terms the core objective can be boiled down to implementation of the waste hierarchy to the greatest extent possible while ensuring protection of human health and the environment.

In England and Wales the regulators have required hospitals to implement comprehensive segregation of offensive waste from clinical waste, on the basis that it is a legal requirement to segregate non-hazardous (non-infectious offensive) from hazardous (infectious clinical) wastes. However, in Scotland and Northern Ireland a different approach has been taken. Although the offensive waste stream is utilised in these countries, its use in the acute healthcare sector has not been actively encouraged by the regulators.

The outcome of these different approaches is that, in England and Wales, many hospitals now produce a larger volume of offensive waste than infectious clinical waste, as ward and patient specific assessments to determined whether a waste is infectious are undertaken instead of the previous reliance on the precautionary principle, an approach that resulted in most wastes being produced directly as a result of patient treatment being classed as infectious.

The quality and reliability of this assessment process is of concern, as it requires dedicated time and rescore to deploy effectively. The decision-making process may also be influenced by economic factors given the potential for savings to be made by diversion of waste to lower cost disposal options. Evidence on the ground from waste auditors and contractors indicates that this is a very real problem that is leading to inappropriate disposal.

Irrespective of whether the assessments have been undertaken correctly, the outcome is that many of our hospitals now divert significant tonnages of waste to landfill that may  previously have been managed using a method from further up the waste hierarchy.

An approach to the regulation of any waste stream that results in significantly increasing landfill volumes is highly unlikely to be sustainable in the long-term. Fresh thinking is needed now to enable the healthcare sector, and the waste and resource management industry to work in partnership to find better solutions that transfer this waste stream up the waste hierarchy. The regulators must be willing to support solutions that are more sustainable by taking as flexible and pragmatic approach as possible within the framework of the law.