Cross-contamination is a critical issue in hospital waste management, with severe consequences when not properly executed. In this interview with Nigel Green, Senior Environmental Scientist from the Department of Natural Resources, Environment, The Arts and Sport; discusses hospital waste management in rural and remote areas, and how this differs to urban health facilities and highlights strategies to reduce cross-contamination.

1. Strategies to reduce risks of cross-contamination when
managing hospital waste
Q&A with Nigel Green, Senior Environmental Scientist from the
Department of Natural Resources, Environment, The Arts and Sport.
Hospital Waste Management
Australian Healthcare Week 2011
Health IQ: Now, what legislation governs the aspects of clinical and related
waste in the territory and are there any potential conflicts?
Nigel Green
Well, that’s a good question, because at the moment, this very little targets per se,
it’s covered under the Waste Management Pollution Control Act as a listed waste
under schedule 2 of the regulations. But in terms of our interests, our interest are
quite minimal in the sense that we monitor any movements of medical related waste
and we do have some governance over where the waste can be disposed of, how it
can be disposed of and that, but we’re looking for more of it, we’ve taken up under
the Health Act, which will look of course at the human implications. So that’s still on
my understanding still being reviewed to a certain extent.
Health IQ: In order to reduce the risk of cross contamination of waste, what
strategies do you have in place and how they work, and do you have any
metrics on them?
Nigel Green
The metrics are quite broad-brush, most ways we’re divided between what’s
happening in the remote, and what’s happening in the arterial townships such as
Daly, Katherine, Alice, Tennant, that sort of thing. In those remote areas, basically a
lot of waste, it’s quite minimal of course, you would not expect too much medical
waste, but what does happen is, it tends to get burnt, their device is called turbo
burners that the Department of Health looked into some time ago and they’re quite
good if they maintain properly and can’t get rid of it. That of course doesn’t cover
those waste that are declared that they cannot be burnt and they have to be shipped
back here to RDH, for collection and ultimate shipment down south for appropriate
disposal down there. Because we don’t have the facilities here. Here, we have an
autoclave at Darwin and Alice Springs, and that deals with most waste, which, after

2. maceration go to landfill. Although in RDH there are issues with source segregation
and that caused some problems periodically.
Health IQ: Now, what is it do you have in auditing this waste stream?
Nigel: Again, the urban areas are fairly good in the sense that we have a
waste manifest system with the transporters and that, and we can keep fairly good
taps - generically anyway - on those medical waste that are being moved around
from clinics and that are brought in to RDH or into others. But in remote areas,
there’s very little information that we have. We are trying to improve that to licensing
of landfills with the population of a thousand or more; trying to get stats in that sense
from those communities. But it is difficult, and with high turnovers of staffing and
poor resourcing; it does cause some problems.
Health IQ: What advice can you give to clinics especially those in remote
and rural locations who are looking for best practice advice waste
management and the prospect of recycling?
Nigel: The simplest solution to that is to pick up the phone - we’re always on
the end and we can answer most queries around medical-related waste, and if we
can’t we have colleagues in the States who can. So it’s really not that difficult, if
you’re really up against the wall and don’t know what to do with a particular waste
stream then give us a call, we’re in general phone directories, but you should be able
to get us through the government switch number as well.
Nigel Green is presenting at the Hospital Waste Management in February 2011.
This event forms part of the Australian Healthcare Week a series of events for
healthcare practitioners. You can visit www.austhealthweek.com.au/hosptitalwaste
for more information on this event or to register you can call Judy on 02-9229-1000.
Health IQ asks Nigel: Can you tell us a bit about yourself?
I started off in the UK working for consultancies, looking in to landfill issues,
landfill design, waste management, hazardous waste; and then I came to the
territory back in 1990 and I’ve stayed here and I’ve done a variety of roles. I’ve
done noise as well as waste, and looking at the environmental assessment
issues. I’m trying to work as much as I can with remote communities, because
they have the most problems that I can see given their remoteness and lack of
skilled offices out there. So I’ve come to this point where I’m a bit of a jack of
all the trades and master of none.