A/HRC/18/31 (b) Separation/segregation at source. Hazardous medical waste, which only constitutes 20 to 25 per cent of the total medical waste stream, should be properly separated from non-hazardous medical waste. Segregation should be carried out as close as possible to the point of generation. Sharps should always be collected in puncture-proof containers to prevent injury to and infection of workers handling them. If properly segregated, the amount of medical waste requiring special treatment can be reduced to 1 to 5 per cent of the waste generated in health-care establishments, and the cost for waste treatment can be reduced accordingly;35 (c) Packaging and labelling. The use of internationally recognized symbols and signs is essential to ensure the safe handling of hazardous waste. A common system of labelling and coding of packaging should be used in all health-care establishments and be part of the waste management instructions for hospital workers who handle hazardous waste. Medical waste should be packaged in resistant and sealed bags or containers to prevent spilling during handling and transportation. If shipped abroad for treatment, medical waste should be labelled in accordance with international agreements (such as the Basel Convention); (d) Handling, transportation and storage. Medical waste should be handled and transported in such a way as to prevent unnecessary exposure to staff and others. Handling and transportation should be minimized to reduce the likelihood of exposure to the waste. Medical waste should be held in storage areas that are identified as containing infectious waste. Such areas should always be fitted with a lock in order to prevent access by unauthorized persons; (e) Recycling. Waste segregation at source is a basic requirement for the recycling of non-hazardous components of health-care waste. Some kinds of hazardous waste can also be recycled. Unused or waste chemicals, for example, can be returned to the supplier for re-processing; (f) Disposal. The choice of disposal methods depends on a number of factors, including the type and amount of hazardous medical waste generated by the health-care establishment; the existence of appropriate sites for waste treatment and disposal (for example, space on hospital premises and distance from the nearest residential areas); and the availability of human, financial and material resources. Large health-care facilities, for example, may produce amounts of waste sufficient to justify the purchase of a relatively sophisticated health-care waste treatment unit (for example, a medical waste incinerator), but are often located densely populated areas. Furthermore, environmentally friendly and safe options used in high-income countries (such as autoclaving) may not always be affordable or possible to implement (owing to, for example, lack of electrical supply) in developing countries. F. Incineration 95. The Special Rapporteur recommends that, in so far as practicable, incineration as a disposal method of hazardous medical waste be substituted with more environmentally-friendly and safe methods of disposal. Autoclaving, for example, is an environmentally sound method to treat infectious waste that requires relatively low investment and operating costs. 96. The Special Rapporteur also recommends that developing countries be provided with adequate financial and technical assistance to design, construct, operate and manage non-incineration medical waste treatment facilities. ___________________ 35 UNEP/CHW.6/40, decision VI/20, p. 2. 21

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