No CrossRef data available.
Article contents
The Precautions of Clinical Waste: Disposable Medical Sharps in the United Kingdom
Published online by Cambridge University Press: 01 September 2009
Abstract
This article deals with recent changes in UK guidance on clinical waste, in particular a shift to disposable, single-use instruments and sharps. I use interviews conducted with nurses from a GP practice and two clinical waste managers at alternative treatment and incineration sites as a springboard for reflection on the relationship between the legislation on clinical waste management and its implementation. Scrutinizing the UK guidance, European legislation and World Health Organization principles, I draw out interviewees’ concerns that the changed practices lead to an expansion of the hazardous waste category, with an increased volume going to incineration. This raises questions regarding the regulations’ environmental and health effects, and regarding the precautionary approach embedded in the regulations. Tracing the diverse reverberations of the term ‘waste’ in different points along the journeys made by sharps in particular, and locating these questions in relation to existing literature on waste, I emphasize that public health rationales for the new practices are not made clear in the guidance. I suggest that this relative silence on the subject conceals both the uncertainties regarding the necessity for these means of managing the risks of infectious waste, and the tensions between policies of precautionary public health and environmental sustainability.
- Type
- Articles
- Information
- Copyright
- Copyright © London School of Economics and Political Science 2009
References
Adams, J. (2000). A Richter scale for risk? In Morris, J. (Ed.), Rethinking risk and the precautionary principle. Oxford: Butterworth-Heinemann.Google Scholar
Baldwin, R. (1996). Regulatory legitimacy in the European context: the British Health and Safety Executive. In Majone, G. (Ed.), Regulating Europe, 83–105. London: Routledge.Google Scholar
British Medical Journal (2009). Environmental waste in health care. British Medical Journal, 338, 1129.Google Scholar
Cooper, T. (2007). Challenging the ‘refuse revolution’: War, waste and the rediscovery of recycling, 1900–50. Historical Research, 81(214), 710–731.Google Scholar
Cooper, T. (2009). Modernity and the politics of waste in Britain. In Warde, P., & Soerlin, S. (Eds), Nature’s end: Reconsidering environmental history. Basingstoke: Palgrave Macmillan.Google Scholar
Department for Environment, Food and Rural Affairs (DEFRA) (2005). Review of the Special Waste Regulations 1996 in England, Hazardous Waste (England and Wales) Regulations 2005 and the List of Wastes (England) Regulations 2005: Final Regulatory Impact Assessment. London: DEFRA.Google Scholar
Department of Health. (2006). Health technical memorandum 07–01: Safe management of healthcare waste. London: The Stationery Office.Google Scholar
Department of Health. (2008). Sustainable development waste, URL (accessed February 2009): http://www.dh.gov.uk/en/Managingyourorganisation/Estatesandfacilitiesmanagement/Sustainabledevelopment/DH_4119635Google Scholar
Douglas, M. (1995 [1966]). Purity and danger: An analysis of concepts of pollution and taboo. London: Routledge & Kegan Paul.Google Scholar
Douglas, M., & Wildavsky, A. (1982). Risk and culture: An essay on the selection and technological and environmental dangers. Berkeley: U California Press.Google Scholar
Environment Agency (2003a). Position statement: Waste incineration in waste management strategies, URL (accessed February 2009): http://www.environment-agency.gov.uk/research/library/position/41225.aspxGoogle Scholar
Environment Agency (2003b). Waste management licensing: Technical guidance on clinical waste management facilities.Google Scholar
Environment Agency (2005). Hazardous waste (England and Wales) regulations 2005. London: The Stationery Office.Google Scholar
Environment Agency (n.d.). Environmental facts and figures: Waste incineration, URL (accessed February 2009): www.environment-agency.gov.uk/research/library/data/34419.aspxGoogle Scholar
Fisher, S. (2005). Healthcare waste management in the UK: The challenges facing healthcare waste producers in light of changes in legislation and increased pressures to manage waste more efficiently. Waste Management, 25, 572–574.Google Scholar
Franklin, S., & Lock., M. (2003). Remaking life and death: Towards an anthropology of the biosciences. Santa Fe, NM: School of American Research Press/Oxford: James Currey.Google Scholar
Gandy, M. (1993). Recycling and waste: An exploration of contemporary environmental policy. Aldershot: Avebury.Google Scholar
Ganczak, M., & Barss, P. (2008). Nosocomial HIV infection: epidemiology and prevention, a global perspective. AIDS Reviews, 10(1), 47–61.Google ScholarPubMed
Gille, Z. (2007). From the cult of waste to the trash heap of history: The politics of waste in socialist and postsocialist Hungary. Bloomington: Indiana UP.Google Scholar
Hacking, I. (2003). Risk and dirt. In Ericson, R.V., & Doyle, A. (Eds), Risk and morality, 22–47. Toronto: Toronto UP.Google Scholar
Hawkins, G. (2006). The ethics of waste: How we relate to rubbish. Oxford: Rowman & Littlefield.Google Scholar
Health Services Advisory Committee (1999). Safe disposal of clinical waste. London: The Stationery Office.Google Scholar
Hutchins, D.C.J., & White, S.M. (2009). Coming round to recycling. British Medical Journal, 338, 609.CrossRefGoogle ScholarPubMed
Kahneman, D., Slovic, P., & Tversky, A. (1982). Judgement under uncertainty: Heuristics and biases Cambridge: Cambridge UP.CrossRefGoogle Scholar
Kaiser, B., Eagan, P.D., & Shaner, H. (2001). Solutions to health care waste: Life-cycle thinking and ‘green’ purchasing. Environmental Health Perspectives, 109(3), 205–207.Google ScholarPubMed
Lianos, M., with Douglas, M. (2000). Dangerization and the end of deviance. British Journal of Criminology, 40, 261–278.CrossRefGoogle Scholar
Majone, G. (1997). From the positive to the regulatory state: Causes and consequences of changes in the mode of governance. Journal of Public Policy, 17(2), 139–167.CrossRefGoogle Scholar
Pruess, A., Giroult, E., & Rushbrook, P. (1998). Safe management of wastes from healthcare activities. Geneva: World Health Organization.Google Scholar
Sunday Times (2009a). Hepatitis B kills 57 in lucrative Indian trade in recycled medical waste. Sunday Times, 11 March.Google Scholar
Sunday Times (2009b). Used needles are causing a health crisis in India. Sunday Times, 22 March.Google Scholar
Sunstein, C. (2002). Risk and reason: Safety, law, and the environment. Cambridge: Cambridge UP.Google Scholar
Sunstein, C. (2005). Laws of fear: Beyond the precautionary principle. Cambridge: Cambridge UP.CrossRefGoogle Scholar
Tudor, T.L., Noonan, C.L., & Jenkin, L.E.T. (2005). Healthcare waste management: A case study from the National Health Service in Cornwall, United Kingdom. Waste Management, 25, 606–615.Google ScholarPubMed
Waldby, C., & Mitchell, R. (2006). Tissue economies: Blood, organs and cell lines in late capitalism. London: Duke UP.Google Scholar
World Health Organization. (2005). Safe healthcare waste management: Policy paper by the World Health Organization. Waste Management, 25, 568–569.Google Scholar