Healthcare waste

Healthcare waste (also called clinical or medical waste) is the waste generated in medical care settings: hospitals, clinics, laboratories, pharmacies, surgeries and activities related to human or animal health.

Managing it correctly is critical because much of it is hazardous to public health and the environment, since it can contain infectious agents, anatomical remains, chemicals or cytotoxic drugs. The growth of healthcare activity, an ageing population and the intensive use of single-use medical products have all increased the volume of this waste.

Legal definition

In Spain, Law 7/2022 on waste and contaminated soil for a circular economy treats healthcare waste as that generated in the care of humans and animals, in biomedical research or in related activities. Each autonomous community has also developed specific rules for its classification and management, in line with its competences in health and the environment.

Classification of healthcare waste

Although there are differences between regional rules, the most common classification in Spain is as follows:

Group I: waste comparable to municipal waste

• Food scraps from patients and staff.
• Uncontaminated paper, plastics and packaging.
• General cleaning waste.

Group II: non-specific, non-hazardous waste

• Dressing material with no blood contamination.
• Disposable gloves, masks and gowns not in contact with fluids.
• Plaster casts.

Group III: hazardous biohazardous waste

• Needles, syringes, scalpels and other sharps.
• Material contaminated with blood, fluids or infectious agents.
• Microbiological cultures.

Group IV: hazardous chemical and pharmaceutical waste

• Expired or cytotoxic medicines.
• Laboratory chemicals.
• Packaging contaminated with hazardous substances.

Group V: anatomical waste

• Unrecognisable human or animal remains.
• Tissues and organs, which require specific incineration.

Regulatory framework

• Directive 2008/98/EC (Waste Framework Directive).
• Regulation (EU) No 1357/2014 on hazardous properties.
• Law 7/2022 on waste and contaminated soil.
• Specific regional rules adopted by each autonomous community, which set the obligations for segregation, storage, transport and treatment of healthcare waste.

Obligations of healthcare facilities

• Segregation at source: identifying and separating the different groups into dedicated containers.
• Temporary storage: hazardous waste in rigid, leak-proof, approved containers, labelled with the group and the date of generation.
• Transport: by authorised hazardous-waste carriers, with the mandatory movement documentation.
• Final treatment: controlled incineration for anatomical, cytotoxic and biological-risk waste; autoclave sterilisation for biohazardous waste; authorised landfill for non-hazardous waste.
• Records and control: registration in the waste production and management register and submission of the annual management report.

Treatment systems

• Incineration: complete destruction of infectious, chemical and anatomical waste at temperatures above 1,000 °C, with emissions cleaned through filters and scrubbers. This overlaps with incineration with energy recovery where heat is captured.
• Autoclave sterilisation: steam under pressure that inactivates biohazardous material so it can be landfilled as non-hazardous waste.
• Chemical disinfection: disinfectants for contaminated waste, less common at large volumes.
• Alternative technologies: microwave and other emerging methods to inactivate pathogens.

Risks of poor management

• Health: spread of infectious diseases and accidental needlestick injuries with contaminated sharps.
• Environmental: toxic emissions from uncontrolled incineration and water pollution from illegal dumping.
• Legal: penalties of up to 3.5 million euros for the most serious infringements under Law 7/2022.

Healthcare waste and the circular economy

Although hazardous healthcare waste must be disposed of safely, there are opportunities to apply circular economy principles: reducing waste at source through sustainable procurement, replacing single-use items with reusable ones where clinically safe, and recovering metals and plastics after sterilisation. The bulk of the stream, however, remains hazardous waste that must be tracked and treated under strict controls.

Conclusion

Healthcare waste is a particularly sensitive stream because of its potential danger to human health and the environment. Spain has a solid regulatory framework and advanced treatment systems, but still faces challenges such as reducing single-use waste and improving traceability. The key is responsible management based on segregation at source, safe treatment and minimisation at the point of generation.

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