The path of hazardous waste from source to disposal
Collecting, packaging, transporting and disposing of hazardous medical waste accounts for a legal obligation strictly regulated for the generating chain (medical unit) – processor (specialized external partner). Each of the procedures are subject to well-defined guidelines and any deviations may have a considerable negative impact on the environment and public health. Successfully fulfilling all stages depends upon a close collaboration between all stakeholders throughout the process. We will further discuss the four stages of neutralization of hazardous medical waste.
Roles and responsibilities
The Romanian legislation provides both the rules and the specific obligations for the separate collection of waste per categories, packaging, temporary storage, transportation, processing and disposal of medical waste, placing a particular emphasis on the hazardous medical waste, in order to prevent contamination of the environment and impairment of the public health.
These rules and obligations are enforced on all healthcare units, regardless of their structure, while the waste generator is also responsible for the proper collection of the medical waste resulting from its activity. The responsibility of managing the waste within the healthcare unit is assigned to the entire staff, in various roles, from the janitor to caregivers, nurses, physicians, head physician, person in charge for prevention and tackling of hospital-acquired infections, as well as the manager of the medical institution.
Transportation and neutralization/disposal of this waste is the responsibility of the economic agents authorized to handle such operations.
Collection and packaging
This responsibility is assigned to the waste generator – namely the healthcare unit. The staff designated to manage the hazardous medical waste must make sure that the waste resulting from medical activities is collected separately, and must prevent the mixture between various types of hazardous waste or between hazardous and non-hazardous waste. The purpose is not only to facilitate treatment and proper disposal, but also to ensure the protection of the staff handling recipients and collecting packaging.
The waste generator is also in charge with weighing the waste, while the weight is double checked upon reaching the destination (final disposal).
The transportation of hazardous medical waste is achieved as per a contract concluded with economic agents authorized to conduct this activity.
If a healthcare unit is made of several buildings located in various areas, the hazardous medical waste is transported through the economic operator contracted by the respective unit.
The transport of hazardous medical waste must be achieved under strict safety and packaging conditions, imposed by the Guidelines for the transport of dangerous goods on public roads, as per A.D.R. (European agreement concerning the international carriage of dangerous goods by road).
All types of medical waste shall be disposed of as per the law  through one of the following processes
D9 – physical-chemical treatment (i.e. – low-temperature chemical treatment, called sterilization) or
D10 – incineration on land. Any of these processes is followed by discarding the product obtained, in proper landfills, by implementing
D1 – deposit onto land (i.e.: landfills for industrial waste).
We believe that all types of medical waste generated by a hospital – including the non-dangerous waste (insert hyperlink to the article on non-dangerous waste) – should be processed through one of the D9 or D10 methods, prior to being discarded on the landfill. If not, there is a risk of biological contamination of the landfills receiving this type of medical waste, lacking prior treatment, and further contamination of the underwater.
The legislation states that the healthcare unit cannot keep the medical waste for more than 48h in the temporary storage space. The collection, processing and disposal should be achieved within maximum 24 h.
In order to adhere to the European Union, Romania adopted the National Plan and Strategy for waste management . According to environmental principles, dangerous waste which was deposited until 31.12.2008 in landfills, against the environmental measures set out by the EU for the member states, started to be managed as per the waste hierarchy, which entails the implementation of the following stages of the waste pyramid in order: prevention, reduction, reuse, recycling, incineration and disposal.
EU’s legislation harmonized in Romania with the implementation of the European Directive and the efforts to adjust it in order to meet the needs of our country created a well-regulated legislative framework.
Order of the Minister of Health no. 1226 of 03.12.2012 approving the Technical guidelines for management of waste generated by healthcare activities and the Methodology of data collection for the national database on waste resulting from medical activities, issued by the Ministry of Health
Government Decision no. 856/2002
Law no. 211/2011 on the regime of waste republished in the Official Journal under no. 220 of 28 March, 2014
Decision no. 1470/2004 approving the National Strategy for the management of waste and the National Plan for the management of waste
World Health Organization
 Pursuant to Law no. 211/2011, Annex 2
 Implemented through Law GD 1470/2004