The utilisation of risk-based frameworks for managing healthcare waste: a case study of the National Health Service in London

The management of waste from healthcare facilities can potentially pose a significant risk. In the UK, there are a number of increasingly stringent pieces of legislation and policies to mitigate against these risks. Using the taxonomy of organisational change (Vuuren, 1998), this study evaluated the inherent risks within the reported practices and policies of 21 Acute Care Trusts within the National Health Service (NHS) in London, England. The most frequently occurring exposures involved contact with sharps, infectious agents and hazardous substances; personal injuries during waste handling; manual handling injuries; slips, trips and falls; and striking against or being struck during procedures. Approximately 65% of the reported exposures occurred within the wards and for this location, highly significant correlations were found between nurses and contact with sharps. The implications of these findings for risk management are also discussed.