Is Your Hospital Treating Trash Like Medical Waste? Rethinking Sustainable Waste Management

Health care organizations increasingly recognize sustainability as an operational priority, but reducing the environmental impact of medical waste requires more than switching products or adopting initiatives labeled “green.” It starts with understanding what is actually entering the waste stream, where it goes after leaving the facility, and whether hospitals have reliable data to measure improvement. Poor waste segregation can send ordinary trash into regulated medical waste streams, increasing treatment costs and environmental impact without improving patient or worker safety.

In this Infection Control Today^® (ICT^®) Q&A, Ashley L. Perry, MS, director of hazardous waste & environmental services at Daniels Health, discusses how hospitals can build more sustainable medical waste programs without compromising infection prevention or occupational safety. Perry explains why baseline waste data and proper segregation are essential, what health care leaders should ask vendors about treatment methods and environmental claims, and how measures such as container utilization can reveal opportunities for improvement. She also emphasizes the importance of bringing infection preventionists into sustainability decisions from the beginning, helping organizations find the “Goldilocks” balance between waste reduction and appropriate safety precautions.

ICT: When a hospital says it wants to make its medical waste program more sustainable, what should that mean? How can leaders distinguish meaningful environmental improvements from initiatives that sound sustainable but have little measurable impact?

Ashley L. Perry, MS: When a hospital says it wants a more sustainable medical waste program, that should mean looking closely at the waste itself and driving down the volume sent to treatment facilities. To verify improvements are being made, hospitals require accurate data to benchmark against. You have to know where you are starting to determine where you can go. With a baseline in place, you can measure the impact of changes in practice or education and track progress over time. Evaluating clinical processes and workflows also helps ensure waste collection containers are placed and sized correctly. You’d be surprised how much impact this can have on segregation.

ICT: Are hospitals putting too much material into regulated medical waste streams? What are the most common segregation mistakes you see, and what are the environmental and financial consequences of treating ordinary waste as regulated medical waste?

ALP: I think any medical waste vendor would say that one of the key opportunities for cost reduction is reducing what goes into regulated medical waste streams. Too often, we see “infectious” coffee cups, wrappers, and other items that are actually general trash thrown into regulated waste containers.

Overclassification has real consequences, both financial and environmental. Regulated medical waste costs considerably more to treat than general trash sent to a landfill, and that treatment is more energy-intensive, producing a larger carbon footprint associated with its disposal.

ICT: What questions should hospital systems be asking waste management companies about what happens to their waste after it leaves the facility, including where it goes, how it is treated, what ultimately goes to landfill, and whether any materials are recovered or recycled?

ALP: The questions listed are exactly what hospital systems should ask their waste management partners—what happens to their waste after it leaves the facility, where it goes, how it is treated, what goes to landfill, and whether any materials are recovered or recycled. They should also ask whether reporting or data are available for the waste they are sending.

ICT: How should hospitals evaluate the environmental footprint of different medical waste treatment methods? Should organizations ask providers for data on transportation distances, energy consumption, emissions, water use, landfill diversion, and other environmental metrics?

ALP: When you think about a health care facility's carbon footprint, waste management is on the lower end of the scale compared to things like electricity or water usage. Speaking specifically to looking at the footprint of medical waste treatment methods, the best data to request would be the volume of waste being sent from the facility itself, what the treatment method is for each waste stream, and then asking the vendor whether they can provide an estimated carbon output per pound of waste treated. Knowing the location of waste treatment facilities is also helpful in estimating transportation-related emissions.

ICT: Sustainability can never come at the expense of infection prevention or worker safety. Where can those priorities potentially conflict in medical waste management, and how can hospitals reduce waste while maintaining appropriate protections for patients, health care workers, EVS personnel, and waste handlers?

ALP: I think these priorities can conflict when departments are focused on different things. I sat in a session at the Clean Med Conference this year that covered this very thing: how to balance the goals of a sustainability team with those of the infection prevention and control (IPC) team. They talked about “finding Goldilocks,” or the balance between sustainability concerns and IPC. The best advice is to ensure that the IPC is included in sustainability initiatives. They are a key stakeholder in this process, especially when we consider waste-reduction practices that could affect container locations, clinical workflow, and the elimination of certain items.

ICT: What sustainability claims from medical waste vendors should health care leaders scrutinize particularly carefully? What documentation or measurable outcomes should a provider be able to produce to substantiate claims about recycling, emissions reductions, landfill diversion, or environmental impact?

ALP: Like other industries, greenwashing is something that exists in the waste management space as well. It is important to be mindful of whether claims are accurate and ask for supporting, science-based evidence of any claims. This is definitely an area where, if it seems too good to be true, then it probably is. Any company making claims about its environmental impact should be able to provide data to support them, whether through sustainability reports, waste reports, white papers, or peer-reviewed studies; there has to be evidence behind the claim.

ICT: If you were helping a hospital write its next medical waste management contract, what requirements or performance metrics would you insist on including to ensure the vendor is accountable not only for compliance and cost, but also for sustainability, transparency, worker safety, and measurable environmental performance?

ALP: Specific to medical waste, beyond compliance and cost, a key metric I'd include is container utilization, with regular reporting on it. Waste volumes are helpful, but understanding how efficiently a container is being used shows a hospital where it's succeeding and where it has room to improve. If a container is designed to hold 18 pounds of waste and it's regularly weighing in at 8 pounds, that is a sign that a lot of trash is in the container. Tracking that can help drive education efforts aligned with sustainability goals. Bonus points if you can track containers down to the department level!