title: Factors driving the development of healthcare waste management in the United Kingdom over the past 60 years.
abstract: Since the creation of the National Health Service (NHS) in the United Kingdom in 1948 there have been significant changes in the way waste materials produced by healthcare facilities have been managed due to a number of environmental, legal and social drivers. This paper reviews the key changes in legislation and healthcare waste management that have occurred in the UK between 1948 and the present time. It investigates reasons for the changes and how the problems associated with healthcare wastes have been addressed. The reaction of the public to offensive disposal practices taking place locally required political action by the UK government and subsequently by the European legislature. The relatively new UK industry of hazardous healthcare waste management has developed rapidly over the past 25 years in response to significant changes in healthcare practices. The growth in knowledge and appreciation of environmental issues has also been fundamental to the development of this industry. Legislation emanating from Europe is now responsible for driving change to UK healthcare waste management. This paper examines the drivers that have caused the healthcare waste management to move forward in the 60 years since the NHS was formed. It demonstrates that the situation has moved from a position where there was no overall strategy to the current situation where there is a strong regulatory framework but still no national strategy. The reasons for this situation are examined and based upon the experience gained; suggestions are made for the benefit of countries with systems for healthcare waste management still in the early stages of development or without any provisions at all.
authors.affiliation: Centre for Environmental Control and Waste Management, Department of Civil and Environmental Engineering, Imperial College London, London, UK. w.townend@ntlworld.com
authors.forename: William K
authors.initials: WK
authors.lastname: Townend
authors.forename: Christopher
authors.initials: C
authors.lastname: Cheeseman
authors.forename: Jen
authors.initials: J
authors.lastname: Edgar
authors.forename: Terry
authors.initials: T
authors.lastname: Tudor
mesh_terms: D006078:Government Programs / Q000458:organization & administration; D017744:Medical Waste Disposal / Q000191:economics / Q000331:legislation & jurisprudence / Q000379:methods / Q000592:standards; D009313:National Health Programs; D011640:Public Policy; D012959:Socioeconomic Factors; D013997:Time Factors; D006113:United Kingdom
chemical_list: D017744:Medical Waste Disposal