Framework environmental management plan



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4.3.2 Waste Issues

It is assumed that the majority of emergency departments, intensive care units, operating rooms, burn units, which are under the scope of the Health Sector Reform - Improving Health System Quality and Efficiency Project, will form part of a larger hospital. This means that the hospital will already have a plan for how to handle its waste, and the waste streams generated by the unit will quite simply be handled in accordance with this existing plan (MO no. 1126/2012).


However, if the unit under the scope of the project is a self-contained unit, not attached to a larger hospital, before the unit starts to operate, a plan on the management of all waste produced must be put in place.
Whether the waste plan already exists in the hospital or has been newly created for the renovated unit, in order to comply with EU environmental law, certain standards on waste management must be followed at all of the rehabilitated units.
Firstly, there are general standards applying to all waste as described in section 2.1.2 above (Waste Framework Directive and Hazardous Waste Directive). There are also standards pertaining to specific sorts of waste such as asbestos, PCBs/PCTs, packaging waste and waste electronic and electrical equipment, batteries and accumulators.
Finally, there are the extremely important standards on regulating how waste can be safely disposed of, particularly on the landfill of waste and on waste incineration. Generally speaking, waste from the units must be disposed of either in an incinerator or a landfill that is compliant with the Incineration of Waste Directive or Landfill Directive respectively.
An important category of waste generated by the units will be that of medical waste. There are two very important EU requirements concerning medical waste that must be followed, namely:

  • Hospital and other clinical waste which is infectious may not be landfilled;

  • Infectious clinical waste must not mixed with other categories of waste and must not be handled directly, it must be placed straight into the incinerating furnace.

In addition to the EU law requirements on medical waste, there are Romanian standards, in Ministerial Order no 1226/2012. These must also be followed at each of the renovated units. A summary of MO 1226/2012 is presented at section 2.4 and guidelines on how to handle medical waste are given in Annex 1, section 13.




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