Nearly 230 million gloves, masks, gowns and aprons have been issued to health and social care organisations in Wales since the start of the coronavirus pandemic and, once used, these items need to be disposed of.

And it’s not just a case of bunging them in the nearest bin.

An apron used by an intensive care nurse who looks after patients with Covid-19 is treated differently to a pair of gloves worn by someone in a virus-free hospital office.

Hospital bosses are used to clinical and hazardous waste, follow nationwide protocols on how to deal with it, and commission contractors to dispose of it.

The protocols also apply to dental and GP surgeries, among others.

Since the outbreak in the UK in March, some councils have also sourced personal protective equipment (PPE) themselves for their social care staff.

There is a lot of plastic to get rid of.

Six of Wales’s seven health boards contacted by the Local Democracy Reporter Service said they followed the latest standard operating procedure guidance on PPE disposal. One didn’t respond at the time of going to press.

Hywel Dda University Health Board, which covers Carmarthenshire, Pembrokeshire and Ceredigion, said it was following NHS England waste updates in April and June on PPE, pending guidance from NHS Wales.

“We expect the NHS Wales guidance to be available shortly but are not expecting any significant differences other than some local differences,” said a Hywel Dda University Health Board spokeswoman.

Hospital waste

Hospitals are accustomed to dealing with clinical waste
(Image: Getty Images)

The NHS England guidance lists waste headings such as known infectious waste, anatomical, medicinal and domestic – and what should go in them.

It also explains what ambulance staff should do when transporting confirmed or suspected coronavirus cases, how soiled linen should be treated, and says that clinical staff working in people’s homes should leave their PPE in a bag when leaving.

Some hospital waste is incinerated, other less harmful waste ends up in landfill sites.

The latest advice is that acute hospital settings should not even send domestic waste to landfill.

NHS chiefs, says the guidance, are working with the Environment Agency and Natural Resources Wales to ensure PPE and other waste is disposed of correctly.

This is a snapshot of some of the 228 million items of PPE issued in Wales since March:
111 million – gloves
65 million – masks
43 million – aprons
2 million – face visors
1 million – gowns

And this is how Swansea Bay University Health Board, which covers Swansea and Neath Port Talbot, disposed of its waste in 2019-2020:
Total waste – 3,718 tonnes
Incinerated – 2,965
Recycled – 585
Landfill – 147
Composted – 21

Rod Taylor, director of estates and facilities at Betsi Cadwaladr University Health Board, North Wales, said: “PPE waste is treated as infectious clinical waste and is disposed of in lined clinical waste bins which are available in clinical areas, entrances, exits and public toilets across our sites.”

The waste, he said, was then dealt with by a clinical contractor.

Cwm Taf Morgannwg University Health Board, which covers Bridgend, Merthyr Tydfil and Rhondda Cynon Taf, uses a Yorkshire-based waste specialist to dispose of its clinical rubbish.

Cardiff and Vale University Health Board said staff had received access to training on PPE disposal, Powys Teaching Health Board said it was working with its contractors to ensure the latest guidance was being followed, and Swansea Bay University Health Board said its waste PPE was being disposed of at an approved disinfection facility.

Wales’s 22 councils are also using and disposing of a lot more PPE than normal.

A spokesman for the Welsh Local Government Association, which represents the authorities, said: “The guidance for disposing PPE is that it should be double-bagged and left for at least 72 hours before going out in the general waste of infected households.

“PPE linked to medical treatment, which may be contaminated by blood or mixed with other things such as dressings, is collected separately though by NHS and goes to its own waste facilities for burning.”

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