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New Hampshire Department of Environmental Services

How to Reduce Sources of Dioxin From Healthcare Facilities

Reduce Red Bag Wastes
One way of reducing dioxin emissions from medical waste incinerators is to reduce the amount of red bag (infectious) waste incinerated. The Sustainable Hospitals Project estimates that only about 10 to 15 percent of medical waste is infectious waste, which includes cultures, human pathological waste, human blood products, sharps, and animal waste. Less than 2 percent of this waste needs to be incinerated in order to kill pathogens.

Placement of red bag waste collection containers in appropriate locations may lead to excessive volumes of red bag waste for disposal. Evaluate the need for red bag collection containers in operating rooms, patients’ rooms, and nurses’ stations.

Red bags come in all sizes, even quart and gallon size bags. Use only a size that is appropriate to collect the amount of infectious waste generated. Larger size bags may encourage inappropriate disposal.

Different areas of a healthcare facility may require different red bag waste collection schedules. If the red bag waste is frequently collected, it may lead to the disposal of excess red bag waste. This can be a problem if the facility is paying for red bag waste disposal by the container, and not by the actual pounds (weight) of waste disposed of. This would affect the destination charge of the waste.

Environmentally Preferable Purchasing

Source reduction includes eliminating the purchase and use of chlorine-containing materials that create dioxin when incinerated. PVC plastic, which can contain up to 57 percent chlorine by weight, is a major source of chlorine in the medical waste stream.

Reduce the amount of PVC plastic products with environmentally friendly alternatives. Non-vinyl plastic substitutes are available or items such as IV drip bags, syringes, tubing, sharps containers, surgical gloves, ID bracelets, mattress covers, shower curtains and even office supplies. The Sustainable Hospitals Project provides a list of vendors who supply PVC-free plastic products to healthcare facilities.

Purchase products in bulk (but not chemicals) whenever possible. This eliminates unnecessary packaging that will need to be properly disposed of or recycled.

Request that manufacturers limit the amount of excess packaging needed for their products.

Reuse of Healthcare Products

Reduce the total amount of disposable items used in the healthcare facility. Whenever possible, reuse patient bed linens, pillows, mattress pads, and hospital gowns.

Reuse sharps containers. Replace single use disposable sharps collection containers with reusable containers that are sterilized by the vendor.

Waste Segregation

Waste segregation can reduce the volume and toxicity of the waste streams, as well as reduce the amount of infectious waste that must be properly disposed of.


Solid waste that contains noninfectious and nonhazardous wastes is often composed of recyclable materials. Segregate waste streams to recycle white office paper, mixed office paper, corrugated cardboard, newspaper, magazines, junk mail, aluminum cans, plastic, glass, batteries, toner cartridges, and fluorescent light bulbs.


Develop, institute and maintain an effective employee-training program on the management of waste streams, especially infectious waste. This can be one of your most effective resources in reducing waste, and also one of your most difficult to accomplish.

NH Department of Environmental Services | 29 Hazen Drive | PO Box 95 | Concord, NH 03302-0095
(603) 271-3503 | TDD Access: Relay NH 1-800-735-2964 | Hours: M-F, 8am-4pm

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