of June 23, 2008 No. 362
About approval of sanitary and epidemiologic rules and regulations "Sanitary and epidemiologic requirements to collection, neutralization, storage, transportation and burial of medical waste"
According to the subitem 6) of Article 7, the subitem 13) of Article 17, article 30 of the Law of the Republic of Kazakhstan of December 4, 2002 "About sanitary and epidemiologic wellbeing of the population", I ORDER:
1. Approve the enclosed sanitary and epidemiologic rules and regulations "Sanitary and epidemiologic requirements to collection, neutralization, storage, transportation and burial of medical waste".
2. To committee of the state sanitary and epidemiological surveillance of the Ministry of Health of the Republic of Kazakhstan () direct to A.A. Belonog this order to state registration in the Ministry of Justice of the Republic of Kazakhstan.
3. To department of legal work and public procurements of the Ministry of Health of the Republic of Kazakhstan (Malgazhdarova B. T.) direct this order to official publication after its state registration in the Ministry of Justice of the Republic of Kazakhstan.
4. Declare invalid the order of the deputy. The Minister of Health of the Republic of Kazakhstan of January 13, 2004 No. 19 "About approval of sanitary and epidemiologic rules and regulations "Sanitary and epidemiologic requirements to collection, use, neutralization, transportation, storage and waste disposal of the medical organizations", registered in the Register of state registration of regulatory legal acts at No. 2674 (No. 6 is published in "Official newspaper" of February 7, 2004 (163)).
5. To impose control of execution of this order on the Chairman of Committee of the state sanitary and epidemiological surveillance - the Chief state health officer of the Republic of Kazakhstan A.A's Belonog.
6. This order becomes effective after ten calendar days after day of official publication.
deputy. Minister of Health
Republic of Kazakhstan K.Omarov
Approved by the order of the deputy. The Minister of Health of the Republic of Kazakhstan of June 23, 2008 No. 362
1. Sanitary and epidemiologic rules and regulations "Sanitary and epidemiologic requirements to collection, neutralization, storage, transportation and burial of medical waste" (further health regulations) are obligatory for execution by physical persons and legal entities, irrespective of patterns of ownership.
2. These health regulations determine procedure for collection, neutralization, storage, transportation and burial of medical waste.
3. In these health regulations the following terms and determinations are used:
1) burial of medical waste - the safe placement of the neutralized medical waste in soil without intention of subsequent their extraction directed to prevention of hit of hazardous substances to the environment and excluding possibility of use of this medical waste;
2) medical waste - the waste which is formed in the course of rendering medical services and carrying out medical manipulations;
3) the address with medical waste - the type of activity connected with collection, neutralization, storage, transportation and burial of medical waste;
4) neutralization of medical waste - reduction or elimination of dangerous properties of medical waste by mechanical, physical (thermal), chemical or biological processing;
5) installation - the specialized processing equipment intended for crushing and disinfecting of medical waste, utilization, burning;
6) storage of medical waste - content of medical waste in specially equipped rooms, containers before their extraction for the purpose of transportation and burning;
4. The waste which is formed shall belong to medical waste:
1) in hospitals, polyclinics, medical out-patient clinics, dispensaries, medical aid stations, inoculative offices;
2) in the organizations of ambulance and emergency medical service, blood transfusion stations;
3) in kliniko-diagnostic laboratories, laboratories of sanitary and epidemiologic examination, pathoanatomical laboratories;
4) in research institutions and educational institutions of medical profile;
5) on objects of pharmaceutical production;
6) in the improving organizations (sanatoria, dispensaries, rest houses, boarding houses);
7) in the organizations of forensic medical examination;
8) in the organizations of long patient care;
9) in the medical and cosmetology organizations.
5. For daily control of the address with medical waste on objects the responsible specialist (the epidemiologist, the deputy chief physician for nurse business, the deputy chief physician) shall be appointed.
6. The responsible specialist of object shall train personnel in rules of safe handling of medical waste with the subsequent control of accomplishment them at workplace.
7. The head of object in coordination with territorial authorities of the state sanitary and epidemiological surveillance approves the scheme of the address with medical waste, according to appendix 1 to these health regulations.
8. The responsible person of object keeps daily quantitative and high-quality account of medical waste in the magazine in form, according to appendix 2 to these health regulations.
9. Persons performing transportation of medical waste from the moment of loading on the vehicle before their acceptance in the established place shall observe measures of safe handling of them.
10. Medical waste on degree of danger is subdivided into five classes of danger:
1) class A - harmless medical waste, similar to municipal solid waste;
2) class B - dangerous (risk) medical wastes;
3) class B - extremely dangerous medical wastes;
4) class G - medical waste, on structure close to industrial;
5) class D - radioactive medical waste.
The characteristic of morphological structure of medical waste is given in appendix 3 to these health regulations.
11. The address of medical waste shall consist of the following stages:
1) collection and neutralization of medical waste on site their educations;
2) temporary storage of medical waste in containers in the territory of object (class A) or in specially allocated rooms (all other classes, except class A);
3) transportation of containers to the place of burial or neutralization by thermal method (burning) of medical waste;
4) neutralization by thermal method (burning) or burial of medical waste.
12. For collection of medical waste one-time water-proof paper bags, packets, metal and plastic reservoirs, boxes of safe utilization (further - KBU), containers are used. For each class of waste sacks, packets for collection shall have different coloring; containers, reservoirs - marking. Metal and plastic reservoirs, containers for collection of dangerous wastes shall be closed densely.
13. KBU shall be made of the dense, not punctured and waterproof material, with the valve fixer excluding possibility of dispersal or loss of medical waste. KBU shall be filled no more than on two thirds of amount and be stored no more days.
14. For transportation of sacks, packets, reservoirs, KBU with waste are used carts which design shall provide possibility of their fixing.
15. Collection of medical waste of different classes is made in the corresponding containers. Marking of containers, reservoirs and packets shall match. The design of containers shall be completely water-proof, not allow possibility of contact of strangers with their content, is unavailable to animals.
16. Containers for collection of medical waste of class B are located in the isolated room of the medical case. It is not allowed to store containers with waste of class B together with containers of medical waste of classes A, B, G, D.
17. Not allowed
1) to use carts not for designated purpose;
2) to mix medical waste of different classes at stages of their collection, neutralization, storage and transportation;
3) to establish reservoirs near electric heaters;
4) to stamp medical waste by hands;
5) to perform collection of medical waste without gloves.
18. Medical waste of class A from places of education goes to the container located in the territory of object and is exported on solid waste landfills (further - MSW).
19. For temporary storage of medical waste of class B, B, G, D on object certain rooms are provided.
20. The room for temporary storage of medical waste of class B and B provides the room for storage of medical waste and the room for sink and storage of net reservoirs.
21. The room for storage of medical waste shall be equipped with supply and exhaust ventilation, refrigeration equipment for storage of biological and food wastes, racks, containers for collection of packets with medical waste from divisions, sink with eyeliner of hot and cold water, bactericidal lamp.
22. The room for sink of reservoirs shall be equipped with bathtubs for sink and neutralization with water eyeliner, ladder for water drain, racks for storage of net reservoirs, case for storage of special clothes (further - overalls).
23. Floor, walls, ceiling of rooms for temporary storage of medical waste are made of materials, steady to washing and to disinfectants.
24. Washing of overalls of the personnel working with medical waste is performed in centralized laundry.
25. Rooms for temporary storage of medical waste are located in close proximity to exit from the case of object and shall have convenient sidings for export, ladders shall be equipped with ladders for export.
26. Packets for collection of medical waste shall have the following coloring: waste of class A - white, B - yellow, In - red, - black.
27. The medical waste which is formed on the following objects shall belong to class A:
1) in chambers of departments (except for infectious, skin and venereologic, ftiziatrichesky) the medical organizations;
2) in administrative rooms of objects;
3) in food blocks, buffets of departments (except for infectious, skin and venereologic, ftiziatrichesky);
4) in the territory, out of the case of the treatment-and-prophylactic organization.
28. Collection of medical waste of class A is performed in reservoirs or one-time packets. One-time packets shall be located on special carts or in reservoirs. The filled reservoirs or one-time packets are brought to installation sites of containers and are overloaded in the containers intended for collection of medical waste of this class. The reusable tare after collection and release is subject to sink and disinfection by the disinfectants allowed for use in the Republic of Kazakhstan.
Food wastes of objects (except for infectious, skin and venereologic, ftiziatrichesky) gather in the metal or plastic reservoir having marking "For food wastes".
29. Large-size medical waste of class A gathers and taken out on carts, portable containers to specially allocated places.
30. The medical waste which is formed in belongs to the class B:
1) operational, intensive care and other handling and diagnostic units, and also procedural, dressing, inoculative offices of object;
2) infectious, skin and venereologic departments of objects, kliniko-diagnostic and pathoanatomical laboratories;
3) the laboratories working with microorganisms of the 3-4th of groups of pathogenicity, vivariums, veterinary clinics;
4) in sanitary rooms, toilets.
31. Medical waste of class B is subject to disinfection.
32. The used pricking and other sharp objects (needles, feathers, razors, ampoules), gather separately from other types of medical waste in KBU without preliminary analysis and disinfection;
33. Medical waste of class B gathers previously in the one-time packets enclosed in reservoirs with densely closed covers.
34. After filling of one-time packet with medical waste of class B on two thirds, the employee responsible for collection of medical waste in this medical division, ties it. All manipulations with packet are made in mask and rubber gloves.
35. Transportation of all types of medical waste of class B outside object is performed in densely closed reservoir.
36. Densely closed reservoirs (tanks, packets) are located in the containers intended for collection of medical waste of class B.
37. Reservoirs, packets with waste of class B shall have marking "Dangerous medical wastes. Class B", with the put object subdivision code, its name, date and surname of person responsible for collection of medical waste.
38. The medical waste which is formed on the following objects belongs to the class B:
1) in departments at patients with especially dangerous and quarantine infections, human immunodeficiency virus (further - HIV), acquired immunodeficiency syndrome (further - AIDS);
2) in the laboratories working with microorganisms of the 1-2nd of groups of pathogenicity;
3) in ftiziatrichesky clinics.
39. Medical waste of class B is subject to disinfection.
40. Collection of medical waste of class B is performed in the one-time packets enclosed in reservoirs with densely closed covers.
41. Reservoirs, packets, with medical waste of class B shall have marking "Extremely dangerous medical wastes. Class B", with the put object subdivision code, its name, date and surname of the responsible person for collection of medical waste.
42. After filling of one-time packet with medical waste of class B on two thirds, the employee responsible for collection of medical waste in this medical division, ties it. All manipulations with packet are made in mask and rubber gloves.
43. Transportation of all types of medical waste of class B outside object is performed in densely closed reservoir.
44. The filled reservoirs are located in the containers established in the places intended for collection of medical waste of class B.
45. The medical waste which is formed on the following objects belongs to the class G:
1) in diagnostic departments;
2) in chemotherapeutic departments;
3) in pathoanatomical departments;
4) in pharmaceutical workshops, drugstores, warehouses;
5) in chemical laboratories.
46. Degree of toxicity of each type of medical waste of class G is determined according to the order of the deputy. The Minister of Health of the Republic of Kazakhstan of March 24, 2005 No. 137 "About approval of sanitary and epidemiologic rules and regulations on utility hygiene", registered in the Register of state registration of regulatory legal acts of the Republic of Kazakhstan No. 3629 (further - the order No. 137).
47. The used luminescent lamps, mercury-containing devices and the equipment gather in densely closed reservoirs preventing fight in storage time and transportations. After filling of reservoir are densely closed and stored in auxiliary rooms.
48. Collection, storage of the cytostatic antineoplastic means relating to medical waste of class G of the 1-2nd of classes of toxicity is performed according to the order No. 137.
49. The medical waste of class G belonging to the 2-3rd class of toxicity gathers and packed into firm packaging, the fourth class - soft.
50. The medical waste which is formed on the following objects belongs to the class D:
1) in diagnostic laboratories (departments);
2) in radio isotope laboratories;
3) in x-ray offices.
51. Collection, storage, burial of medical waste of class D is performed according to requirements of the order of the Minister of Health of the Republic of Kazakhstan of January 31, 2003 No. 97 About approval of health regulations and regulations "Sanitary and hygienic requirements for ensuring radiation safety" registered in the Register of state registration of regulatory legal acts No. 2198.
52. The radioactive medical waste of class D having short lifecycle (firm, liquid and gaseous forms) is allowed to be stored in the relevant storages before their disintegration, and then they leave as medical waste of class A. Radioactive "long-living" medical waste of class D goes for burial to special polygons (burial grounds).
53. Transportation of medical waste shall be safe for personnel and the environment.
54. Transportation of medical waste is performed by specially trained personnel.
55. The vehicle shall have special marking. The vehicle shall have the sanitary passport of the established sample, according to the order of the deputy. The Minister of Health of the Republic of Kazakhstan of April 20, 2004 No. 349 "About approval of rules of issue, accounting and maintaining the sanitary passport of the vehicle", registered in the Register of state registration of regulatory legal acts No. 2840
56. When transporting medical waste of class A use of the vehicle used for transportation of municipal solid waste is allowed.
57. For neutralization (disinfection) the disinfectants registered and allowed for use in the Republic of Kazakhstan are used. Disinfection of medical waste is performed in places of their education.
58. Disinfection are exposed all waste of class B, except for the waste arriving on special installations on their neutralization and also organic waste of operating rooms (bodies, fabrics) from noninfectious patients who are subject to burial.
59. Medical waste of class B and B which collection is performed in KBU and which are destroyed by thermal method shall not be exposed to disinfection.
60. Disinfection of containers for collection of medical waste of classes A, B and B, bodies of the vehicle is carried out once a week and in process of pollution in places of unloading.
61. On objects places for washing and disinfection of intercase containers and the vehicle are allocated. The place for disinfection shall be asphalted and have single drain. Sewage after disinfection shall gather and merge in sewer network of object. Plums of liquid medical waste without neutralization in sewer network are not allowed.
62. Remaining balance of pathogenic biological agents, the used ware, solid medical waste from "infectious" zone of laboratories gather in reservoir and are neutralized in autoclaves or disinfectants.
63. Test tubes and bottles with clots of blood are neutralized with use of disinfecting solution. Haemo games irrespective of method of the subsequent destruction are exposed to neutralization by autoclaving.
64. The vehicle for transportation of medical waste, shall be equipped with the waterproof closed body which is easily exposed to disinfection processing. Use of this vehicle for other purposes is not allowed.
65. After loading of medical waste from placements of temporary storage on the vehicle, the place where they were, the used stock and the equipment are disinfected.
66. Corpses of the animals who are experimentally infected with cultures of pathogenic microorganisms, in case of works with them and fallen or destroyed are burned afterwards.
67. Burning of medical waste in the territory of objects and settlements out of specialized installations is not allowed (incinerators and the muffle furnaces).
68. Neutralization by thermal method (burning) of medical waste - is carried out by thermal impact on medical waste at temperature not below 800-1000 degrees Celsius (further-? С).
69. Medical waste of classes B, B is burned on specialized installations (incinerators, the muffle furnaces).
70. In case of mixing of cytostatic medical waste of class G with other types of medical waste they are subject to burning.
71. Solid pharmaceutical medical waste is exposed to burning. The discharge of liquid solutions in the sewerage is allowed under condition if solutions have no the destroying effect on materials of pipes and elements of constructions of the sewerage.
72. Medical waste on burning is accepted in the presence of the accompanying act with the specified classes of waste, the signed head of object.
73. Products of burning of medical waste or ashes are removed on solid waste landfills.
6. Sanitary and epidemiologic requirements to conditions of temporary storage and burial of medical waste
74. The open area for installation of containers shall have the asphalted surface and to be convenient for entrance of the vehicle and carrying out handling works.
75. The open areas for installation of containers are located at least in 25 meters from medical cases and at least 100 meters from food blocks. On the open area the arrangement no more than 5 containers is allowed.
76. Waste of class A, B, B is stored in the place of education no more days, and in containers on special platforms or in rooms for temporary storage of reservoirs with waste no more than three days. Biological waste of class B, and also food wastes are stored at temperature not above plus 5 °C.
77. Storage and transportation to the place of burial of medical waste of classes A, B, B is performed in densely closed reusable containers. Waste disposal of class B is performed separately from other classes of waste. Export of waste from the territory is performed when filling container on two thirds.
78. Storage of medical waste of class G is carried out in auxiliary rooms, specially allotted for this purpose.
79. In case of absence in the territory of object of installation on burning of medical waste export of medical waste of classes A, B, B shall be carried out daily.
80. Medical waste of class B (materials and tools, medical waste from operational, microbiological laboratories and vivariums), after the disinfection which is carried out according to Chapter 5 of these health regulations is exported on solid waste landfills.
81. Burial of medical waste of class G is performed on polygons for toxic waste.
to sanitary and epidemiologic rules and regulations "Sanitary and epidemiologic requirements to collection, neutralization, storage, transportation and burial of medical waste"
Register of medical waste
____________________________________за 200___год
(Наименование объекта)
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¦Виды медицин-¦Объем меди-¦Сдано в поме-¦Захоронение¦Ф.И.О. от-¦Дата ¦
¦ских отходов ¦цинских от-¦щения времен-¦или сжига-¦ветствен- ¦сдачи¦
¦ ¦ходов (да-¦ного хранения¦ние МО ¦ного за¦ ¦
¦ ¦лее - МО) ¦МО ¦ ¦сбор МО ¦ ¦
¦ ¦(кг) ¦ ¦ ¦ ¦ ¦
+-------------+-----------+-------------+-----------+----------+-----¦
¦ 1 ¦ 2 ¦ 3 ¦ 4 ¦ 5 ¦ ¦
+-------------+-----------+-------------+-----------+----------+-----¦
¦МО класса Б: ¦ ¦ ¦ ¦ ¦ ¦
¦МО класса В: ¦ ¦ ¦ ¦ ¦ ¦
¦МО класса Г: ¦ ¦ ¦ ¦ ¦ ¦
¦МО класса Д: ¦ ¦ ¦ ¦ ¦ ¦
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to sanitary and epidemiologic rules and regulations "Sanitary and epidemiologic requirements to collection, neutralization, storage, transportation and burial of medical waste"
+--------------------------------------------------------------------+
¦ Класс ¦ А ¦ Б ¦
+---------+---------------------------+------------------------------¦
¦Категория¦ Неопасные ¦ Опасные (рискованные) ¦
¦опасности¦ ¦ ¦
+---------+---------------------------+------------------------------¦
¦Характе- ¦Медицинские отходы, не име-¦Потенциально инфицированные¦
¦ристика ¦ющие контакта с биологичес-¦медицинские отходы. Материалы¦
¦ ¦кими жидкостями пациентов¦и инструменты, загрязненные¦
¦ ¦(неинфекционных больных).¦выделениями, в том числе¦
¦ ¦Пищевые отходы отделений¦кровью. Патолого-анатомические¦
¦ ¦объекта, кроме инфекционных¦отходы. Органические отходы:¦
¦ ¦(в том числе кожно-венеро-¦операционные (органы, ткани),¦
¦ ¦логических, фтизиатричес-¦плаценты, зародыши и другие¦
¦ ¦ких). Мебель, инвентарь не-¦жидкости организма. Все меди-¦
¦ ¦исправное диагностическое¦цинские отходы инфекционных¦
¦ ¦оборудование, не содержащее¦отделений (в том числе пище-¦
¦ ¦токсических элементов. Не-¦вые), кожно-венерологических¦
¦ ¦инфицированная бумага,¦больниц. Отходы клинико-диаг-¦
¦ ¦смет, строительный мусор. ¦ностических лабораторий. Меди-¦
¦ ¦ ¦цинские отходы из микробиоло-¦
¦ ¦ ¦гических лабораторий, работаю-¦
¦ ¦ ¦щих с микроорганизмами 3-4-й¦
¦ ¦ ¦группы патогенности. Биологи-¦
¦ ¦ ¦ческие отходы вивариев. ¦
+---------+---------------------------+------------------------------¦
¦ Класс ¦ В ¦ Г ¦ Д ¦
+---------+---------------------------+---------------+--------------¦
¦Категория¦Чрезвычайно опасные ¦Медицинские от-¦Радиоактивные ¦
¦опасности¦ ¦ходы по составу¦медицинские ¦
¦ ¦ ¦близкие к про-¦отходы ¦
¦ ¦ ¦мышленным ¦ ¦
+---------+---------------------------+---------------+--------------¦
¦Характе- ¦Материалы, контактирующие с¦Лекарственные ¦Все виды меди-¦
¦ристика ¦больными карантинными и¦средства, диаг-¦цинских отхо-¦
¦ ¦особо опасными инфекциями,¦ностические ¦дов, содержа-¦
¦ ¦ВИЧ/СПИД. Медицинские отхо-¦препараты, вак-¦щие радиоак-¦
¦ ¦ды из лабораторий, работаю-¦цины, дезинфи-¦тивные компо-¦
¦ ¦щих с микроорганизмами¦цирующие средс-¦ненты. ¦
¦ ¦1-2-й групп патогенности.¦тва с истекшим¦ ¦
¦ ¦Медицинские отходы фтизиат-¦сроком дейс-¦ ¦
¦ ¦рических, больниц. Меди-¦твия. Цитоста-¦ ¦
¦ ¦цинские отходы от пациентов¦тики и другие¦ ¦
¦ ¦с анаэробной инфекцией. ¦химические пре-¦ ¦
¦ ¦ ¦параты. Ртуть-¦ ¦
¦ ¦ ¦содержащие ¦ ¦
¦ ¦ ¦предметы, при-¦ ¦
¦ ¦ ¦боры и оборудо-¦ ¦
¦ ¦ ¦вание. ¦ ¦
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The document ceased to be valid according to the order of the deputy. The Minister of Health of the Republic of Kazakhstan of July 23, 2010 No. 533