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   Health care waste / ATHISA MEDIO AMBIENTE

The deterioration of health care material
All material that has reached the end of its useful life is health care waste. Only personnel specialized in hospital centres, veterinary surgeons or private clinics are able to take this type of decision: breakage, possible infection, manufacturing defect or normal wear and tear are the usual reasons for throwing away this material. But the process of eliminating health care waste is so complex and so  important for the environment that no hospital should manage this task alone. We have been doing this since 1992. And we get it right!

The birth of a star service
In 1996, we established the first health care waste treatment factory in Barreiro (Lisbon) in partnership with Ambimed. Two other plants were set up in Beja (Alentejo) in 2004 and in Oporto a year later. During 2006, further plants will be constructed in Guillena and Alcala de Guadaira (Sevilla), in Elche with our partner LGA and in Tetouan (Morocco).

In total, we treat 24.000 tons of health care waste every year thanks to which, we have been able to grow as a business in all senses and in a very short time. The excellent relationship with each of our clients and the good results obtained have attracted the attention of other countries as Rumania, Bulgaria, Moldavia, Poland, Egypt, Tunisia and Turkey.

Four groups of Health care waste
According to generally accepted international qualifications, there are four groups of health care waste to differentiate. We follow these criteria in our daily tasks:

Chemical risks Health care waste
These are those that have been exposed to dangerous chemical activity, normally anti-tumoral, Cytostatic waste, medicine whose shelf life has expired and other types of chemically contaminated waste as batteries, thermometers, dissolvents, lubricants and sharp objects.

Biological risks Health care waste
These are treated with the maximum care from the clinical centres to the treatment plant. The risks of infection and consequent problems are obvious: infected material, anatomical remains, blood and blood derivatives, secretions, excretions and body fluids

Non dangerous Healthcare wastes
Handling, storage, collection and transport are managed from the health centre itself:
curative materials for medical treatments, plaster, clothing and one-used material not contaminated with blood or other contaminants.

Assimilated to household waste
These do not required a special treatment different from normal household waste: cardboard, paper, office materials, remains from kitchens, workshops and gardens are treated as urban waste in the appropriate containers for cardboard/paper, plastic and glass.

Conditioning of health care waste
Our clients are usually hospitals, health centres, private and public clinics, veterinary clinics, laboratories, pharmacies, etc. All have the same need: to treat the waste which are being produced normally at a great rate. For this, we provide our clients with various means for the conditioning of all types of health care waste according to the demand of each situation :

The reusable container
It is supplied in 3 colours according to type of health care waste: green for those with biological risks, yellow for cytostatics and expired medicines and red for animal remains. The average life is one year and it is then recycled.

It offered a highly efficient mechanical resistance to the conditioning of chemical agents and sharp objects.

It is totally impermeable and with a capacity of 60 litres. It is the most advisable option for conditioning health care waste. It is closed with 3 exterior claws insuring that it is completely sealed.

See its history in the right hand column.

Isolating bags

Every container carries is lined by an isolating bag for health care waste. These are of one-use only opaques, aseptic and resistant to breakages and impacts with a capacity from 60 to 80 litres.

It has a easy used system of opening and hermetic sealing, making it the ideal complement to the reusable container.

One-use containers
For sharp objects.This is offered in models of different capacities, namely 1, 3, 5, 8 and 10 litres.
With a handle to transport it.

Labelling, collection and transport
Every container bares a label with the information of the hospital to which it is going, a reference number, the type of reusable container and the date of delivery and collection, among other data. The information is verified before delivery to our clients.
Our fleet of lorries is responsible for collecting them in the health centres, loading them onto the lorries and transporting them immediately to the nearest treatment plant.

Weighing and storage of health care waste
Once checked  against the identifying label and bare code, each container is weight on precision scale and the weight noted. As a minimum volume of health care waste is required for treatment by autoclave, waste is store in a cold chamber at -18º C for no more than 24 hours, still in its bag and container.

Washing of reusable containers
After unloading the bag of health care waste, every reusable container is sprayed with a strong disinfectant and rinsed with water under pressure. The containers are then dried and stored for reuse.
Special treatments
While the reusable containers are completely disinfected, our specialists decide what type of treatment to follow with the health care waste. The load is put in a larger wheeled container which is put into the autoclave.

This is the classic biological sterilisation process carried out on health care waste with biological risks with steam and high temperature and under pressure, so following the recommendation of EPA ( Environmental Protection Agency ) to destroy bacteria, fongae, virus and parasite and other risks that this waste may contain.

Let´s see the four phases of autoclave:

A vacuum is created until a relative pressure of - 0,85 atm. is obtained. Steam is inserted and when the third injection of steam is finished, the proportions inside the chamber are 99.80 % steam and 0,20% air.

The chamber is heated to a temperature of 134º C and a pressure of +2.2 atm.

A total sterilisation is carried out by continuous steam injections by maintaining temperature and pressure.

The last phase extracts the steam injected until a vacuum of - 0.90 atm. is reached, so eliminating all the humidity accumulated in the process. Gradually, the atmospheric pressure is reduced according to the temperature of the chamber.

After this meticulous process, the waste is compacted, crushed and finally, taken to a controlled dump as household waste.

IPhysical—chemical inertization

Chemical risks waste, specifically phytosanitary waste, the remains of medicine and Cytostatic waste are treated in OMIM, the Organic Molecule Inertization Machine, which crushes the waste and impregnate it with water, so removing any chemical traces after which it is taken to a dump as household waste. The resultant contaminated water is submitted to a exhaustive session of ultraviolets until it is totally distilled.


The design of the reusable container was an important landmark with which the company won the Silver Broom Award 1994, awarded by the prestigious ATEGRUS.

Until then, the containers were of one-use only, increasing the total weight of the health care waste by 25% because the container had to be treated as waste and destroyed along with the health care waste it contains.

It was then that the company decided to bring out a plastic container that could withstand use for a year after which, it would be recycled in our plastic treatment plant and then reused.

The container is easy to handle, resistant, hermetically sealed, washed and rigorously disinfected after each use. The container is supplied in 3 different colours according to the type of health care waste: green for biological risks, yellow for cytostatics and expired medicines and re for animal remains.

This container has now been redesign and today has obvious improvements while still retaining the multiuse and recycling capacities of the original.

The W.H.O.warns of the diseases that can be transmitted by inadequate handling of health care waste:

  Hemorrhagic fever
  Q Fever
  Active tuberculosis
Viral hepatitis
  Abdominal typhus
  Paratyphoid fever
  Bacterial dysentery
  Porcine plague

We know at first hand the lifecycle of all these health care waste. We explain it in detail to the personnel of the clinical centres in short courses specifically oriented to the handling of the various waste recipients developed over the years.


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