Hazardous waste mismanaged by country's largest ambulance service, audit finds

Management of hazardous healthcare risk waste is an integral part of infection control. File picture

The management of hazardous waste by the country’s biggest ambulance service is entirely deficient, according to an audit undertaken following complaints from two members of staff.

The external audit found healthcare risk waste generated by Dublin Fire Brigade’s ambulance service is not being properly separated from general waste, is not secured, tagged, tracked or stocked once it is generated. 

Proper records of the waste not being kept and the physical area where the waste is secured is not properly cleared and “does not portray a professional image”.

The audit also notes that “there is no accountability at any level for these failures”.

Management of hazardous healthcare risk waste is an integral part of infection control. 

The audit found previous reports on the matter in 2009 and 2011 made a series of recommendations that were not implemented.

Dublin Fire Brigade operates an emergency ambulance service with the National Ambulance Service in the greater Dublin area. 

The audit, completed by consultancy Quadra, was conducted in June 2020. 

Earlier in the year, two staff members in the fire brigade made separate complaints about the handling of the waste. 

In a response to a series of questions, Dublin Fire Brigade said the commissioning of the audit preceded the receipt of complaints from the staff members.

Among the findings of the audit were:

• Healthcare risk waste (HCRW) was not secure from interference by unauthorised personnel.
• Only two stations (out of 12) could be considered to have centralised collection points for HCRW 
• Non-segregation of waste at generations point and collection point.
• Absence of tagging and tracking, record maintenance, accountability/monitoring.
• Cleanliness of area, waste containers and HCRW lockers do not portray a professional image.

The audit noted it was clear that “there was a lack of engagement from line mangers with processes dealing with HCRW” and that “all aspects of the current policies for healthcare risk waste management have been unsuccessful in their scope and objectives to meet present-day needs of legislation and guidelines”.

In a statement issued to the Irish Examiner, Dublin Fire Brigade said it had engaged with the regulatory authorities in response to the audit.

“All the recommendations from the Quadra report have subsequently been actioned with the majority now completed,” it said.

“Comprehensive procedures and arrangements exist to ensure staff are trained in the area of HCRW management. As part of the requirement, all staff must undertake a specific training module on NCRW management.” 

However, sources in the fire brigade say the training module is an “online multiple-choice thing that a six-year-old could get the hang of”.

According to sources in the fire brigade, no training in cleaning had been provided, apart from an instruction to use wet wipes or paper towels sprayed with Bioguard to wipe electronic equipment in the ambulances.