Chemical waste collection for vets and dental practices

The items that come up in both settings are the ones outside everyday clinical bins:

• photographic fixer and developer, including stock left over from a move to digital imaging
• formalin and specimen pots for biopsy work
• disinfectant, sterilant and cleaning concentrates, particularly discontinued products
• out of date medicines and materials, kept apart by type
• mercury-bearing items such as old thermometers and bulk mercury containers

Controlled drugs, compressed gas cylinders, asbestos, explosives and radioactive materials do not join these collections, and each is handled as a manual enquiry. If you hold oxygen or nitrous oxide, your gas supplier should be the first call in any case.

The specifics are different enough to justify separate pages. Dental practices have a particular legal position on amalgam. Veterinary practices have a wider medicines stream and their own rules on controlled drugs.

• product names and approximate quantities, ideally with the safety data sheet to hand
• what your clinical waste contractor already takes, and how often
• any unlabelled or damaged containers, with their location, left where they are
• the type and number of X-ray chemical containers, if you still have them
• your parking and access arrangements, including times when clinical work stops
• the practice's legal name, as it should appear on the note

Group owners can add a list of sites and who is responsible for each one. A short, accurate list from a practice manager is all that is needed at this stage, and it will show whether the job is one visit or something that needs a closer look first.

Human and animal healthcare are coded separately, and a mixed or moved practice can catch people out. GOV.UK's classification guide sets the two side by side. Hazardous chemicals are 18 01 06* in human healthcare and 18 02 05* in animal healthcare. Cytotoxic and cytostatic medicines are 18 01 08* and 18 02 07*. Other medicines are 18 01 09 and 18 02 08. Photochemicals sit outside both of these, under chapter 9 of the List of Waste, whichever animal or person the X-ray was taken of.

Amalgam has its own code, 18 01 10*. The veterinary list has no equivalent, so a veterinary dentist with a historical bottle of amalgam should raise it as a question and not guess.

If your waste paperwork has been copied from another practice, it is worth checking that the codes belong to your type of work. A receiving site cannot easily correct a description it did not write.

Your contractor's scope is set out in your agreement, and it may be broader or narrower than you assume. Most contracts in these sectors centre on sharps, infectious waste, offensive waste, medicines and, for dentists, amalgam. Many practice managers are surprised to find what sits outside them.

Chemicals are the main gap. HTM 07-01 says waste chemicals should not go into clinical, offensive or municipal waste streams, which means a yellow bag is not the place for an old bottle of disinfectant concentrate. A stray bottle in the wrong bin can lead to a rejected load, and your contractor's audit may ask how it got there.

Our advice is to take your last few collection records, list what was actually collected, then walk through the practice looking for what was not. That short exercise usually identifies the whole job.

Most of the chemical waste we would expect from a small practice has been there for a long time. It tends to surface when something changes. A practice goes digital and the old processor chemicals remain in the darkroom. A retiring principal sells up, and the new owner finds a shelf of unlabelled bottles. A refurbishment empties a cupboard that nobody has opened in a decade.

These moments are worth planning for. The person who knows what the bottles are is about to leave, so get them to walk the store and write it down. A corporate group buying several practices should also include this in its integration checklist. Each holder has its own duty of care, and handing waste on does not end it. In England, a register of consignment notes must be kept for three years at the premises. A new owner should know where that file is, and should ask for it during the sale.

HTM 07-01 names dentists and veterinary practices directly in its audit schedule. Permitted sites in England and Wales need a pre-acceptance audit before they can accept healthcare waste, starting before the first batch and then repeating every two years for practices producing under 5 tonnes of clinical waste a year. The purpose is to check that what is described on paper matches what is really being produced.

It is worth treating this audit as a useful review. If you have stopped wet-film processing or started a new service, the waste profile has changed, and your paperwork should follow. When a chemical stream is missing from the audit but present in your cupboards, it usually means the store has not been looked at for a while.

Small premises rarely have a dedicated chemical store, which means disinfectants, fixer and cleaning products often share a cupboard with paper towels. Some of these should not be near each other. Bleach-based disinfectants with acids or ammonia products can release toxic gas, so check labels and keep them separated.

Your COSHH arrangements should also deal with what happens if something goes wrong: the right equipment for a spill, the right people trained, the arrangements for any waste created and the information available for emergency services. In a practice of a few people, that may be a single page on the wall, but it needs to exist. It should cover what is waiting for collection as well as what is in use.

Mercury deserves separate mention. Old thermometers and sphygmomanometers still surface in vets' and dentists' cupboards. They are hazardous waste, and if one is broken the droplets should never be vacuumed. Our mercury and heavy metal page goes through this in more detail.