DASRI: reminder of obligations regarding the management of medical waste

What does DASRI mean?

Waste from Health Care Activities with Infectious Risks refers to waste generated from diagnostic, monitoring, and preventive, curative, and palliative treatment activities in the field of human medicine.

This waste presents an infectious risk if it contains viable microorganisms or toxins, which are known to cause disease in humans or other living organisms based on their nature and quantity.

List of DASRI-type waste:

Infectious waste:

Soft waste:

Tubings (tubes)Syringes (without needles)Compresses, bandages

Needles, cutting, perforating waste:

NeedlesBladesCathetersRazorsPieces of broken glassScalpels

Semi-liquid waste:

Liquid bagsBlood sampling tubesDrainsSuction bottlesSpittoonsAll biological liquids and their containers (blood bags, transfusion bags, etc...)

Chemical/toxic waste

Expired medicationsUnused medications

Who is responsible for managing DASRI?

In general, this includes all healthcare facilities and all establishments conducting medical or non-medical interventions on humans. This certainly includes health transporters who work daily with patients in varying states of health.

Health transports, biological laboratories, hospitals, vaccination centers, nursing homes, testing centers, research establishments, etc., the spectrum of organizations subject to regulations regarding Waste from Health Care Activities with Infectious Risks (DASRI) is broad.

What are the responsibilities and obligations?

DASRI are waste from medical actions. In this context, the organization producing this type of waste must define a degree of biological hazard concerning this waste. The goal is to prevent any potential contamination of the population if this waste poses a severe risk to public health.

An internal protocol at the facility regarding the organization and circuit of DASRI must be established. It should include all the steps for managing the disposal of DASRI: sorting, storage, collection, destruction.

As a producer of this waste, the professional is responsible for the disposal of waste from healthcare activities with infectious risks that they produce. This responsibility remains with the producer even if they hand over their waste to a third party for disposal. Furthermore, it is the producer's responsibility to find solutions for the disposal of the waste generated in their professional activities.

The sorting of DASRI

If it is advisable to separate dangerous residues for safety and to respect hygiene and public health rules, the cost incurred by the disposal of hazardous waste is 4 to 6 times higher than that of regular waste. For financial reasons, it is therefore necessary to differentiate and prioritize the types of waste.

Sharp, cutting, perforating waste and "semi" liquid waste (blood, biological liquids) as well as anatomical waste (organic waste) must be disposed of as infectious risk waste. The same applies to waste whose appearance can induce emotional risks (shocking), meaning organic remains.

For soft waste, it is the professional's responsibility to assess the infectious risk and make appropriate decisions. That is to say: treat them as waste at risk or not.

Unused or expired medications should be disposed of in the same manner as sharp, perforating waste, etc...

Here is a table summarizing the different storage forms based on the nature of the waste.

The storage and collection of DASRI

Storage can initially be done in an intermediate room and then in a centralized room that must meet the requirements of Article 8 of the decree of September 7, 1999.

This storage must be done in appropriate containers or bins:

Infectious waste:

Sharp / piercing waste:

Rigid containers like needle boxes or plastic drums

Soft waste

: Cardboard containers, plastic bags or plastic drums

Anatomical / organic waste:

Cardboard or rigid containers or plastic drums or jerry cans

Chemical waste:

Medications:

Rigid containers labeled "Cytological Medications" or specific bins provided by specialized waste collectors.

To dispose of DASRI, it is necessary to call upon an approved service provider with whom a contract must be established according to the terms set out in Article 2 of the decree of September 7, 1999.

The destruction of DASRI

2 possible methods:

Incineration

The incineration of DASRI consists of burning the waste in a furnace heated to a high temperature (about 850°C). It can be performed in a specific facility, a hazardous waste incineration facility, or a household waste incineration facility.

Treatment by disinfection

Waste from healthcare activities with infectious risks can be treated by disinfection devices in such a way that they can subsequently be collected and processed by organizations not specialized in handling DASRI (in particular incineration). This treatment helps to eliminate the infectious nature of the waste.

The traceability of DASRI

The public health code stipulates that those responsible for the disposal of DASRI must create documents that allow for the tracking of disposal operations.

3 elements to be respected:

The signing of a contract between the responsible person and the service provider to whom they entrust their waste for disposal.The issuance of a transfer receipt or a DASRI CERFA tracking slip 

(with or without grouping)

The certificate of DASRI disposal according to the quantities produced: annual summary or return of the CERFA tracking slip within the month following disposal.

The slips and transfer receipts must then be kept/accessible for at least 3 years.

Tracking and tracing DASRI

The responsibility of establishments may be engaged in case of problems related to infectious waste. It is recommended to establish quality procedures to track and trace step-by-step the management of DASRI.

For health transporters, this is a process requiring a significant amount of administrative time. Execution can be complicated and difficult to trace. There is a solution to facilitate traceability and communication between managers and operators responsible for these disinfection operations.

VESUV, an application that digitizes the controls and equipment tracking of your vehicles. In the case of DASRI, the application's strength lies in the ease of executing quality procedures and retrieving their history.

Operators execute quality procedures via checklists on a smartphone, providing the information needed by managers. If anomalies are detected during the execution of these procedures, the manager is alerted automatically and in real time.

No more paper, data is automatically saved in the cloud. From anywhere, you can access all the information regarding the equipment and the condition of your health vehicles with a single click. Because of this, you know at all times who, when, and how the quality procedures were conducted.