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Chapter 18 — Wastes from human or animal health care and/or related research Non-Hazardous

EWC Code

18 01

Wastes from natal care, diagnosis, treatment or prevention of disease in humans

EUR-Lex Commission Decision 2000/532/EC — Official Journal L 226, 06/09/2000

Annual Volume

850,000 tonnes/year EU clinical waste

Valorisation Range

€1.8B clinical waste management market

Primary Route

High-temperature incineration

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Waste Classification

EWC 18 01 covers wastes arising from natal care, diagnosis, treatment and prevention of disease in humans. Sub-entries distinguish by infection risk and hazard: 18 01 01 (sharps not infectious), 18 01 02 (body parts and organs including blood bags), 18 01 03* (infectious waste — sharps, dressings, linen from infectious patients), 18 01 04 (non-infectious wastes — dressings, plaster casts from non-infectious sources), 18 01 06* (chemicals containing dangerous substances), 18 01 07 (non-hazardous chemicals), 18 01 08* (cytotoxic and cytostatic medicines), 18 01 09 (non-hazardous medicines) and 18 01 10* (amalgam waste from dental care).

Clinical waste (18 01 03*) classification requires risk assessment at point of generation. Waste from patients with known or suspected infectious conditions (Category A pathogens: Ebola, Lassa, MRSA, CJD) classified as Category A infectious substance. Standard clinical waste from non-infectious patients may be lower risk but still requires controlled disposal to prevent healthcare-associated infection.

Cytotoxic and cytostatic medicines (18 01 08*) — primarily cancer chemotherapy drugs — are acutely toxic, mutagenic and carcinogenic. Dedicated waste streams in sealed yellow UN containers, never mixed with general clinical waste. Amalgam from dental practices (18 01 10*) contains mercury; amalgam separators mandatory in EU dental practices under Mercury Regulation 2017/852.

Typical Generators

Hospitals and clinics
GP surgeries
Dental practices
Nursing homes
Pharmacies
Home healthcare patients

Disposal & Valorisation Routes

Established valorisation pathways for EWC 18 01, ranked by economic value and market depth. High-temperature incineration is the primary route.

High-temperature incineration

Primary

Infectious clinical waste (18 01 03*) and cytotoxic waste (18 01 08*) incinerated at permitted medical waste incinerator at ≥850°C (≥1100°C for cytotoxics) with ≥2 second dwell time per IED Chapter IV. Incineration is definitive destruction; ash disposed as hazardous waste.

Alternative treatment (autoclave/microwave)

Secondary

Non-cytotoxic infectious clinical waste may be treated by validated alternative technologies: autoclaving (134°C, 18 min), microwave or chemical disinfection. Treated waste may then be disposed as municipal solid waste. Validation against specific pathogens required under national approval.

Amalgam recovery (dental)

Backstop

Dental amalgam waste (18 01 10*) collected by amalgam separator, amalgam capsule waste and extracted teeth with amalgam fillings sent to licensed mercury recovery facility. Mercury recovered for reuse under Mercury Regulation exemptions for dental amalgam.

These are the established routes for EWC 18 01. Which one your stream qualifies for depends on its composition, volume and region.

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NACE Receiving Industries

Primary & secondary off-takers

01
Hazardous waste treatment

Licensed clinical waste incinerators and treatment facilities

02
Hospital activities

Hospitals generating clinical waste streams requiring managed disposal

03
Precious metals production

Mercury recovery from dental amalgam waste under Mercury Regulation

04
Manufacture of basic pharmaceutical products

Pharmaceutical returns — expired and unused medicines from 18 01 09

Source: NACE Rev.2 — Eurostat, 2008

Regulatory Context

Key legislative frameworks governing EWC 18 01 classification, transport, and treatment.

Mercury Regulation 2017/852/EU — dental amalgam

Mandatory amalgam separators in EU dental practices from 1 January 2019. All captured amalgam waste classified 18 01 10* and sent to licensed mercury recovery. Phase-down of dental amalgam use to continue; complete ban on dental amalgam from 1 January 2025 for children, pregnant and breastfeeding women.

IED 2010/75/EU — clinical waste incineration

Clinical waste incineration regulated under IED Chapter IV (Waste Incineration). ELVs for dioxins (0.1 ng TEQ/m³), HCl, HF, SO2, NOx, CO, total dust, heavy metals. Operating temperature ≥850°C; cytotoxics ≥1100°C. Continuous emission monitoring mandatory for large facilities.

ADR 2023 — Category A infectious substance transport

Infectious clinical waste containing Category A pathogens transported under ADR UN 2814 (human) or UN 2900 (animal) Class 6.2. Triple packaging (leak-proof primary, absorbent secondary, rigid outer). Shipper declaration and specialist carrier required. Most standard clinical waste transported as UN 3291 regulated medical waste.

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Industries That Use This Waste

Sectors that valorise EWC 18 01 as an input material or secondary raw material.

Explore EU waste flows — Waste Atlas

Visualise 17 years of E-PRTR industrial facility data. See how EWC 18 01 and related waste streams flow across European industries and sectors.

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Source: EUR-Lex Commission Decision 2000/532/EC · NACE Rev.2 — Eurostat 2008

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