Hospital waste includes items with high infectious or toxic properties. Until the 1980s, this waste was disposed of alongside general waste and industrial waste. Within the waste disposal industry, medical waste was referred to as "mixed industrial waste." Consequently, incidents where sanitation workers pricked their hands on syringes were all too common.

Hospital waste includes items with high infectious or toxic properties. Until the 1980s, this waste was disposed of alongside general waste and industrial waste. Within the waste disposal industry, medical waste was referred to as "mixed industrial waste." Consequently, incidents where sanitation workers pricked their hands on syringes were all too common.
Illegal dumping also increased, partly due to hospitals' financial struggles leading to reluctance to spend money on waste disposal. However, to break this cycle, the Ministry of Health and Welfare announced the "Medical Waste Disposal Guidelines" in November 1989. These guidelines specified storage, collection, transportation, and processing methods for the safe handling of items like syringes, tubes, and blood-soaked gauze, and were notified to prefectural governments.
Then, in 1992, the Waste Management and Public Cleansing Act was amended, introducing the new definition of "infectious waste." Infectious waste was classified alongside explosive and toxic wastes as either Specially Managed Industrial Waste or Specially Managed General Waste. Sterilization became mandatory, and medical institutions were assigned management responsibility.
According to a 1989 Ministry of Health announcement, medical waste generated by healthcare facilities amounted to 1,810 tons per day, with infectious waste alone reaching 354 tons daily. "After all, it's a new market. Various industries entered the field—real estate, taxi companies, construction firms, and more,"
"Until now, waste disposal was handled at low prices or practically for free. But when it comes to infectious waste disposal, the cost is more than ten times higher," says Noboru Watanabe, Chairman of the Medical Waste Specialized Committee at the National Industrial Waste Federation. Over 200 companies participate in this committee, pursuing proper disposal methods and advancing the creation of so-called "voluntary standards" that will become the future industry benchmark.
Indeed, the medical waste disposal business saw a period of spectacular growth. Major companies from other industries, like NEC and Fujitsu, entered the field, creating computerized collection systems. Some even came up with unique ideas, like equipping trucks with incinerators for on-site processing. Itochu Corporation partnered with Watakyu Bedding, a major hospital bedding supplier. Noboru Watanabe, a member of the Medical Waste Specialized Committee of the Waste Association, stated:
"Companies with transportation and incineration capabilities have seen their work decrease, I hear. Since the law was enacted, it appears to be functioning smoothly, but in reality, it's only superficial," stated Mr. Watanabe of the Medical Waste Research Institute. Even after the law was amended, the Ministry of Health and Welfare issued the "Infectious Waste Disposal Manual," providing detailed guidance on processing procedures.
Furthermore, a system was established where a "Special Management Industrial Waste Management Ticket (Manifest)" is issued for entrusted disposal. This allows medical institutions to determine the final disposal method, consult with the Japan Medical Association, and ultimately verify that disposal has been completed. However, illegal dumping and the fraudulent use or forgery of manifests are rampant.
That is the current situation. Proper disposal entails significant costs. While using communication satellites to monitor the entire waste disposal process is a future possibility, the industry as a whole is currently in disarray. Mr. Watanabe stated, "Many companies have already dropped out. If you try to do it properly, it's impossible, so this is difficult for all the contractors. Everyone is confused.
No one thinks this situation is acceptable." Discussions are underway to help medical institutions understand the importance of this issue. Additionally, three officials from the Ministry of Health and Welfare—the Director of Industrial Waste Management, his Assistant, and the Assistant Director of the Water and Environment Planning Division—are attending these meetings as observers. Furthermore, practical training sessions are planned for Osaka and Fukuoka, involving the same core members plus local waste disposal operators.
"It seems the administration has finally gotten off its rear end. They've got plans to manage this, so they're serious," (Mr. Watanabe) said. It's unlikely that legal-level processing will be implemented exactly as is on April 1, 1995. Nor is it certain that illegal operators can be effectively cracked down on. However, there's no doubt that this committee's actions will become the mainstream of the medical waste disposal business in the near future.
Only about 30 companies meet the "voluntary standards." Watanabe is calling for 1,500 companies to join the Medical Waste Specialized Subcommittee. While membership has gradually increased since its launch in September 1992, it currently stands at just over 200 companies. It's fair to say a significant number of companies have dropped out at this stage.
Mr. Watanabe predicts that ultimately, around 300 companies will join, and among them, several dozen will likely give up, unable to cope with the strictness of these "voluntary standards." "Even if they're called strict, they're based on laws and manuals. Currently, only about 30 companies, mainly major players in the processing industry, can meet these standards.
These standards make it easier for the government to provide guidance, give operators benchmarks, and help hospitals become more aware." (Mr. Watanabe) In a sense, these "voluntary standards" are a survival hurdle. What exactly are these "voluntary standards" (summary on page 13)? For incinerators, for example, they encourage the use of large furnaces (with a daily incineration capacity of 50 tons or more).
Since separate collection at medical institutions is impractical, the voluntary standards allow medical waste to be co-incinerated in large, mixed-combustion furnaces capable of agitation, but limit the proportion of medical waste to 20%. Large furnaces already face strict regulations on wastewater and exhaust gas.
Restrictions on collection also apply, such as refusing containers with damage or leaks. Container specifications are to be determined later. So, how will the medical waste business develop in the future? "This legal revision only addressed infectious waste within medical waste, but hospitals actually produce highly explosive and corrosive waste too.
Ultimately, these can be treated the same as existing industrial waste. However, the Ministry of Health has become significantly more proactive compared to before, so administrative guidance will likely be issued again soon. Globally, medical waste is categorized into 6 to 8 types and processed separately. Japan will follow this model. When that happens, manufacturers possessing specialized incinerator development technology and transport/collection companies with established sorting and collection know-how will likely gain a strong position."