Clinical waste EWC codes explained: a plain-English guide

Updated 6 November 2026 · By the Clinical Waste Removal team

Short answer: Clinical waste in the UK is coded using the List of Waste, often called EWC codes. Human healthcare waste sits under chapter 18 01 and veterinary waste under 18 02. An asterisk marks hazardous waste, so infectious waste is 18 01 03*, cytotoxic and cytostatic medicines are 18 01 08* and dental amalgam is 18 01 10*, while offensive waste is 18 01 04 and non-cytotoxic medicines are 18 01 09.

What EWC codes are and why they matter

Every waste stream has a six-digit code from the List of Waste, still widely known as the European Waste Catalogue or EWC. The code must appear on your waste transfer notes and hazardous waste consignment notes. It tells the carrier and treatment facility what the waste is and whether it is hazardous, which decides how it can be transported and treated. A wrong code can mean waste goes to the wrong facility, or is rejected.

Codes marked with an asterisk are hazardous. Hazardous waste needs a consignment note in England and Wales, rather than a standard transfer note.

The waste producer is responsible for choosing the right code, although in practice most businesses rely on their contractor to suggest codes for each container type. You should still understand them, because the codes on your paperwork are your evidence that waste was described accurately under the Duty of Care. Scotland and Northern Ireland use the same List of Waste codes, even though their hazardous and special waste paperwork differs.

Human healthcare codes, chapter 18 01

Code	Description	Typical example
18 01 01	Sharps, except 18 01 03	Non-infectious sharps
18 01 02	Body parts and organs, including blood bags, except 18 01 03	Anatomical waste in red-lidded containers
18 01 03*	Waste subject to special requirements to prevent infection	Orange and yellow bag infectious waste, most used sharps
18 01 04	Waste not subject to special requirements to prevent infection	Offensive tiger bag waste
18 01 06*	Chemicals consisting of or containing hazardous substances	Formalin, some disinfectants
18 01 07	Chemicals other than 18 01 06	Non-hazardous chemicals
18 01 08*	Cytotoxic and cytostatic medicines	Purple-lidded medicines and sharps
18 01 09	Medicines other than 18 01 08	Blue-lidded medicines
18 01 10*	Amalgam waste from dental care	White amalgam containers

Veterinary codes, chapter 18 02

Veterinary waste follows the same pattern under 18 02. Sharps are 18 02 01, infectious waste 18 02 02*, non-infectious waste 18 02 03, hazardous chemicals 18 02 05*, other chemicals 18 02 06, cytotoxic and cytostatic medicines 18 02 07* and other medicines 18 02 08. Animal carcasses and some animal tissues may also fall under animal by-products rules.

Mixed streams and combined codes

Many containers hold more than one type of waste, so they carry more than one code. A yellow-lidded sharps container with syringes used for injections is often coded 18 01 03* and 18 01 09, because it is both infectious and contains medicine residue. A purple-lidded container is often coded 18 01 03* and 18 01 08*. Your contractor should confirm the codes for each container type.

Orange-lidded sharps, no medicines: commonly 18 01 03*
Yellow-lidded sharps, non-cytotoxic medicines: commonly 18 01 03* and 18 01 09
Purple-lidded sharps, cytotoxic medicines: commonly 18 01 03* and 18 01 08*
Orange bag infectious waste: 18 01 03*
Tiger bag offensive waste from healthcare: 18 01 04

Medicines returned from households

Medicines handed back to a pharmacy by members of the public count as household waste, not healthcare waste. They are coded under chapter 20 of the List of Waste: 20 01 31* for cytotoxic and cytostatic medicines and 20 01 32 for other medicines. Pharmacies often have both their own stock and patient returns, so they may need both sets of codes.

Hazardous properties and the asterisk

A hazardous code tells everyone in the chain that the waste needs extra care. On a hazardous waste consignment note, the producer also records the hazardous properties that apply, using HP codes. For infectious clinical waste the key one is HP9, infectious. Cytotoxic and cytostatic medicines are usually classed as toxic and carcinogenic, mutagenic or toxic for reproduction, which is why they must go for high-temperature incineration.

Clinical waste also counts as a dangerous good in transport, usually under UN3291, so packaging must be approved for that use. This is why contractors supply UN-approved bags and containers, and why you should not use ordinary bin bags or improvised containers.

Common coding mistakes

Coding all bag waste as 18 01 03* when much of it is offensive 18 01 04
Using a single code for sharps containers that also contain medicine residue
Using human healthcare codes for veterinary waste, or the other way round
Coding patient-returned medicines at a pharmacy as healthcare medicines
Leaving codes off transfer notes or copying old codes after procedures change
Forgetting to code specialist streams such as gypsum or chemicals separately

To get codes right, work through these checks:

Base codes on where the waste came from and what is in it, not just the container colour
Check codes on every note match the waste actually collected
Ask your contractor if a new procedure or product changes your waste
Keep codes consistent across sites so audits are straightforward