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Medical Waste Disposal

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The Facts, the History and What You Need to Know

Medical Waste Disposal. The Facts and the History and what you need to know. Hospital waste streams are complex, and the types of waste produced can be confusing. Let’s start with a high-level overview: medical waste, can be referred to as any kind of waste produced at a medical facility even just regular garbage. Regulated medical waste or infectious waste is waste that is capable of transmitting infection or disease to humans or animals. Items like, sharps, human body fluids, or blood is not general waste. Medical waste names vary greatly depending on the state you are in. Some states call infectious medical waste, medical waste, regulated medical waste, other states call it biomedical waste, some states refer to it as infectious waste while others call it potentially infectious medical waste. Either way, it’s important that everyone understands how to properly handle and dispose of it. Read on to learn more about all things medical waste!

The History of Medical Waste

To understand where all the different names for medical waste came from, we have to go back to the beginning of medical waste with the Medical Waste Tracking Act of 1988.

In 1988 congress passed the Medical Waste Tracking Act of 1988. The act amends the Solid Waste Disposal Act to require the Administrator of the Environmental Protection Agency (EPA) to establish a two-year demonstration program to track listed medical wastes, and segregate, contain, and label such wastes to protect waste handlers and the public. And to establish record keeping requirements and penalties that could be imposed for mismanagement.

After medical wastes washed up on several East Coast beaches, concern over the potential health hazards caused congress to enact this Act. This was a two-year program that started on June 24, 1989 and expired on June 21, 1991.

The Act was in effect for the states of, New York, New Jersey, Connecticut, Rhode Island, and Puerto Rico. The purpose of the program served to focus attention on the medical waste issue and provided a model for the states and other federal agencies in developing their own medical waste programs.

The United States EPA defines medical waste as.

“Medical waste is a subset of wastes generated at health care facilities, such as hospitals, physicians’ offices, dental practices, blood banks, and veterinary hospitals/clinics, as well as medical research facilities and laboratories. Generally, medical waste is healthcare waste that that may be contaminated by blood, body fluids or other potentially infectious materials and is often referred to as regulated medical waste.”

However, over the years some people refer to medical waste as any waste produced at a medical facility and regulated medical waste as the infectious waste.

Other Names for Medical Waste

This is where the other names for medical waste came into play, when the federal level program was over, and the individual states adopted their own medical waste policies based on the “Federal Model Guidelines for State Medical Waste Management”. The states came up with their own medical waste management program, including names, and definitions. In Michigan according to the Department of Environment, Great Lakes, and Energy (EGLE) medical waste is called medical waste. In Ohio medical waste is called infectious waste as per the Ohio Codes Rule 3745-27-30. Illinois EPA calls medical waste Potentially Infectious Medical Waste. In Florida medical waste is called Biomedical Waste. And then in Arizona medical waste is called biohazard waste. It is easy to see how convoluted the names became.

What Is Medical Waste?

Regardless of what it is called most states agree to a “general definition” of medical waste, which is waste that that may be contaminated by blood, body fluids or other potentially infectious materials and is often referred to as regulated medical waste. However, definitions and processes vary by state concerning medical waste.  Medical waste can be found in hospitals, health care clinics, doctors’ offices, blood banks, dentists’ offices, veterinary clinics, and other places where people receive medical care or treatment. If you’ve ever been to a doctor’s office, hospital, or other medical facility, then you’ve probably seen all kinds of waste containers, from biohazards to needles. Most of this kind of waste is called medical waste in some form, however, tattoo shops, body piercing, and med spas can also produce medical waste.

Medical Waste Definition and Examples

Definitions of Medical Waste

 According to the Healthcare Environmental Resource Center. There is no universally accepted definition of medical waste. However, most regulatory agencies define medical waste as any material generated that may transmit disease or cause injury to patients, health care workers, or other persons. These materials include sharps, contaminated needles, syringes, bandages, dressings, blood products, body fluids, tissues, and surgical items.

Some state regulations use a general definition, while others list specific wastes and categories of waste that are considered infectious. Some states have adopted the definition found in federal standards like the DOT definition.

Examples of Medical Waste

The following six medical wastes are commonly regulated by states.

Medical Waste Handling and Storage Regulations

The OSHA Standard for Bloodborne Pathogens

OSHA standards require that employers provide safe working environments free of hazards that could cause injury or illness. These include proper training on how to handle and store biohazardous materials including providing protective equipment when handling substances that pose risks.

In 1991 OSHA Occupational Safety and Health Administration enacted the bloodborne pathogens standard 29 CFR 1910.1030. This standard serves to protect those with occupational exposure to bloodborne pathogens, such as the Human Immunodeficiency Virus (HIV) and the Hepatitis B Virus (HBV).

The Bloodborne Pathogens Standard has numerous requirements, including the development of an Exposure Control Plan. The Standard also includes rules specific to medical waste.  Regulated medical waste includes blood and items contaminated with blood or other potentially infectious materials.

What is an Exposure Control Plan?

The exposure control plan is the employer’s written plan that outlines the protective measures an employer will take to eliminate or minimize employee exposure to blood and other potentially infectious materials.

The exposure control plan must contain at a minimum:

The Bloodborne Pathogens Standard uses the term, “regulated waste,” to refer to the following categories of waste.

  1. Liquid or semi-liquid blood or other potentially infectious materials (OPIM).
  2. Items contaminated with blood or OPIM and which would release these substances in a liquid or semi-liquid state if compressed.
  3. Items that are caked with dried blood or OPIM and can release these materials during handling.
  4. Contaminated sharps
  5. Pathological and microbiological wastes containing blood or OPIM.

It is the employer’s responsibility to determine the existence of regulated waste.

Provide Personal Protective Equipment (PPE)

PPE includes any type of clothing, gloves, goggles, masks, aprons, boots, shoes, etc., that an employee uses while performing work duties. It also includes items such as hard hats, ear plugs, eye protection, and respirators. Employers must ensure that employees use these personal protective devices correctly and safely.

Definitions

There are two general categories of PPE: general purpose and special purpose. General purpose PPE includes any item used by an employee to perform his/her job duties. Special purpose PPE includes items designed specifically for a particular task. Examples of special purpose PPE include face shields, shoe covers, and respiratory equipment.

Management of Sharps

How should sharps containers be handled?

Each sharps container must either be labeled with the universal biohazard symbol and the word “biohazard” or be color-coded red.  Sharps containers must be maintained upright throughout use, replaced routinely, and not be allowed to overfill.

The containers should be closed immediately prior to removal or replacement to prevent spillage or protrusion of contents during handling, storage, transport, or shipping. Placed in a secondary container if leakage is possible. The second container must be, closable, constructed to contain all contents and prevent leakage during handling, storage, transport, or shipping; and labeled or color-coded according to the standard.

Reusable containers must not be opened, emptied, or cleaned manually or in any other manner that would expose employees to the risk of injury.

Upon closure, duct tape may be used to secure the lid of a sharps container, as long as the tape does not serve as the lid itself.

Where should sharps containers be located?

Sharps containers must be easily accessible to employees and located as close as feasible to the immediate area where sharps are used example, patient care areas.

What type of container should be purchased to dispose of sharps?

Sharps containers are made from a variety of products.  If they meet these standards, containers must be closable, puncture resistant, leak proof on sides and bottom, and labeled or color-coded, OSHA will consider them to be of an acceptable composition.

How do I Dispose of Regulated Waste?

Disposal of all regulated waste must be in accordance with applicable state regulations.  These rules are typically published by state environmental agencies with the state department of health.

In addition to state rules for disposing of regulated waste, there are basic OSHA requirements that protect workers.  The OSHA rules state that regulated waste must be placed in containers which are closable, constructed to contain all contents and prevent leakage of fluids during handling, storage, transport, or shipping, labeled or color-coded in accordance with the standard, and closed prior to removal to prevent spillage or protrusion of contents during handling, storage, transport, or shipping.

If outside contamination of the regulated waste container occurs, it must be placed in a second container meeting the above standards.

Communication of Hazard to Employees

When are Labels Required?

A warning label that includes the universal biohazard symbol, followed by the term “biohazard,” must be included on all bags, containers or anything containing regulated waste. Also, on doors used to store, dispose of, transport, or ship medical waste.

What are the required colors for the labels?

The background must be fluorescent orange, orange or red, with symbols and lettering in a contrasting color. The label must be either an integral part of the container or affixed as close as feasible to the container by a string, wire, adhesive, or other method to prevent its loss or unintentional removal.

Training Which Employees must be Trained?

All employees with occupational exposure must receive initial and annual training, this includes full time employees, part time employees and any employee that has occupational exposure. Employees are required to be trained on company time.

We hope this article provides you with a better insight to medical waste. The OSHA BBP Standard 1910.1030 is longer and more detailed than the overview given here. In addition to that each state has specific guidelines to follow when generating, handling, storing, transporting, and treating medical waste.

Bio-MED medical waste has been providing medical waste services to the Midwestern states for over 25 years. We directly train and employ our own drivers, we own and equip our trucks to safely haul medical waste, we own our own processing plant that treats your medical waste. From start to finish we can handle all your medical waste needs.

At Bio-MED we also offer an easy Online Training and Compliance Portal where you can manage your account online and more! Contact us today to see all the features.

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References

U.S. EPA – Medical Waste  https://www.epa.gov/sites/default/files/2016-02/documents/model_guidelines_for_state_medical_waste_management.pdf

Michigan’s Department of Environment, Great Lakes, and Energy – Medical Waste https://www.michigan.gov/egle/about/organization/materials-management/medical-waste-regulatory-program

Ohio’s laws & Administrative Rules – Medical Waste https://codes.ohio.gov/ohio-administrative-code/rule-3745-27-30

Healthcare Environmental Resource Center – https://www.hercenter.org/

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