Medical Waste

What is Medical Waste?

Medical waste, also commonly known as biohazardous waste or clinical waste, is any kind of waste that poses potential risks to humans and other living organisms if not handled correctly. Medical waste can consist of anything from used bandages and syringes to blood samples and discarded surgical equipment. Working in the healthcare industry can involve handling medical waste every day, but many people don’t know exactly what it is when they hear this phrase for the first time. To get you up to speed on what we mean by medical waste and why it needs special handling, we’ve compiled a list of some of the most common types of medical waste along with where they come from.

Medical waste comes from a variety of different sources, such as clinical laboratories, healthcare settings, and assisted living facilities. It can also be generated from regulated health care activities involving animals. The type of waste, how it is generated, where it is generated, how it is transported, and how it is treated all depend on the type of waste it is.

Examples of Medical Waste

The U.S. 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.”

The Healthcare Environmental Resource Center list six medical waste commonly regulated by states.

• Pathological waste. Tissues, organs, body parts, and body fluids removed during surgery and autopsy.
• Human blood and blood products. Waste blood, serum, plasma, and blood products.
• Cultures and stocks of infectious agents (microbiological waste). Specimens from medical and pathology laboratories. Includes culture dishes and devices used to transfer, inoculate, and mix. Also includes discarded live and attenuated vaccines.
• Contaminated sharps. Contaminated hypodermic needles, syringes, scalpel blades, Pasteur pipettes, and broken glass.
• Isolation waste. Generated by hospitalized patients isolated to protect others from communicable disease.
• Contaminated animal carcasses, body parts and bedding. From animals intentionally exposed to pathogens in research, biologicals production, or in vivo pharmaceuticals testing.

Names For Medical Waste

It may surprise you to find out medical waste does not have a universally accepted definition for medical waste, or even a universally accepted name. In most states medical waste is called, infectious waste, biomedical waste, regulated medical waste, medical waste, and biohazardous medical waste. And generally defined as in the “Examples of Medical Waste Above”.

The reason this is the case is because when the Medical Waste Tracking Act of 1988 ended, which only covered four states (New York, New Jersey, Connecticut, Rhode Island). The U.S. EPA who promulgated the MWTA regulations and set forth a Model Guidelines for State Medical Waste Management. Because each state is its own entity, these guidelines, developed by the Council of State Governments, are intended to serve as a ready-reference tool for all aspects of medical waste management. By virtue of its definition, guidelines are not mandatory and are therefore not enforceable through civil charges or fines.

Each state bodies of government came up with their own definition, treatment requirements, and name for what is commonly know as medical waste. And governing bodies, names, definitions, and treatment requirements can all vary by state.

Medical Waste Facts

Of the total amount of waste generated by health-care activities, about 85% is general, non-hazardous waste.

The remaining 15% is considered hazardous material that may be infectious, toxic, or radioactive.

Every year an estimated 16 billion injections are administered worldwide, but not all the needles and syringes are properly disposed of afterwards.

State regulations can and often do vary, local regulations may apply and there is always some form of federal oversight when it comes to medical waste, knowing what regulations affect your business and providing the proper training to those handling your medical waste can be the difference between a successful medical waste management program and a failed one.

Measures to ensure the safe and environmentally sound management of health care wastes can prevent adverse health and environmental impacts from such waste including the unintended release of chemical or biological hazards, including drug-resistant microorganisms, into the environment thus protecting the health of patients, health workers, and the public.

Lack of awareness about the health hazards related to health-care waste, inadequate training in proper waste management, absence of waste management and disposal systems, insufficient financial and human resources and the low priority given to the topic are the most common problems connected with health-care waste.

Medical Waste Disposal Methods

It wasn’t too long ago when medical waste was generally disposed of by incineration, in fact most hospitals had a big smokestack attached to them. It was found out that hospitals using on site incinerators were exposing the public to an emission stream that included mercury, dioxins, and other highly toxic substances. In 1997 the EPA tightened standards for medical waste incinerators and that brought about the closure of several thousand on-site medical waste incinerators at healthcare facilities.

Today autoclaving, or some other method of sterilization is a more environmentally friendly way to treat medical waste, some medical waste must be incinerated but the incinerators of today are much more regulated and environmentally friendly, than the incinerators of the past.

Some of the common ways to treat medical waste are listed below.

Heat: steam autoclaves, microwave systems, dry heat and hot air systems, plasma arc

Chemical agents: chlorine compounds (including hypochlorite, chlorine dioxide), ozone, alkali, other disinfectants (peracetic acid, glutaraldehyde, etc.– typically used for small batches).

Medical Waste Best Practices

To keep waste from spreading and protect those working in healthcare settings from potential exposure to harmful pathogens, it’s important to make sure medical waste is handled and disposed of properly. This starts with making sure all employees are properly trained and understand what waste they may come into contact with, how to identify the waste and understand what waste goes into what container.

All medical waste should be contained and labeled properly, and workers should understand your policies, state and federal regulations and follow standard infection control practices to prevent transmission of infectious diseases. Failure to segregate medical waste properly ends up with medical waste not being treated or disposed of properly, this can lead to hefty fines and more implications for your business.

Medical Waste Color Codes

Medical waste generator facilities and treatment plants follow a color-coding system to standardize the management of various types of waste generated on-site and for treatment. Facilities that process infectious waste (such as blood, sharps, and used bandages) will have a different color code than facilities that handle other types of waste.

The standardization of color-coded containers and waste bags makes it easier for facilities to manage their waste by providing a standardized way to identify the contents of the bags. The color codes also help workers in the field easily recognize the contents of different containers and bags so they can properly dispose of them.

Who Regulates Medical Waste?

We regulate medical waste as a worker and public health concern in the United States. The individual state’s decide what part of the process is managed by what agency, in many states the Environmental Protection Agency (EPA) is responsible for regulating the management of medical waste, it could also be the health department, or a combination of agencies. Medical waste generators such as hospitals, clinics, laboratories, and other healthcare facilities are responsible for managing their waste properly. In some states generators of any amount of medical waste are required to register with the state.

Aside from local and state agencies, there are also federal regulations involved with medical waste. For example, OSHA’s Bloodborne Pathogens Standard 1910.1030 has regulations all employers of employees who have occupational exposure must follow. The Department of Transportation (DOT) has regulations that must be followed when transporting medical waste. If you are unclear what regulations your location must follow, contact the local EPA or Health Department for guidance, or contract with a medical waste disposal company whose job it is to know and follow all regulations.

Medical Waste Generators

A medical waste generator is any company or facility that produces medical waste as a by-product of a service. Providing healthcare services often produces medical waste, veterinarians caring for animals, tattoo shops, funeral homes, long term care facilities, nursing homes, and more. Some states require a medical waste management plan for generators of medical waste. These plans could include things like.

If you are a regulated medical waste generator, prepare and maintain a Medical Waste Management Plan and update it at least every two years. Keep a copy of the plan at your site. Ensure your plan includes:

• Name and address of the generating facility
• Types of infectious or pathological wastes generated
• Collection, storage, transport, and disposal methods used for infectious wastes
• Packaging and labeling of infectious wastes
• Transporters and disposal facilities used for infectious wastes
• BBP exposure control plan, or the steps you have taken to minimize potential employee exposure
• Name of the individual responsible for implementation of the management plan
• Amount of infectious and pathological waste generated in the previous two years

Types of Medical Waste

Medical waste can have different meanings in different states. Below we have listed some common types of waste generated by healthcare facilities as per the World Health Organization (WHO).

Infectious medical waste: waste contaminated with blood and other bodily fluids (e.g., from discarded diagnostic samples), cultures and stocks of infectious agents from laboratory work (e.g., waste from autopsies and infected animals from laboratories), or waste from patients with infections (e.g., swabs, bandages, and disposable medical devices).

Pathological waste: human tissues, organs or fluids, body parts and contaminated animal carcasses.

Sharps waste: syringes, needles, disposable scalpels, and blades, etc.

Chemical waste: for example, solvents and reagents used for laboratory preparations, disinfectants, sterilant and heavy metals contained in medical devices (e.g., mercury in broken thermometers) and batteries.

Pharmaceutical waste: expired, unused, and contaminated drugs and vaccines.

Cytotoxic waste: waste containing substances with genotoxic properties (i.e., highly hazardous substances that are, mutagenic, teratogenic, or carcinogenic), such as cytotoxic drugs used in cancer treatment and their metabolites.

Radioactive waste: such as products contaminated by radionuclides including radioactive diagnostic material or radiotherapeutic materials; and

Conclusion

Medical waste is any waste that has the potential to cause harm to living things if not handled correctly. Medical waste can come from a variety of different sources, such as laboratories, hospitals, and assisted living facilities. It can also be generated from regulated health care activities involving animals. The type of waste, how it is generated, where it is generated, how it is transported, and how it is treated all depend on the type of waste it is. When in doubt about the best way to dispose of something, it’s best to check with your medical waste disposal company to make sure you’re following regulations. Medical waste generators are responsible for that waste until it is rendered non-infectious by a treatment plant, until then it is the generators responsibility, because of this you can see why choosing the right medical waste partner is so important to your operations.