Medical Waste

The US Environmental Protection Agency (EPA) and the Occupational Safety and Health Administration (OSHA) set the regulations for the collection, treatment, and disposal of biohazardous waste. In addition, the Center for Disease Control (CDC) provides additional guidelines for the management and disposal of biohazardous waste. Finally, state and local authorities, as well as universities and individual facilities, may impose their own specific standards and practices as well.

Biohazard remediation is the process of thorough cleaning, sanitization, and deodorizing a site where a fatal accident has occurred. It is a category of hazardous waste management that requires the handling of human blood, body fluids, and feces; rendering workers potentially exposed to staph, hepatitis, HIV, and other communicable diseases.

Regulated Medical waste is classified within the packaging group PG II. Its correct shipping name is Regulated Medical Waste, n.o.s and it belongs in the Hazard Class 6, Division 6.2. A Division 6.2 infectious substance (which includes regulated medical waste) is a hazardous material that is subject to regulation under the Hazardous Materials Regulation (HMR). All employees involved in its transportation (including loading, unloading, handling and preparing or reviewing shipping papers) must be trained HazMat employees.

A medical waste generator is typically a person or business involved in the following activities:

• The diagnosis, treatment, or immunization of human beings or animals.
• Research pertaining to the activities specified above.
• The production and testing of biological agents.

Infectious medical waste is waste generated in the diagnosis, treatment or immunization of human beings or animals which has been or is likely to have been contaminated by an organism capable of causing disease in healthy humans. While waste generators must follow CDC isolation precautions, most discarded biological waste products or materials that are potentially infectious infectious can be disposed of as regulated medical waste.

Sharps waste is a stream of regulated medical waste composed of used "sharps", aka any device or object used to puncture or lacerate the skin. Common items typically categorized as sharps include hypodermic needles, disposable scalpels and blades, lancets, broken capillary tubes, and culture slides. All used sharps must be disposed of in an approved sharps disposal container.

Interchangeably known as biohazardous, biomedical waste or biowaste, this waste stream includes:

• Cultures of infectious diseases and/or agents
• Sharps (E.g., needles, scalpels, and lancets)
• Anything soaked in blood, like gloves, gauze, and gowns
• Human body tissues
• Animal body tissues
• Human body fluids
• Wastes from rooms of patients having communicable diseases
• Something containing environmentally-restricted molecules or organisms
• Multi-hazardous substances, so-called because they contain some combination of noxious elements wherein neutralizing one can make the other more dangerous (E.g. tissue samples preserved in formalin).

Any waste stream that contains blood, body fluids, or other potentially infectious materials is considered an RMW, also known as “biomedical” or “infectious medical” waste.

Sharps containers are designed to contain needles, syringes, lancets, scalpels and other sharp objects contaminated with blood or bodily fluids; gauze pads or other absorbent material that when squeezed would drip bodily fluids.

Not unless there are warranted exceptions. Linens are reused and therefore do not enter the waste stream. According to the Centers for Disease Control and Prevention, “Although soiled linen may harbor large numbers of pathogenic microorganisms, the risk of actual disease transmission from soiled linen is negligible…common-sense hygienic practices for processing and storage of linen are recommended." (From www.cdc.gov/HAI/prevent/laundry.html):

Medical waste autoclaves are used specifically for regulated medical waste, which involves anything contaminated by blood, bodily fluids, or other potentially infectious materials. That includes:

• Used medical sharps and sharps containers.
• Bloody bandages or gauze.
• Masks or gowns (worn by doctors or patients).

An autoclaving machine is a device that sterilizes regulated medical waste. It uses steam heated to approximately 300 degrees Fahrenheit to achieve this sterilization.

Certain operating specifics about this machine vary from state to state. For example, some states require the sterilized waste to also be shredded before being landfilled. Other states do not require this extra step. The amount of time the biohazardous waste needs to be in the actual machine also varies from state to state.

Any entity that transports toxic material must be properly “permitted” and licensed to do so. For the vast majority of hospitals & clinics, this means contracting a reputable company to transit RMW offsite to a treatment, storage, or disposal facility. Such waste must be accompanied by a specialized bill of lading, called a hazardous waste manifest. Other paperwork might be required, such as a land disposal restriction form. If required documentation is inaccurate or missing, legal culpability lies with your hospital or clinic, not with the transporter, therefore it's extremely important to understand who you're partnering with and have full knowledge of any subhaulers or third parties.

Medical waste should be contained separately from other waste at the point of origin. All regulated medical waste must be placed in a red bag or designated medical waste container (rigid, leakproof and leak-resistant with a tight fitting lid) labeled with the words "Biohazardous Waste" or with the international biohazard symbol and the word "BIOHAZARD."

Sharps containers should never be filled more than the manufacturer’s recommended fill level. If the manufacturer has not specified a fill level, up to ¾ full is the maximum recommended level to fill the sharps container before replacing.

As glass is something that could potentially puncture skin, it is considered a sharp and should be disposed of into a safety-grade sharps container.

Once they are full and sealed, single-use sharps containers can be disposed of in the regulated medical waste stream. This is typically a cardboard box or container correctly labelled and designated for Regulated Medical Waste (red bag waste).

Per federal regulation, medical waste generators are responsible for packaging and preparing their waste for collection. The process of preparing these wastes for collection is as follows:

Step 1: Line your container with a properly marked biohazard bag prior to use.
Step 2: Tie the bag when the container is full. Each bag must be hand-tied by gathering and twisting the neck of the bag.
Step 3: Secure the lid on the container. Make sure all closure and/or locking mechanisms are engaged. Red bags must not be visible once the container is closed.
Step 4: Check the containers markings. Ensure that federal markings (biohazard symbol, this-side-up-arrows, regulated medical waste, N.O.S., and UN number) are present. Ensure you’re complying with your individual state regulations.