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All about Medical Waste Disposal Vol.6

1. A (Brief) History of Medical Waste Removal

For Regulated Medical Waste Management Disposal Services call Patriot ShreddingBelieve it or not, medical waste management, removal and disposal is still a rather new topic considering the hundreds of years behind medical treatments and innovation.

We started realizing the need for proper medical waste removal when, in the late 1980s, beaches were being littered with disposed syringes, medications, and other healthcare-related waste. Pretty alarming, right?

The federal government had already established laws to protect our water resources through the River and Harbor Act of 1886 and the Federal Water Pollution Control Act of 1948, but it wasn’t until 1965 that the federal government made a solid waste management plan. Congress passed the Solid Waste Disposal Act (SWDA), the first effort to implement a comprehensive management framework for the nation’s solid waste.

But this was an all-encompassing law, and it’s because of the lack of distinction that medical waste started flooding, quite literally and figuratively, our waterways and beaches. It was then that we saw other laws, such as the Resource Conservation and Recovery Act (RCRA), to be implemented by EPA. The goals of RCRA were to protect the environment, conserve resources, and reduce the amount of waste being generated. RCRA gave us the first regulations for the management of hazardous waste. This included the identification of solid and hazardous wastes, standards for generators of hazardous waste, standards for transporters of hazardous waste, and standards for hazardous waste disposal facilities.

With illegal medical waste still an issue for the environment, we come to the Medical Waste Tracking Act (MWTA) of 1988, a “United States federal law concerning the illegal dumping of body tissues, blood wastes, and other contaminated biological materials.”

It seems rather surprising that it took until the late 1980s to have mandated laws for such a community and environmental health issue, but it was a step that further advanced the Solid Waste Disposal Act.

While medical waste disposal is primarily regulated at the state level, federal laws have dictated the safety and efficacy of how each state implements waste removal, disposal, and treatment.

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2. Medical Waste Control

Patriot Shredding Medical Waste Disposal ServicesWaste, in general, is any substance (solid, liquid, or gas) that has no direct use and is discarded permanently. A waste is considered hazardous if it exhibits any of the characteristics such as being flammable, reactive, explosive, corrosive, radioactive, infectious, irritating, sensitizing, or bio-accumulative. Medical waste is limited to infectious, hazardous, and any other wastes that are generated from health care institutions, such as hospitals, clinics, dental offices, and medical laboratories. The management of medical waste has been of major concern due to potentially high risks to human health and the environment. In the past, medical wastes were often mixed with household wastes and disposed in municipal solid waste landfills.

Hassan et al., 2008 report a survey on Bangladesh hospitals that generate a total of 5562 kg/day of wastes, of which about 77.4% are non-hazardous and about 22.6% are hazardous. The average waste generation rate for the surveyed hospital is 1.9 kg/bed/day or 0.5 kg/patient/day. The study reveals that there is no proper, systematic management of medical wastes except in a few private hospitals that segregate their infectious wastes. Some cleaners were found to salvage used sharps, saline bags, blood bags and test tubes for resale or reuse. In Bangladesh, proper medical waste management is a new phenomenon and the government of Bangladesh is trying to develop a new and modern approach to deal with medical waste properly. Project in Agriculture, Rural Industry, Science and Medicine (PRISM-Bangladesh), a reputed national NGO in Bangladesh, with the financial support from the Canadian International Development Agency

(CIDA) has recently developed a disposal facility for low-cost medical waste treatment and management in Dhaka City.

Similarly, the generation of medical waste in Korea has been increasing in quantity and variety, due to the wide acceptance of single-use disposable items (e.g. gloves, plastic syringes, medical packages, bedding, tubing, and containers). In recent years, increased public concerns over the improper disposal of medical waste have led to a movement to regulate the waste more systematically and stringently by the Korea Ministry of Environment. Waste minimization and recycling are still not practiced, thus significant amounts of medical wastes are to be disposed. Incineration is the main method of medical waste treatment in Korea.

In the United Arab Emirates (UAE), there are over 800 clinics and hospitals that generate hazardous medical wastes [5,6]. The main method of medical waste treatment in most countries of the Middle East is incineration; however, other techniques that produce less pollution are now being introduced. The literature shows numerous case studies on the mismanagement of medical wastes as described above for illustration purposes.

Medical Waste Tracking Act and Definition

The World Health Organization (WHO) has classified medical waste into different types: a) Infectious: material-containing pathogens in concentrations high enough to cause diseases on exposure. This includes waste from surgery, lab cultures, used dressings, and others. b) Sharps: disposable needles, syringes, blades, broken glasses. c) Pathological: tissues, organs, body parts, human flesh, blood and body fluids. d) Pharmaceuticals: drugs and chemicals that are returned, spilled, expired or contaminated. e) Chemical: waste resulting from diagnosis, or cleaning material. f) Radioactive: waste contaminated with radioactive substances used in the diagnosis and treatment of diseases. g) Pressurized containers including gas cylinders; and h) Substances with high heavy metal content: broken mercury thermometers, blood pressure gauges. Infectious, pathological and sharps are the most dominant types of medical waste.

The definition of medical waste excludes waste containing microbiological cultures used in food processing, urine, saliva, and nasal secretions unless they contain blood. Like any household and office, medical facilities also generate general wastes such as paper and plastic that are not dangerous to human beings. Medical waste such as sharps (i.e. needles, syringes, scalpels, etc.) can endanger humans in a non-infectious way.

Regardless of its quantity and where it is generated, medical waste has serious sometimes fatal effects on exposure. Medical staff, janitors, medical center visitors, and patients are exposed to the risk of infection and diseases as a result of exposure. Thus, medical waste hazards and risks exist not only for the waste generators and operators but also for the general community including children who play near disposal areas. The possible exposure pathways include direct contact, airborne transmission, contaminated water sources and the environment in general.

Medical Waste Management Techniques

  • Segregation
  • Separating Different Categories of Medical Wastes
  • Disinfection
  • Incineration
  • Disinfection by Plasma
  • Emerging Technology

Medical wastes are highly hazardous and put people under risk of fatal diseases. The understanding of medical waste management and control techniques is important. In this paper, introductory materials on the definition of medical waste, medical waste management regulatory acts, the risks of exposure, medical waste management procedures and control techniques are presented.

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