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Medical waste disposal. Medical Waste Committee (WT-3). Technical Council Air & Waste Management Association.

Medical (biomedical) wastes pose numerous potential health and safety hazards. In addition to their infectious and toxic characteristics, the highly variable and inconsistent nature of medical waste streams has increased public concern about storage, treatment, transportation, and ultimate disposal. In recent years, techniques have been developed to reduce human exposure to the toxic and infectious components of medical wastes. The most commonly used techniques include internal segregation, containment, and incineration. Other common techniques include grinding, shredding, and disinfection, e.g., autoclaving and chemical treatment followed by landfilling. Of all the available technologies for medical waste treatment and disposal, incineration has been found to be the most effective method overall for destroying infectious and toxic material, volume reduction, and weight reduction in the medical waste stream. Incineration destroys the broadest variety of medical waste constituents and can recover energy from the medical waste stream. Incineration also is an appropriate alternative to burial of human pathological remains.

Humans

Up from the beach: medical waste disposal rules!

The recent incidents of floating debris, garbage, wood, and medical waste on our nation's beaches have focused public attention on waste management problems. The handling and disposal of solid waste remains a major unresolved national dilemma. Increased use of disposables by all consumers, including the medical profession, and the increasing costs of solid waste disposal options have aggravated the solid waste situation. Medical waste found on beaches in the summer of 1988 could have been generated by a number of sources, including illegal dumping; sewer overflow; storm water runoff; illegal drug users; and inadequate handling of solid waste at landfills and coastal transfer facilities, which receive waste from doctors' offices, laboratories, and even legitimate home users of syringes. As officials from New Jersey have determined, the beach garbage is no mystery. It's coming from you and me. In response to the perceived medical waste disposal problem, various state and federal agencies have adopted rules to regulate and control the disposal of medical waste. This article outlines the more significant rules that apply to medical waste.

Medical Waste

[Medical waste disposal in private practice. Survey among a sample of general practitioners in Haute-Vienne].

The physicians are daily confronted to the problem of medical waste disposal. The risk for public health is low and particularly concerns the "sharps". This research has for objective the survey of factors influencing practices of liberal general practitioners in Haute-Vienne (France) about medical waste disposal. The chosen method is epidemiological survey through a questionnaire near a sample of 156 general practitioners. Most physicians declare practising medical waste selection and more than a half of them use appropriate disposal methods. But many physicians leave his waste during visits. The admission of the existence of a risk related to medical waste improves physicians' disposal practices (selection, appropriate disposal methods). The organization of training sessions meant for liberal health care workers and the setting of new methods of waste collecting may contribute to the improvement of physicians' practices in this field.

Adult

Inactivation of human immunodeficiency virus by a medical waste disposal process using chlorine dioxide.

OBJECTIVE: To study the ability of a medical waste disposal process using chlorine dioxide to inactivate human immunodeficiency virus type 1 (HIV-1). DESIGN: Stock HIV-1 (HTLV-IIIB strain) was treated with chlorine dioxide under the following settings: cell culture medium alone, culture medium with 25% blood, culture medium with medical supplies treated by the Condor machine (Winfield Environmental Corp., Escondido, CA). MT-2 cells in 96-well tissue culture plates were inoculated with serial tenfold dilutions of treated and untreated HIV-1. Cytopathic effect was read on day five, and the TCID50 (50% tissue culture infectious dose) was calculated. RESULTS: Treatment of HIV-1 with chlorine dioxide in culture medium alone resulted in a 5.25 log10 reduction in TCID50. Treatment of HIV-1 with chlorine dioxide in the presence of 25% blood caused a 6.25 log10 reduction in HIV-1 infectivity. Treatment of HIV-1 with chlorine dioxide in the presence of medical supplies treated in the Condor machine resulted in a 4.75 log10 reduction in HIV infectivity. CONCLUSIONS: Chlorine dioxide inactivated HIV-1 in vitro. Chlorine dioxide inactivated HIV-1 in the presence of blood and in the presence of medical supplies under conditions that simulated the conditions existing in the Condor machine.

Blood

Medical waste disposal: to burn or to landfill?

Conflicting regulations and varying definitions with regard to medical wastes and their disposal have long been a source of confusion for health care institutions attempting to resolve this problem. Presented for the interest of other concerned agencies are guidelines recently drafted by the task force on medical waste disposal of the Maryland Department of Health and Mental Hygiene for the handling and disposal of medical wastes.

Facility Regulation and Control

Guidelines for defining and disposing of medical waste.

Considerations of ecology, public health hazards, and rising health costs have been critically reevaluated in the matter of appropriate medical waste disposal at nursing homes and hospitals. The Maryland Department of Health has intermittently received reports from the public of human tissues, bandages, and other inappropriate, unaesthetic materials visible in landfill areas. The Department has experienced increasing concern for communicable disease transmission, e.g. hepatitis, to landfill waste handlers and to the general public. Incineration had been considered as an alternative to landfilling of medical wastes, but fear of increasing hospital costs dampened initial enthusiasm for this possibility, particularly when coupled with fears of air pollution by smoke and noxious fumes generated by incineration. Other problems requiring resolution were conflicting definitions of medical waste and disposal requirements by federal, state, and local regulatory bodies. On-site incineration of all waste generated at hospitals is proposed as an economical and ecologically feasible solution to this public health problem in Maryland.

California

[Management of waste disposal in medical institutions].

Recently new regulations were elaborated for the management of medical wastes in Austria, FRG, Canada and USA. There is no rule laying down the requirements of the management of medical wastes in Hungary. On the basis of foreign experiences the medical wastes are proposed to range into categories as follow: I. Waste that should be handled in special way within and outside the health care facilities. II. Waste, that should be handled in a special way within the health care facilities. III. General waste (municial-type waste). Basic requirement is the segregating collection of wastes. Color-coding is proposed to identify the content of containers and bags. Incinerators combined with pyrolysis and emission control unites should be preferred to the disposal of medical wastes. The author proposes to issue a rule setting out definitions and basic principles of management of medical wastes. Individual health care establishments should prepare own written policies and measures for waste handling appropriate to their specific requirements.

Austria

[Waste disposal from medical practices and laboratories].

The major part of wastes from medical practices can be classified as refuse without any further consideration or it can be used for recycling. However, certain waste products need a specific treatment; most of all, there are waste products that are infectious or that could mechanically cause injuries due to their design. The amount of infectious wastes that could be established in our waste-separation-model was extremely small and therefore, can easily be added to the refuse after adequate disinfection. Only practitioners themselves can decide on the spot which wastes need or not need to be disinfected.

Austria