Medical institutions generate waste like any other place, company, or industry. This waste is known as medical waste and differs from regular household and office waste. It contains different substances and materials that are potentially harmful or infectious. Therefore, it needs to be handled carefully.
This article will teach you all you need to know about medical waste – its meaning, types, and how to manage it properly. Let’s get into it!
What is Medical Waste?
Medical waste, also called biomedical waste, is any waste material generated from medical institutions like hospitals, clinics, medical research laboratories, diagnostics centers, or pharmacies. It can be obtained from any medical or biological activity such as diagnosis, prevention, or treatment of illnesses and diseases. Medical waste could be infectious, potentially infectious, or cause physical injury if not correctly disposed of.
Medical waste is a form of hazardous waste. Examples of medical waste include:
- Blood and materials containing blood
- Microbial cultures from medical laboratories
- Identifiable body parts. e.g., amputations
- Used bandages and wound dressings
- Human or animal tissue
- Scalpels, needles, syringes, and catheters
Institutions That Generate Medical Waste
Medical waste is generated by institutions that diagnose, prevent, and treat diseases in living humans and institutions that preserve and cater to the dead. The following are institutions that generate medical waste:
- Hospitals and health clinics
- Nursing homes
- Physicians' offices
- Emergency medical services
- Morgues and funeral homes
- Animal research and testing laboratories
- Blood banks and collection services
- Medical research laboratories
Types of Medical Waste
Medical institutions perform different activities daily, with no two being the same. As a result, they generate different types of medical waste. This doesn't reduce their risk of being infectious, dangerous, or hazardous; it simply means that they have to be sorted, treated, and disposed of separately and differently to ensure safety.
Medical waste is split into four major categories. Other types of medical waste fall under these major categories. They are as follows:
- General Medical Waste
- Infectious Medical Waste
- Hazardous Medical Waste
- Radioactive Medical Waste
1. General Medical Waste
This type of waste makes up most of the non-hazardous waste in a medical institution and doesn't pose any chemical, radioactive, biological, or physical hazard.
Materials that fall under general waste include:
- Paper
- Plastic
- Glass
- Food
- Other office waste
Since they pose no hazard, general medical waste can be disposed of regularly. They don't require special handling to be disposed of.
2. Infectious Medical Waste
Infectious medical waste is waste that could be potentially infectious and transmit diseases to humans and animals. It's usually separated from other wastes using special packaging and handled with extreme caution by trained professionals to eliminate the risk of infections.
Below are materials that fall under infectious medical waste:
- Personal protective equipment (PPE)
- Waste contaminated with blood and other bodily fluids – for example, discarded diagnostics samples
- Cultures and stocks of infectious materials from laboratory work, like waste from autopsies (human or animal) and waste from infected animals or humans.
- Wound dressings
- Sharps, including scalpels, needles, and lancets that have been used on an animal or human
- Pathological waste such as amputations and recognizable body parts and organs.
Infectious waste is disposed of in red bins or containers mainly by incineration. Different cities have different rules for the storage, transport, disposal, and processing of infectious medical waste.
3. Hazardous Medical Waste
Hazardous medical waste encompasses all materials that are physically dangerous but don't cause infections in humans or animals. This type of waste usually possesses characteristics that make them too dangerous to be combined with other types of waste.
Here are materials that fall under hazardous medical waste:
- Sharp objects: unused or expired sharp objects like needles and scalpels that could cause injuries rather than infections if not properly disposed of.
- Chemical waste: corrosive chemicals, reagents, and solvents used in laboratory preparations, sterilants and disinfectants, metals contained in medical devices (like mercury in a microwave), and batteries.
- Pharmaceutical waste: expired and unused drugs, injections, and vaccines.
- Cytotoxic waste: waste that is highly mutagenic, carcinogenic, or teratogenic. Drugs used in cancer treatment fall under this category.
- Poison
- Fluorescent light bulbs
Like infectious medical waste, hazardous waste has specific packing and storage instructions to minimize the risk of injuries. It's disposed of in yellow bins or containers and handled with extreme care by trained professionals.
4. Radioactive Medical Waste
Radioactive medical waste comprises all wastes that contain radioactive material or have been exposed to radioactive isotopes or radionuclides. If handled without proper attention, radioactive medical waste could be the most deadly of all medical wastes.
Most radioactive medical waste is generated from radioactive therapy and nuclear medicine. Materials that fall under radioactive medical waste include:
- Sharps used for radiation purposes
- Clothing and utensils exposed to radioactive isotopes
- Disposable materials exposed to radiation
Radioactive medical waste is usually stored in green bins with the symbol for radioactivity on them. It needs to be collected by trained professionals and treated until harmless before it can be thrown away.
Medical Waste Management
Due to the potentially harmful nature of medical waste, it needs to be monitored from the point it is generated to the point it is disposed of. Medical waste management is the process of sorting, storing, treating, and disposing of medical waste following an area's medical waste disposal policy to guarantee its safety and protect the people in contact with it from generation to disposal.
Where Does it Go?
Due to its potentially infectious and hazardous nature, medical waste must be treated before being disposed of in a sanitary landfill. However, this depends on the type of medical waste and the type of treatment that it will undergo.
As general medical waste (which consists of household or office waste) makes up 85% of medical waste, it can be disposed of regularly. Hazardous, infectious, or radioactive waste must undergo autoclaving or incineration before any safe remnants are carried to a sanitary landfill.
Medical Waste Disposal
Medical waste disposal includes the ways medical waste is sorted, treated, and disposed of safely without causing injury or infection to humans. Aside from general medical waste, which can be disposed of normally, other medical wastes must go through treatment before they become safe.
There are two main medical waste treatment methods. Each is peculiar to each type of medical waste but ensures safety and sterility so that it can be disposed of properly. They are:
- Autoclaving
- Incineration
Autoclaving
Autoclaving is a sterilization method whereby objects are placed in an autoclave to be treated under high pressure and temperature using steam to kill off all microorganisms and spores. The efficacy of autoclaving relies on the principle that the boiling point of water (steam) increases under high pressure.
An autoclave sterilizes and disinfects medical instruments, laboratory apparatus, and medical waste. The ideal treatment conditions in the autoclave are 121°C (250°F) at 6.8kg (15 pounds) per square inch for 30-60 minutes.
Autoclaving is used for treating infectious medical waste and sharp objects to kill off any microorganisms that could cause infections. After treatment in the autoclave, medical waste can proceed to recycle or the sanitary landfill.
Incineration
Incineration is the controlled combustion of waste products to destroy any organic material. It aims to destroy medical waste into incombustible inorganic materials that would be safe for disposal. It also helps eliminate microorganisms and pathogens from medical waste and reduce them to ashes. The end products of incineration are ashes, flue gas, and heat. The ashes are the solid components left of waste put into the incinerator. They are inorganic and incombustible.
General, infectious, and hazardous medical waste can be treated and disposed of using an incinerator. Some forms of hazardous waste, such as pharmaceutical or chemical waste, require higher temperatures than most to be destroyed.
Other types of medical waste disposal methods include:
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Chemical treatment
This is the process of using chemicals to kill or deactivate pathogens present in medical waste. It's mainly used for infectious waste such as sharp objects and liquid waste such as urine, blood, and hospital sewage. However, pathological waste such as body parts and animal carcasses is not treated using chemicals.
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Encapsulation
In this medical waste disposal method, sharps, chemicals, and pharmaceutical wastes are poured into high-density polyethylene or metallic cubes. The cubes are not entirely filled, and the remaining portion is filled with mortar. It is then dried and sealed before disposal. Encapsulation is unsuitable for other types of infectious waste besides sharps, but it can be used after burning such waste.
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Inertization
This is the process of combining medical waste with cement and other substances before disposal. It reduces the chances of toxic waste mixing with groundwater or surface water. It's most suitable for pharmaceutical waste and incineration ashes with high metallic content.
Medical Waste Disposal Policy
Medical waste disposal policy is the set guideline that medical institutions must follow when disposing of their waste to ensure the protection of every person involved in the generation, handling, and disposal of medical waste.
According to the Centre for Disease Control and Prevention, here are the guidelines for proper medical waste disposal:
- Use a single, leak-proof biohazard bag to contain regulated medical waste, as long as it is sturdy and the waste it contains can be disposed of without coming into contact with the bag's exterior. A leak or puncture to the bag requires placement into another biohazard bag.
- Puncture-resistant containers should be used to collect sharps – used or unused. Avoid recapping, bending, or breaking needles to avoid needlestick injuries and possible infections.
N.B: Additional precautions should be put in place by medical institutions to prevent the production of aerosols when handling items contaminated with blood – especially for rare diseases like Ebola Virus or Lassa Fever.
- Health institutions should create on-site storage facilities for medical waste before terminal treatment. These storage facilities should be emptied regularly to avoid accumulation. Medical waste requiring storage should be kept in labeled, puncture-resistant, and leak-proof containers that prevent or minimize foul odors. The storage area should be well-ventilated and watertight from pests.
- Regulated medical waste should be treated to reduce the microbial population in the waste to make it safer for handling and disposal. Its absolute sterility is not compulsory because it won't be deposited at a sterile site.
- Waste from laboratories and microbiological processes should be treated in the autoclave at 121°C for 90 minutes before further activities are carried out.
Disclaimer: The above information should not be used as a medical waste disposal policy guide. To know how to reduce medical waste and the appropriate and lawful methods to dispose of it, consult your local or state government medical waste management authorities.
Medical Waste Disposal Services
A medical waste disposal service is a licensed outfit with trained professionals who are experts in the management and disposal of medical waste following the medical waste disposal policy of the area in which they operate. They assist medical institutions in medical waste pickup, sorting, storing, and disposing, preventing injury or infection.
The cost of medical waste disposal varies depending on what type of waste to dispose of, the volume of the waste, and the competency of the waste disposal services. Generally, they offer two types of payment agreements. A contract agreement where the time limitation for providing the service is specified.
People typically pay $200 to $400 monthly for medical waste disposal. In a service agreement that is less formal and the time frame can be adjusted, medical waste disposal costs are less than $100 a month.
Regulated Medical Waste
Regulated medical waste includes all waste material generated in the production, research, and testing of health care and biological theories. Waste in these categories is primarily infectious, pharmaceutical, and pathological medical waste.
Regulated Institutions
Regulated institutions are medical institutions that produce waste that could be classified as regulated medical waste. Examples of regulated institutions include:
- Hospitals, nursing homes, and physicians' offices
- Clinical laboratories, including research laboratories
- Veterinary hospitals
- Funeral homes
- Home health service providers
- Pharmaceutical companies
- Universities with basic medical or clinical microbiology laboratories
- Blood banks
Regulated medical waste falls into which hazard class?
Regulated medical waste could fall into any of the following categories, depending on the institution that generates it:
- Infectious medical waste
- Pathological medical waste
- Pharmaceutical medical waste
- Sharps
Regulated medical waste falls into which packaging group?
Regulated medical waste falls into the PGII packaging group. It belongs to Hazard Class 6, Division 6.2. A Division 6.2 infectious substance (which includes regulated medical waste) is a dangerous material that’s regulated strictly by the Hazardous Materials Regulation (HMR).
The Hazardous Materials Regulations (HMR) are issued by the U.S. Department of Transportation (USDOT). The rules and regulations control the transportation of hazardous materials in interstate, intrastate, and foreign commerce.
Hence, due to the potentially infectious toxic nature of regulated medical waste, all the personnel — HazMat (Hazardous Materials) employees — involved in transporting it undergo rigorous training.
Conclusion
Medical waste cannot be treated as regular waste because it's potentially harmful and can spread pathogens. Consequently, you would want to check out references and statistics from the World Health Organisation regarding medical waste. Lastly, don't hesitate to contact us for more information on medical waste or our medical waste services.