Medical waste disposal requires a specialized level of care.
Toxicity concerns are considerable when it comes to managing medical waste, but so are the sheer number of waste types found in facilities that typically produce this type of waste.
As a medical waste generator, you are responsible for managing all aspects of your waste, from the moment it is generated to its final disposal. Not doing so will put you in jeopardy of violating the Resource Conservation and Recovery Act (RCRA) and may result in substantial fines and penalties.
Disposing is more than simply driving the waste to the landfill, however. Certain medical waste must be treated before it is properly disposed of, while other items can be recycled to help promote your institution’s sustainability efforts.
Below we’ll explore these medical waste disposal methods, as well as what you need to know about resources available that can help you properly dispose of your medical waste.
Medical Waste Types
There are several types of medical waste. While some are hazardous, others are non-hazardous. However, each waste type may have its own set of requirements for disposal. Even the volume of the waste may determine how it is disposed of.
If you manage a hospital, research facility, pharmacy, blood blank, dental office, nursing home or other type of healthcare institution in the United States, you know the importance of proper medical waste disposal. Knowing your disposal requirements begins with recognizing the type of waste that you have on-hand.
Here is a list of different categories medical waste typically falls under.
Chemical Waste
Chemical waste is common in medical facilities and includes:
- Cleaners and disinfectants like ammonia, phthalates, glycol ethers, glutaraldehyde and formaldehyde
- Laboratory chemicals like acids, peroxides, methanol, acetone, hydroxides and isopropanol
- Pesticides like carbaryl, glyphosate and pyrethrins
- Industrial paints that include volatile organic compounds
- Chemicals found in IV bags and tubing like PVCs, dioxin and phthalates
- Brominated flame retardants found in items like hospital beds, waiting room chairs and hospital privacy curtains
Chemical waste disposal must be thoughtfully considered to avoid devastating effects on waterways, soil, wildlife and human life.
Laboratory Waste
Laboratory waste is often found in hospitals and university labs, but also common in research facilities. Laboratory waste disposal can involve discarding hypodermic needles, biohazards, drugs, mixtures and solutions, and cleaning agents. This waste may come in liquid, solid or compressed gas form.
While some lab waste is disposed of through various treatment methods, some waste like ethyl alcohol, xylene and formalin can be recycled, distilled or filtered.
Pharmaceutical Waste
Some pharmaceutical waste is considered hazardous based on its ignitability, corrosivity, reactivity and toxicity. Listed hazardous wastes include a variety of drugs, from epinephrine to nitroglycerin and many chemotherapy agents.
Chemotherapy Waste
Chemotherapy waste includes controlled substances like morphine and hydrocodone, and trace chemotherapy waste like IV bags, tubing, vials and syringes. Bulk chemotherapy waste are drugs that do not meet the threshold for being considered “empty” by the RCRA, as well as items that are used in the event of a spill or extremely contaminated personal protective equipment (PPE).
Dental Waste
Examples of dental waste include mercury, dental amalgams used for fillings and x-ray developer chemicals. Lead is also used in dental offices as foil for x-ray packets, x-ray protective aprons and boxes for storing x-ray film.
Biomedical Waste
Infectious biomedical waste is a concern in different types of medical facilities, from hospitals to dental offices. Blood-saturated gauze, swabs and compresses are common, as are sharps waste.
Other types of biohazardous waste include body fluids, pathological waste, body parts, organs, tissues, blood products and human blood. Handing these potentially infectious items with care are important to avoid infectious diseases.
Non-Hazardous Medical Waste
The majority of healthcare waste (85%) is not classified as hazardous, according to the World Health Organization. Examples of non-hazardous medical waste include plastic packaging, clean glass and plastic, paper and cardboard, and office products. In California, aerosol cans are not considered hazardous waste as long as they are completely depleted.
Non-Medical Waste
Although some waste items aren’t exclusive to medical environments, they are still often found in physician’s offices, hospital, labs, clinics and testing facilities. You are still required to properly dispose of this waste, which may include developing a plan to take care of items like kitchen waste, solid waste and universal hazards like pesticides, cleaning fluids and batteries.
Electronic waste is another common type of waste found in facilities, and in California, many types of e-waste are considered hazardous. Examples of electronic waste include lab equipment, computers, servers, tablets and televisions.
Medical Waste Treatment Methods
Before any waste is disposed of in landfills, it must be determined whether that waste is safe. There are several treatment technologies that sterilize medical waste before it is disposed of, effectively making it less hazardous.
Treatment of medical waste helps ensure infectious waste, potentially infectious agents or toxic items do not seep into the soil or nearby water sources at landfills and create a risk to the environment and the general public.
Below are some of the treatments being used today.
Autoclaving
Autoclaving provides sterilization through steam. Though autoclaving is a good solution for sterilizing microbiological wastes, it is not an appropriate solution for other types of waste such as pathological and toxic chemicals.
Chemical Disinfection
Chemical disinfection is usually reserved for chemical and liquid waste. Chlorine is a common chemical used during this process. The types of microorganisms in the waste and how contaminated the product is determines whether this is an effective choice for sterilization.
Microwaving
Irradiative sterilization uses the same technology as microwaves to disinfect waste. Waste is shredded and mixed with water. The waste is then heated so that all biological elements are neutralized.
Incineration
Incineration typically used as a disposal method for pathological waste and pharmaceutical waste. During this process, medical waste incinerators reach temperatures as hot as 2,000 degrees F. Trace chemotherapy waste is permitted under California law to undergo the incineration process.
Where Medical Waste Gets Disposed Of
Knowing where to dispose of medical waste can be complicated since some medical waste is hazardous while other types are non-hazardous. Guidance in your disposal options is key since making a mistake can put you in jeopardy of violating the Resource Conservation and Recovery Act (RCRA), OSHA rules, California Department of Public Health rules, Environmental Protection Agency (EPA) regulations and California state environmental laws.
Drop-off Sites
Drop-off facilities are designed to make the disposal of medical waste easy. In California, there are several sites available for different types of medical waste, from sharps needles to pharmaceutical medications.
This option offers convenience, but most locations on the CalRecycle site only accept limited types of medical waste. While these sites can be a great choice for businesses that generate small amounts of regulated medical waste, many only accept waste generated in the residential sector. Therefore, it’s important to check with that drop-off site before going to ensure it will accept commercial waste.
Treatment, Storage and Disposal Facilities (TSDF)
If your business generates significant amounts of medical waste and waste that is not accepted at drop-off sites, it’s likely your waste will need to be disposed of at a treatment, storage and disposal facility (TSDF).
In order for that waste to get to treatment facilities it will need to be taken by a licensed hazardous waste transporter if that waste is potentially harmful to the environment and human health.
Hazardous waste disposal companies have distinct advantages. Perhaps one of the greatest is that they have access to and can transport your medical waste to the appropriate medical waste treatment facility that will accept it. This includes out-of-state facilities licensed to accept certain types of waste.
The best medical disposal companies will also use sampling and testing methods to identify any unknown wastes to ensure you are meeting all appropriate federal and state regulations. If you regularly generate waste, they can also provide schedule pickups.
Landfills Or Incinerators
As we mentioned above, incineration is a popular way to dispose of some types of medical waste, including pathological waste and pharmaceutical waste.
If your medical waste has been chemically treated or sanitized, it may also be disposed of in a landfill. Many of these landfills will have protections in place to keep waste from seeping into the soil around it. The design of a landfill may include a liner, a leachate collection system and cover, as well as regular monitoring of methane levels and groundwater.
Medical Waste Recycling Facilities
Certain kinds of medical waste can be disposed of through recycling. Although most items one would think of as “medical” must go through special procedures for disposal, there are several items found in medical, pharmaceutical and medical research facilities that can simply be recycled.
For example, items commonly found in the healthcare industry include:
- Office paper and cardboard
- Aluminum and steel cans and other food containers
- Glass bottles
- Plastic containers
- Newspapers
In fact, the World Health Organization points out that of all the waste produced by health care facilities and activities, 85% of that waste is non-hazardous.
In addition to the solid waste items mentioned above, several items found in healthcare facilities are considered universal hazards, such as:
- Fluorescent lights
- Pesticides
- Batteries
- Lamps
- Electronic devices
- CRT glass
- Non-empty aerosol cans
Though many of these items are recyclable, they cannot simply be thrown into a recycling bin and instead require proper sorting and removal by an experienced medical waste disposal vendor.
Medical Waste Disposal And Management Services
Knowing the proper disposal methods for each type of medical waste that your facility generates is critical to ensuring that you meet all waste disposal guidelines.
Hazardous waste, certain controlled substances and even dental waste streams all require very specific disposal methods to ensure hazardous chemicals and substances do not cause devastating effects. Even the same type of waste may require different disposal methods depending on the quantity.
It’s also important to note that your particular substance disposal procedures may differ from another organization’s, even when disposing of the same substance, according to the U.S. Drug Enforcement Administration (DEA).
That’s why it is important to work with a trusted and experienced medical waste disposal provider to ensure your waste streams are disposed of properly and according to your specific requirements.
When choosing a medical waste handling and disposal partner, look for a company that:
- Identifies wastes using sampling and testing methods
- Offers prompt pickups and scheduled pickups to meet your needs based on your waste volume
- Handles all required information and paperwork associated with your waste
- Transports waste to medical waste facilities
It’s also essential that a company you choose has extensive experience in medical waste management. There are many hazardous waste disposal vendors in the market. Not all hazardous waste disposal companies have experience in medical waste disposal.
Medical waste disposal is a very specialized field and requires the utmost care and experience to ensure that you accurately identify your waste stream, characterize it and properly transport it … all while avoiding any health hazards.
Our article, Choosing The Right Vendor For Medical Waste Disposal Los Angeles, explores the experience level that your waste disposal company should have, as well as how you can ensure your transporter is registered and legal.
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