Welcome to the fascinating and often overlooked world of medical waste management. You may not think of it as the most interesting topic around, but there’s more to medical waste than meets the eye.
From used bandages to radioactive isotopes, the stuff that gets thrown away in a medical setting can be pretty wild. If you’re not talking trash in your facility (and we mean in the good way), you could find yourself in a heap of garbage.
Improper disposal of medical waste can lead to serious consequences, including legal liabilities, fines and reputational damage. Handing off your medical waste to a disposal company simply isn’t enough. It’s critical to know what happens to medical waste that you generate once it is no longer in your hands, and why choosing a highly qualified medical waste disposal company is key to ensuring your organization is in good hands.
How Medical Waste Is Treated
Before medical waste is disposed of, it must be considered safe. There are several treatment technologies available today that sterilize medical waste before it is disposed of in order to make 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.
Here are some solutions used to treat medical waste:
Autoclaving provides sterilization through steam. Although 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.
Biological treatments use enzymes to neutralize hazardous waste, especially infectious organisms. However, this type of treatment is not yet commonly used today.
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.
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 is 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.
Microwaving with high-powered equipment takes hazardous medical waste and turns it into non-hazardous waste using heat. Once waste becomes non-hazardous, it can be disposed of in normal landfills or through an incineration process.
It’s also important to note that some medical waste can’t be treated using the methods above or simply don’t require treatment. For example, medical facilities can generate solid waste and universal hazards like pesticides and cleaning fluids. Non-medical waste removal would be required for these items.
Another example is electronic waste like computers and televisions. Many forms of e-waste are considered hazardous and would require the services of a hazardous waste disposal company.
Where Medical Waste Disposal Occurs
Where medical waste is disposed of often depends on the toxicity of the waste and any laws in place that govern where and how it can reach its final destination.
Knowing where to dispose of multiple types of medical waste can be complicated since some waste may be classified as hazardous, while others may be non-hazardous. Choosing the right destination for your waste is important since there are several regulations you must follow from organizations or laws like the Resource Conservation and Recovery Act (RCRA), OSHA, California Department of Public Health, Environmental Protection Agency (EPA) and the state of California.
Here are a few destinations your medical waste may end up after it leaves your facility:
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.
Landfills Or Incinerators
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. In fact, there are several items found in medical, pharmaceutical and medical research facilities that can be recycled. According to the World Health Organization, of all the waste produced by health care facilities and activities, 85% of that waste is non-hazardous.
For example, items commonly found in the healthcare industry that can be recycled include:
- Office paper and cardboard
- Aluminum and steel cans and other food containers
- Glass bottles
- Plastic containers
In addition to the solid waste items mentioned above, several items found in healthcare facilities are considered universal hazards, such as:
- Fluorescent lights
- 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.
How To Determine Where Your Waste Goes
Determining where your waste goes begins with understanding the different types of medical waste, their hazards and where regulations say that type of waste must ultimately go.
Most medical facilities have multiple waste streams. Even within their medical waste stream are multiple types of medical waste. Here are some of the most common types:
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 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.
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 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).
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.
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.
Bottom line: With a general understanding of these different types of medical waste, you can begin determining what type of facility each waste stream must be transported to where it will either be treated or disposed of. Determining this on your own can be challenging, which is why having a reputable medical waste disposal company by your side is crucial.
What To Look For In Medical Waste Disposal
Selecting a vendor to manage your facility’s medical waste is not as straightforward as randomly choosing a company online. You are responsible for ensuring the safe disposal of your medical waste, which makes selecting the right medical waste disposal company for your business an important decision.
One of the most common questions asked is whether a vendor must have a medical waste disposal license. According to the California Department Of Public Health, only medical waste transporters listed with the health department are allowed to transport medical waste.
Under this law, medical waste transporters must carry paperwork that the California Department of Public Health issues to them. To acquire this paperwork, transporters must meet a list of requirements that can be found in our article, Should A Disposal Company Have a Medical Waste Disposal License?
As we mentioned above, there are several types of hazardous and non-hazardous wastes that you may generate. Working with a waste disposal vendor that is experienced in medical waste is a must. An experienced disposal company will not only help you identify your medical waste but will also help you determine which regulations pertain to your waste to help make the disposal process go more smoothly.
Make sure that the company you are considering is able to provide you with the information you need to make the best decision for your medical or lab facility as well. The best vendors will provide you with:
- Documentation of compliance history
- Licenses and permits
- Proof that personnel are properly trained
- A statement of qualifications (SOQ)
- Whether subcontractors are used, and if so, which companies
- A list of references
One final trait of an experienced disposal company is if it offers a walk-through program. This type of program offers your business the opportunity for an expert in medical waste management to evaluate your company and offer any insights into needed areas of focus, such as:
- Waste storage evaluation
- Emergency readiness
- Hazardous waste evaluation
A walk-through program will give you confidence that the company you are about to work with not only has the experience necessary to safely and properly dispose of your waste but can customize a plan based on your facility’s specific needs.
While there are many vendors that will transport your medical waste off-site, choosing one that will dispose of your waste safely involves thorough research and consideration so that you can be sure your medical waste is in safe hands.