Contaminated Medical Waste

 
Medical wastes can be categorized as infectious or 
noninfectious.  Infectious wastes include human or biological 
waste and any items that may be contaminated with pathogens.  
Noninfectious--but still hazardous--wastes include toxic 
chemicals and flammable and/or explosive waste.
 
Any biomedical waste which is generated requires disposal.  
Much of the waste is hazardous and must be packaged, 
transferred, and disposed of properly to protect the persons 
handling it and the environment.
 
INFECTIOUS WASTE MANAGEMENT PLAN
 
This plan has been developed to maintain compliance with 
state and local regulations.  This plan will assist in 
    - Designation of waste that should be managed as 
      infectious,
    - Segregation of infectious waste from noninfectious 
      waste, 
    - Packaging, storage, treatment, and disposal of 
      infectious waste,
    - Planning for contingency measures in emergency 
      situations, and
    - Staff training.
 
1.  Types of Infectious Waste
 
    Infectious wastes may be classified as isolation wastes, 
    cultures and stocks of infectious agents, and associated 
    biological products and human blood, pathological wastes, 
    contaminated sharps, body parts, and/or miscellaneous 
    contaminated wastes.  The primary types of wastes are:
 
   A.  Biomedical waste which includes any solid or liquid 
        waste which may present a threat of infection to 
        humans, including nonliquid tissue, body parts, 
        blood, blood products (serum, plasma and other blood 
        products), and body fluids from humans; and 
        laboratory wastes which contain human disease-causing 
        agents.  The following are also included:
        i.  Used materials saturated, soaking or dripping
            with blood, blood products, body fluids, or 
            excretions or secretions contaminated with 
            visible blood.
        ii. Non-absorbent, disposable devices that have been 
            contaminated with blood, body fluids or, 
            secretions or excretions visibly contaminated 
            with blood, but have not been treated by an 
            approved method.
    B.  Pathological waste including tissue, organs, body 
        parts, and body fluids that are removed during 
        surgery.  Body fluids are those fluids which have the 
        potential to harbor pathogens, such as human 
        immunodeficiency virus and hepatitis B virus and 
        include blood, blood products, lymph, semen, vaginal 
        secretions, cerebrospinal, synovial, pleural, 
        peritoneal, and pericardial and amniotic fluids.  
        Body excretions such as feces and secretions 
        including nasal discharges, saliva, sputum, sweat, 
        tears, urine, and vomitus shall not be considered 
        biomedical waste unless visibly contaminated with 
        blood.
    C.  Contaminated sharps are hypodermic needles, syringes, 
        Pasteur pipettes, broken glass, and scalpel blades. 
        These items should be considered infectious wastes 
        because of the possibility of contamination with 
 
   blood-borne pathogens.
    D.  Miscellaneous wastes that are not designated as 
        infectious should be assumed to be infectious and 
        should be managed as such to maintain consistent 
        levels of protection for both the environment and for
        workers handling these wastes. Miscellaneous wastes 
        include those from contaminated equipment.
    E.  Contaminated equipment refers to discarded equipment 
        and parts that are used in patient care, medical and 
        industrial laboratories, research, and the production 
        and testing of certain pharmaceuticals.
 
2.  Identification and Point of Generation of Biomedical 
    Waste
 
    The types of infectious waste generated include 
    biomedical waste, pathological waste including body 
    fluids, miscellaneous wastes, and contaminated 
    equipment.  Such infectious waste is generated in all 
    patient areas and in the toilet facilities.  Infectious 
    waste, when identifiable, is immediately segregated from 
    general office waste at the point of origin.  Waste which 
    is doubtful for contamination, thereby falling under the 
    definition of infectious waste, must be considered as 
    contaminated and segregated as such into the appropriate 
    biohazard container--sharps container or red bag.
 
3.  Treatment and Disposal Methods
 
    Several methods are used for infectious waste treatment, 
    depending on the type of waste material.  These treatment 
    methods include steam sterilization, thermal 
    inactivation, chemical disinfection, and removal by a 
 qualified waste disposal contractor.  After treatment, 
    the wastes or their ashes can be disposed of  by 
    discharge into sanitary sewer systems (for liquid or 
    ground-up waste) or burial in sanitary landfills as 
    approved by the governing legal jurisdiction.
 
    We maintain a contract for transport from the site of all 
    contaminated waste not treatable on-site.  Contractor
    assumes responsibility for compliance with state and 
    Federal regulations referable to terminal disposal of 
    biomedical waste. 
 
4.  Steam Sterilization (Autoclaving)
 
    Steam sterilization (autoclaving) involves the use of 
    saturated steam within a pressure vessel at temperatures 
    high enough to kill infectious agents in the waste. This 
    method of processing waste is not used by this facility.
    
5.  Separation of Infectious and Noninfectious Wastes
 
    Infectious and noninfectious wastes should be separated 
    at the point of generation. If the infectious waste 
    contains noninfectious hazards, it should be identified 
    and subjected to additional treatment.
 
    Infectious waste should be discarded into clearly 
    identifiable containers or plastic bags that are 
    leakproof and puncture-resistant.  Red bags and labels 
    are usually used for identification of  infectious waste. 
    The containers should also be marked with the universal 
    symbol for biological hazards.
 Packaging/Containment: General Handling of Containers
 
    Infectious wastes should be contained from the point of 
    origin to the point at which they are no longer 
    infectious. The packaging should be appropriate for the 
    type of waste involved; it must endure handling, storage, 
    transportation, and treatment. 
 
    A.  Liquid infectious wastes can be placed in capped or 
        tightly stoppered bottles or flasks. 
 
 
    B.  Solid or semisolid wastes may be placed in plastic 
        bags, but the following precautions must be 
        maintained:
        i.    Only tear-resistant bags are permitted. 
        ii.   Sharps must be placed in impervious, rigid, 
              puncture-resistant containers made of rigid 
              plastic or similar materials.
        iii.  Bags must not be loaded beyond capacity, weight 
              or volume.
        iv.   Bags should be protected from coming into 
              contact with sharp external objects.
        v.    Filled red bags shall be sealed at the point of 
              original, prior to removal from those 
              locations.  ('Sealed' is defined as: tied or 
              otherwise secured to prevent leakage or 
              expulsion of contents.)
        vi.   All filled red bags and sharps containers shall 
              be transferred to the storage area.
        vii.  When handling or transporting plastic bags of 
              infectious waste, care must be taken to prevent 
              tearing the bags. 
 
  Sharps must be placed in an approved sharps 
        container:
        i.    Prior to putting sharps containers into use, 
              tops must be securely snapped or affixed into 
              place.  Once filled, the cover or lid of the 
              container shall be securely closed, in 
              accordance with the manufacturer's 
              instructions.
        ii.   Sharps containers shall never be filled above 
              the 'full line'.
        iii.  Sharps containers shall be kept secure and out 
              of the reach of small children and unauthorized 
              personnel.
 
 
        iv.   Sharps containers may be kept until full to
              the 'full-line' provided that no soft or non-
              biomedical waste are contained within.
    D.  Spills of biomedical waste shall be handled via the 
        following procedure:
        i.    Persons cleaning spills of biomedical waste are 
              to wear appropriate personal protective 
              equipment.
        ii.   The contents of the spill shall be removed by 
              mechanical means (tongs, dust pan and broom, 
              etc.); such contents are never to be gathered 
              using hands--even when wearing protective 
              gloves.
        iii.  All surfaces contaminated with spilled or 
              leaked biomedical waste shall be cleaned with a 
              solution of industrial strength detergent (such 
              as Cavicide) before being disinfected with a 
              solution of 10% chlorine bleach.
   Any cloths used in cleanup shall be disposed of 
              in the red bag and handled as though containing 
              broken fragments.
 
7.  Handling and Transportation
 
    On-site biomedical waste is stored in a sanitary 
    condition in a vermin-free area. 
 
    When waste is to be moved about for treatment or storage, 
    special handling or packaging is necessary to keep bags 
    intact and to ensure containment of the waste. The 
    following precautions should be maintained:
 
    A.  Containers of sharps must be placed within a rigid or 
        semi-rigid container such as a cart, bucket, box, or 
        carton lined with a plastic bag.  Recyclable 
        containers and carts that are used repeatedly for 
        transport and treatment of bagged waste should be 
        disinfected after each use. Single-use containers 
        should be destroyed as part of the treatment process.
    B.  Containers should be covered with the lids during 
        transport. Infectious waste shall not be compacted
        on-site. This process could damage the packaging and 
        disperse the contents of the package.
    C.  Transport containers, usually 30-gallon boxes, shall 
        be used for in-facility storage of biomedical waste 
        before transport; such containers shall be sealed 
        prior to transport to the exterior storage 
        container.  Extra boxes are stored in the facility 
        for use as necessary.
 
8.  Exterior Storage
  Infectious waste should be stored for a minimum amount of 
    time.  Prior to storage it should be packaged securely 
    enough to ensure containment of the waste and to prevent 
    penetration by rodents and vermin.
 
    Infectious waste should be discarded into clearly marked 
    containers that are puncture resistant and leak-proof.  
    Red bags and/or labeling are usually used to designate 
    infectious waste. The containers should also be marked 
    with the universal symbol for biological hazards.
    
    Limited access to any storage area is a must.  The 
    universal biological hazard symbol should be posted on 
    the storage area door, waste containers, freezers, or 
    refrigerators. A sign with the words warning of the 
    infectious waste hazard is also recommended.
 
    Containers for biohazardous material should be a 
    designated, distinctive color.
 
9.  Records and Training
 
    Records relating to handling and transport of biomedical 
    waste shall be maintained in the administrative offices 
    for at least three years.  These records may consist of 
    pickup service manifests, receipts, and other documents.  
    Training program materials will be maintained as a part 
    of these records.
 
    All employees shall be trained as a part of the 
    orientation process and annually on procedures for 
    handling and transport of biomedical waste.  Formal 
 training, will be held annually.  A listing of 
    employees who attend each training program will be 
    maintained.  The program will cover all pertinent 
    components of this written plan.
 
 
Approved By Governing Board    
SP.4
Control #178.2
GUPTA GASTRO