Medical waste

Any solid waste that is generated in the diagnosis, treatment, or immunization of human beings or animals, in research pertaining thereto, or in the production or testing of biologicals. Since the development of disposable medical products in the early 1960s, the issue of medical waste has confronted hospitals and regulators. Previously, reusable products included items such as linen, syringes, and bandages; they were sterilized or disinfected prior to reuse, and the principal waste product was limited to human pathological tissue.

Most hazardous substances are described by their relevant properties, such as corrosive, poison, or flammable. Medical waste was originally defined in terms of its infectious properties, and thus it was called infectious waste. However, given the difficulty of identifying pathogenic organisms in waste that might cause disease, it has become standard practice to define medical waste by types or categories. While definitions differ somewhat under different regulations, in the United States the Centers for Disease Control and Prevention (CDC) cite four categories of infective wastes that should require special handling and treatment: laboratory cultures and stocks, pathology wastes, blood, and items that possess sharp points such as needles and syringes (sharps). These categories require that the generator of these wastes exercise judgment in identifying the material to be included.

The waste category that has generated a great deal of interest is sharps. Needles and syringes, in particular, pose risks, since the instruments can penetrate into the body, increasing the potential for disease transmission. Improper disposal of these items in the past has been the catalyst for increased regulation and tighter management control.

Treatment of medical waste constitutes a method for rendering it noninfectious prior to disposal in a landfill or other solid-waste site. The treatment technologies currently used for medical waste include incineration, sterilization, chemical disinfection, and microwave, as well as others under development. See also Hazardous waste.

Any discarded biologic product, such as blood or tissues, removed from operating rooms, morgues, laboratories, or other medical facilities. The term may also be applied to bedding, bandages, syringes, and similar materials that have been used in treating patients, as well as animal carcasses or body parts used in research.

Medical waste is generally defined as any solid waste generated during the medical diagnosis or treatment of humans or animals, in related research, or in the production of biologicals used in clinical activities. Concern about medical waste streams has been growing. Syringes washing up on New Jersey beaches in the 1980s following massive illegal dumping of medical wastes into New York harbor threw a spotlight on the issue. Similar beach problems have occurred in Britain and have been suggested to be a cause of hepatitis B among users of recreational waters.

A number of factors make management of medical wastes more difficult than other waste streams. Standard landfill disposal is complicated by the potential for infection of workers and of the general public. On-site incineration of hospital wastes, a common practice that effectively destroys infective organisms, is of increasing concern as a source of dioxins due to the high chlorine content of many of the disposable plastics in common medical use. Local opposition has made it more difficult to site and plan hospital incinerators. Mercury from amalgam fillings discarded in dental offices has been suggested to be a cause of mercury discharge into surface water from publicly owned water-treatment works.

While there are federal guidelines concerning medical wastes, including a 1989 Medical Waste Tracking Act administered by the U.S. Environmental Protection Agency (EPA), the major regulatory control is by state and local authorities. The increased cost of safe disposal of medical waste has led to efforts to reduce the size of the waste stream, including consideration of a return to reusable syringes, endoscopy tubes, and other medical devices. This requires a careful assessment of the tradeoff with simplicity of use, certainty of sterility, and lower costs provided by the disposable items. There is also a tradeoff between increased medical-waste disposal costs and the likelihood of illegal dumping. Clinically useful plastics formulated without chlorine are also being actively sought to decrease the risk of dioxins from incineration.

Not all medical waste comes from obvious point sources such as hospitals, doctors' offices, clinical laboratories, and research facilities. Over a million syringes are used at home by diabetics and others on a daily basis. This has led to community-based approaches to collect and safely dispose of these syringes and needles. Similarly, the trend toward shorter hospital stays means postoperative patients are more frequently discharged to their homes with surgical dressings and other potentially contaminated medical paraphernalia. Chronic infectious diseases are also now more likely to be treated at home than in a hospital. Patients, families, and visiting nurses should be instructed in the proper handling of these wastes. Landfilling of medical wastes is a particular problem in many developing countries, where scavenging of landfills is an organized activity among the poor. In addition to exposure to infectious agents, there have been instances where discarded radioactivity sources, such as cobalt used in the treatment of cancer, have been recycled into the community with devastating effects.

(SEE ALSO: Environmental Protection Agency; Municipal Solid Waste; Ocean Dumping; Sewage System)

Bibliography

Phillip, R.; Pond, K.; and Rees, G. (1997). "Research and the Problems of Litter and Medical Wastes on the U.K. Coastline." British Journal of Clinical Practice 51(3):164–168.

Phillips, G. (1999). "Microbial Aspects of Clinical Waste." Journal of Hospital Infection 41:1–6.

Thomas, C. S. (1977). "Management of Infectious Waste in the Home Care Setting." Journal of Intravenous Nursing 20(4):188–192.

— BERNARD D. GOLDSTEIN

Medical waste, also known as clinical waste, normally refers to waste products that cannot be considered general waste, produced from healthcare premises, such as hospitals, clinics, doctors offices, labs and nursing homes.

Contents 1 Europe 2 United Kingdom 3 United States 4 References 5 See also 6 External links

Europe

In Europe, wastes are defined by their European Waste Catalogue (EWC) Codes. EWC Codes are 6 digits long, with the first two digits defining the over-arching category of waste, the next two defining the sub-category, and the last two defining the precise waste stream. Clinical waste comes under the "18" codes, for example: "18 01 01" corresponds to healthcare waste (18), from humans (01), that is sharp and not infectious (01).

United Kingdom

In the UK, clinical waste and the way it is to be handled is closely regulated ^[1]. Applicable legislation ^[2] includes the Environmental Protection Act 1990 (Part II), Waste Management Licencing Regulations 1994, and the Hazardous Waste Regulations (England & Wales) 2005, as well as the Special Waste Regulations in Scotland.

United States

In 1988 the Federal government passed The Medical Waste Tracking Act which set the standards for governmental regulation of medical waste. After the repeal of the act, States were given the responsibility to regulate and pass laws concerning the disposal of medical waste. All fifty states vary in their regulations from no regulations to very strict.

Disposal of this waste is an environmental concern, as many medical wastes are classified as infectious or biohazardous and could potentially lead to the spread of infectious disease. Examples of infectious waste include blood, potentially contaminated "sharps" such as needles and scalpels, and identifiable body parts. Sharps include used needles, lancets, and other devices capable of penetrating skin. Infectious waste is often incinerated.The most common method of sterilization is an autoclave . The autoclave uses steam and pressure to sterilize the waste. The preferred method for body parts is incineration. Additionally, medical facilities produce a variety of waste hazardous chemicals, including radioactive materials. While such wastes are normally not infectious, they may be classified as hazardous wastes, and require proper disposal.

References

1. ^ http://www.medical.initial.co.uk/regulations/index.php
2. ^ NetRegs - Current legislation lists

See also

• Eco-friendly dentistry
• Scavenger system

External links

• www.indmedica.com/journals
• Medical waste at the Open Directory Project

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