Biomedical Waste

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Garbage is nothing but waste. Garbage is a big problem around the world. Landfills are getting filled, and many are beginning to leak into household water supplies or infiltrate the air of the factories and houses which are built on them. It’s a huge problem and getting bigger every year. There are different types of waste and one of them is BIO MEDICAL WASTE. Let’s see what is BIO MEDICAL WASTE?

Biomedical Waste
Biomedical waste, also known as infectious waste or medical waste is defined as solid waste generated during the diagnosis, testing, treatment, research or production of biological products for humans or animals. Biomedical waste includes syringes, live vaccines, laboratory samples, body parts, bodily fluids and waste, sharp needles, cultures and lancets.

Sources
• The main sources of biomedical waste are hospitals, medical clinics and laboratories. Because biomedical waste can be detrimental to human health, the law requires such facilities to follow procedures that protect the public from coming into contact with it. Agencies that regulate different aspects of biomedical waste include Occupational Safety and Health Administration (OSHA), Food and Drug Administration (FDA) and Nuclear Regulatory Commission.

CLASSIFICATION OF BIOMEDICAL WASTE
Approximately 75-90% of the biomedical waste is non-hazardous and as harmless as any other municipal waste. The remaining 10-25% is hazardous and can be injurious to humans or animals and deleterious to environment. It is important to realise that if both these types are mixed together then the whole waste becomes harmful.

Categories
Biomedical wastes may be categorized as follows: • • • • • • • • • • Human Anatomical Waste: Human body parts, tissues and organs. Animal Waste: Animal body parts, carcasses, excreta, bleeding parts and wastes generated at veterinary hospitals. Microbiology and Biotechnology Waste: Wastes from laboratory cultures, live or attenuated vaccines, human and animal cell culture used in research, wastes from biological toxins. Waste Sharps: Needles, syringes, blades, scalpels. Discarded Medicines Soiled Waste: Cloth containing blood stains, blood coated cotton balls, soiled plasters. Solid Waste: Waste generated from disposable items like tubing and catheters. Liquid Waste: Waste generated from laboratory housekeeping activities. Incineration Waste: Ash generated from incineration of biomedical waste. Chemical Waste: Chemicals used for disinfection.

Containment
• Biomedical waste like sharps should be contained in leak proof, rigid, puncture- and break-resistant containers that are tightly lidded and labeled before storage, transport or disposal. Biomedical waste excluding sharps should be placed in leak proof plastic bags strong enough to prevent tearing, ripping and bursting open under normal conditions. The container holding the biomedical waste should be labeled with the international biohazard symbol.

Management
• Biomedical waste can be managed properly by ensuring proper segregation at the source, the use of accurate packaging (leak resistant, puncture resistant and not susceptible to degradation by cleaning agents in case the packaging is reused), appropriate color coding, proper in-house movement of waste (minimizing employee exposure to biomedical waste in a workplace), designating waste storage areas and ensuring safe disposal.

Disposal
• Biomedical waste can be disposed of through incineration or decontamination by heating with steam under pressure in an autoclave. Trash chutes must not be used for the transfer or disposal of biomedical waste.

What Is the Origin of Biomedical Waste?
Biomedical waste is any waste fabricated during the diagnosis, testing, treatment, research or production of biological materials by either animals or mankind. Biomedical waste has the potential to be hazardous to human health if it is left unregulated.

Biomedical Waste Facilities
• Biomedical waste facilities, such as hospitals, clinics, nursing homes, laboratories, funeral homes, dentist offices, veterinarian or physician complexes, medical transporters (e.g., ambulances) and storage and treatment facilities for biological entities, all produce biomedical waste.

Human and Animal Biomedical Waste
• Human body parts, tissues and organs, as well as animal body parts, carcasses, excreted bodily wastes, parts containing blood and wastes generated at veterinary hospitals produce biomedical waste.

Microbiology and Biotechnology Biomedical Waste
• Microbiology and biotechnology cultivate biomedical waste in the form of laboratory cultures, live or non-live vaccines, human and animal cell cultures used during research and biological toxin waste.

Secondary-Contact Biomedical Waste
• Items that come into contact with biological-waste functions are also considered biomedical waste originators. Needles, syringes, blades, scalpels, blood stained material or cotton balls and dirtied plasters are a few such examples.

Synthetic Biomedical Waste
• Discarded medicines, used tubing and catheters, chemicals used for disinfection purposes and any waste that is a consequence of laboratory upkeep are all instigators of biomedical waste as well.

Altered Biomedical Waste
• Even if biomedical waste is chemically altered, by fire or by water, it is still classified as biomedical waste. Thus, ashes created from burned biomedical material or diluted formulas containing biomedical waste are also origins of biomedical waste.

Biomedical Waste Disposal Methods
Discharging untreated biomedical waste into the environment is a prohibited practice, according to the Maine Department of Environmental Protection. It defines biomedical wastes as all material that may contain human pathogens in hazardous concentrations, including sponges, surgical gloves, masks, dressings, syringes, needles, lancets, capillary tubes, scalpel blades and dialysis unit waste. Treatment methods for biomedical waste include incineration, steam sterilization and chemical decontamination.

Incineration

It is a waste treatment process that involves the combustion of organic substances contained in waste materials.

Incineration destroys harmful microorganisms and toxic substances often contained in biomedical waste. It is also the method for destroying recognizable human anatomical remains, reports Environmental Health and Safety at the University of California. The disadvantage of this method is that it releases persistent pollutants to the air, including dioxin and toxic metals such as mercury, reports the Center for Environmental Studies at Virginia Commonwealth University. Medical waste incinerators are a major contributor of dioxin pollution to the environment.

Steam Sterilization
• Steam sterilization is a process of submitting biomedical waste to high pressure saturated steam at a minimum temperature of 249.8 degrees F for at least 20 minutes before its disposal. This treatment uses a machine called an autoclave. Although most pathogens such as bacteria and viruses are destroyed at high temperatures and pressures, some resistant strains of the microorganism that causes Creutzfeldt-Jakob disease, a brain degenerative disorder, can survive steam sterilization, says Margaret Alexander in “Nursing Practice: Hospital and Home: The Adult.”

Chemical Decontamination
• According to Environmental Health and Safety at University of California, chlorine, quaternary ammonium and phenolic compounds can treat liquid or semi-liquid biomedical waste. However, this method brings environmental disadvantages when used in excess to treat bio-contaminated waste water. Quaternary ammonium compounds, or quats, are hazardous to most wildlife, especially fish and other aquatic creatures.



BIO MEDICAL WASTE MANAGEMENT PROCESS 1. Segregation • ƒ Biomedical waste must be stored in a secure environment at all times. • ƒ Whenever possible, biomedical waste must not be mixed with chemical, radioactive or other laboratory trash. • ƒ The various types of biomedical waste should be segregated from each other. • ƒ Fluid waste should be contained separately from solid waste.

This may be unavoidable (i.e. radioactive carcasses) and in such instances special handling may be required. For further information contact ORM.

2.

Containment & Labelling

Containers for biomedical waste must be appropriate for its contents. There are several different kinds of containers and bags available for the containment and disposal of biomedical waste. The various types of packaging and associated labelling used for different types of biomedical waste are outlined below. All containers for biomedical waste must display the biohazard symbol and the words ‘Biohazard’ in a colour contrasting the container.

3. Treatment
If not sent off-site for disposal, all biological waste should be decontaminated prior to disposal (including level 1 agents). Decontamination of waste results in the destruction or removal of microorganisms to a lower level, such that there is no danger of infection to others. The two main choices for waste decontamination at the University of Ottawa are autoclaving (preferred) and chemical disinfection. Waste that has been decontaminated or disinfected is no longer considered biomedical waste. Therefore, once the waste has been treated it can be disposed of in the regular waste stream. Any waste that cannot be treated (i.e. sharps, carcasses, tissues and body parts) remains biomedical waste and must be incinerated off site.

4. Handling/Transportation • • • • • •
ƒUntreated waste should be handled as little as possible. ƒAvoid contaminating exterior surface of waste container, or ensure exterior surfaces are decontaminated. ƒAvoid transport of untreated waste through non-lab or high traffic corridors. ƒSecondary containers must be used when transporting waste (especially for liquids). The secondary containers should be decontaminated after use. ƒWhenever possible use carts with raised sides for transport. ƒEnsure containers or bags are tightly closed or taped shut during transport

5. Collection Collection of biomedical waste varies for different services or faculty/departments depending upon waste generation practices, available resources or management approaches. For more specific information contact your service or faculty/departmental representative (Appendix A). 6. Storage Although biomedical waste should be treated as promptly as possible it can be held temporarily. Treatable waste should not be allowed to accumulate. Waste that is to be disposed off-site should be stored in designated areas which are secure and access is limited to delegated individuals. To prepare for off-site disposal the following measures must be undertaken. 7. Disposal

Biomedical Waste (BMW) Frequently Asked Questions
1. What is biomedical waste? Biomedical Waste (BMW) means any infectious, pathological and/or chemotherapy waste generated during the administration of medical care or the performance of medical research involving humans or animals. The definition of BMW excludes hazardous and radioactive waste as defined in state law. Some examples of BMW include blood and other bodily fluids, sharps, discarded animal carcasses known to have been exposed to an infectious agent, etc. 2. Who generates BMW? A "generator" of BMW is any person who owns or operates a facility that produces BMW in any quantity. This includes, but is not limited to, the following: hospitals, skilled nursing facilities, laboratories, physicians’ offices, veterinarians, dental offices, funeral homes, industry, etc. In the case where more than one generator of BMW is located in the same building, each individual business entity is considered a separate generator. Note: waste generated by an individual at home is specifically not regulated as BMW. 3. Is BMW regulated as hazardous waste? BMW is regulated as hazardous waste only if it contains a listed hazardous waste or exhibits a hazardous characteristic per the CT Hazardous Waste Management Regulations. 4. What are "sharps"? Sharps are discarded needles and lancets that have been used in animal or human patient care/ treatment or in medical, research, or industrial laboratories. Sharps include items such as hypodermic needles, syringes, dental carpules, and scalpel blades. Please note that certain exemptions apply to farmers. For a list of qualifying items see CGS section 22a-209b(13).

5. How should individuals at home dispose BMW? Sharps used at home are not regulated as BMW. However, throwing them in the household trash or flushing them down the toilet presents serious risks for both you and others who may come in contact with such items. Improper disposal of sharps can lead to: • • • Needle-stick injuries that cause infection and spread disease; Injuries to curious children, waste haulers, recycling workers, and animals; or Needles washing up on our beaches and riverbanks.

The DEEP recommends checking with your supplier (i.e. your physician, local hospital, or pharmacy) to see if they are willing to accept properly packaged used sharps. Some companies even offer mail-back disposal services to their customers. To properly dispose of sharps: • • • Seal them in rigid, puncture-resistant containers that you can’t see through (i.e. bleach or detergent bottles, coffee cans, etc.); Label the containers "Do Not Recycle;" and Reinforce containers with heavy-duty tape before throwing them in your household trash.

DO NOT: • • • • Throw loose needles in the trash; Flush needles down the toilet; Place needles in soda bottles, cans, or glass containers; or Put sharps containers in the recycling bin.

6. Who is allowed to ship used sharps through the mail? Homeowners and small quantity BMW generators (those who produce less than fifty pounds of sharps per month) may ship their used sharps via the mail. In CT, sharps are the only kind of BMW that may be shipped through the mail. This is usually accomplished via mail-back services that send a special container for their customers to use. 7. Who can accept BMW from households? Hospitals and regional hazardous waste collection facilities can legally accept BMW generated by households. Check first with a local hospital or your town to see if there is a facility that does so. 8. Is BMW generated by visiting health care nurses at homes of patients regulated by the DEEP? Yes. BMW generated in the home during the administration of medical care (e.g. sharps, IV bags, etc.) is regulated. We also encourage healthcare providers to accept BMW generated by their patients, since many patients lack knowledge of proper disposal techniques. 9. How should BMW be disposed? BMW must be packaged, labeled, and marked as required by state regulations. Generators and permitted BMW transporters must deliver the waste to a permitted "BMW treatment facility" to store, treat, or dispose the waste. The methods of treatment/ disposal are as follows: • Chemotherapy waste – by incineration

• •

Pathological waste (i.e. human tissue, organs, body parts) – by incineration Infectious waste (i.e. body fluids or items dripping with body fluids, discarded sharps, BMW generated from research, etc.) – either by incineration, discharge to a sanitary sewer, treatment by steam sterilization or other alternative treatment technology.

BMW may be treated in accordance with methods specified in the regulations. If treated, BMW must be rendered unrecognizable in order to be disposed as municipal solid waste. 10. Can I dispose BMW in a sewer? Yes, but chemotherapy and pathological waste must NOT be disposed in a sewer under any conditions. Only infectious wastes that are not pathological or generated from chemotherapy can be discharged to a sanitary sewer, provided the waste is in liquid or in semi-solid form, the sewage treatment plant does not prohibit the discharge and secondary treatment is provided and all discharge permits are obtained. 11. What are CT’s BMW packaging and labeling requirements? Before transporting BMW, the generator must: • • • • • Place the waste in a red bag to render it universally recognizable as BMW. Package it in rigid, leak and moisture resistant containers. Use a container that is strong enough to avert tearing or bursting under normal circumstances and seal it to prevent leakage. Make sure each container displays the universal biohazard symbol or the words "BIOHAZARD" in large, easy-to-read lettering. Never reuse a container that housed BMW for any purpose unless: a. its surfaces were protected from contamination through the use of a liner or bag that was removed with the waste, or b. it has been thoroughly washed and disinfected, with all visible traces of prior contamination removed.

12. How should BMW be stored? BMW must be stored so that it avoids being mixed with other materials, and access to it must be limited to personnel authorized by the generator, transporter, or BMW treatment facility operator to handle it. Outdoor storage areas, such as dumpsters, sheds, or trailers, must be locked. The areas used for storage must be constructed of finished materials that are impermeable and can be easily maintained in a sanitary condition. BMW storage should be in a manner and location that protects it from water, precipitation, wind, animals, and does not provide a breeding place or food source for insects or rodents. BMW may be refrigerated during storage to maintain a non-putrescent state. Finally, a sign displaying the universal biohazard symbol and/or the words "BIOHAZARD" must be posted wherever BMW is stored. 13. What should be done with used BMW containers? Disposable containers must be disposed with the BMW. Reusable containers must be cleaned and decontaminated prior to usage. 14. Can other types of waste be mixed with BMW? Yes, but with varying processing rules. If BMW is mixed with hazardous waste it is regulated as hazardous waste. Likewise, if it is mixed with radioactive waste it is subject to radioactive waste regulations. If BMW is mixed with other forms of solid waste, then the combined waste must be managed as BMW. However, properly treated BMW from approved treatment facilities that is physically unrecognizable may be disposed as municipal solid waste. 15. Are BMW generators required to implement a written BMW Management Plan?

Yes. A BMW Management Plan must be written for each facility and contain policies and procedures for the segregation, mixture, treatment, and disposal of BMW. An OSHA Exposure Control Plan may suffice if it provides for these policies and procedures. 16. May I transport / treat BMW without a permit in CT? Any person in the business of transporting BMW must obtain a BMW transporter permit issued by the DEEP pursuant to RCSA section 22a-209-15(g). Homeowners and small quantity BMW generators may transport their own waste under specific conditions. See the BMW regulations for more details. BMW treatment facilities located in CT must also obtain a DEEP permit. To receive the most current list of permitted transporters/ treatment facilities contact the DEEP or visit our website. 17. What are the BMW tracking requirements? A generator who transports or offers for transport BMW must use the tracking form in Appendix 1 of RCSA section 22a-209-15 to track its movement from the site of generation to a permitted BMW treatment facility. It is necessary to prepare at least the number of copies that will provide the generator and each transporter with one copy, and the operator or each BMW treatment facility where the waste is headed with two copies. A transporter may not accept BMW without a tracking form. For exceptions to the rules and more detailed guidelines, see RCSA section 22a-209-15(h). 18. I am a licensed hazardous waste transporter. Do I need a separate permit to transport BMW? Yes. CT requires separate permits for transporting hazardous and BMW. 19. Are trauma scene responders subject to BMW requirements? No, but any BMW generated at the scene must be managed in accordance with the BMW regulations. Entities engaged in this business should provide appropriate training to their employees and contract with a licensed transporter to ensure compliance with current regulations. 20. Are ambulance or emergency service vehicles allowed to transport BMW to any hospital? Yes. Many hospitals accept BMW that comes in with the trauma victim. If the ambulance does not have the time or resources to transport BMW, emergency service vehicles may also take it to the hospital. If the hospital refuses to accept the waste, entities should either take it back to their own facility for eventual pickup by a BMW transporter or drop the waste off at a permitted treatment facility. 21. Should hospitals let patients take home BMW (limbs, organs, etc.)? The DEEP is aware that hospitals may get requests from patients to take home their pathological waste for religious or other reasons. However, since hospitals bear the responsibility for BMW generated at its facility, allowing this practice places the public in danger of improper disposal. Hospitals should exercise caution and restraint when deciding on this delicate matter by doing their best to educate their patients about proper disposal techniques. 22. What should be done to clean up a BMW spill? Secure the spill area with personnel using protective equipment described in RCSA section 22a-209-15(e). Damaged containers and spilled BMW must be placed into red plastic bags that meet the requirements outlined in the regulations. Spill responders must decontaminate the affected area and take any other appropriate clean-up measures. Finally, any reusable equipment used in the clean-up process must be cleaned and decontaminated; non-reusable equipment must be appropriately bagged, and disposed. For more details call the DEEP’s Emergency Response and Spill Prevention Section at (860) 424-3024. 23. What should I do if I come across suspected BMW?

Do not handle the waste yourself. You should call your town’s health department or the DEEP’s Emergency Response and Spill Prevention Section at (860) 424-3024. 24. How should waste generated from a veterinarian’s office be treated? Objects from animals known or suspected to have been exposed to infectious diseases (such as bloodsoaked bedding, etc.), or any other BMW generated from treatment or research in a veterinary hospital must be managed as infectious waste and incinerated.

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