News
Infectious Waste Segregation Guidelines
INFECTIOUS WASTE SEGREGATION
GUIDELINES
PREPARED BY
AMERICAN MEDICAL WASTE PROFESSIONALS LLC
(AMPRO)
5/20/07
INFECTIOUS WASTE
Infectious waste means waste that epidemiologic evidence indicates is capable of transmitting a dangerous communicable disease (as defined in the Indiana State Department of Health regulations, 410 IAC 1-3-5). The term includes, but is not limited to:
1. Pathological wastes, including tissue, organs, body parts, and blood or body fluids in liquid or semiliquid form that are removed during surgery, biopsy, or autopsy.
2. Biological cultures and associated biologicals.
3. Contaminated sharps.
4. Infectious agent stock and associated biologicals.
5. Blood and blood products in liquid or semi liquid form.
6. Laboratory animal carcasses, body parts, and bedding.
7. Infectious wastes as defined in the Indiana State Department of Health regulations (410 IAC 1-3-5).
8. Other waste that has been intermingled with infectious waste.
Specific examples of these wastes include the following:
· Saturated or grossly spoiled disposables (bloody gauze, dressings, lab pads,
· Containers, catheters or tubes with fluid blood or blood products not discarded or flushed (blood sets, suction canisters, and drainage sets)
· Dialyzers and tubing
· Microbiology specimens, used culture plates, tubes, bottles and devices
· Blood spill clean up materials
· Placentas and surgical specimens
PATHOLOGICAL WASTE
The following infectious waste should be further segregated and clearly marked “Must Incinerate” on all four sides of the container. See AMPRO representative to obtain the proper marking.
· Pathological wastes consisting of consisting of recognizable body parts such as an amputated arm, leg, head or torso that may be of a size to not be properly treated by limited exposure to steam, could create and aesthetic concern for workers moving the bins of infectious that have been processed, or a potential concern at the landfill. Large animal carcasses should also be labeled for incineration.
· Antineoplastic waste or chemotherapy waste and any items trace-contaminated during the preparation or use of antineoplastic or chemotherapy drugs. Trace contaminated items include the following:
· Gowns
· Gloves
· Masks
· Barriers
· IV tubing
· Empty bags/bottles
· Empty drug vials
· Spill cleanup materials or kits
· HEPA filters from Pharmacy laminar air flow hoods
· Needles and syringes
· Infectious waste form the treatment of variant Creutzfeldt - Jakob disease, Creuzfeldt-Jakob Disease, or Mad Cow Disease.
New Look at P & U Waste
I have
been researching a relatively new twist on an old rule that may affect our
hospital clients. Recently, there
has been a growing concern that small quantities of P or U listed hazardous
waste may be finding its way into the infectious waste that we collect from our
client hospitals.
There are two basic ways that P and U listed waste
can end up in AMPRO's infectious waste stream:
1.
Through Chemotherapy
agents that are in our cytotoxin (yellow) containers. These agents
are:
Chlorambucil
U035
Cyclophosphamide
U058
Daunomycin
U059
Melphalan U150
Mitomycin C
U010
Strepozotocin
U206
Uracil Mustard
U237
As long as the pure agent is not in
the container and the container contains only trace amounts of these agents,
then the containers are “RCRA empty” and we can collect the material in the
yellow containers and process it as infectious waste. If the pure liquid is
present, then the waste is considered hazardous and must be handled by a
Hazardous Waste transporter and treated by a hazardous waste treatment facility.
This may require the nurses in the areas where these agents are being used to
segregate this agent from the tubing, bags and syringes that contain only trace
quantities of the agent.
- Through the disposal of expired
drugs. If any expired drugs contain any U or P listed waste, the expired drugs
must be handled as a hazardous waste and transported using a licensed HW
transporter and treated by a HW Treatment facility. This may require the
pharmacy to segregate drugs containing P and U listed waste from those drugs
that don’t have these materials in order to properly handle these
materials.
One final condition; if the
generator (hospital) generates less than 220 lb of these materials per month,
then the hospital is a “conditionally exempt generator” and legally does not
have to comply with these rules. My recommendation is to comply with these rules
no matter what quantity. This may be an issue during accreditation and its
better to be on the safe side.
I've uploaded some good resources in PDF format on this topic (see links below). The most complete is the document “Managing Pharmaceutical Waste”. The first 22 pages of this document should be studied. Click to view these documents.