The Medical Waste Tracking Act of 1988 defines medical waste as “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.” Medical waste can be classified into four different categories: infectious, hazardous, radioactive, and general.
Infectious waste
Waste that has the possibility of causing infections to humans. It can include human or animal tissue (blood or other body parts), blood-soaked bandages, discarded surgical gloves, cultures, stocks, or swabs to inoculate cultures. Many waste stream in this category, including human or animal tissue, can also be labeled as pathological waste, which requires specific treatment methods. Pathological waste is either known or suspected to contain pathogens.
Hazardous waste
Waste that has the possibility to affect humans in non-infectious ways, but which meets federal guidelines for hazardous waste under the Resource Conservation and Recovery Act (RCRA). Hazardous waste includes chemicals, both medical and industrial. Some hazardous waste can also be considered infectious waste, depending on its origin and exposure to human or animal tissue prior to discarding. Old drugs, including chemotherapy agents, are sometimes hazardous. Although not RCRA waste, sharps are hazardous in that they can cause injuries. Among waste managers, sharps are objects that can puncture or lacerate the skin; they include needles and syringes, discarded surgical instruments such as scalpels and lancets, culture dishes, and other glassware.
Radioactive waste
Radioactive waste can be generated from nuclear medicine treatments, cancer therapies, and medical equipment that uses radioactive isotopes. Pathological waste that is contaminated with radioactive material is usually treated as radioactive waste rather than infectious waste. Mos hospitals generate radioactive waste and even some doctors’ offices and veterinary offices if they offer brachytherapy.
General waste (Municipal Solid Waste)
About 85% of waste generated at medical facilities is no different from general household or office waste and includes paper, plastics, liquids, and any other materials that do not fit into the previous three categories. Waste professionals refer to this as municipal solid waste, and it is usually disposed of in landfills.
An alternative classification scheme comes from The World Health Organization. The WHO classifies medical waste into:
- Sharps
- Infectious
- Pathological
- Radioactive
- Pharmaceuticals
- Others (often sanitary waste produced at hospitals)
Pathological waste and Clinical waste
Pathological waste is included in the above categories but is designated separately because of the potential psychological impact on observers. It consists of recognizable tissues, organs, and body parts derived from animals and humans. If you can tell the waste came from a living organism, it is pathological waste: Material removed from the body in surgery and fluids and solids removed in autopsies is pathological waste, with the exception of teeth. More on pathological waste.
In the United Kingdom, the term clinical waste is used. The UK’s Controlled Waste Regulations (1992) defines clinical waste as having some human or animal tissue, used swabs or dressings, pharmaceutical products, blood or bodily fluids, or syringes, needles, or other sharps.
Regulated waste
In the US the term regulated waste is used in healthcare contexts mostly to refer to worker safety standards and procedures. OSHA promulgated rules for dealing with bodily fluids called the Bloodborne Pathogens standard. It refers to regulated waste as blood or “other potentially infectious materials” (OPIM) and items contaminated with these materials as well as pathological and microbiological wastes containing blood or OPIM. (Feminine hygiene products do not count as regulated waste, and OSHA has ruled that bandages that are not saturated to the point of releasing fluid if compressed don’t count either.)
Management of regulated waste
OSHA’s Bloodborne Pathogens Standard requires that healthcare facilities dealing with regulated waste have an Exposure Control Plan to protect workers and minimize the chances of transmission of hepatitis C, hepatitis B, and HIV. The plan is supposed to specify which employees have routine contact with blood and blood products and what to do after an exposure.
OSHA also requires that regulated waste be put in closable containers and that if there is any chance of leaks from those containers, that a second container is employed.
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