Medical Waste Disposal

Medical waste is broadly classified as any item that comes into contact with body fluids. Specifically, it is any solid waste that is generated in the diagnosis, treatment or immunization of humans. This type of waste was once collected in special bags and plastic boxes in clinical settings and then disposed of like normal trash. However, this process was quickly found to spread diseases and viruses and potentially cause outbreaks.

Today, the red biohazardous containers and bags seen throughout hospitals and doctors’ offices are used to safely remove sharps, needles, and IV catheters that contain any human blood or bodily fluid. Medical waste also includes paper towels, wipes, gloves, syringes without needles, bandages or dressings with small amounts of dry blood or fluid, and any other material from medical care. Syringes with needles or sharp objects that can pierce through a plastic bag require a special storage container for additional protection.

Sharps disposal can be a tricky business. One needle stick can take a life, or deliver thousands in fines from the EPA or other government bodies. To make things worse, regulations are always in flux, and they can change drastically across state or even local lines.

The tendency is to “err on the side of caution.” Unfortunately, that can also send costs exploding through the roof.

Where’s the “sweet spot” for sharps disposal? In the waste disposal world, knowledge truly is power. Below, find answers to all your questions, from “What are sharps?” to sharps disposal best practices and more. Image Via: Wikimedia Commons

Sharps can be defined as “any object that can cut or pierce the skin.” In the medical world, there’s an added element from potential contamination by bloodborne pathogens. Because this combination can spread disease, proper sharps disposal is a priority in any healthcare facility.

The FDA recommends putting all sharps in a special sharps disposal container. After that’s done, there are three main disposal methods.

Mailback. This sharps disposal method literally sends the biohazardous waste through the mail. Since the sharps are properly packaged and labeled first, it’s safe and legal.
Collection. One sharps disposal choice is packaging medical waste on-site. A disposal company then comes to collect it and take it off for treatment.
On-Site Treatment. Some facilities elect for on-site sharps disposal. This is the most resource-intensive method since it requires specialized equipment.

Here are some examples of sharps requiring special disposal in a sharps container:

Needles. Hollow needles used for injecting medications.
Connection Needles / Connection Sets. Needles that connect to tubes. Mainly used for home hemodialysis patients.
Syringes. The “plunger” body used to inject drugs. May have needle attached.
Scalpels and other blades.
Lancets. AKA “fingerstick” devices. These short, double-edged blades are used to get blood drops for testing. (Think, “diabetes blood test prick.”)
Scissors used to cut flesh or dressings.
Infusion Sets. Tubing/needle systems used to deliver medications beneath the skin.
Glass. Even unbroken glass that hasn’t necessarily been contaminated may still need sharps disposal.
Epi Pens. Auto injectors pre-filled with epinephrine in case of anaphylactic shock.
Sharp Plastic may need special disposal.
Insulin Pens. Auto-injectors pre-filled with insulin for diabetics.

What are the different containers for sharps disposal? How many are there? What are the colors?

MedPro’s red sharps disposal containers come in several handy sizes. Each leakproof, puncture-resistant container comes with a prepaid mail-back shipping box, reducing waste disposal costs as much as 50%.

Sizes

1.2 Gallon Sharps Disposal System
8 Gallon Sharps Disposal System
2 Gallon Sharps Disposal System
18 Gallon Sharps Disposal System
3 Gallon Sharps Disposal System
28 Gallon Sharps Disposal System
5 Gallon Sharps Disposal System

The NIH lists several principles for the safe disposal of sharps.

The full list is here.

Healthcare staff should follow best practices for safe sharps handling and disposal. Important rules include handling sharps as little as possible, then immediately discarding them in a puncture-resistant, sealed container.

Sharps containers themselves are covered by several safe handling standards. Containers should be filled only to the “fill line,” closed between uses, and kept out of reach of the public.

Do you still have questions about sharps disposal?

MedPro has several informative blog posts about sharps.

Looking for sharps containers? Wondering what you can put in sharps containers, and what you can’t?

Trying to figure out what to do with sharps from your home? MedPro’s blog is a wealth of disposal information.

Here’s a sampling of titles:

Where Do I Get Sharps Containers?
When Should I Dispose of my Sharps Containers?
What Should I do with Used Needles?
How Do You Dispose of Sharps Containers from Home?
5 Things to Consider Before Purchasing Sharps Containers
What Can You Put in a Sharps Container?

For the full list of MedPro’s Medical Waste articles, click here

All sharps disposal companies are not created equal. Some carry different levels of insurance to protect their customers. Some hold their customers liable even while the waste is in transit. Certain companies levy much higher fees and charges for disposal. Some companies, meanwhile, offer waste disposal for as much as 50% less cost, with as much as $15 million in insurance to protect their clients.

Who’s liable for your medical waste? With some sharps disposal firms, you remain liable for your waste until it’s neutralized. With MedPro, you’re safe as soon as the waste leaves your facility.
How much insurance do they carry? Does your firm have enough insurance to protect you in the event of a catastrophe? MedPro carries $15 million in insurance.
How much experience does the company have? It’s as true in any business as it is in sharps disposal: experience matters. A smooth system of routes, processes, compliance, and affiliates doesn’t sprout up overnight.
Are they transparent and accessible? There’s no one-size-fits-all solution to medical waste disposal. Your sharps needs may be light or heavy, and your area may have very different EPA regulations than those a few miles distant. Pick a partner who will talk to you and work with you.
What are the fees? Find out what you’re paying, and what you’re paying for, up front. Waste companies can have very different fee schedules when it comes to sharps disposal.
Will they train your staff? Proper disposal of sharps starts with your own staff. Sharps must be packaged and shipped according to regulations. Some companies provide this training.
Are they compliant at every level? Sharps regulations vary by state, and even national disposal regulations can change. Choose a partner that’s always 100% compliant, up to date, and most of all, insured.

A sharps violation can cost even a small practice $70,000 or more. Fines can come from OSHA, the EPA, or other national or local government bodies. Almost all sharps violations are avoidable. All it takes is a little knowledge.

Here are some of the most common sharps disposal violations.

Disposing of sharps in non-compliant containers. Non-compliant containers include milk containers, water bottles, glass containers, or soda cans. All of these can puncture easily or break.
Placing sharps in the regular trash. This practice exposes employees and members of the public to needle sticks. It also introduces biohazards into landfills.
Bending or breaking needles before discarding. This is a habit thought by some to reduce the risk of needle sticks. In fact it’s been found to elevate the risk.
Improperly sealing sharps containers. Sharps containers must be sealed to prevent spillage, and to prevent sharps being squeezed out under pressure.
Incorrectly labeling containers. Sharps must be clearly labeled as biohazardous sharps in bright red, puncture proof containers.
Putting sharps in the wrong container. Sharps should never be disposed

A needle stick from a sharp can let a bloodborne pathogen in under your body’s defenses. That said, sticks don’t always mean infection. There’s a plan to fall back on if you’re injured by a sharp.

If you get a needle stick or a cut from a sharp, the CDC advises taking the following steps without delay:

1) Wash the cut/needlestick with soap and water.

2) Flush any splashes to your skin, mouth, or nose with water.

3) Irrigate eye contamination with saline, sterile irrigants, or clean water.

4) Report the needlestick or cut to a supervisor. 5) Seek immediate medical treatment.

5) Seek immediate medical treatment.

Sharps disposal is one of the most important duties of any healthcare worker. Proper disposal keeps us safe from bloodborne pathogens. Improper disposal opens us up to infection and hefty fines.

The key to staying safe from needle sticks and cuts is knowing what sharps are, and how to dispose of them. A reliable disposal company can carry the lion’s share of the sharps disposal burden.

A good partner can provide the sharps containers and systems that can keep your employees safe, and the training to ensure their proper use. A reliable waste disposal company like MedPro can do it all with $15 million in insurance, all at up to 50% less cost than other options.

Medical waste is any kind of waste that contains infectious material (or material that’s potentially infectious). This definition includes waste generated by healthcare facilities like physician’s offices, hospitals, dental practices, laboratories, medical research facilities, and veterinary clinics. This includes:

Anything that is soaked in blood (gloves, gauze, gowns, etc.)
Human or animal tissues created during procedures
Cultures of infectious diseases/agents
Any waste produced in patient’s rooms with communicable diseases
Discarded vaccines

Medical waste can contain bodily fluids like blood or other contaminants. The 1988 Medical Waste Tracking Act defined it as waste generated during medical research, testing, diagnosis, immunization, or treatment of either human beings or animals. Some examples are culture dishes, glassware, bandages, gloves, discarded sharps like needles or scalpels, swabs, and tissue.

Medical waste goes by several names that all have the same basic definition. All of the terms below refer to waste created during the healthcare process that’s either contaminated or potentially contaminated by infectious material.

Medical Waste
Biomedical Waste
Clinical Waste
Biohazardous Waste
Regulated Medical Waste (RMW)
Infectious Medical Waste
Healthcare waste

The terms are used interchangeably, but there’s a distinction between general healthcare waste and hazardous medical waste. The WHO categorizes sharps, human tissue, fluids, and contaminated supplies as “biohazardous,” and non-contaminated equipment and animal tissue as “general medical waste.”

In fact, office paper, sweeping waste, and kitchen waste from healthcare facilities is still technically medical waste, though it’s not regulated and not hazardous in nature.

The term “medical waste” can cover a wide variety of different byproducts of the healthcare industry. The broadest definition can include office paper and hospital sweeping waste. The list below displays the most common waste categories as identified by the WHO.

Sharps. This kind of waste includes anything that can pierce the skin, including needles, scalpels, lancets, broken glass, razors, ampules, staples, wires, and trocars.
Infectious Waste. Anything infectious or potentially infectious goes in this category, including swabs, tissues, excreta, equipment, and lab cultures.
Radioactive. This kind of waste generally means unused radiotherapy liquid or lab research liquid. It can also consist of any glassware or other supplies contaminated with this liquid.
Pathological. Human fluids, tissue, blood, body parts, bodily fluids, and contaminated animal carcasses come under this waste category.
Pharmaceuticals. This grouping includes all unused, expired, and/or contaminated vaccines and drugs. It also encompasses antibiotics, injectables, and pills.
Chemical. These are disinfectants, solvents used for laboratory purposes, batteries, and heavy metals from medical equipment such as mercury from broken thermometers.
Genotoxic Waste. This is a highly hazardous form of medical waste that’s either carcinogenic, teratogenic, or mutagenic. It can include cytotoxic drugs intended for use in cancer treatment.
General Non-Regulated Medical Waste. Also called non-hazardous waste, this type doesn’t pose any particular chemical, biological, physical, or radioactive danger.

The list below gives a quick overview of the topline facts around medical waste, including quantity, breakdown, dangers, and how the waste gets treated.

Quantity. U.S. hospital create an estimated 5.9 million tons of biohazardous and other medical waste every year. That’s 33 lbs of waste per staffed bed every single day.
Breakdown. 85% of all medical waste is deemed non-hazardous and general. The other 15% is hazardous and may be either infectious, radioactive, or toxic.
Danger. Biohazardous waste can contain harmful microorganisms that can infect healthcare workers, patients, and the general public.
How it’s treated. Healthcare waste can be treated on-site or off-site, by truck service or by mail. It can be incinerated, autoclaved, microwaved, or treated by chemical or biological means.

There are several medical waste disposal methods healthcare providers can choose from. The first question is where the waste gets disposed of: on-site or off-site? The second is how the waste gets transported if it’s disposed of off-site.

Here’s another great service for medical offices: MedPro Waste Disposal offers low-cost, secure medical waste disposal with predictable service and predictable cost. Check out our practice savings calculator here to see how much you could save on your medical waste disposal.

Medical waste is disposed of by first making it safe through a sterilization process. Waste that cannot be recycled, like gauze or needles, still needs to be made sanitary and non-hazardous before it can be disposed of. This process is usually done by using an autoclave. A medical autoclave is a device that uses steam to sterilize equipment and other objects. This means that all bacteria, viruses, fungi, and spores are inactivated by using temperature’s so high, that no bacteria can survive and thus the items are deemed safe for recycling or disposal.

Autoclaving is often used to sterilize medical waste prior to disposal in the standard municipal solid waste streams. This application has become more common as an alternative to incineration due to environmental and health concerns raised because of the combustion “by-products” emitted by incinerators, especially from the small units which were commonly operated at individual hospitals. Incineration or a similar thermal oxidation process is still generally mandated for pathological waste and other very toxic and/or infectious medical waste.

Medical waste is generated from medical and biological activities, such as the diagnosis, prevention, or treatment of diseases. Producers (or generators) of medical waste include veterinary clinics, health clinics, funeral homes, nursing homes, hospitals, medical research laboratories, physician offices, dentist and home health care.

Generally Medical waste is classified as; healthcare waste that that may be contaminated by blood, body fluids or other potentially infectious materials and has the potential (left untreated) to harm humans, animals, or the environment. This type of waste is often referred to as regulated medical waste, biomedical waste or simply medical waste. The classification of medical waste can vary from state to state be sure to check your local laws governing medical waste.

In 1988 the U.S. federal government passed the Medical Waste Tracking Act which set the standards for governmental regulation of medical waste. This was enacted after a 30-mile garbage slick composed primarily of medical and household waste prompted closures of numerous New York and New Jersey beaches for extended periods of time. This act expired in 1991 and since, medical waste is primarily regulated by state environmental and health departments.

There are other federal agencies that have regulations regarding medical waste. These agencies include CDC (centers for disease control), OSHA (Occupational Safety and Health Administration), the FDA (U.S. Food and Drug Administration) and other potential federal government agencies (DOT for example).

OSHA is one example of a federal agency that has regulations regarding medical waste; the OSHA code of federal regulations 29 CFR 1910.1030 has many parts to it. We have highlighted some of the bullet points below but you should visit this page on the U.S. Department of Labor to view the full CFR.

Exposure Control Plan – Each employer having an employee(s) with occupational exposure as defined by CFR 29 1910.1030 shall establish a written Exposure Control Plan designed to eliminate or minimize employee exposure.
Methods of Compliance – Universal precautions shall be observed to prevent contact with blood or other potentially infectious materials. When differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials.
Personal Protective Equipment – When there is occupational exposure, the employer shall provide, at no cost to the employee, appropriate personal protective equipment such as, but not limited to, gloves, gowns, laboratory coats, face shields or masks and eye protection, and mouthpieces, resuscitation bags, pocket masks, or other ventilation devices.
Training – The employer shall train each employee with occupational exposure in accordance with the requirements of CFR 29 1910.1030. Such training must be provided at no cost to the employee and during working hours. The employer shall institute a training program and ensure employee participation in the program.
Vaccination – The employer shall make available the hepatitis B vaccine and vaccination series to all employees who have occupational exposure, and post-exposure evaluation and follow-up to all employees who have had an exposure incident.

On-Site Medical Waste Treatment

The on-site treatment of medical waste is generally limited to large, well-monied hospitals and facilities. On-site treatment is extremely cost-prohibitive. That’s because the required equipment is expensive to buy, expensive to maintain, and expensive to manage and run. The regulatory maze around such equipment (and its use) presents yet another barrier to entry.

Off-Site Medical Waste Treatment

Off-site medical waste treatment is a far more cost-effective option for most small and mid-sized medical practices and facilities. Third-party vendors whose main business is healthcare waste collection and disposal have the equipment and training needed to handle the process. Vendors can collect the waste either by truck or by mail.

Truck services require a contract with a specially licensed disposal company to haul the waste away for regular destruction. The waste is hauled in special containers to a dedicated disposal facility.
Mail or box services use the U.S. Postal Service to ship the waste safely to a facility for treatment. This is generally the most cost effective of all the methods. It requires a vendor fully versed and experienced in all special Postal Service regulations and best practices.

No matter where medical waste is processed, it’s ultimately treated by incineration, autoclaving, microwave, biological, or chemical treatment. Incineration, once by far the most popular method, has decreased in usage since the 1990’s, as regulation has forced other methods to come online.

Incineration. Before 1997, over 90% of all infectious medical waste was disposed of by incineration. Changes to EPA regulations has led providers to seek other disposal means. This is still the only method used on pathological waste such as body parts and recognizable tissues.
Autoclaving. Steam sterilization renders biohazardous waste non-infectious. After it’s been sterilized, the waste can be disposed of normally in solid waste landfills, or it can be incinerated under less-stringent regulation.
Microwaving. Another way to render hazardous healthcare waste non-hazardous is to microwave it with high-powered equipment. As with autoclaving, this method opens up the waste to normal landfill disposal or incineration afterward.
Chemical. Some kinds of chemical waste may be neutralized by applying reactive chemicals that render it inert. This is generally reserved for waste that’s chemical in nature.
Biological. This experimental method of treating biomedical waste uses enzymes to neutralize hazardous, infectious organisms. It’s still under development and rarely used in practice.

Healthcare workers can avoid most medical waste problems by adhering to a few key best practices. Employees should know the laws, then classify and separate all waste by type into the correct, color-coded waste containers. Waste should be labeled depending on its category, and the right documentation should accompany all containers during transit. A dependable medical waste disposal company can help a facility put these best practices to work.

Know the healthcare waste laws. Healthcare waste is regulated by the DOT, EPA, OSHA, and the DEA. It’s vital to be aware of all guidelines from each agency when preparing, transferring, and disposing of hazardous waste.
Classify medical waste correctly. Identifying the kind of waste you’re dealing with is the first step in properly disposing of it. Avoid putting non-hazardous waste in with the rest to prevent overspending.
Separate the waste by type. Waste should be separated out into the different categories, including sharps, pharmaceutical, chemical, pathological, and non-hazardous. Regulated medical waste goes in red bags. Sharps that go into these bags must be put into puncture-proof containers first.
Use the right medical waste containers. Put all waste in approved containers depending on how it’s classified. Some waste can go in certified cardboard boxes,
while other waste gets put in special tubs or even locked up for transit.
Prepare the containers properly. Healthcare waste containers and bags must be taped for shipment, then packaged according to DOT weight restrictions. Containers should be stored in a secure, dry area before pickup or shipping. It’s essential to properly label all waste before transport as well.
Include the right documentation. Proper documentation of healthcare waste is crucial to protect both the provider and the waste disposal company. The right paperwork should accompany each container and bag throughout the process.
Use the medical waste disposal color code. The color coding system for waste segregation calls for all sharps to go in puncture resistant red biohazard waste containers. Biohazard waste goes in red bags and containers. Yellow containers are for trace chemo waste, while pharmaceutical waste goes into black containers for hazardous materials and blue for all others. Radioactive wastes like Fluorine-18 or Iodine-131 get put in shielded containers marked with the radioactive symbol.
Hire the right waste disposal company. Multiple regulating bodies, various hazards, and several different kinds of waste present a daunting challenge for healthcare

The approach to handling medical waste in the U.S. has evolved markedly since the 1980s. In that decade, a series of incidents of healthcare waste washing up on East Coast beaches gained widespread media attention. The events caused calls for increased regulation, which came in the form of 1988’s Federal Medical Waste Tracking Act.

The Act imposed strict rules on the transportation of waste from hospitals and other facilities. When it expired in 1991, the states largely took on the regulatory burden, basing their individual programs on lessons learned from the Act.

New solutions in the medical waste industry continue to offer advancements in security, convenience, cost savings, and speed of service. Among the most useful are a few waste disposal firms that accept waste-transfer by mail.

Unless it’s managed properly, medical waste can present several health hazards to healthcare employees, waste workers, and the general public. Discarded needles can expose us to needle sticks and possible infection if they’re accidentally sent to recycling facilities, or if containers break open in transit. Housekeepers and janitors are also at risk when sharps poke their way out through plastic bags.

Hazardous waste can expose us to microorganisms, radiation burns, poisoning, pollution, and other dangers. Finally, improperly treated waste sent to landfills can contaminate our drinking water and environment.

There’s no shortage of medical waste regulation. In the late 1980s, the waste was overseen by the EPA and the Federal Government. Afterward, regulations were passed by various state agencies. State health agencies and environmental programs have information about who governs healthcare waste in each state.

Several federal bodies maintain laws concerning medical waste. These include the Occupational Safety and Health Administration (OSHA), the Centers for Disease Control (CDC), the U.S. Food and Drug Administration (FDA), the Department of Transportation (DOT), and the Drug Enforcement Administration (DEA).

Medical waste can come from any medical or biological activity or source. For example, the prevention, diagnosis, or treatment of different diseases all can create hazardous waste.

The list of waste-generating facilities below includes all caregiver locations like private physician practices and dental offices, but also veterinary practices, research labs, funeral homes, and anyplace else that meets medical needs.

Physician Practices
Retail Health Clinics
Dental Offices
Urgent Care Clinics
Veterinary Practices
Medical Research Laboratories
Nursing Homes
Home Healthcare or Infusion Situations
Funeral Homes
Hospitals
Commercial Offices and Buildings

We’ve created a small toolbox below of various resources and medical waste solutions, from government websites and documents to laws, vendors, and educational materials.

The EPA maintains a map-based list of links to state environmental agencies and hazardous waste programs around the country.

MedPro Disposal provides a low-cost, fully compliant pickup, transportation, treatment, and disposal solutions for regulated medical waste, pharmaceuticals, and sharps. They also offer a mail back sharps container service and compliance training for safety needs.

The WHO Provides a Free 308 Page Manual on the safe management of healthcare waste, including general info like definition and classification to minimization, reuse, collection, storage, and more.

Medical waste is classified as any possibly contaminated byproduct of medical research, treatment, or other healthcare activity. It can come from physician’s offices, dentists, veterinary clinics, research laboratories, or funeral homes.

The guide above explains the definition, types, history, and dangers of healthcare waste, including how it gets disposed of, best practices, tools, resources, and regulating bodies.

Got a comment or a question? Give us a shout via the comments form below! Looking to get your medical waste disposal needs handled? Keeping reading about how you can request a free cost-savings analysis to ensure you have the best possible solution.

MedPro Disposal was founded to address a common complaint across all industries dealing with medical and bio-hazard wastes: They loved their service, but hated the cost.

To combat rising costs in the industry, we created MedPro Disposal for business owners like you who need great service to help your business running smoothly, but don’t think something as simple as waste should cost an arm and a leg.

Let us manage your medical waste so you can focus on what matters most, your patients.

Medical Waste Disposal and Management Services

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