Category Archives: Regulatory Compliance

suspicious package illustration

Hazardous Mail

Hazards are Everywhere.

We already know this. They are in the air, in our house, in our trash… and  now, hazardous mail. We may be either receiving or sending hazardous mail on a regular basis.

Have you ever ordered bleach through a delivery service? Imagine if it spilled on the delivery guy.

When we think of a mailman having a bad day, we usually imagine an aggressive dog at one of the delivery addresses or a long block, heavy packages, and a heat wave. We don’t usually think of severe bodily injury and hospital stays.

But the Postal Service does.

The USPS spends $101 million annually to screen every piece of first-class mail sent or received by U.S. households and mail sent to federal addresses in Washington.

With tens of thousands of postal facilities to protect, the U.S. Postal Inspection Service has responded to more than 52,000 calls about suspicious mail since 2001. Inspectors respond to about 10 calls daily. Most are false alarms.

The Postal Service now relies on both human checks and machine screenings to track suspicious mail. Shift supervisors receive regular updates on evolving threats. Postal Inspectors practice regularly with local law enforcement agencies in anticipation of an attack.

Employees are trained to be on the lookout for envelopes without a return address, an invalid Zip code, or weird or scribbled jargon.

Sharp objects protruding through boxes or dust or liquids leaking from envelopes is also a potential threat.

Questionable pieces of mail are supposed to be turned over to inspectors for further screening.

Hazardous, Resticted, Harmful:

To put it simply:

Some Things cannot be sent in the mail.

Those Things fall into one of the above categories: Hazardous/Harmful, Restricted, or Perishable/NonMailable Things.

If you need to send something that falls into the above categories, you need to label it properly. Ask for help to do this, because the labeling and shipping protocols are long and complicated.

If you send a Hazardous, Restricted, or Harmful Thing in the mail without following the correct protocol, you will be slapped with a very large penalty.

Hazardous Material:

A Hazardous Material is any article or substance designated by the U.S. Department of Transportation as being capable of posing an unreasonable risk to health, safety, or property during transportation.

In international commerce, hazardous materials are known as “Dangerous Goods.”

Every hazardous material is assigned to one of these nine hazard classes:

Class 1: Explosives.

Class 2: Gases.

Class 3: Flammable and Combustible Liquids.

Class 4: Flammable Solids.

Class 5: Oxidizing Substances, Organic Peroxides.

Class 6: Toxic Substances and Infectious Substances.

Class 7: Radioactive Materials.

Class 8: Corrosives.

Class 9: Miscellaneous Hazardous Materials.

Some of the nine hazard classes are further separated into divisions based on their physical or chemical properties. For postal purposes, Exhibit 331 summarizes the mailability of hazardous materials by hazard class.

In general, if it can kill or injure another person, it is Hazardous Mail. If it is likely to destroy, deface or otherwise damage the mail, postal equipment or other property, it is Harmful Mail.

Harmful matter includes, but is not limited to:

  1. All types and classes of poisons, such as caustic poisons (acids and alkalis), and oxidizers. Controlled substances are also included in this class.
  2. All poisonous animals, except scorpions mailed for medical research purposes or for the manufacture of anti-venom (or antivenin or antivenene); all poisonous insects; all poisonous reptiles; and all types of snakes, turtles, and spiders.
  3. All disease germs or scabs.
  4. All explosives, flammable material, infernal machines, and mechanical, chemical, or other devices or compositions that may ignite or explode. Highly flammable liquids, gases or solids, or any material that under conditions that take place during transportation can cause fire through friction, absorption of moisture, or spontaneous chemical changes or from retained heat from manufacturing or processing, including explosives or containers previously used for shipping high explosives with a liquid ingredient (such as dynamite), ammunition, fireworks, radioactive materials, matches, or articles emitting obnoxious odors.

Watch out for items that include these words on their description. There’s a strong likelihood you can’t just pop them in a box and stick them in the mail:

Acidic, Caustic, Combustible, Communicable, Corrsoive, Explosive, Flammabe, Compressed gas, Radioactive, Poison. Toxic, Infectious, Volatile.

The USPS and UPS have an updated list of items you can’t put in the regular mail on their websites.

Restricted Matter:

Restricted matter includes articles on which mailing restrictions have been imposed for reasons other than risk of harm to persons or property involved in moving the mail.

Motor vehicle master keys, abortive and contraceptive devices, odd-shaped items in envelopes, locksmithing devices and intoxicating liquors are examples of restricted items.

Perishable Matter:

Perishable matter is anything that can deteriorate in the mail and thereby lose value, create a health hazard, or cause an obnoxious odor, nuisance, or disturbance, under ordinary mailing conditions.

Examples of perishable matter include mailable types of live animals, food items, and plants.

The Postal Service provides these labels and tags for sticking on the outside of mail containing bees, live animals, or perishable matter:

  1. Label 27, Bee Ware!
  2. Label 28, Live Animals.
  3. Tag 9, Perishable — Do Not Delay.
  4. Label 127, Surface Transportation O

Perishable matter that is not restricted, (like cookies that can go stale) may be sent at your own risk as long as it is packaged properly and if it can possible be delivered within appropriate and reasonable time limits to prevent deterioration.

So probably you’ll have to forego sending that potato salad to China.

Acceptability for Mailing Hazardous Mail:

The USPS works with shippers wishing to mail various unconventional and even harmful substances. There is a protocol in place for mailing Hazardous, Harmful, Restricted and Perishable Materials.

Acceptability for mailing hazardous materials depends on many factors. A partial list of considerations would be: The container fluid/vapor capacities, the ability of the complete mail piece to contain the material, and the method of absorbing and containing the material in case of accidental leakage of the primary receptacle.

Normal conditions for transport should always be taken into consideration. All shippers who offer packages containing liquids, for example, must be trained to understand and apply the stringent standards for vibration, pressure and temperature because of the higher risk and possible dire consequences. This is especially critical when it comes to shipments by air.

To determine mailability of a specific material, a mailer must submit a material safety data sheet (MSDS) and the following information to the PCSC:

  1. Common and proper shipping name of the material, hazard class, and the assigned United Nations (UN) or North American (NA) identification number.
  2. Chemical composition by percentage of weight.
  3. Flashpoint.
  4. Toxic properties.
  5. Irritant action when inhaled, swallowed, or with contact to skin or eyes.
  6. Special precautions necessary to permit handling without harm to USPS employees or damage to property or other mail.
  7. Explanation of warning labels and shipping papers required by local, state, or federal regulations.
  8. Description of the proposed packaging method, including the addressing, required markings, and documentation.
  9. Volume of material per mailpiece, proposed number of pieces to be mailed, class of mail, and post office(s) of mailing.

The postal service will then determine if you can mail the Thing, in what kind of container, and which labels you would need to affix to it.

Full responsibility rests with the mailer to comply with all Postal Service and non–Postal Service laws and regulations in the mailing of hazardous material.

Anyone who mails, or causes to be mailed, a nonmailable or improperly packaged hazardous material can be subject to legal penalties.

Fines or Imprisonment.

Civil penalties are assessed for knowingly violating a hazardous material transportation law or a regulation, order, special permit, or approval issued under that law.

The following updated civil penalties apply to violations occurring on or after October 1, 2012:

The maximum civil penalty is increased from $55,000 to $75,000 for knowingly violating federal hazardous material transportation law.

The maximum civil penalty for knowingly violating laws and regulations that result in death, serious illness, severe injury to any person, or substantial destruction of property is increased from $110,000 to $175,000.

The $250 minimum civil penalty has been eliminated.

The civil penalty for violations related to training has reverted to $450.

When someone breaks the rules, it puts us all at risk. The consequences for doing so should be substantial enough to discourage misconduct.

(Quoted from PHMSA administrator Cynthia Quarterman)

Here’s an example of the fines you may have to pay:

Amazon improperly shipped a package containing flammable liquid adhesive by air via FedEx. FedEx employees discovered a gallon container of the adhesive that was leaking.

The adhesive is classified as a hazardous material under the DOT regulations.

Amazon sent the shipment without the requisite shipping papers or emergency response information. They did not mark, label or properly package the shipment. Obviously, they also failed to properly train their employees in preparing hazmat packages for shipment by air.

They were fined $91,000.

There have lately been other civil suits about improperly sent mail, with similar fines.

Just saying.

It’s all in the packaging, people. If you need to send something, make sure you know what container is considered appropriate and which labels need to be on there.

Hazardous Mail, Harmful Mail, Restricted Mail, and Perishable Mail, can all end up with you in jail or owing flamboyant fines to the Postal Service.

Although the Postal Service makes every effort to inform its customers about the mailability of harmful Things,  it is the responsibility of the mailer to fully meet all requirements prior to mailing. 

So, be responsible.

If the product you are shipping may pose a risk to life, limb or property, check to make sure how it can be made mailable. There are a lot of lists of all the stuff you can’t mail. Peruse them at your leisure.

___________

We are MedWaste Management – California’s medical waste disposal experts!

Established in 2008, MedWaste Management brings great benefit to the healthcare industry and the general public alike. We publish this blog to to spread useful and practical information to help people stay safe, smart and healthy!

Call us with any questions or to start service at (866) 254-5105. We are always happy to speak!

Check out our services and other great resources in the links below.

Medical Waste Disposal Services 

MedWaste’s Blog Index

Medical Waste Regulations

MedWaste’s Product Store 

Home Generated Medical Waste Drop-Off Points In California

Illegal Dumping of Medical Waste is an Expensive Gamble

This past June, the Pennsylvania Department of Environmental Protection let it be known that violations with medical waste disposal for hospitals will be treated harshly. They fined both the UPMC and the Allegheny Health Network after an investigation found both were illegally disposing of their medical waste.

The investigation began almost 3 years ago when a local waste management company discovered untreated medical waste was mixed in with municipal garbage at a state landfill. Initially, it was believed that all had come from UPMC, but a further probe revealed that 2 hospitals in the Allegheny Health Network were also responsible. Both of the health systems were fined, yet the investigation continued around the state to ensure that no other medical facilities were also guilty of the practice.

Biological waste disposal violations were subsequently found in 12 hospitals operated by UPMC, which was then hit with a $451,000 fine. It was found that they were dumping large quantities of contaminated needles, wound dressings containing blood, and other bodily fluids right at the landfill. Two hospitals in the Allegheny Health Network – West Penn and Forbes – are guilty of similar practices, and were fined a total of $86,900 by the state.

According to a representative from the state’s environmental protection agency, the biggest concern was that none of the waste had been sterilized prior to shipment and dumping. This practice puts the local water supply at risk of contamination as the medical waste begins to break down and decompose on its own. The presence of contaminated needles was also noted, as these are an immediate health risk for any individual who comes into contact with them.

A spokesperson from the Allegheny Health Network admits a breakdown in their normally strict policies of medical waste disposal. Once the breakdown was discovered, they immediately took steps to reeducate staff members involved in the path of medical waste inside of the hospitals. They also opted to begin using a professional medical waste disposal company that could ensure that all medical waste was properly sterilized before it was left at any landfill.

What Led to These Violations

During the inspections following the initial discovery of untreated medical waste in a landfill, investigators found a number of violations inside of area hospitals. Noted was improper labeling, storage, and the handling of untreated medical waste before it even left the facility. This is why it is extremely important to implement a strategy that starts at the very collection of medical waste from where it is being generated.

To avoid this happening to your medical facility, it is imperative that you work with a reliable medical waste management service provider. Not only do we treat medical waste, be assist in educating your employees, providing you with the proper materials for collection, and structuring a plan for its safe removal from your hospital. This is your best defense against having to pay almost half a million dollars in penalties.

California’s Role in Shaping the Medical Waste Disposal Industry

When it comes to medical waste disposal rules and practices, no one is doing it better than the state of California. Since 1972, state lawmakers have been making a concerted effort to better regulate medical waste, providing federal regulators with an exemplary lead to follow.

The California Hazardous Waste Control Law – or HWCL – was enacted in 1972, four years before the Resource Conservation and Recovery Act – RCRA – was put into place by the federal government. Since that time, California has always been a few steps ahead of the feds, ensuring residents that they will not be affected by medical waste disposal hazards. Medical waste disposal for hospitals, clinics and any other type of healthcare facility is closely monitored at the state level, starting from the point at which it is generated all the way to the methods used for sterilization.

Not only was California first in recognizing the need for medical waste disposal regulation, they have enacted stricter regulations consistently over the last 5 decades:

  • As per the HWCL, the Department of Toxic Substances Control must grant permits to companies treating hazardous waste. The same was not initially set forth in the regulations given by the RCRA.
  • A list was made of hazardous wastes and a toxicity characteristic by the HWCL ten years before the RCRA put forth a similar list.
  • There is a sewer exclusion included for wastes as per the Clean Water Act, yet this exclusion is not recognized in the state of California.
  • California laws clearly define toxicity characteristics whereas the federal government makes no concessions, not even for copper, zinc or nickel. They also look at carcinogens, another point missed in federal regulations.
  • Under California law, more hazardous wastes are regulated that what is recognized by the federal government.

The stringent guidelines set forth by the California government may be good news for residents, yet it poses problems for healthcare facilities. Knowing the expectations of OSHA and the EPA is not enough. Health care providers must be up to speed on the myriad of rules given at the state level, on top of what can be expected form their federal counterparts.

In order to avoid systematic inspections and fines imposed by state regulators, the administrator of a dental office or health clinic in California needs to be fully aware of all of the rules being imposed. This makes biological waste disposal for dental offices a burdensome task that can consume your resources as you work to be compliant. Professional medical waste disposal companies are fully equipped to relieve you of the burden, making your facility safe for patients and your employees.

Don’t risk being subject to expensive fines due to accidental non-compliance with California laws. Use a locally based company that has been registered with the state in order to ensure that your medical waste disposal needs are being met, with regard for the laws enforced at every level.

199 Cases Where Toxic Agents Almost Slipped Through the Cracks

The Federal Select Agent Program conducted their first ever annual report, discovering 199 instances where lab technicians were inadvertently exposed to toxic or infectious substances last year. Luckily, all of these were near misses. Yet they do unearth a need for continued education and high standards when it comes to the handling and removal of samples from laboratories across the nation.

The Federal Select Agent Program is responsible for overseeing dangerous substances that are studied inside of federal, state, private and academic labs. These substances include things like the bird flu, Ebola virus and even anthrax. New regulations were issued to the agency in 2014, resulting in an overall inspection of the handling of certain dangerous elements. It was during this inspection that agents found 199 cases where a lab worker was a breath away from becoming infected with a potentially deadly agent.

The safe handling of certain dangerous agents has been a focus ever since it was reported by the CDC that several labs had mishandled dangerous pathogens in the past, putting the entire surrounding population at serious risk of mass infection. As a result, the CDC, Department of Health and Human Services and the Department of Agriculture are now working jointly on a task force that works solely to monitor these labs and their medical waste disposal procedures among other things.

In total, there were 12 potential losses uncovered, and a total of 233 potential releases of toxic agents. When investigated further, it was found that all of the potential losses could be traced to either a clerical error or of samples being destroyed in an autoclave by mistake. Medical waste disposal for laboratories has to include education on which types of agents are acceptable for that type of destruction. With some toxins, the autoclave will actually release harmful gases, putting the lab worker at risk of infection when the mechanism is opened.

As for the 233 potential releases of a toxic agent, there were 199 instances in which a lab technician may have been exposed by error. This included an instance where viable Anthrax had mistakenly left a military base and was sent to a number of outside laboratories both in the US and abroad. Luckily, none of these potential releases resulted in illness, death or the spread of infection to any surrounding area.

Medical waste disposal for laboratories is often of a much larger scope than in other types of facilities. Not for the amount of medical waste being generated, but for the types of agents and toxins it may have been exposed to. Laboratories that are operating as research agencies need to be acutely aware of the types of substances they are disposing of, and ensure that it is being segregated away from any typical medical waste and common garbage.

Do You Know Where Your Surgery Center’s Medical Waste Will Eventually End Up?

The journey of medical waste begins the moment it is removed from the human body. In a surgery center, it could be a small tumor that has been removed or tissue samples after a procedure. Here it is placed inside of a biological waste bag before being transported to a designated pick up area.

At the Pick Up Area for Medical Waste

The pick up area inside of your surgery center should be removed from patient rooms and surgical suites. There should be outside door access to reduce the risk of contamination from the materials being brought back inside the facility. It should also be locked, without access only permitted to authorized personnel. This would include drivers for the biological waste disposal company you work with.

Pick Up of Medical Waste

Licensed drivers in state approved vehicles will arrive at your facility for pick up. They will note the amount and types of medical waste reserved for destruction, and ask for signatures from authorized members of your staff. You will also be provided with documentation proving that they retrieved the medical waste from your surgery center.

If you are using reusable containers for medical waste, these may be switched out during this time. The drivers will take your full containers and provide you with sterilized new ones to use.

The medical waste retrieved from your surgery center will then be hauled to a special treatment facility. This facility should have special licensing from the state that allows them to dispose of medical waste from surgery centers.

Inside the Medical Waste Treatment Facility

Once the medical waste reaches a treatment facility, it is segregated by type, depending on the color of the bag or other container. The bags are left unopened, and either put into an autoclave until sanitary or incinerated. If autoclaved, the waste is then further broken down to reduce the amount of waste left over. This is typically done by shredding the materials. In most instances, materials that have been subjected to an autoclave can then be added to regular trash in an ordinary landfill.

Some plastics might even be recycled after having been sterilized inside of an autoclave. The material left over is then reused in a way that will decrease the impact your surgical center has on the environment.

Regulated Medical Waste Disposal Companies

While the licensing and regulation of medical waste disposal transporters and companies may vary slightly from state to state, all have to adhere to stringent guidelines set forth by OSHA, the EPA and various other governmental bodies. This is to ensure the safety of workers inside of your surgery center, as well as the general population and the environment.

Make sure that when you are looking at ways to better manage the biological waste inside of your surgery center, you are checking that these licensing requirements are being met. This will ensure that your facility is in compliance at all times with all laws and regulations.

The Importance of Biological Waste Disposal for Doctor’s Offices

You are likely already familiar with the terminology biological waste, and those bright red bags that yell out “handle with caution”. But do you know exactly what is supposed to go inside (and not), and what happens to it once it leaves your office? There are risks associated with the handling of biological waste in doctor’s offices, and severe consequences if not completed correctly.

Biological – or biohazardous – waste is defined as being any waste that contains potentially infectious agents. These are found in any area where human blood and tissues are exposed, such as in your doctor’s office. Some common examples include:

  • Bodily Fluids – This includes amniotic fluid, semen, saliva, pleural fluid and vaginal secretions.
  • Microbiological Waste – Usually the byproducts of laboratory testing, such as live viruses, blood samples, specimen cultures and the devices used to transfer them.
  • Blood Products – Blood, plasma and any other tissues or fluids containing blood residue.
  • Pathological Waste – Pathological waste refers to any organic object that is identifiable as being human in source, such as body parts, tissues and organs.
  • Sharps Waste – Items, such as needles, that not only potentially contain harmful pathogens from biological waste but that also have the potential to pierce skin and transfer those pathogens into the blood stream of another individual.

In 1988, the US Congress enacted the Medical Waste Tracking act, which allowed them to study the methods of medical waste disposal for doctor’s offices and begin regulating it. As a result, all medical waste must now be collected by a company with a specific license for handling hazardous products. They are then held responsible for rendering it harmless by using one of the following methods:

  • Incineration: The EPA estimates that up to 90% of all biohazardous waste is being incinerated. This must be done by a licensed contractor, either on or off of the site where medical waste is collected. Incineration offers many benefits besides sterilizing, such as reducing the overall amount of waste and avoiding having to sterilize it before breaking it down.
  • Autoclaving: When medical waste from doctor’s offices is subject to an autoclave, this usually entails two steps. The first is the sterilization of the waste using intense steam, followed by shredding the materials. This usually allows for the waste to then be disposed of in a typical landfill.

As the administrator for a doctor’s office, you have the responsibility of ensuring that medical waste disposal is being conducted in a manner that reduces its risk to your patients, staff, and the environment. Your optimal choice in guaranteeing this is by working with a professional medical waste disposal company. Not only can a company like MedWaste Management sterilize and destroy medical waste generated inside of your doctor’s office, they can help you to put a system in place for its safe collection and storage.

Are You Up to Speed on Texas Medical Waste Disposal Regulations

Medical waste disposal for clinics, and other health care facilities, in Texas has recently changed. The Texas legislature revised the rules during their 84th regular session, and made them effective as of this past May 26th. If you are not familiar with the changes, and make accommodations for them, you could be facing repercussions in the future.

In Texas, medical waste management includes its collection, handling, storage, transport and processing. The regulations in place are applied to any individual or entity that is involved in any aspect of controlling and managing medical waste. That term – medical waste – refers to treated and untreated waste from health care facilities that contains human and animal waste, bulk blood and bodily fluids, microbiological waste, pathological waste and contaminated sharps.

What Kind of Medical Waste Generator Are You?

In Texas, there are two types of medical waste generators that your facility can be classified as:

  • SQG – A small quantity generator (SQG) is one that produces less than 50 pounds of medical waste each month.
  • LQG – A large quantity generator (LQG) is producing 50 pounds or more of medical waste every month.

Neither of these types of medical waste generators is required to obtain a permit in order to store medical waste on site, so long as it consists only of waste that has been produced by that facility. Medical waste should be securely stored on site, and not interfere with overall objective of the health care facility.

Can You Transport Your Own Medical Waste to a Processing Facility?

Regardless of the type of medical waste generator your Texas clinic is, you will need to have it removed safely from your facility. If you are an SQG, you can do this yourself without the need of any special permit or registration. An LQG however you will need to obtain a special registration, and submit an annual summary of the medical waste disposal transport.

Both types of medical waste generators do need to maintain records of each shipment of medical waste leaving the facility in the form of a manifest. The information contained in these manifests must be in accordance with state laws, providing an extensive record of the type and amount of medical waste leaving your facility. Most health care providers find it simpler to use separate companies, like MedWaste Management for this purpose.

Not only does working with a third party take the burden of transporting medical waste off of your shoulders, it ensures that you are in full compliance with the myriad of regulations handed down by the Texas legislature. Medical waste disposals for hospitals is an enormous responsibility, and with these new rules, it has become even more difficult for Texas health care providers to keep up and stay compliant on their own.

OSHA Weighs in on Blood Collection Tubes and Recycling

The Occupational Safety and Health Administration (OSHA) oversees practices and policies that could be hazardous to the physical well-being of workers in any field. With health care workers, one of their primary concerns is with the safe handling of sharps. Needle pricks may be small cuts to the skin, but the potential to introduce disease into a worker makes them a high risk to work with.

Not only has OSHA addressed the risk potential of sharps by demanding the use of special containers for their collection, they have furthered their cause by making recommendations for the use of tube holders. These devices are typically attached to the needle in order to facilitate the collection of blood when it is being drawn. In the past, some hospitals and other medical labs have attempted to reuse these tube holders to cut costs, yet to do so is putting the health of workers at risk.

Blood Collection Needles and Tube Holders

A blood collection needle is able to screw onto a blood tube holder, and a blood tube is inserted into the holder to collect the blood. The needle has two ends, one which is inserted into the laboratory patient, and one at the back the transports the blood into the blood tube. Modern blood tube holders can be reused, but are not in most circumstances in order to minimize a worker’s exposure to blood. The process of removing the tube holder from the needle increases the possibility that the health care provider will be injured by a needle stick.

Proper medical waste disposal for laboratories does not allow for the removal of tube holders before placing the needle inside of the sharps collection bin. OSHA specifically recommends that needles be disposed of immediately after use, including any blood tube holder that is attached to it. Removing this holder places worker’s at too high of a risk for possible injury and exposure to harmful blood pathogens.

There are very limited circumstances for when a contaminated needle or other sharp is allowed to be manipulated after its use. To do so, you will have to show that the action is required in order to complete a specific medical or dental procedure. Trying to save money on your laboratory costs by reusing parts of contaminated needles and collection devices is in violation of the standards set forth by OSHA.

According to OSHA, the appropriate disposal of contaminated sharps includes:

  • The close availability of sharp containers that contain an opening large enough to pass the entire blood collection assembly, including the blood tube holder.
  • Having sharp containers made portable for those employees who move between various patient rooms.

If you have your own questions or concerns about medical waste disposal in your laboratory, and how to handle sharps, MedWaste Management can help. With our expert methods, you will have no problem in meeting the demands of OSHA when it comes to medical waste disposal inside of your laboratory.

Preventing zoonotic disease transmission inside of a veterinary practice

There are standards for precautions in veterinary medicine that are designed to help stop the spread of certain diseases from animals to the humans caring for them. Among these standards are guidelines that specifically target medical waste disposal at these clinics.

In 2003 there was an outbreak of African monkey-pox infection inside the United States. Of the 71 individuals who became infected with the disease, 18 were individuals working inside of veterinary clinics. As a result, authorities realized the potential risk that these workers were facing, and the immediate need for infection control methods in veterinary medicine. African monkey-pox is just one of 868 known human pathogens that are zoophytic. Others include plague, salmonellae, and Q fever.

Veterinary Medical Waste Disposal

The AVMA defines veterinary medical waste as being sharps, tissues, contaminated materials and animal carcasses. They recommend that these items be handled with care and packaged in a way that prevents spills or leaks. Sharps used for the treatment of animals need to be placed inside of puncture and leak resistant rigid containers that are able to be sealed permanently. If the waste has not been sterilized, it should be placed inside of containers that bear the universal biohazard symbol.

Sharp containers used in veterinary medicine should be found in every area where animals are being cared for. All used syringes should be placed inside of these boxes after fluids have been drawn or medicines have been injected into an animal – infected or not. You are not permitted to cut needles before disposing of them, nor should the syringe be removed by hand. If there is a need to remove the syringe from the needle prior to disposal, it should be done using the needle removal device found on many sharps containers.

As with other healthcare facilities, sharps containers should never go above 2/3 capacity and the contents should never be transferred from one box to another. The safest method for removal and replacement is with a licensed medical waste disposal company. MedWaste Management can assist you in finding permanent locations for sharps containers inside of your clinic and replace them for you on demand.

Following the guidelines for infection control is extremely important in veterinary medicine. Animals are carriers for numerous diseases, many of which can be transmitted to humans. Transmission is not just through contact with blood or other bodily fluids. In some instances these diseases are airborne, making the handling of all materials that an infected animal has come in contact with critical.

In order to secure the health and safety of the individuals working inside of your veterinary clinic, and the general population, always follow the guidelines stated for medical waste disposal in veterinary practices. Working with a professional medical waste disposal company will significantly cut the risk of infectious materials being exposed to workers and patient-owners.

How often should I schedule pick up for my medical waste disposal?

blog post 5

As a matter of fact, there aren’t any Federal infectious medical waste disposal regulations at this time. This issue was left for each State to decide what their regulations will be.

OSHA’s Bloodborne Pathogen Standard does not address this issue either.

In California, the storage times are different for biohazardous waste disposal and sharps disposal.

A facility that generates less than 20 pounds of biohazardous waste per month may store it for 30 days.”

That means pickup for a small medical waste generator should be scheduled for about once a month.

The waste may be stored for up to 90 days if kept at 32 degrees Fahrenheit or below.

Good storage habits may allow a less frequent pickup schedule.

Good storage habits would mean storing the medical waste containers in a place that is easily cleaned, not permeable (in case of spills) and made of durable materials that would provide protection from water, rain and wind so the containers remain dependably intact. Good storage would keep the containers in a place with limited access, preferably in a place where only trained employees can enter, so that the chance of damage, leakage or spills is minimal.

Good storage would be a place where the floor is not carpeted, has no open seams, and if there are floor drains, they must discharge to a sanitary sewer disposal system. The area should be kept clean and well-maintained, be in good repair, and if there are biohazardous waste containers in there, the international biohazard symbol needs to be posted at the entry.

Once a medical waste disposal box is filled, it needs to be packaged. Then, it should be picked up within 30 days. The countdown begins once the box is packaged.

However, sharps disposal containers have a different time frame. They can remain in place until they are ready to be changed, which is just slightly before the level reaches the “full” line. So, if you are a generator of mainly sharps disposal, like a tattoo parlor, the frequency of the medical waste pick-up would depend on the frequency of your sharps disposal containers reaching the full lines.

Hospitals and Nursing Homes are under other State regulations that require biohazard and regular trash to be removed every day or sooner, if needed. This is to protect patients and visitors, who are also at risk of exposure, especially little children, who are curious and may try to check out any unfamiliar things in their environment. Other people at risk for contamination and infection are support service workers. Cleaning personnel and laundry workers are the first people exposed to medical waste that is improperly disposed of or left around.

(Again, the sharps disposal containers are not included in the daily removal requirement.)

If you’re a small medical waste disposal generator, and you’re still not sure how often to schedule pick-up for your medical waste, here are some indicators:

To determine how frequently your facility needs to schedule pickup by a medical waste disposal company, you should weigh the amount of biohazardous waste (sharps not included) that your business generates in a month, and call to consult with our OSHA-trained experts.

You’ll know if your medical waste has been lying around for too long. One indicator that it’s beyond time to schedule a pickup is odor. Odors can indicate improper storage of your medical waste disposal (like a hot, moist boiler room), or be indicative of the type of waste you’re disposing of, but it’s a pretty reliable yardstick for the frequency of your pickup.

Don’t wait until it becomes that clear, though. Contact us for help to determine how often you should be scheduling pickups before the situation gets smelly.

 

 

The Dangers of Medical Waste Disposal

indexThe International Red Cross states: “Hospitals are responsible for the waste they produce. They must ensure that the handling, treatment, and disposal of that waste will not have harmful consenquences for public health or the environment.”

Incineration, which is one of the most commonly used methods for medical waste disposal, does not eliminate toxic substances that are found in the medical waste. Incinerators concentrate hazardous substances, then redistribute them, and the oxygenation even creates new toxins, like dioxins. These chemical substances are known as Hazardous Air Pollutants. (HAPs)

Dioxins are among the most toxic manmade chemicals found on this planet. , apart from plutonium. Dioxins were the contaminant factor in Agent Orange that was used in the Vietnam War. They are a Class 1 human carcinogen. According to the EPA, the risk of cancer in Americans increases a thousand fold because dioxins get stored in the body. The EPA studied dioxins and concluded that there does not appear to be any “safe” level of exposure to dioxins.

Dioxins are very persistent in the environment. They can resist physical, chemical and biological degradation for decades. They cause multiple reproductive and developmental abnormalities. They have been linked to disrupted sexual development, birth defects, and damage to the immune system.

Besides dioxins, which are created by the combination of the chemicals in the medical waste disposal (PVC for one) and the chemicals generated by the burning process, incinerators emit chlorine, mercury, arsenic, lead, cadmium, ammonia and benzene. The heavy metals (mercury, lead and cadmium) are not destroyed by burning. They are just concentrated in the ash and released from the incinerator stacks into the air. The ash is disposed of with general trash and sits around in piles at the landfills.

The heavy metals emitted from the smokestack spread for miles around to be eventually inhaled by local inhabitants, or ingested when they eat produce that was grown in gardens that lay in the vicinity of a medical waste disposal incinerator.

Most of these toxins are both toxic and bio-accumulative, which means that they insidiously accumulate in the human body. They are not combustible, do not degrade, cannot be destroyed. They have been implicated in a broad range of behavioral and emotional problems, especially in children. Some of these problems would be: Autism, ADHD, learning disabilities/difficulties/delinquency. Problems seen more in adults would include dementia, depression, Parkinson’s disease. Autism rates are increased around places where mercury is released into the environment, like coal power plants… and incinerators.

Medical Waste Disposal is particularly notorious because they may also generate and/or emit radioactive toxins and highly infective mutated proteins called prions.

Protests have spurred action against medical waste disposal companies, and incinerators have been shut down. Other, safer methods for medical waste disposal are being examined. Hopefully there will be a solution that will satisfy all parties, but we will have to work hard and work together to reach it.

For much more detailed information about dioxins, and about the damage incinerators can cause us humans who live in the same area/state/country, you can follow these links:

http://www2.epa.gov/dioxin/learn-about-dioxin

https://ec.europa.eu/research/endocrine/pdf//qlk4-ct99-01446.pdf

http://greenaction.org/?p=2408

http://www.truth-out.org/news/item/19069-hypocritical-smoke-the-scandal-of-medical-waste-incineration

Medical Waste Disposal: Destination

blog post 2Hopefully, if you’re reading my blog, you’re in the healthcare industry and you have an OSHA-compliant medical waste disposal program in place. You know what sort of medical waste goes into which container or bag, and you already hired a medical waste management company to cart everything away. You receive a paper that says that you have responsibly disposed of the medical waste you generated. You have taken care of the safety of your staff and your patients.

Here’s what happens after that.

Where does the medical waste disposal matter go?

The short answer: To be sterilized.

Once the medical waste disposal matter is sufficiently sterile, it can be chucked in a landfill or even discharged into the sewer system. Basically, it follows the path of other regular, standard, general garbage.

The following are the primary methods used for treatment and sterilization of medical waste:

Incineration:

This entails incinerating (i.e. burning) the medical waste in a medical waste incinerator. This is the simplest way to take care of medical waste disposal matter, because it doesn’t need to be sorted and the burning reduces the volume of the waste and sterilizes it. After incineration, the waste/ash can be dumped in a landfill.

There is a big downside. The EPA is still examining if incineration should continue to be used in the medical waste disposal process. The irony is that during the process of destroying substances that may harm the environment and people in it, the toxins and pollution generated and released by the incinerators are harmful to the environment.

Autoclaves:

These are used 90% of the time for treating medical waste disposal matter. They are closed chambers that apply pressure, steam, and heat to kill microorganisms and sterilize the medical waste.

It’s a two-step process. The medical waste disposal matter is still recognizable after being sterilized, so it needs to be shredded or otherwise manipulated before it can be treated like other trash.

Some facilities use small countertop autoclaves to sterilize their equipment so that it can be reused. Large autoclaves are used to sterilize the medical waste disposal matter that will need further mechanical destruction.

Mechanical/Chemical Disinfection:

This is a process that involves chemical agents for disinfection. (chlorine, for example.) Mostly, this process would be used for liquid wastes, though it can also be used to treat solid waste. Sometimes the medical waste disposal matter is grinded before being exposed to the liquid chemical for disinfection. The grinding ensures that all parts of the waste are sufficiently exposed to the chemical and makes it easier to dispose of the residue. If the material that results is a liquid, it is chucked in the sewer system, while solid residues are disposed of in landfills.

Microwave:

Microwave destruction is an application of microwave technology to disinfect waste. The process begins with shredding. This reduces the volume of the waste. The shredded waste is then mixed with water and put in a microwave unit. The power of the microwave disinfection is that it heats the waste internally. The steam that results from the high temperature neutralize biohazards.

Microwave disinfection is one of the cheapest ways to neutralize biohazards. It reportedly uses lower energy than an incinerator. It is done in one unit. Computerized controls are used to make sure the minimum parameters for disinfection and proper equipment function are kept. The process can be done by unskilled workers. The volume is significantly reduced and the waste can be dumped in a landfill.

Not recommended for getting rid of pathological waste

Irradiation:

This method is not often used. It entails getting the medical waste matter exposed to a source of cobalt. (Cobalt gives off gamma radiations that get rid of all the microbes in the waste matter.) The cost of cobalt, and the cost of operation, is high enough to discourage commercial ventures from using this method to treat their medical waste disposal matter.

There have also been some questions about the process and whether it properly and adequately disinfects the medical waste matter.

Thermal inactivation:

This involves heating the medical waste. The waste is heated to temperatures that kill off infectious agents. It’s usually used to sterilize large volumes of liquid medical/clinical wastes. The chamber of the machine is preheated to a very intense, specific temperature and held for a specific amount of time, then released.

That, in a nutshell, is where the medical waste disposal process takes the medical waste that’s carted off from your facility.

I will be addressing specific methods and some of the concerns associated with them more thoroughly in my next blog.