“Taking out the trash” is a lot less simple when it includes cast-off wound dressings, hypodermics used on patients with potentially infectious diseases, and tumors and other excised tissue. Different types of medical waste get handled according to their content and risk levels, but many people working in healthcare are unaware of what actually happens to the waste.
In the 20th century, many facilities incinerated waste on their premises, but an investigation in the early 1990s by the Environmental Protection Agency (EPA) discovered harmful pollutants were being emitted as a result. Through sustained efforts, the medical community has worked hard towards safe disposal systems.
Currently, the bulk of medical and hazardous waste is collected from the generation site and transported safely to a treatment facility. Here’s what happens to it.
Before medical waste can be disposed of, some items are sterilized using steam at a very high temperature in a sealed-chamber, autoclave device. This inactivates all bacteria, viruses, and spores present in the waste, making it safe for recycling or disposal.
Liquid waste and materials that are easily shredded aren’t suitable for autoclaving, so these might be sterilized using chemical disinfection. This method combines disinfectant with the waste, after which it is disposed of safely. Since the chemicals themselves are potentially hazardous, disinfection alone isn’t enough to sanitize the waste.
Microwaving is another high-temperature method of sterilization, which works best for “soft” items such as bandages, dressings, medical staff gowns, and gloves. The waste is shredded to ensure equal exposure to microwaves, and water is added to solid waste to facilitate the heating.
Incineration and Disposal
This method is used to reduce sanitized waste to non-toxic ashes, and items such as chemotherapy drugs, non-explosive pharmaceuticals, general housekeeping products, and certain controlled substances can also be safely incinerated. After incineration, the remaining ash is a smaller quantity, which is considered safe for disposal in a landfill.
Mixed waste, typically a combination of chemically hazardous and radioactive waste, is usually reduced in a radioactive waste incinerator that eliminates almost all toxic particles. The fact that some toxicity can remain means this type of waste cannot be disposed of in a landfill, because it can present a threat to the environment through seepage into groundwater. The solution is long-term storage of the ash and by-products in containers, which prevent it from escaping and contaminating the environment.
Reprocessing and Recycling
With statistics showing 85% of hospital waste is non-infectious, efforts are being made to improve the recycling of items where possible. Types of waste that can be recycled include glass and rigid plastic containers. In some instances, these may need to be sterilized or rinsed to remove residual contents.
Items such as single-use plastic IV bags, for example, can be melted down and materials repurposed and reused, which reduces the quantity of waste requiring disposal. Other non-hazardous devices and equipment that health care systems are increasingly recovering for reprocessing include:
endotracheal tubes, and
blood pressure cuffs.
In 2018, Cleveland Clinic was able to recycle one-third of waste produced across all facilities by working with vendors such as Hewlett Packard to recycle electronics. The clinic also managed to recycle more than 4,000 tons of paper and 194 tons of clinical plastics.
Why it Matters
Medical facilities are accountable for waste from the time it’s generated until it is completely disposed of in a manner compliant with regulations. The “cradle to the grave” legislation of the Resource Conservation and Recovery Act (RCRA) gives EPA control over hazardous waste from start to end.
Under this philosophy, liability for medical waste disposal doesn’t end when the driver or mail carrier picks it up at your premises. You must ensure you use approved and permitted companies to transport and treat the waste until it reaches its eternal resting place safely—whether that be landfill or permanent storage. In addition, every party handling waste is required to complete documentation to maintain the chain of custody. Improper disposal can affect anyone coming in contact with the waste. Discarded sharps are a serious risk for workers in medical waste disposal and recycling facilities, and companies have paid hefty fines on occasion for failure to manage their waste properly.
Legislation and penalties aren’t the only reasons safe disposal matters, however. For healthcare organizations that exist to provide healing, it’s important to avoid actions that could cause harm to anyone. If your waste isn’t adequately protected and ends up accessible to people or animals, the resulting fallout could damage your reputation irreparably.
The Take Away
Healthcare organizations wanting to thrive over the long term need to practice good stewardship, both for company visibility purposes and for ethical reasons. Download our eBook to determine whether using a medical waste disposal specialist is the solution for you.