The following article deals with medical waste management. Living through a pandemic is a dark and uncertain time. As establishments and commerce close down and mobility is limited, we find ourselves at odds over what to do and how to survive the lockdown. However, as businesses open once again, and governments adjust to give the economy breathing room: we unfortunately still battle the risk of acquiring COVID-19.
With the influx of disposable personal protective equipment (masks, gloves, safety glasses, face shields, etc.) that can protect you from pathological or infectious substances, the risks of acquiring the virus has significantly lessened. However, this protection comes hand in hand with a different problem altogether.
Merely disposing of medical waste through ordinary waste collection facilities or through other improper methods can cancel the global effort towards preventing the spread of COVID-19, and other infections, viruses, and bacteria. That is why there are dedicated facilities that aim to facilitate proper medical waste disposal.
What are medical wastes?
Although broadly classified under medical waste, biohazard wastes are under different categories such that they are dealt with and disposed of differently. Roughly, there are six categories of medical waste that are commonly regulated.
• Pathological Waste – These are anatomical waste that include human tissues, organs, or body parts that are removed through and for different hospital procedures that are meant to be disposed of.
• Blood Products – These include human blood or bodily fluids and other potentially infectious materials such as: cerebrospinal fluid, semen, saliva, vaginal secretions, other bodily fluids that are contaminated with blood, etc.
• Microbiological Waste – These refer to infectious agents such as cultures, culture dishes, specimens, stocks, expired or unused vaccines that may be hazardous to humans as these materials are likely contaminated by infectious organisms.
• Contaminated Sharps Waste – These are contaminated wastes that have the ability to puncture the skin and introduce infection towards the blood stream. Examples of such are needles, syringes, broken glass, scalpels, insulin pens, etc. Contaminated sharps are one of the leading causes of the transmission of Hepatitis B & C, and one of the causes for the transmission of HIV.
• Isolation Waste/Wastes from Highly Communicable Diseases – These are wastes from materials or secretion from patients that have been under quarantine for having communicable diseases such as Ebola, monkey pox, etc.
• Animal Waste – These are animal body parts that have been contaminated with infectious agents within laboratories and research facilities.
How are medical wastes segregated?
Categorizing these wastes and disposing of them in designated areas is not only efficient, but safe as well. Healthcare and Medical disposal facilities ideally should segregate these wastes according to how they must be handled in the facility, through color-coded trash bins. Without proper segregation, theirs is an increased potential of unlabeled and unidentified medical waste to be dumped in landfills where it is left untreated and may harm individuals that it encounters.
The most prominent form of healthcare waste segregation is to identify the waste and place them in the following containers:
• Red Containers – Red is a federally regulated color that signifies biohazard waste and is marked with a biohazard symbol. This bin is generally where infectious waste, blood products, contaminated PPEs, cultures, and pathological wastes go.
Furthermore, red bins are where sharps containers are disposed towards which contains medical sharps such as the ones mentioned above. Red containers are regulated to ever be used for anything else other than biohazardous waste.
Medical sharps should be disposed of through sharps container, and these containers must be puncture-proof, leak-proof, fitted with covers, and only filled up until 75% of their capacity.
Furthermore, if unable to access authorized sharps containers, containers made from dense cardboard are recommended.
• Yellow Containers – These containers usually contain syringes, vials, IV bags, gloves, and other PPEs that have been exposed to chemotherapy procedures as these wastes carry cytotoxic substances that are lethal to humans. These wastes are often incinerated in medical waste disposal facilities.
• Blue Containers – Pharmaceutical wastes that are not regulated by the RCRA (Resource Conservation and Recovery Act) or deemed as hazardous such as antibiotics, IVs, ibuprofens, injectables, and other pills go to blue containers.
• Black Containers – Wastes that are identified by the RCRA as solid hazardous chemical wastes are placed in black containers. These include hazardous medication, and doses of such, bulk medication, P-listed drugs, and pathological wastes.
Proper Practices on Handling of Healthcare Wastes
The WHO (World Health Organization) outlines the following practices in properly storing and handling medical waste.
Healthcare employees must seal or close waste bags when they are three-quarters full through a seal especially when these bags are heavy and cannot be tied through the neck. Medical waste bags should never be sealed through stapling.
WHO also recommends that:
• Medical wastes should be collected on a regular schedule, as frequent as possible
• Removed bags/containers must immediately be replaced
• Bags/containers cannot be taken away unless they are appropriately labelled in accordance to their contents
Healthcare wastes should have a designated storage room, in an area that separate from other functional rooms within the establishment. Ideally, these wastes must be stored in refrigerated rooms, however, upon unavailability, the WHO recommends the following temperatures for storage:
• On a temperate climate, the lifespan of healthcare wastes in storage should not exceed 72 hours during winter and 48 hours in summer.
• On warm climates, it should not exceed 48 hours during the cool seasons and 24 hours during the hot season.
Disposal of Healthcare Wastes in Medical Disposal Facilities
As healthcare facilities may partner up with medical disposal companies, dedicated disposal facilities deploy two or more of the following treatments to get rid of biohazard wastes:
• Incineration – The process of burning hazardous wastes. After 1997, this method had become scarce and only used for specific types of hazardous waste because of its environmentally damaging impact.
• Autoclaving – The process of sterilizing wastes through steam that removes the infectious property of these wastes.
• Microwaving – Placing wastes under a high-powered microwave that similarly sterilizes hazardous wastes.
• Chemical Treatment – Applying chemicals that deactivate infectious substances in medical waste.
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