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The History of Medical Waste Disposal

garbage collection

DSNY archival photo: Department of Street Cleaning collection cart

Life Before Medical Waste Management: Unsanitary and Even Deadly

Imagine you could take a time machine back to, say, the late 1800s in New York City. You’re walking down the sidewalk and pass a dead horse lying on the cobblestone street. It’s the same dead horse that lay there yesterday…and the day before. Everywhere you turn there are piles of trash. Most other city folks have grown accustomed to the smell, but to a newcomer like you—accustomed as you are to proper sanitation—the mingling odors of manure, urine, dead animals and other wastes nauseates you. If you lived in this environment long enough, your chances of contracting a contagious and perhaps deadly disease were very high.
It’s tempting to look back through history and wish you were born into a “simpler time.” The fact is the health and sanitation laws and regulations on disposal of biohazardous waste that are in place today make our cities and towns much more pleasant (not to mention healthier) than in those halcyon days of yore.
Take sanitation workers. We don’t spend a lot of time thinking about how these men and women make our lives better just by virtue of doing their job. Yet the majority of Americans enjoy clean water and air. When you walk to work every morning you don’t have to tramp through dangerous human and animal waste clogging the streets and sidewalks and overflowing into the oceans and rivers.

Dawn of Public Health Reform

In the U.S. and England in the 19th century, there was a much different standard of sanitation than these countries enjoy today. That began to change in the mid to late 1800s. British sanitary reformer Edwin Chadwick famously conducted research into the poor conditions of prisons and hospitals in England. His research precipitated the passage of the Public Health Act of 1848 and inspired reforms in the United States. U.S. Colonel George E. Waring, a cavalry officer in the Union army, helped to establish sanitary engineering as a profession, which boosted its presence in modern life.
Fellow Briton Joseph Lister was the first to connect modern germ theory with medical sanitation. The germ theory of disease linked the existence of microorganisms, or germs, to the onset of diseases. Humans acted as hosts for these microorganisms, and their growth and reproduction caused illness. In the 1870s Lister applied the germ theory to hospital-borne illnesses, with poor medical sanitation the cause.

Medical Sanitation Extends Human Life Expectancy in the Twentieth Century

According to the medical journal Modern Drug Discovery, modern sanitation efforts led to Americans enjoying longer lives.
Most medical historians believe that the sanitation movement, and its attendant improvements in urban health and food safety, contributed far more to the increase in Western life expectancy in the 20th century (primarily through the prevention of infectious diseases) than did much of modern medicine.
Holzbog horse drawn street cleaning cart

Holzbog horse drawn street cleaning cart

Indeed in the twentieth century waste technology began to improve by leaps and bounds, and stricter sanitation laws were introduced. The purpose of the Solid Waste Disposal Act of 1965 was to reduce waste and protect human and environmental health by introducing waste management technologies and standards designed to decrease pollution and promote better municipal waste disposal.
There were those who didn’t feel the SWDA went far enough. In the summer of 1988, medical waste washed up on five East Coast beaches. Congress responded by enacting the Medical Waste Tracking Act of 1988. Regulations on how medical waste could be disposed of became more stringent—and as a result our environment is cleaner and our lives are healthier.
So the next time you see one of Cyntox’s medical waste professionals doing a pickup of your red bags and sharps containers, take a moment to reflect on what your work and home life would look life without the benefit of good biohazardous waste management!

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Laboratory Waste Disposal: The Importance of Having a Safe Disposal Plan

laboratory waste disposal Medical laboratories are at the center of medical diagnosis, discovery and advancement. The essential and important work done daily in labs across the country naturally results in medical waste: some benign, some hazardous. The lab manager should understand and be aware of the type, volume and method of storage for each waste stream, from the moment it is generated to when and where it is ultimately disposed.
This makes it critical for lab managers to have a laboratory waste disposal plan in place for dealing with the various waste streams generated by their facility, and to train his or her staff on how to handle medical waste properly.
This plan should be transparent, thorough, cost-efficient and should take into account local rules and regulations for Regulated Medical Waste (RMW). Depending on the type of waste, it may be governed by the Environmental Protection Agency (EPA), the Occupational Safety and Health Administration (OSHA), the U.S. Drug Enforcement Administration (DEA), and others. Your medical waste provider should be able to provide more details on these different agencies’ requirements.
Identifying and separating medical lab waste
The best way to approach the safe identification and disposal of medical waste is to train your technicians and the rest of your staff exactly how to classify and what to do with waste from the point of generation to removal. Staff should be informed of the dangers of mixing waste streams and the importance of properly sealing and storing waste receptacles before pick-up.
Here are the key waste streams you will likely encounter in the lab:
    1. Sharps: these include scalpels, glass shards, needles, etc. Make sure your staff has a sharps disposal container close at hand where used sharps can be deposited. Once the container is about ¾ full, seal and remove it from the lab.
    2. Infectious waste: this is anything contaminated with blood or other body fluids. Improper disposal of infectious waste can result in the transmission of disease, necessitating its separation from regular trash. Place infectious waste in a separate bag or container supplied by your designated medical waste disposal provider.
  • Chemical waste: according to OSHA, there are approximately 400 substances that constitute chemical waste. These include carcinogens, toxins, irritants, corrosives, sensitizers, hepatotoxins, nephrotoxins, and neurotoxins. All laboratories that use chemicals need to have a written chemical hygiene plan in place to protect staff from exposure. Staff must also dispose of chemical waste in a proper receptacle provided by your medical waste disposal partner.
  • Pharmaceuticals: these include narcotics used as standards. Check with your medical waste disposal provider to see if they will collect controlled substances.
  • Radioactive materials: It is essential that you properly dispose of any radioactive materials, such as those used in research and to diagnose and treat certain kinds of Cancers. These materials should be stored in a closed container that is kept isolated and at a distance from the workspace. Again, check with your medical waste provider to see if they collect radioactive materials. If they do not, they should be able to refer you to someone who will.
  • Recyclable materials: these are your standard plastics, paper, glass and aluminum. Follow your state and local regulations for recycling.
  • Regular trash: Make sure your regular trash bins are clearly marked with a list of what can and cannot be placed inside to avoid someone placing RMW in with common trash.
  Plan to succeed: be vigilant and proactive
A good plan also requires strict oversight if it’s to be effective. Lab managers should not only train new employees on safe medical waste disposal, but also periodically audit their lab to make sure the proper protocols are being followed. Many medical waste disposal providers offer training to managers and staff to help them stay compliant. Ask your provider if they offer such a service.
Medical lab managers can also be proactive in reducing the amount of medical waste generated. Part of their overall plan can include replacing certain chemical solutions with less hazardous versions, employing methods to neutralize certain chemicals on-site, and evaluating new medical testing procedures to see if they increase or decrease the amount of waste that will be generated.  These actions save money and reduce staff exposure to harmful substances.
If you’re unsure about any aspect of lab waste disposal, be sure to consult your medical waste disposal provider, who knows the local rules and regulations for each waste stream. Your provider can help keep your facility from being fined for improper handling and disposal of your RMW, as well as protect your staff and the public from any harmful exposure.
  1. Medical Laboratory Observer Staff, “Waste Management for the Clinical Lab,” Medical Laboratory Observer, December 1, 2009. Retrieved from http://www.mlo-online.com/waste-management-for-the-clinical-lab.php
  1. Scungio, Daniel J., “Identify and Manage Clinical Laboratory Waste,” Medical Lab Management, May-June 2013. Retrieved from http://www.medlabmag.com/article/1111/

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Healthy Smiles and a Healthy Environment: Safe Dental Waste Disposal

dental wasteProper disposal of dental waste is crucial to safeguarding staff, patients, and the public, as well as protecting the environment. Laws differ by state, so check with your dental waste disposal provider to make sure you are compliant. However, there are certain guidelines that every dental practice should know and follow.  
Soft soiled waste disposal Blood and body fluid precautions are designed to reduce the risk of spreading diseases such as Hepatitis C and D. Following these precautions means safely disposing of soiled soft waste generated in your procedure room. Your dental waste disposal provider will supply you with small and large red bags or other red waste receptacles. Place your soft soiled waste, such as blood or saliva-saturated cotton or gauze, extracted teeth, and surgically removed hard and soft tissue in the small red bags. The small bags should be kept close at hand in every procedure room. This minimizes staff and patient exposure to dental waste. When they are full (but never to overflow), seal or fasten the bags shut and place them in the larger red bag or receptacle for pick-up.
Mercury-containing amalgam disposal Dental amalgam is of particular concern because of the potential for mercury in the amalgam to be released into the environment, where it is especially toxic to fish (the leached mercury accumulates in their tissues.)
In an effort to help dentists safely recycle Amalgam wastes, the America Dental Association (ADA) developed “Best Management Practices for Amalgam Waste” (BMPs). These best practices for handling and disposing of amalgam waste include the following:
  • Choose amalgam capsules (individually-dosed containers of amalgam) of different sizes to reduce waste. Be sure to properly dispose of used amalgam capsules as well as amalgam scrap (the excess mix left over after the procedure.)
  • The ADA does not recommend using bulk elemental mercury (liquid or raw mercury).  If you have bulk elemental mercury in the office, ask your dental waste disposal provider if they accept bulk mercury. It should never be poured down the drain or placed in the red bag where you normally place soft soiled waste, nor mixed in with your regular solid waste.
  • The use of chairside traps and filters in your office vacuum system is a safe way to control dental amalgam. Disposable—rather than reusable—amalgam traps are preferable. Check with your dental waste disposal provider to see if they accept disposable amalgam traps along with your other amalgam waste.
  • When handling amalgam, staff should wear protective gear such as utility work gloves, fluid resistant face masks, and safety glasses.
  • Always use the designated sealed receptacle marked for amalgam waste given to you by your dental waste disposal provider. Make sure you talk to your provider about what can and should be placed in this container.
  • Choose a provider who complies with the ADI-ANSI standard.
Dental sharps disposal Disposing of dental sharps is the same as with medical sharps—place needles, scalpels, glass carpules, burs, acid etch tips, files, blades, orthodontic wire, etc. in designated sharps containers. Always keep these containers close at hand and be careful to not overfill them.
Chemicals, disinfectants and sterilizing agents disposal Always check the Material Safety Data Sheets (MSDS) for safe handling and disposal of all chemicals, disinfectants and sterilizing agents. If possible, avoid using chemical sterilants; instead opt for steam or dry heat to sterilize your instruments. Sterilant absorbed on cloths or paper products, as well as emptied, rinsed sterilant containers can be placed with your regular solid waste.
Silver and lead waste disposal Silver and lead waste disposal generated primarily through X-ray film and related equipment requires special attention. They include:
  • Spent X-ray fixer solution (used to develop X-rays)
  • Undeveloped X-ray film
  • Lead foil in X-ray packets
  • Lead aprons
Never throw these away in the regular garbage, down the sink or in with compost. Contact your dental waste disposal provider to find out if they handle these particular silver and lead wastes.
Following these guidelines for dental waste management is the best way to assure your staff and patients that you are protecting their health and safety and being mindful of your impact on the environment.  
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How to Properly Dispose of Pharmaceutical Waste

Properly Disposing of Pharmaceutical Waste
Pharmaceuticals are more popular than ever, with 7 out of 10 Americans taking one or more prescription drugs—including antibiotics, antidepressants and pain-blocking opioids, according to researchers from the Mayo Clinic and Olmsted Medical Center.
With such massive quantities of prescription pills being generated each year, medical facilities, pharmacies and patients are facing the problem of what to do with all their leftover and expired medications.
Improperly disposing of pharmaceutical waste can cause environmental damage and poses a threat to human and animal health.
For businesses that are discovered illegally dumping their pharmaceuticals, it can also mean costly lawsuits and a tainted public image.
Legal trouble for three big pharmacy chains
In 2012, the drugstore chain Walgreens was slapped with more than $16.5 million in damages for “illegally dumping pharmaceutical and biohazardous wastes throughout California.” As part of the lawsuit settlement, Walgreens also agreed to “fund environmental projects that will further consumer protection and environmental enforcement” in the state.
The same year and also in California, the popular chain CVS “agreed to pay $13.75 million in a settlement to resolve claims that it violated environmental law over a seven-year period by improperly storing and disposing of pharmaceutical and medical waste.” Their agreement also required the company comply with California’s rules of how to properly dispose pharmaceutical waste.
And in 2013, the drugstore chain Rite-Aid paid $12.3 million dollars after they were charged with dumping “toxic, corrosive or ignitable materials ranging from pharmaceuticals and pesticides to paint, aerosols, and bleach in local landfills over the course of six and a half years.” They were tasked with instituting an environmental protection training program and partnering with medical waste disposal companies compliant with state medical waste regulations for safe collection and disposal of their pharmaceutical waste.
The fallout for these major pharmacies went beyond the hefty fines—it was also a public hit to their brand’s image. If you are a company in the business of preventing and treating disease, being caught improperly dumping pharmaceutical waste that threatens environmental and human health does not make for positive publicity.
Safe drug disposal alternatives
Evidence suggests that prescription drugs pose a significant danger to the environment—but pharmacists, other medical professionals and even patients themselves can play a role in prevention.
A long-term solution to the proliferation of so many prescription drugs is promoting better public health programs and advising patients of prescription-free alternatives to wellness that lessen the need to produce large quantities of prescription drugs in the first place.
The next best solution is learning and following your state’s regulations for safe disposal of your pharmaceutical waste. If you are a hospital, pharmacy or other medical facility, check out tools for safe pharmaceutical waste disposal for health systems
The FDA advises individual patients with unused and expired medications to first consult the medication bottle for instructions on proper disposal. Although some medications may be safely flushed down a toilet or sink, many others should never be flushed—so patients should be told to carefully read the instructions on their medication before taking action. Certain other drugs can be thrown in with the household trash, but they should be mixed with undesirable garbage or sealed in a container so that animals or humans seeking unused drugs illegally won’t pull them out of the trash. Again, it is best for patients to first consult the instructions that come with their particular prescription. Individuals can also research local programs that allow them to drop off their medications at a central location for proper disposal. Local law enforcement agencies can help people who are interested in locating these programs. The DEA also offers mail-back programs and drop-boxes for unused drugs. Individual consumers can get more guidelines on the safe disposal of pharmaceuticals here.
Hospitals and medical facilities can also get help from waste management companies like Cyntox. With locations in 44 states, Cyntox is familiar with the regulations in every state we serve and can keep your business compliant with regulations for pharmaceutical waste. Give us a call today for a free quote.
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costs of medical waste disposal

How Much Does Medical Waste Disposal Cost?

The most frequently asked question we hear from medical professionals and staff members is “how much will medical waste disposal cost?” Our answer is always the same—it varies. There is no one price for every client. What we can tell our potential customers up front is what variables go into the final cost. The good news is once the rate is assessed, it won’t suddenly spike due to hidden fees.

So what goes into the formula for determining the cost of your medical waste disposal bill? There are three major factors and some minor ones.

1. Volume
How much medical waste are you generating? That is a factor in determining the cost. In this case, more is better. It will cost you less if you are generating a high volume of medical waste than if you only fill your receptacle about once a month.

2. Location
What state are you in? Each state has its own regulations about what constitutes regulated medical waste (RMW). For example if you are located in California, their definition of RMW is going to be different than Arizona or Rhode Island. So the price will vary based on different state regulations. Cyntox, which has locations in 44 states, is familiar with the regulations in each state and can keep you compliant with your local regulations.

The second consideration is, are you in the city, a suburb or a rural area?  If you’re in an urban area chances are the medical waste disposal company has several clients on your route already and so adding your practice to the list won’t be a big deal. If you are located in a more remote area, however, it is going to cost more because A. the truck will likely be going out of their way to get to you, perhaps even making a special trip and B. the cost of fuel will be higher.

3. Frequency
Like with volume, the frequency with which you have your medical waste picked up will affect your price. The more frequent the pick-ups, the less it will cost. That being said, make sure you are not having your bins picked up half-full. Just like with so many things in life, you need to find the happy medium between having your bins picked up promptly and not getting over-serviced. A good medical waste company can help you make an assessment of how frequently you’ll need to schedule pickups based on factors like average RMW volume.

In addition to these top three factors, there are a few other variables to keep in mind.

4. What kind of waste are you generating?
Are you generating pharmaceutical waste? How about trace chemotherapy and pathological waste? These kinds of wastes are generally treated separately and so may affect your grand total.

5. Does your staff require training?
Companies like Cyntox offer clients BBP Training to satisfy the annual OSHA Bloodborne Pathogens requirement on exposure control principles and practices. There’s also Hazcom Training, which satisfies OSHA’s Hazard Communication Standard, and HIPAA Training, which satisfies the HHS privacy requirement. Adding these trainings to your bill will affect the price.

6. What is the quality of the medical waste management company’s customer service? And what about the drivers—are they reliable, safe and punctual?
Companies that offer top-notch customer service with easily accessible representatives to answer your questions, as well as excellent drivers with top-notch safety records, will cost you a little more in manpower but will provide peace of mind.

Just like with any service, you get what you pay for. Medical waste disposal is not an area where you want to go with the cheapest provider! You could end up with a medical waste management company with insufficient insurance in the event of a truck spill. Or you may find that the cheap company isn’t making frequent or consistent pick-ups or isn’t versed in your state’s regulations. You also need to be on the lookout for companies who offer a cheap introductory price but then toss in a lot of hidden fees that you only discover six months down the line and already roped into a contract.

7. Why Cyntox?
Although your costs are affected by the variables above, you can be assured that Cyntox does everything it safely can to slash your rates. And once your rate is determined, you won’t be surprised when you actually get the bill. Our invoices ALWAYS reflect the agreement you signed. We will never pull a bait-and-switch on you by unexpectedly raising the price.  There is no fine print in our contracts and we offer a 90-day, commitment-free grace period so you can try us out and make sure we fit your needs before signing anything. Besides the service fee, the only additional fee is a 10% fuel charge fee, and if you are located in New York, Connecticut, New Mexico or Arkansas we are required to put a tax on your service.

It pays to do your homework and shop around, and we encourage you to do so. We are confident that once you do the math and compare what you’ll get for the price, Cyntox will be at the top of your list.        
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medical waste managing

Managing Your Medical Waste Disposal: A Comprehensive Guide

Proper medical waste management is vital in protecting the welfare of our health care workers, staff and patients. Taking a wider view, it is also crucial to the health and safety of our communities and the environment.

Good medical waste management includes proper handling, storage, transport, processing and disposal of waste. The consequences of negligence in this area can be dire.
“Poor waste management may jeopardize patients and their families, employees handling medical waste, care staff, and the others who come in contact with it,”
reported Your Renewable News. “The inappropriate disposal or treatment of the waste may result in pollution or environmental contamination. These risks can be significantly reduced using appropriate and simple measures.” When you choose to outsource your medical waste management, you demonstrate a commitment to your workers and to the community. You are guaranteeing that skilled workers who are trained in the safe collection, handling and transportation of medical waste are on the case and doing their part to protect your facility. But even if you outsource your medical waste management, you still have an important role to play in health and safety. Your prime responsibility as a health care facility becomes the proper handling and storage of medical waste before it is picked up and taken off-site.

Managing your medical waste disposal

The rule of thumb with medical waste disposal is timely discard as close to the point of waste generation as possible. That means assessing the types of waste you will generate in a specific setting and then making sure you have the proper, labeled receptacles close at hand. In that assessment, your medical facility should make sure its compliant with your state’s guidelines on what constitutes medical waste. If you are using an off-site medical waste disposal company, make sure they too are up-to-date and compliant on the latest regulations for your state. Check this interactive map of state environmental agencies and list of state health agencies for more information.

Use the right waste receptacles every time

Proper medical waste receptacles and bags should be made of combustible, non-halogenated plastics and should be color-coded and labeled for the type of medical waste they contain. Color coding and labeling helps avoid any confusion among healthcare workers as well as those who handle removing your medical waste to take it off-site. As a reminder of what goes where, post instructions on waste separation and identification at each waste collection site.

medical waste containers

Some common medical waste containers.

Chemical and pharmaceutical waste should be disposed in a brown plastic bag or container and general health care waste in a black plastic bag. Infectious waste that comes from lab cultures, surgeries or autopsies on patients with infectious diseases, and infected lab animals should be discarded in strong, leak-proof yellow bags or containers. Infectious waste containers and bags should always be marked with the international infectious substance symbol. If you are handling highly contagious infectious materials, it should be sterilized as soon as possible by autoclaving. Make sure this waste is immediately disposed of in a yellow container capable of being autoclaved.

Consult your medical waste disposal company for more information about guidelines for color-coding and labeling your medical waste, as well as the handling and swift disposal of highly contagious materials.

Proper sharps disposal and the costs you can incur when you don’t comply

Proper sharps disposal is an important component of your overall medical waste disposal plan. “Sharps” are any medical devices with sharp points or edges that can puncture or cut the skin; they include needles, syringes, lancets, and auto injectors like insulin pens.

According to the CDC, “Occupational exposure to bloodborne pathogens from needlesticks and other sharps injuries is a serious problem, resulting in approximately 385,000 needlesticks and other sharps-related injuries to hospital-based healthcare personnel each year.” Injuries from sharps are associated with hepatitis B and C, HIV, and more than 20 other pathogens. Everyone from health care workers to janitors and other cleaning personnel can suffer injuries from encounters with improperly discarded sharps.

sharps disposal

Beware: Sharps are called sharps because they are… sharp!

Negligence in sharps disposal can also result in steep fines. In April 2016, Cooper Hospital was fined $55,000 by The Occupational Safety and Health Administration (OSHA) for various employee training violations, including not teaching them to immediately discard “contaminated sharps, such as needles, in appropriate containers” and improperly labeling their sharps containers.

And the costs don’t stop with fines. According to Waste360, “The CDC estimates that for each needle stick, direct costs can range from $71 to over $5,000 for initial and follow-up treatment. Further direct costs can include medical care should a transmission occur and litigation as well as indirect costs related to lost time and emotional costs.”

Safely dispose your medical sharps/needles

Sharps injuries can be avoided by disposing of each needle properly after its one-time use. Your waste management company will supply you with the appropriate marked containers. The CDC recommends organizing your work area with the sharps disposal containers within reach. They also warn against overfilling the containers and advise workers to keep fingers away from the opening of the receptacle.

Most containers come with a hole to insert the sharps.

Most containers come with a hole to insert the sharps.

Make sure to let other hospital personnel know if you see a needle that has been improperly discarded—in a trash bin or other receptacle that is not labeled as a sealed sharps container. Let someone know immediately if you see used sharps in linens, beds, or on the floor.

Removal of all medical waste receptacles

It is advisable to remove medical waste receptacles once they are three-quarters full. Good medical waste management companies follow a regular pickup schedule so your waste is never sitting idle for too long, but in some instances you may want to arrange for a special pickup and removal.

By consistently following these simple guidelines, you will not only help your medical waste management partner to better serve you; you will also have peace of mind that you are doing your part in protecting your greatest assets: your staff and patients.

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What Happens To My Medical Waste After It’s Taken Away?

For some people, out of sight is out of mind. But if you DVR “How It’s Made” on the Discovery Channel or regularly spend time on websites like HowStuffWorks.com, you might be just a little curious. What exactly happens to all your organization’s medical waste once the bags and containers are hauled away?

First, let’s go back a few decades in history. In the summer of 1988, medical waste washed up on five East Coast beaches. Medical waste appearing on our shoreline is almost as scary a prospect as bloodthirsty sharks, and a public outcry ensued. Congress sprang to action, enacting the Medical Waste Tracking Act of 1988.  Regulations on how medical waste could be disposed of became more stringent.  

Fast forward to the present.  Today we know more about the risks of poor medical waste management.  It is helpful to keep in mind a statistic from the World Health Organization (WHO), which states, “about 85% of waste generated by healthcare is general and non-hazardous waste. 15% is considered hazardous.” Also, at the conclusion of the Medical Waste Tracking Act in 1991, the EPA determined that healthcare professionals face a higher risk handling infectious waste at its source than the general public once the waste is disposed of and time has elapsed.  

Of course, when it comes to medical waste disposal of any kind, safety and compliance are still crucial elements in keeping the public and environment healthy.  It is now up to each state’s environment and health departments to decide how to best regulate the collection, transportation, treatment and disposal of their state’s medical waste. You can read up on your particular state’s regulations here.
Apart from some variations among states, managing medical waste disposal follows five key stages:
  • Segregation: what treatment does the waste require?
  • Packaging: what receptacle does it get stored in before it’s transported?
  • Transportation: medical waste must be safely and securely transported to a treatment or disposal facility.
  • Treatment/Destruction: Depending on if the medical waste is Regulated Medical Waste (RMW), a treatment or destruction method must be assigned.
  • Disposal: The treated medical waste is disposed of in a landfill or approved sewer system.
Having a medical waste disposal provider who is timely and dependable is the first requirement for any efficient disposal process. Medical waste—even when it is safely contained in the proper receptacle—is not something that should sit around for too long. Once it is picked up, the trained driver must follow strict protocols for transporting the waste. Different kinds of medical waste need to be segregated in the truck, and the truck needs to be marked so other drivers on the road know it is carrying potentially infectious materials. Having a protocol in place in the event of an accident, including a spill containment and cleanup kit on every truck, is also necessary.

Choosing a method of treatment

Once the medical waste arrives at its destination, it’s ready for treatment. According to the EPA, before 1997 “more than 90% of potentially infectious medical waste was incinerated”—often on-site, where the waste was generated. But new emission standards for medical waste incinerators spurred alternative methods, and now several additional options for treatment of RMW and non-infectious medical waste exist.

These methods include steam sterilization, chemical disinfection with grinding or encapsulation, thermal inactivation, irradiation, grinding and shredding, and compaction. The type of method used depends in part on what type of medical waste is at issue—is it sharps, cultures and stocks or human blood? All need to be treated in specific ways.

  Steam sterilization is using saturated steam within a pressure vessel (sometimes called an autoclave) to kill infectious properties in the waste. Chemical disinfection with grinding or encapsulation involves grinding the waste in a hammermill while also using a chemical disinfectant. Thermal inactivation uses the transfer of heat to reduce infectious properties in the waste. Materials that can’t be treated thermally can be irradiated. Irradiation exposes waste to ultraviolet or ionizing radiation to break down infectious agents.

Finally, compaction is a method to reduce the volume of waste. It is not a treatment method, per se, but it can transform the waste into something unrecognizable—another essential element of the disposal process.   Once solid medical waste is treated, it is considered municipal waste, and it is shipped to a sanitary landfill. If the waste is in liquid form, it can be sent to a health-department approved septic system or sanitary sewer system for further treatment at a wastewater plant.

So the next time you see your sharps bin or your medical waste boxes carried off, know that great care is being taken to safely dispose of it for good.

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zika virus

Should I Be Worried About the Zika Virus?

The latest mosquito-borne disease to cause concern in the medical world is the Zika virus. Although the first cases of Zika in humans were discovered in Uganda and Tanzania in 1952, an outbreak in Brazil and Colombia in 2015 made national news in the U.S.  So just how prevalent is Zika, how does it spread and what harm can it cause?

Just the facts: what you need to know about Zika
Zika has been called an emerging virus: According to the World Health Organization (WHO), “from 1 January 2007 to 6 April 2016, Zika virus transmission was documented in a total of 62 countries and territories.” WHO has declared the virus and associated birth defects an international public health emergency.

Spread mainly through mosquito bites, WHO recently stated that six countries (Argentina, Chile, France, Italy, New Zealand and the United States) have now reported locally acquired infection through sexual transmission from an infected man to his  partners. Zika can also be spread from mother to child during pregnancy or around the time of delivery. Some cases of transmission through blood transfusions have been reported in Brazil.

According to the Centers for Disease Control and Prevention (CDC), symptoms of the virus are generally mild and include a low fever, skin rash and conjunctivitis—what is commonly known as “pink eye.” These symptoms usually last less than a week. However, some patients are asymptomatic.

Zika can be diagnosed in the laboratory by testing serum or plasma to detect virus, viral nucleic acid, or virus-specific immunoglobulin M and neutralizing antibodies. Currently, there is no specific antiviral treatment available for Zika virus disease. Rest, fluids and the use of analgesics and antipyretics are recommended.

The CDC is advising health care providers with patients who are complaining or actively displaying symptoms of the Zika virus to ask their patients about their recent travel history. If they suspect the presence of the virus, it should be reported to their state or local health department.

Zika in the U.S.
The CDC reports that the number of cases in the United States is relatively small right now, at 358 patients (as of April 13, 2016.) Furthermore, all 358 cases were travel-related. Locally acquired Zika cases have been reported in the U.S. territories of Puerto Rico, the U.S. Virgin Islands and American Samoa. Estimates put the number of cases in U.S. territories at 471 (as of April 13, 2016.) Authorities are paying particularly close attention to Puerto Rico because of the quick spread of the virus in that territory.

It’s important to note, however, that the mosquito that transmits the virus, Aedes aegypti, is present in more U.S. states than previously believed. According to a recent article in TIME, the current state count is 30. As spring turns to summer and humidity rises, the number of states with the Zika-carrying mosquito could increase.

Concern for pregnant women and women planning to get pregnant
The locus of concern in the medical community is primarily around pregnant women and women who are planning to conceive in the next two months. This is due to the association of the presence of the Zika virus in the mother with a serious birth defect of the brain in the infant called Microcephaly. Just this month, the director of the Centers for Disease Control and Prevention, Dr. Thomas R. Frieden, announced that “there is no longer any doubt that Zika causes microcephaly.”

Microcephaly is a condition where a baby’s head is smaller than normal because the brain has not developed properly during pregnancy. Depending on how severe the birth defect, Microcephaly can cause related problems such as seizures, developmental delays, intellectual disability, problems with movement and balance, feeding problems, and hearing and vision loss. It has also been found that Zika can cause premature births.

The CDC reported, “Zika’s damage is likely worst when it hits a fetus in the first trimester of pregnancy, the crucial time in brain development. By the time the baby’s immune system begins to combat the virus, much of the damage has been done.”

No vaccine for Zika… yet
According to BBC News, a Zika vaccine is in development and could be ready for human trials as early as September. Again the focus of the vaccine is for pregnant women to prevent microcephaly in their infants.

So just how worried should you be about the Zika virus? As Zika is a developing story and medical experts are learning new features of the virus that indicate Zika is worse than they originally thought, we recommend vigilance. This includes staying informed and taking precautions in areas where mosquitoes are present by wearing insect repellant containing DEET (diethyltoluamide) or IR 3535 or Icaridin and proper clothing that covers exposed skin, like long pants and long-sleeved shirts. If you are pregnant or plan to become pregnant in the next eight weeks, it’s advisable not to travel to areas where Zika is prevalent.

Clean water, sanitation and hygiene are all factors in preventing disease, particularly mosquito-borne viruses like Zika. Proper biomedical waste management, including laboratory waste management and syringe and sharps disposal, are also essential safeguards against the spread of disease. If you have any questions about medical waste regulations in your area, please contact cyntox.
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sharps container

What To Look For In A Medical Waste Disposal Company

Choosing a medical waste disposal company can be tricky if you’re not sure what to look for. If you’re a busy doctor’s office or hospital you might be tempted to just pick the first company that appears in your Google search results. After all, what’s the difference—they all do essentially the same job, right? You just want to get rid of your biohazardous waste quickly, safely and with as few headaches as possible so you can get back to the rest of your work.

Sifting through all the options

The good news is that the medical waste management business is growing, which means consumers have more choice of services. According to RNR Market Research, there are several factors contributing to this growth, including more medical waste regulation and an aging Baby Boomer population requiring more health services and procedures, which in turn incurs larger amounts of medical waste. This is good news for consumers because it means there are more options in medical waste disposal companies. But having lots of options can be confusing, especially if you’re not clear on what differentiates one company from another.

When it comes to choosing a medical waste disposal company, instead of flying blind take a minute to get informed on the key factors to look for and the questions to ask when searching for a service. Spending a few minutes of research now means that you won’t have to revisit the same decision six months later, when it turns out the company you picked isn’t meeting your needs or fully complying with your state’s regulations.

1. Do you have to immediately sign a contract or can you “try before you buy?”

If you’re like most people, you don’t want to be tied down to one provider until you’ve had a chance to see if you’re a good fit and if you’re happy with the company’s services for the price. Look for a medical waste disposal company that offers a contract-free grace period so you can try them out first. Customer loyalty has to be earned. Any company that doesn’t offer a no-commitment trial might not be confident in it’s ability to keep you as a customer.

2. Will your annual service rates go up unexpectedly?

No one likes negative surprises, but some companies may try to impose hidden fees and service charges. One medical waste disposal company in Tennessee was sued for regularly raising its rates even though it promised only to do so under “limited conditions.” Make sure there isn’t any fine print in your bill or contract.

3. Is the company fully compliant with federal and state regulations for medical waste disposal?

You might assume this is a given for any medical waste management company, but regulations differ from state to state and are subject to change. You want to make sure the company you choose understands all the regulations and is keeping up-to-date with new rules as they arise.

4. Does the company offer a variety of materials and receptacles to suit your waste management needs?

A small clinic is going to have different needs than a city hospital. Make sure the medical waste disposal company you choose offers a variety of sizes of tubs, barrels and containers for your use, as well as complementary red biohazard bags, liners and boxes.

5. Does the company make regular and/or frequent pickups?

No hospital staff member wants to see medical waste just sitting around, even if it’s in a sealed receptacle. A good medical waste management company will make regular pickups so your waste is gotten rid of quickly and efficiently!

6. Can you reliably reach someone in customer service if you have questions, especially about what to dispose of and where?

It may not be immediately obvious what waste can go in your waste receptacles and no one should expect you to have to guess! For instance, a sharps container is usually thought of as a receptacle for needles syringes but it can actually hold all medical waste materials that have the ability to puncture skin. On the other hand, standard office supplies and household items should never be thrown in your red biohazard bags. If you’re unsure of what you can dispose safely and where, it helps to have access to a quality customer service team who can answer your questions and are there when you need them.

It pays to be informed

Knowing the right things to look for in a waste management company will help you make the right decision the first time. It’s a good feeling when you know you can count on your service provider to be honest, professional and compliant.

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