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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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