Handling and Disposal of Infectious Wastes

Biomedical Waste Regulations OSHA “Bloodborne Pathogens Standards” 29 CFR part 1910.1030 Sharps containers & waste packaging Generators, Transporters, and Disposal Facilities are Regulated by States DSHS Title 25 Part 1.131- 1.137 “Definition, Treatment, and Disposition of Special Waste from Health Care Related Facilities” TCEQ Chapter 330.1001 Subchapter Y: “Medical Waste Management” Centers for Disease Control (CDC) “Biosafety in Microbiological and Biomedical Laboratories” Laboratory and clinical practices Defines certain infectious agents

Infectious Waste Management Designation Packaging Storage Treatment and disposal Contingency Plan Record-keeping

What is an Infectious Waste? Waste capable of producing an infectious disease Presence of a pathogen of sufficient virulence Dose Portal of entry Resistance of host Includes: Isolation wastes Microbiological waste (cultures and stocks) Bulk human blood and blood products >100ml, free flowing, or saturated disposable products Infectious animal carcasses, body parts, and bedding Pathological Waste Sharps

Packaging Rigid leak proof containers Sealed and impervious to moisture Absorbent to capture any free liquids Labeled with biohazard symbol Closed container for aerosols Sharps in approved container and color coded

Packaging Rigid leak proof containers Sealed and impervious to moisture Absorbent to capture any free liquids Labeled with biohazard symbol Closed container for aerosols Sharps in approved container

Typical Containers Used for Infectious Wastes

Typical Sharps Containers

Infectious Waste Storage Secure from theft Secure from the elements (rain, water, and wind) Store as not to generate noxious odors or attract animals (vector control) Posted with the biohazard symbol Spill equipment available

Labeling Words “Medical Waste” or “Infectious Waste” and universal biohazard symbol In some states Spanish is required (TX) Offsite shipments require the name and address of generator and transporter to be affixed to the container Red plastic bags used as inner packaging do not require labeling Liner must be tied

Treatment and Disposal Biological waste must be rendered non-infectious prior to final disposal into a landfill This can be achieved either onsite or offsite by utilizing an approved method of treatment such as Autoclaving Chemical treatment and maceration Dry heat / thermal inactivation Incineration

Offsite Treatment and Disposal Approved medical waste transporter Treatment options Incineration Steam Sterilization Onsite maceration and disposal (microwave and chlorine) Audit your contractor’s facility

Recordkeeping - Offsite Treatment Manifests Certificate of incineration Reconciliation of manifests Records should be maintained for at least three years

Onsite Treatment and Disposal Steam sterilization (Autoclave) Chemical disinfection Thermal inactivation (Dry heat) Incineration

Steam Sterilization Types of wastes (micro, blood, etc.) Packaging of inner containers allow steam to enter bags Temperature, pressure, and time dependent minimum parameters 250F, 15 psi, 30 min. Volume and configuration of load do not overload autoclave Quality control documentation is required

Quality Control Autoclave temperature tape recommended Parameter monitoring (pressure and temperature) every load Efficacy monitoring 50 -100 lbs/month - monthly 100 -200 lbs/month - biweekly >200 lbs/month - weekly routine parameter monitoring maybe substituted for biological monitoring

Autoclave Use Logs Must include: Date waste is treated Type of waste Treatment conditions (time, temperature & pressure) Amount of waste treated Name & initials Location or room number

Autoclave Efficacy Testing

Liquid Infectious Waste Disposal Chemical disinfection is generally used for liquid wastes EPA registered disinfectant; 1:10 bleach solution, or 70% iso-propanol Totally immersed for at least 10 minutes Disinfectant must be thoroughly drained prior to disposal if used on solids, and solids need to be macerated

Contingency Plan Written plan to address clean up procedures, protection of personnel, and disposal of waste for (worst case scenario) : Spills of liquid waste Equipment failure Rupture of packaging Incorporate into SPCC/Hazardous waste and substances contingency plan or biosafety manual

Alan.Lucas@uth.tmc.edu 713-500-8104 Questions? Alan.Lucas@uth.tmc.edu 713-500-8104