Biological Waste from Laboratories Why so many rules and what does Stericycle have to do with it?

Yes. Your lab waste is regulated. MA state regulation 105 CMR 480.000 Human blood and materials contaminated with human blood Human parts, tissues, fluids Cultures of infectious agents as well as all labware used with cultures generated in research and clinical laboratories Biotechnology by-product effluents such as cultures and solutions contaminated with microorganisms (including genetically altered) Animal carcasses, body parts, body fluids, blood, bedding Sharps BPHC and NIH Recombinant and synthetic nucleic acids Waste that because of its characteristics may cause, or significantly contribute to, an increase in mortality or an increase in serious irreversible or incapacitating reversible illness; or pose a substantial present potential hazard to human health or the environment when improperly treated, stored, transported, disposed of, or otherwise managed. Human parts - (excludes urine, teeth, snot, vomit, fecal materials)

MA approved mechanisms of biological waste disinfection Steam disinfection / autoclaving; Chemical disinfection; Incineration at an approved incineration facility; or Any other method approved in writing by the Department. Pathological waste – human and animal tissues and body parts must be incinerated Sharps – must be disinfected and then processed to eliminate the physical hazard

Steam disinfection / Autoclaving In order to use autoclaving as the mechanism of inactivation of waste: Every load must be evaluated for proper heating Annual calibration by trained individual Quarterly qualitative biological challenge – spore reduction Document everything and keep records for 3 years. How much time would this cost your lab personnel?

Feasibility of other mechanisms of disinfection on our campus Chemical disinfection Done routinely for liquid waste Addition of bleach to liquid waste followed by disposal down sink Incineration at an approved incineration facility An approved incineration facility is not available on campus Shredding/grinding of sharps Equipment not available on campus

The Stericycle option. Removes solid waste (not yet inactivated) from campus and performs disinfection and disposal processes off site: autoclaving Incineration shedding/grinding Relies on ability to ship waste via DOT regulations

Pathological Waste Solid Waste Collected in cardboard boxes specifically labeled “incinerate only” Transported to Stericycle autoclave plant in Woonsocket RI Waste is autoclaved, shredded and compacted Transported to approved Stericycle incineration facility in Haw River, North Carolina Transported to North Andover, MA for incineration to generate elecricity Ash is landfilled

Pathological Waste Solid Waste Collected in cardboard boxes specifically labeled “incinerate only” Transported to Stericycle autoclave plant in Woonsocket RI Waste is autoclaved, shredded and compacted Transported to approved Stericycle incineration facility in Haw River, North Carolina $$$ Transported to North Andover, MA for incineration to generate elecricity Ash is landfilled

NOT the mechanism of disinfection Pathological Waste Solid Waste Collected in cardboard boxes specifically labeled “incinerate only” Transported to Stericycle autoclave plant in Woonsocket RI Waste is autoclaved, shredded and compacted Transported to approved Stericycle incineration facility in Haw River, North Carolina NOT the mechanism of disinfection $$$ Transported to North Andover, MA for incineration to generate elecricity Ash is landfilled

Exceptions Risk Group 3 and 4 infectious microorganisms MA regulations require this to be inactivated on site Autoclave Committee on Microbiological Safety (COMS) stipulations that require autoclaving of specific organisms before disposal into a Stericycle biowaste container Rare Still required to go into Stericycle biowaste containers because most autoclaves on campus are not calibrated and validated to meet state requirements

Stericycle services at SPH Solid waste options: Gray plastic bins lined with red bag Lab staff retrieve these from storage areas in loading dock Cardboard boxes lined with 2 red bags Red bags provided by custodial NOT for autoclaving Sharps waste options: Disposable sharps containers purchased by labs Placed in either gray bins or boxes when full Removal of waste from labs Request pick up of waste by custodial staff

Common misconceptions It’s a “burn box”. Everything is incinerated to kill the infectious agents. I have to autoclave all waste before putting it into the Stericycle bin/box. We have to use the cardboard boxes because everyone else on our floor does. Drawbacks to boxes: Should not be placed directly on the floor Should have plastic lid rather than cardboard Contributes to volume of waste