Types of Medical Waste
The Medical Waste Tracking Act of 1988 defines medical waste as "any solid waste that is generated in the diagnosis, treatment, or immunization of human beings or animals, in research pertaining thereto, or in the production or testing of biologicals." Medical waste can be identified by one of four different categories: infectious, hazardous, radioactive, and general.
- Infectious waste describes waste that has the possibility of causing infections to humans. It can include human or animal tissue (blood or other body parts), blood-soaked bandages, discarded surgical gloves, cultures, stocks, or swabs to inoculate cultures. Much of this category, including human or animal tissue, can also be labeled as pathological waste, which requires specific treatment methods. Pathological waste is either known or suspected to contain pathogens.
- Hazardous waste describes waste that has the possibility to affect humans in non-infectious ways, but which meets federal guidelines for hazardous waste under the Resource Conservation and Recovery Act. Some medical waste is hazardous waste. This includes sharps, which are generally defined as objects that can puncture or lacerate the skin, but can include needles and syringes, discarded surgical instruments such as scalpels and lancets, culture dishes and other glassware. Hazardous waste can also include chemicals, both medical and industrial. Some hazardous waste can also be considered infectious waste, depending on its usage and exposure to human or animal tissue prior to discard. Old drugs, including chemotherapy agents, are sometimes hazardous.
- Radioactive waste can be generated from nuclear medicine treatments, cancer therapies and medical equipment that uses radioactive isotopes. Pathological waste that is contaminated with radioactive material is treated as radioactive waste rather than infectious waste.
- General waste makes up at least 85% of all waste generated at medical facilities, and is no different from general household or office waste, and includes paper, plastics, liquids and any other materials that do not fit into the previous three categories.
An alternative classification scheme comes from The World Health Organization. The WHO classifies medical waste into:
- Others (often sanitary waste produced at hospitals)
Sharp wastes make up most of the volume of medical wastes produced by SQGs. The next highest is blood and body fluids.
About household medical waste.
Pathological waste is included in the above categories, but is designated separately because the potential psychological impact on observers. If you can recognize the waste came from a living organism, it is probably pathological waste: consists of recognizable tissues, organs, and body parts derived from animals and humans. Material removed from the body in surgery and fluids and solids removed in autopsies is pathological waste, with the exception of teeth.
Pathological waste is almost always treated by incineration. Autoclaves are not used for pathological waste.
In the US the term regulated waste is used in healthcare contexts mostly to refer to worker safety standards and procedures. OSHA promulgated rules for dealing with bodily fluids called the Bloodborne Pathogens standard. It refers to regulated waste as blood or "other potentially infectious materials" (OPIM) and items contaminated with these materials as well as pathological and microbiological wastes containing blood or OPIM. (Feminine hygiene products do not count as regulated waste, and OSHA has ruled that bandages that are not saturated to the point of releasing fluid if compressed don’t count either.)
Management of regulated waste
OSHA’s Bloodborne Pathogens Standard required healthcare facilities dealing with regulated waste to have an Exposure Control Plan to protect workers and minimize the chances of transmission of hepatitis C, hepatitiis B, and HIV. The plan is supposed to specify which employees have routine contact with blood and blood products and what to do after an exposure.
OSHA also requires that regulated waste be put in closable containers and that if there is any chance of leaks from those containers, that a second container be employed.