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Regulated Medical Waste Treatment Methods

October 24, 2013

Once your business has determined that it generates medical waste, it’s necessary that you focus energy on hazardous medical waste disposal and regulated medical waste management.  Nothing is more important than this step.

There are numerous available and emerging waste treatment technologies to treat Regulated Medical Waste (RMW) and render it less hazardous, each with its own set of advantages and liabilities.  The information can be overwhelming and difficult to digest, but hopefully this article will help you familiarize yourself with your options for treatment methods for medical waste.  They include:

1.) Incineration:

This is the process of burning of waste in temperatures ranging from 1,800°F to 2,000°F (982°C to 1093°C).  On-site incineration provides the advantage of a quick, easy disposal method for hazardous medical waste disposal, but there are emissions concerns.

While some states and localities actively encourage incineration as the preferred method of treatment, others have enacted moratoriums on incinerators to suspend permitting until further information on the safety of the option is available.

2.) Autoclaving:

Autoclaving, which is also known simply as steam sterilization, is the most commonly utilized alternative to incineration for regulated medical waste management.  It is both less costly and carries no documented health impacts.  In this method, wastes are sterilized or disinfected prior to disposal in a landfill.  Bags of waste are placed in a chamber and steam is introduced for a determined period of time at a specified pressure and temperature.  This assures the destruction of microorganisms.

Approximately 90% of regulated medical wastes, including microbiological waste disposal, are suitable for autoclaving.  Autoclaves are not suitable, however, for pathological, cytotoxic, or other toxic chemical wastes.

3.) Gas sterilization:

In this process, medical waste is fed into an evacuated air-tight chamber and treated with gas sterilization agents (such as ethylene oxide or formaldehyde). The gas that comes into contact with the waste will kill harmful, infectious agents.

It’s important to note that the EPA does not recommend ethylene oxide for treating infectious wastes because of its toxicity.

4.) Chemical disinfection:

This process involves the use of chemical agents for disinfection, such as chlorine, for liquid waste disinfection. Chemical disinfection processes are most appropriate for liquid wastes, although they can still be used to treat solid wastes.  There are a number of factors that should be considered regarding the effective usage, including: the types and biology of microorganisms in the wastes, degree of contamination, type of disinfectant used as well as its concentration and quantity, contact time, and mixing requirements.

Another option is the grinding of medical waste before exposing it to a liquid chemical disinfectant. Grinding ensures sufficient exposure of the chemical agent to all parts of the waste and assists in easy disposal of any residues. The resulting liquids are placed into the sewer system, while solid residues are disposed in landfills.

5.) Microwave technology treatment:

The application of microwave technology treatment also can disinfect waste. Waste is first shredded, and then mixed with water and internally heated to neutralize all present biologicals.  Computerized controls are employed to ensure the minimum parameters for disinfection and proper equipment function.  As with autoclaving, approximately 90% of medical wastes can be treated with this process.  The shredding process results in a volume reduction, and energy use is reportedly lower than that of an incinerator.

6.) Irradiation:

This method involves sterilizing waste by exposing it to a cobalt source. Cobalt gives out gamma radiations that destroy all microbes in waste.  The high cost of cobalt and high operating costs, however, have discouraged commercial ventures from using the technology for the treatment and management of medical waste.  There also have been some questions raised about the actual process of radiating the material and achieving adequate disinfection.  As with autoclaving and microwave methods, it is not recommended for pathological wastes.

7.) Thermal inactivation:

This process involves heating waste to temperatures at which infectious agents are killed.  It is used for treating large volumes of liquid clinical wastes.  A chamber is preheated to an intense, specified temperature and held for a specified time, then released.

Before adopting a medical waste disposal strategy, make sure your business knows the applicable regulatory requirements.  Assess capabilities, costs, and associated health and environmental risks.  Bear in mind that some special treatment issues warrant consideration regarding specific pieces of the regulated medical waste stream, such as sharps (check out Special Treatment Considerations: Sharps for more information).

Flexibility for the generators to meet their management needs and comply with requirements will allow for adoption of the most suitable treatment options, as well as ensure safe and compliant management of medical wastes. Stay informed about the regulatory requirements for medical waste disposal through the EPS

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