Cementatious Considerations for Medical Waste Solidification

May 1, 2001

Cementatious Considerations for Medical Waste Solidification

By Mark A. Ceaser

most common cause for alarm in the medical field pertaining to waste disposal is
the exposure of the worker to infectious wastes and contraction of diseases from
these wastes. With the increased risk of exposure to blood borne pathogens in
handling body fluids and disposal of items that have been tainted by these
fluids, awareness and education for the prevention of percutaneous wounds is the
highest priority.

The Resource Conservation and Recovery Act (RCRA) controls the manner in
which all forms of hazardous materials are disposed. With amendments to the
regulations enacted on November 8, 1984, landfill burial of free liquids on
absorbents or biodegradable items that release the liquids under the pressure of
the increased garbage levels are prohibited. Untreated items that are not
incinerated, steam sterilized, or chemically treated for disinfection still have
biological activity that can continue unchecked.

RCRA mandates that all characteristics of said wastes be listed on the
manifest and properly treated before final disposal. A low-cost alternative to
existent medical waste disposal methods that meets these treatment standards and
does not draw upon high energy costs is cementatious solidification.

Solidification processes are used for various hazardous waste disposal of
items that cannot be recycled or disposed of in an effective manner, such as
incineration. By physical and chemical treatment of hazardous wastes by
solidification, the waste is fixated and stabilized in a cement matrix that will
not allow release of the fluids under pressure.

Cementatious solidification incorporates a range of materials such as gypsum,
lime, and portland cement to form a slurry that will fixate the wastes. In most
cases, the cement mixture is added directly over the container holding the
wastes, although direct mixture of the cement and wastes do occur. As the
setting process occurs, the outside oxygen supply and raising of the pH cause
the biological activity to cease.

In most medical wastes, disposal of needles is most commonplace. Having
direct contact with people that have had injections or blood drawn, they would
be the most likely item to need treatment. A number of devices are available to
incinerate the needles; however, many facilities use a common needle disposal
container prior to its being disposed of via a waste management company.

These containers can still pose a threat to the worker handling the items, as
the needles are still in a free state. In addition, with the containers holding
sharps such as razors, glass, dental devices, and surgical retractors, open
exposure to infectious elements still exists. A person can conceivably still run
the risk of being cut via handling these items. Cement stabilization is the
solution to these preventable incidents.

Double-bagged "red bag" wastes commonly refer to wastes treated
with some form of sterilization. However, the bags still do not prevent the
possibility of the worker being injured and exposed in handling the items in
transfer. Solidification of these wastes on-site provides the added benefit of
safety and increased stabilization of the residue.

With more than 800,000 needle sticks a year occurring in the healthcare
marketplace, the risk of exposure and injury is an alarming certainty. Treatment
of medical sharps should be given utmost priority, and it begins at the source
of its generation. On-site treatment of the wastes will provide a safe passing
down for the handlers of the materials until its final destination. The
solidified mass within the container gives this security to the handler, as its
structural strength provides safety and security.

The Centers for Disease Control and Prevention (CDC) recommends institution
of preventive measures for work-related infections and use of proper disposal
equipment in handling needles and infectious wastes. Cement solidification gives
additional support to this emphasis on safety. With proper identification of
treated biomedical materials in this manner, exposure and disposal risks are
significantly reduced.

Meeting the conditions of local, state, and federal regulations for waste
disposal will determine final costs and definition of the materials. Guidelines
vary pertaining to designation of what is and is not considered biomedical
wastes; however, there is universal acknowledgment that the dangers of exposure
should not go unnoticed.

Mark A. Ceaser is President/GM of OMNI/ajax (www.omni-ajax.com),
in Great Meadows, NJ.

For a complete list of references click here