By Mark A. Ceaser
Themost common cause for alarm in the medical field pertaining to waste disposal isthe exposure of the worker to infectious wastes and contraction of diseases fromthese wastes. With the increased risk of exposure to blood borne pathogens inhandling body fluids and disposal of items that have been tainted by thesefluids, awareness and education for the prevention of percutaneous wounds is thehighest priority.
The Resource Conservation and Recovery Act (RCRA) controls the manner inwhich all forms of hazardous materials are disposed. With amendments to theregulations enacted on November 8, 1984, landfill burial of free liquids onabsorbents or biodegradable items that release the liquids under the pressure ofthe increased garbage levels are prohibited. Untreated items that are notincinerated, steam sterilized, or chemically treated for disinfection still havebiological activity that can continue unchecked.
RCRA mandates that all characteristics of said wastes be listed on themanifest and properly treated before final disposal. A low-cost alternative toexistent medical waste disposal methods that meets these treatment standards anddoes not draw upon high energy costs is cementatious solidification.
Solidification processes are used for various hazardous waste disposal ofitems that cannot be recycled or disposed of in an effective manner, such asincineration. By physical and chemical treatment of hazardous wastes bysolidification, the waste is fixated and stabilized in a cement matrix that willnot 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 mostcases, the cement mixture is added directly over the container holding thewastes, although direct mixture of the cement and wastes do occur. As thesetting process occurs, the outside oxygen supply and raising of the pH causethe biological activity to cease.
In most medical wastes, disposal of needles is most commonplace. Havingdirect contact with people that have had injections or blood drawn, they wouldbe the most likely item to need treatment. A number of devices are available toincinerate the needles; however, many facilities use a common needle disposalcontainer prior to its being disposed of via a waste management company.
These containers can still pose a threat to the worker handling the items, asthe needles are still in a free state. In addition, with the containers holdingsharps such as razors, glass, dental devices, and surgical retractors, openexposure to infectious elements still exists. A person can conceivably still runthe risk of being cut via handling these items. Cement stabilization is thesolution to these preventable incidents.
Double-bagged "red bag" wastes commonly refer to wastes treatedwith some form of sterilization. However, the bags still do not prevent thepossibility of the worker being injured and exposed in handling the items intransfer. Solidification of these wastes on-site provides the added benefit ofsafety and increased stabilization of the residue.
With more than 800,000 needle sticks a year occurring in the healthcaremarketplace, the risk of exposure and injury is an alarming certainty. Treatmentof medical sharps should be given utmost priority, and it begins at the sourceof its generation. On-site treatment of the wastes will provide a safe passingdown for the handlers of the materials until its final destination. Thesolidified mass within the container gives this security to the handler, as itsstructural strength provides safety and security.
The Centers for Disease Control and Prevention (CDC) recommends institutionof preventive measures for work-related infections and use of proper disposalequipment in handling needles and infectious wastes. Cement solidification givesadditional support to this emphasis on safety. With proper identification oftreated biomedical materials in this manner, exposure and disposal risks aresignificantly reduced.
Meeting the conditions of local, state, and federal regulations for wastedisposal will determine final costs and definition of the materials. Guidelinesvary pertaining to designation of what is and is not considered biomedicalwastes; however, there is universal acknowledgment that the dangers of exposureshould not go unnoticed.