By Kelli M. Donley
Regulations for the disposal of medical waste are different depending on eachcity and state's laws. However, the risk of exposure to medical waste isconstant for healthcare workers (HCWs), even though the field of disposal offersa variety of options.
Ultimately, the goal with all liquid waste products is to keep hazardousmaterial from infecting anyone else before being properly destroyed. Thisincludes: having efficient equipment to clean up a spill, place the liquid,dispose of the liquid, and clean the canister. There are also human aspects thatneed to be taken into consideration. For effective liquid waste disposal, theHCW working with the waste must be sufficiently covered with personal protectiveequipment (PPE). Where the disposal takes place is also an issue; a non-patientarea should be designed and equipped for disposal to eliminate any possibilityof a patient becoming infected during the process.
The HCW also must know whether the canister used to dispose of the waste canbe reused, or whether it also needs to be disposed. Also, a clean canisteralways should be available for backup.1
One option when disposing of liquid waste is solidification. Physical andchemical treatment of hazardous waste can turn liquid into a fixated andstabilized cement matrix. Once solid, the mixture cannot release any potentialinfectious pathogens.2
OSHA guidelines clearly support standard precautions to treating blood andother bodily fluids, as though they are all infectious. Considering all patientshave not been diagnosed with potential bloodborne diseases, each spill andcontainer of waste should be handled as though the liquid being disposed is HIVand hepatitis positive. 1
The 1910.14.a.i. guideline concerning liquid waste states: "Anyreceptacle used for putrescible solid or liquid waste or refuse shall be soconstructed that it does not leak and may be thoroughly cleaned and maintainedin a sanitary condition. Such a receptacle shall be equipped with a solidtight-fitting cover, unless it can be maintained in a sanitary condition withouta cover. This requirement does not prohibit the use of receptacles which aredesigned to permit the maintenance of a sanitary condition without regard to theaforementioned requirements."3
Yet, the best equipment for disposing of liquid waste is a matter of opinion.
Mark A. Ceaser, the president and GM of Omni/Ajax in Great Meadows, says adebate surrounding solidification is a matter of perspective. While one productis said to solidify liquids, the result may actually be more gel-like and leakinfectious materials when moved.
He argues that education is crucial for both HCWs and those developing thetechnologies, to prevent people in both areas from being exposed to potentiallyfatal waste.
"People think, 'If I can just throw it into a container, then I canthrow it in a dumpster.' That is no longer the game. You can't play that and notrisk the possibility of being fined due to improperly treated materials,"he said. "Hopefully, as time goes on, people will become more educated onthe risks of improper medical waste disposal so they treat medicalwaste--infectious waste--with respect and have an understanding that it is aticking time bomb. How do you know when you were at work and you brushed upagainst a (sharps) container and possibly got clipped that the waste insidewasn't HIV infected material? You are trying to avoid these circumstances sothat workers don't have these exposures and possible risks."
To eliminate these risks, a plethora of medical companies offer theirsolutions to minimize the amount of waste and also methods of protecting HCWs.
Ceaser's company, Omni/Ajax, produces OMNI-KAP a fluid solidification powderthat was specifically designed for containerized wastes.
Metrex Medical offers a Vital 1 Safety Kit for liquid medical waste clean-upspills. The kit, following Universal Precautions, contains several products tohandle a spill, including a solidifier and a large towel. There are also severalPPE elements included. The kit has instructions on how to handle a potentiallyhazardous spill and make sure the materials are disposed of properly.
The company, based in Orange, Calif. also manufacturers a canister andseveral chemical products specifically for proper disposal of liquid waste. ThePremicide biohazardous fluid sanitizer/solidification system works with thePremiGuard Closed Delivery system so blood, urine, and vomit are notaerosolized, sprayed, or splattered on any HCWs. Instead, the liquid waste istransformed into a solid substance that can be safely taken to an incineratorfor disposal.
Metrex, which recently acquired OBF Technologies, uses one of the most widelyknown sterilants in their solidification products--glutaraldehyde. Theysuccessfully converted liquid glutaraldehyde into dry crystals. This allowsliquids to become encapsulated by the sterilant, further reducing the infectiouspotential of the waste.1
The Red Away system, created by Dornoch Medical Systems, Inc., has a designslightly different than others on the market. The disposal unit allows thereusable suction canister to be flushed out by a jet that pushes on a rod anddislodges a cap that is located on the bottom of the canister. Blood and otherliquid waste can then exit directly into the sewer drain. The system reportedlyeliminates any risk of splashing or aerosolization with the 60-second flushingcycle.
Chris Hosler, vice president of marketing for Dornoch, said the system wasdesigned for staff safety.
"Dornoch's unique reusable suction canister will help eliminate morethan 4,000,000 pounds of red bag waste this year. More importantly, the RedAway's innovative engineering control design is protecting employees in morethan 130 facilities from the splash, aerosolization, and clean-up risksassociated with traditional suction canister disposal options," he said.
Another perk of the system is the convenience of installation. The companyreports that no conversions are necessary to connect the system because sterilefield and the vacuum sources are identical.
Mirotek Medical also has a line of products specifically for liquid wastecleanup. Their LTS-PLUS treats and encapsulates liquids at thepoint-of-generation. Their method of collecting the liquids reportedly reducesthe HCWs potential exposure risk to the waste.
The company also produces ISOSORB, a solidification product that the companysays is a faster polymer than others on the market.
Infection control practitioners and hospital administrators who areinterested in updating their system of liquid waste disposal should researchwhich company would best fit their healthcare center. With their decision, thetop priority should always be ensuring HCW safety.
For more information on OSHA guidelines concerning liquid waste, long onto: www.osha-slc.gov/OshStd_data/1910_0141.html.
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