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For some people, out of sight is out of mind.

However, if  you DVR “How It’s Made” on the Discovery Channel or always spend your time on such websites as How Stuff Works, it means  you might be a little curious. What exactly happens to all your organization’s medical waste once the bags and containers are hauled away?

First, let’s go back a few decades in history.

In summer of 1988, medical waste washed up on five East Coast beaches. If medical waste is noticed on our shoreline, it is very dangerous. Congress started acting, after having accepted the Medical Waste Tracking Act of 1988.  Regulations on how medical waste could be disposed of became stricter.

Fast forward to the present.

Nowadays were more aware about the risks of poor medical waste management.  It is helpful to keep in mind a statistic from the World Health Organization (WHO), which states, “about 85% of waste generated by healthcare is general and non-hazardous waste. 15% is considered hazardous.” Also, in summarizing of the Medical Waste Tracking Act in 1991, the EPA determined that healthcare professionals face a higher risk handling infectious waste at its source than the general public once the waste is disposed of and time has elapsed.

Surely, when we are speaking about medical waste disposal of any kind, safety and compliance are still crucial elements in keeping the public and environment healthy.  It is now up to each state’s environment and health departments to decide how to best regulate the collection, transportation, treatment and disposal of their state’s medical waste. You can read up on your particular state’s regulations here.

Besides  some variations among states, managing medical waste disposal follows five key stages:

  • Segregation: the required treatment by the waste?
  • Packaging: what receptacle does it get stored in before it’s transported?
  • Transportation: medical waste must be safely and securely transported to a treatment or disposal facility.
  • Treatment/Destruction: Depending on if the medical waste is Regulated Medical Waste (RMW), a treatment or destruction method must be assigned.
  • Disposal: The treated medical waste is disposed of in a landfill or approved sewer system.

The first requirement for any efficient disposal process is to have a medical waste disposal provider who is timely and dependable. Even in those cases when medical waste is safely contained in the proper receptacle – it shouldn’t sit around for too long. Once it is picked up, the trained driver must follow strict protocols for transporting the waste. Different kinds of medical waste need to be segregated in the truck, and the truck needs to be marked so as to warn other drivers on the road that  it is carrying potentially infectious materials. It is also very crucial to have a protocol in place in the event of an accident, including a spill containment and cleanup kit on every truck, is also necessary.

Choosing a method of treatment

As soon as the medical waste arrives at its destination, it’s ready for treatment. According to the EPA, before 1997 “more than 90% of potentially infectious medical waste was incinerated” – often on-site, where the waste was generated. But new emission standards for medical waste incinerators bring alternative methods, and now  there exist several additional options for treatment of RMW and non-infectious medical waste.

These methods include steam sterilization, chemical disinfection with grinding or encapsulation, thermal inactivation, irradiation, grinding and shredding, and compaction. The type of method used depends in part on what type of medical waste is at issue – is it sharps, cultures and stocks or human blood? All of them need to be treated in specific ways.

Steam sterilization uses  saturated steam within a pressure vessel (sometimes called an autoclave) to vanish  infectious properties in the waste. Chemical disinfection with grinding or encapsulation includes grinding the waste in a hammer mill while also using a chemical disinfectant. Thermal inactivation uses the transfer of heat to reduce infectious properties in the waste. Those materials that can’t be treated thermally can be irradiated. Waste is exposed to ultraviolet  or ionizing radiation to break down infectious agents through Irradiation.

In the end, compaction is a method to reduce the volume of waste. Though it is not a treatment method, however, it can transform the waste into something unrecognizable – another essential element of the disposal process. When solid medical waste is treated, it is considered municipal waste, and it is shipped to a sanitary landfill. If the form of the waste is liquid, for further treatment at a wastewater plant it can be sent to a health-department approved septic system or sanitary sewer system.

So the next time when you see your sharps bin or your medical waste boxes carried off, take into account that great care is being taken to safely dispose of it for good.