Medical Waste Disposal – The Definitive Guide 2020

Dr. Intan Airlina

By Dr. Intan Airlina
Updated: Jun 2020

Medical Waste Disposal-1

Before you hire a medical waste disposal company read this and avoid the mistakes of locking into a multi-year contract with the wrong company, which could cost you years of paying up to 83.6% more, unreliable and inconsistent pick-ups, and OSHA or HIPPA trouble from an amateur hauler.

As a Medical Doctor (MD) and expert in medical waste disposal, I created this “Definitive Guide” to answer all your questions about: drop-off (near you), top companies, containers, costs, treatment methods, regulation, facility, and problems.

What Is Medical Waste?

According to the EPA (Environmental Protection Agency), the definition of medical waste is fairly broad “all waste materials generated at health care facilities, such as hospitals, clinics, physician’s offices, dental practices, blood banks, and veterinary hospitals/clinics, as well as medical research facilities and laboratories.”

It fails to include any organization that produces medical waste such as syringes or needles from their employees or customers, or the home producer for that matter. Medical Waste Disposal-2

How Much Medical Waste Is Produced?

In 2012, the United States spent up to $2.5 billion for the proper disposal of medical waste. Moreover, with annual growth of 4.8%, by 2017 the annual market is expected to $3.2 billion. For instance, consider these medical waste statistics:

In short, almost all healthcare activities related to humans produce medical waste. So, can you imagine the dangers of what would happen if it was disposed of improperly?
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The Epidemiology

(How Often Diseases Occur in Different Groups of People and Why) Medical Waste Disposal-4 WHO (World Health Organization) even mentioned that in 2000, there were 32% new Hepatitis B infections due to improper way of contaminated syringe disposal. In 2002, WHO conducted a research to review 22 countries about their way of medical waste disposal management and resulting various ranges from 18% up to 64% that used improper methods of biomedical waste management.

Dangerous, huh?

Who Are At Risk For Biomedical Waste Exposure?

People who have the highest risk of being the biomedical waste, for instance, healthcare workers, patients, waste collection and disposal staff, and even our environment. The biomedical waste may pose an occupational hazard when managed incorrectly. Therefore, we need special precautions and the well-trained personnel to manage those biomedical wastes and keep the risk low.

Why We Need To Manage The Biomedical Waste In The Right Way?

There are several reasons to manage the biomedical waste in an appropriate way:

  • Health – Nobody wants to see blood drops on the floor when they walk into hospital visiting a sick friend because the risk of being infected by any number of diseases
  • Infection risk – the risk of infection obtained from sharp injuries can lead to infection
  • Environment pollution – The risk of air, water and soil pollution directly from waste due to defective incineration or autoclaving can be harmful.

The biomedical waste treatment and disposal need to be in a complete management to ensure the safety of the workplace and maintain our health. If you maintain the safety process correctly, it will:

  • Effectively reduce your legal liability
  • Reducing the danger to the community, personnel and patients
  • Keep your reputation high

The OSHA (Occupational Safety and Health Administration) has an established procedure for dealing with biomedical waste hazards that can minimize our risk with contaminated articles. Thus, we at BioMedical Waste Solutions, LLC, use OHSA standards as our guidance to dispose the medical waste properly.

Regulated VS Unregulated

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Of all the health care waste (HCW) there is essentially two types: Regulated medical waste (RMW) and unregulated medical waste (UMW). Approximately 75% to 90% of HCW is UMW (unregulated) or known as healthcare general waste (HCGW). This waste is similar to typical household waste consisting of papers and plastics that are not been in contact with patients and is categorized as non-infectious. This type of waste is simply disposed in accordance with municipal regulations. Approximately only 10% to 25% of HCW is infectious/regulated medical waste (RMW).

Naturally this RMW has to be handled with special care as we’ll describe below because it could pose a threat to the health of others, either by contaminating the environment or through direct contact with an individual. Easier way to differentiate the two types is to ask yourself “could this waste kill someone or make them sick?” If yes, then this waste is regulated and must be handled with special care.

NOTE: The use of “medical waste”will be regarded as “regulated medical waste” (RMW), unless otherwise stated.

Eight Categories of Medical Waste

It’s important to know what kind of medical waste your facility produces then you can determine the proper disposal. The WHO classified the medical waste into eight (8) categories of medical waste:

  1. Infectious waste – Waste that may transmit infection from virus, bacterial, parasites to human, i.e.: lab cultures, tissues, swabs, equipment and excreta
  2. Sharps – Sharp waste, such as needle, scalpels, knives, blades, etc.
  3. Pathological – Human tissue or fluids i.e. body parts, blood, other body fluids
  4. Radioactive – Unused liquid in radiotherapy or lab research, contaminated glassware, etc.
  5. Chemical – Expired lab reagents, film developer, disinfectant
  6. Pharmaceuticals – Expired and contaminated medicines
  7. Pressurized containers – Gas cylinders and gas cartridges
  8. General waste (UMW) – No risk to human health because no blood or any related bodily fluid, i.e.: office paper, wrapper, kitchen waste, general sweeping, etc.

Because the management for every waste categories are different.

Medical Waste Disposal Drop-Offs (Near You!)

Is the disposal for a residence or an organization?

For Residences

Depending on where you live, it may be possible to take your sharps and waste for drop-off at specific collection sites or medical waste facilities. A few of these services are free but most have a nominal fee.

It’s important to check for information specific to your state, as almost every state and local government has its own regulations and guidelines to provide the best way to dispose of it.

In general, there are two important steps to prepare for drop-off:

Ensure your sharps disposal containers are labeled correctly
Secure the lid of the disposal container in the appropriate manner per local guidelines

For the reasons mentioned above, it is almost always recommended to use an external pick up service for your disposal. Drop-off can be time-consuming, confusing, and even more expensive than using an external company for easy, stress-free pick up disposal service.

For Organizations

Considering the numerous federal and Statewide regulations for waste, it’s incredibly important for an organization to select a professional disposal company to deal with their waste.

What are the top disposal companies? Check out our suggestions below.

Medical Waste Disposal Top Companies

Are you looking for the best disposal companies? Look no further. We’re it. We’re affordable, reliable, and 100% compliant. We know that waste disposal can be tedious and complicated.

Our job is to provide you with the highest quality service so you remain completely in regulation with medical waste—on both the federal and local levels.

Low-Cost, Reliable, & Compliant Medical Waste Disposal. Relax while we take care of your medical waste disposal, so you’ll never have to worry about it again!

Affordable-Pricing

Low Cost

Keep costs low with actual fixed rates and no hidden fees. The average organization saves up to 83.6% with us versus Stericycle.

Reliability

Reliable

In just 14 years, we’ve grown to over 10,000+ happy clients because we virtually guarantee timely and reliable pick-ups.

Compliance

Compliant

Compliance with State and Federal laws governing the proper disposal of medical waste is not a choice. It is the law. We have you 100% covered.

Our Medical Waste Disposal Services Serve Top States & Cities:

Texas Medical Waste Disposal (TX)
California Medical Waste Disposal (CA)
Florida Medical Waste Disposal (FL)
Louisiana Medical Waste Disposal (LA)
New York Medical Waste Disposal (NY)
Illinois Medical Waste Disposal (IL)
Connecticut Medical Waste Disposal (CT)
New Jersey Medical Waste Disposal (NJ)
Pennsylvania Medical Waste Disposal (PA)
Ohio Medical Waste Disposal (OH)
Georgia Medical Waste Disposal (GA)
North Carolina Medical Waste Disposal (NC)
Michigan Medical Waste Disposal (MI)
Virginia Medical Waste Disposal (VA)

Washington Medical Waste Disposal (WA)
Arizona Medical Waste Disposal (AZ)
Massachusetts Medical Waste Disposal (MA)
Tennessee Medical Waste Disposal (TN)
Indiana Medical Waste Disposal (IN)
Missouri Medical Waste Disposal (MO)
Maryland Medical Waste Disposal (MD)
Houston Medical Waste Disposal
San Antonio Medical Waste Disposal
Dallas Medical Waste Disposal
Austin Medical Waste Disposal
Fort Worth Medical Waste Disposal
Los Angeles Medical Waste Disposal
Chicago Medical Waste Disposal

New York Medical Waste Disposal
Philadelphia Medical Waste Disposal
San Diego Medical Waste Disposal
San Jose Medical Waste Disposal
Jacksonville Medical Waste Disposal
Phoenix Medical Waste Disposal
Columbus Medical Waste Disposal
Charlotte Medical Waste Disposal
San Francisco Medical Waste Disposal
Indianapolis Medical Waste Disposal
Seattle Medical Waste Disposal
Denver Medical Waste Disposal
Miami Medical Waste Disposal
Boston Medical Waste Disposal

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Medical Waste Disposal Containers: Cataloging, Colors, Size, & Types

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Organizations that generate medical waste must ensure they take care of all disposals using the appropriate containers. The role of these containers is to safely store materials until they are removed from the site location. To be secure, containers must be tough against holes and leaks, sturdy, and fire-resistant. It is crucial that staff members are properly trained so that containers are used correctly and adhere to workplace health & safety laws.

Container Cataloging

The United States requires that waste containers be color-coded (colored images below). OSHA’s Bloodborne Pathogen Standard states that workers should recognize that medical waste disposal containers need to be compliant with “Universal Precautions”. Even if your state doesn’t adhere to color requirements, it is our recommendation that your organization does so to ensure OSHA and federal compliance.

Codes for Colors

These are the most commonly used color codes in the United States:

Blue Yellow Red/Bright Orange Black
Used for non-RCRA pharmaceutical wastes such as antibiotics. Normally used for containers that hold chemotherapy waste. Federally regulated color used in medical waste disposal containers holding biohazardous waste. This is also used for sharps containers. Used for RCRA regulated hazardous materials such as Warfarin, Nicotine patches, or gum.
Blue
Used for non-RCRA pharmaceutical wastes such as antibiotics.
Yellow
Normally used for containers that hold chemotherapy waste.
Red/Bright Orange
Federally regulated color used in medical waste disposal containers holding biohazardous waste. This is also used for sharps containers.
Black
Used for RCRA regulated hazardous materials such as Warfarin, Nicotine patches, or gum.

Container Sizes and Types

Containers most typically are stand-alone baskets, but wheeled carts and mounted receptacles are also easy to find. Sizes range anywhere from 1 quart to 20 gallons of capacity, but most commonly are 8, 12, and 18 gallons.

Medical waste disposal costs

How does an organization decide whether to manage disposal in-house (by purchasing machinery) or have an external company take care of it?

Purchasing machinery, such as incinerators and autoclaves, can often appear to cost less per lb of waste disposal. However, the costs of these capital expenditures are usually far out of reach for medium-sized clinics and medical centers.

It is important to consider the additional costs of operating this machinery, which include:

  • Maintenance costs (scheduled maintenance work by an authorized technician)
  • Replacement parts costs
  • Utility costs
  • Training costs for employee use

As an example, steam sterilizers utilize water, steam, and electricity to operate. These costs can add up fast over the course of 20 years. Just the water costs to operate the autoclave can amount to over $100,000!

One of our customers, a hospital, previously had a large on-site autoclave machine onsite which they poured thousands of dollars into for maintenance and replacement parts. They called us when it became obvious that these operating costs far exceeded the cost of using an external disposal company.

Costs for pick-up vary greatly from state to state and also based on your volume and frequency.

Our cost is up to 83.6% more affordable than Stericycle (America’s largest medical waste management company).

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Medical waste disposal treatment methods

Incineration is the most commonly used disposal treatment. Recently, alternative treatment methods are becoming increasingly popular. Choosing a treatment system should be done carefully, on the basis of various factors, many of which depend on local conditions.

Here is a summary of the 5 most common treatment methods:

Incineration. A high-temperature dry oxidation process that reduces waste to inorganic, incombustible matter, and results in a very significant reduction of waste volume and weight. This process is usually selected to treat wastes that cannot be recycled, reused, or disposed of in a landfill site.

Wet and dry thermal treatment. A treatment procedure based on the exposure of shredded infectious waste to high-temperature, high-pressure steam, and is similar to the autoclave sterilization process. With sufficient temperature and contact time are sufficient, it inactivates most types of microorganisms.

Irradiative (microwave irradiation). A treatment method where waste is shredded, then humidified and transferred to an irradiation chamber equipped with a series of microwave generators. After irradiation, the waste is compacted inside a container and enters the municipal waste stream

Chemical disinfection. Used routinely in health care to kill microorganisms on medical equipment and on floors and walls, is now being extended to the treatment of health-care waste. Chemicals are added to waste to kill or inactivate the pathogens it contains, usually resulting in disinfection rather than sterilization.

Land disposal. If a municipality lacks the means to treat wastes before disposal, the use of a municipal land disposal site has to be regarded as an acceptable disposal route.

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Brief History of Regulated Biohazardous Waste Disposal in America:

In 1988, a famous act namely Medical Waste Tracking Act (MWTA) was addressed to handle the disposal of medical waste in coastal areas due to numerous medical and household waste throughout several coastal areas, therefore a two-year program was implemented in the affected areas (New York, New Jersey, Connecticut, Rhode Island, and Puerto Rico). This act was expired in June 21, 1991.

During that time, EPA gathered all information and performed medical waste related studies and together with MWTA, they managed to look at several treatment technologies that was available at that time involving incinerators, microwave units, and several varieties of mechanical and chemical systems that can be used for reducing the waste. Thus, resulting a different local regulation of medical waste management that was implemented to each state, such as Medical Waste Management 2015, as one of the recent medical waste regulation for California State.

Sorry to disappoint our Walking Dead fans, but improper disposal of medical won’t be the cause of the Zombie Apocalypse in America because stringent regulations, laws, and guidelines. Medical Waste Disposal-9

Medical waste disposal regulations

Federal agencies that regulate medical waste include the EPA, the Occupational Safety and Health Administration, and the U.S. Department of Transportation. The Centers for Disease Control and Prevention provides guidance, but not regulation.

Currently, Federal law doesn’t provide a clear definition of medical waste. Usually, individual state health departments create these regulations to identify which wastes require special management and disposal processes.

Medical waste disposal regulations by State
Most of the 50 states have some form of disposal regulations in place. Unlike hazardous waste regulations, which are all based on the federal Resource Conservation and Recovery Act (RCRA) standards, the medical waste regulations by state vary a great deal.

Generally, the state EPA holds the prime responsibility for developing and regulating disposal practices. However, in some states (e.g. Missouri and Oklahoma) the department of health plays a leading role or serves as a primary regulatory agency (e.g. Colorado). Often the department of health is responsible for onsite management and an environmental agency takes care of transportation and disposal.

The majority of states have regulations for packaging, storage, and transportation of medical waste. Others require health care facilities to register and obtain a permit for waste.

Stages of Medical Waste Disposal

Where does medical waste go? How is medical waste disposed of? For purposes of this guide, we are going to focus on disposal in the US. Let’s share with you the cautious and special care process in which medical waste is collected, stored, transported and treated with.

Stage 1 – Collecting & Segregating The biomedical waste has to be collected in containers that are resilient and strong from breakage during the handling process. Do not place sharps, used needles, syringes, or other contaminated tools in common waste disposal or recycle bin because the entire waste will be infectious by doing so. The segregation also needs to be performed between the liquid and solid biomedical waste products. Categorizing the medical waste with correct segregation to isolate and manage each waste in the proper way. For this purpose, the segregations come in colored waste containers, label coding and plastic bags.

Stage 2 – Storing & Transporting Specific requirements for storage facilities, such as a secure area that is inaccessible to the general public, as well as separated it from areas for food consumption. The storage facilities also have to be accompanied with refrigerator or freezer unit that can be used with medical waste if necessary. Some facilities even provided special vehicles and protective devices to dispose, handling or transport the biomedical waste products. Remember to observe and keep maintaining the protective devices periodically so it won’t be a source of transmitting the infections.

Stage 3 – Treatment The needs of professional handling that work according the by-law regulation such as the OSHA are needed to ensure that the regulated medical waste (RMW) is handled properly. The treatment process will use several medical waste equipment that ranged from handling, carts, shredding, conveying, size reducing, compactors, to sterilization or recycling. The following equipment is needed to properly process the waste in order to reduce the hazards, and maintain the environment:

  • Carts and containers – commonly used to collect the medical waste i.e. dumpers, containers, compactors can be used to collect the medical waste
  • Conveyors – this equipment help to segregate the waste
  • Sterilizers – such as: autoclave, shredder, and size redactor
  • Handling the waste – such as: compactors, containers, pre-crushers, and deliquefying system
  • Recycling system – i.e. balers and size reduction equipment

Incineration – Type 1 of Medical Waste Treatment The incineration technology used a high temperature thermal process that can convert inert material and gases with the combustion process. It will process the waste to convert into ash, gas, and heat. There are three types of incinerators that are commonly used for biomedical waste:

  1. The Multiple Hearth Type– it has a circular steel furnace that contains solid refractory hearths with a central rotating shaft to convert the waste into ash
  2. Rotary Kiln – it is an incinerator, shape like a drum, commonly for medical and hazardous waste
  3. Controlled Air – there are two process chambers that will handle the waste. The complete combustion and oxidizing it, leading to a stream of gas with carbon dioxide and water vapor composition. It is commonly used for waste that has organic materials.

In addition, for some cases, performing a shredding for biomedical waste needed as an aid for incineration process.

Non-Incineration System (Autoclaving, Irradiation, Chemical Methods) – Type 2 of Medical Waste Treatment

Aside from the incineration technology, the non-incineration method also provided to dispose the biomedical waste, it contains four basic processes such as thermal, irradiative, chemical, and biological.

The autoclaving system (a photo of our autoclave machine is below) is commonly used for the human body fluid waste, sharps, and microbiology laboratory waste. This system requires high temperature (thermal) that produces steam to decontaminate the biomedical waste. The steam plays a critical role in the medical waste autoclaving process therefore a good waste holding container is required. Medical Waste Disposal-10 While most of human body fluid waste can use this method, but the cytotoxic agents that used for chemotherapy cannot use this method due to those types of waste are not degraded with autoclave steams. Beside autoclaving, irradiation is the other thermal method which uses a high frequency microwave for disposal. The wave will generate heat to the waste materials and kill all the bacteria, or any other contamination in the tools.

Another way of performing treatments for biomedical waste is chemical decontamination, this method can be used for microbiology laboratory waste, human blood, sharps and body fluid waste, but cannot be used for treating anatomical waste. Aside from that, biological processes is a method that employ enzymes to destroy the organic matter of the waste, however there are very few non-incineration technologies have been based on this biological method.

On-Site and Off-Site Treatment of Medical Waste
To differentiate which biomedical waste that can be performed on-site and off-site is important. Because in majority of the cases, the biomedical waste is a mixture and can be very difficult to manage it properly or even to segregate it, which is why an accurate simplified management of medical waste in segregating it according to the regulations will reduce the erroneous element. The on-site treatment usually requires expensive equipment. Not all facilities have this due to major infrastructure expenditure, but it is generally cost effective for very large hospitals and laboratories.

Thus most medical waste producers choose off-site treatment known as regulated medical waste disposal companies because these companies have:

  • The proper medical waste equipment
  • Been state certified operating permits
  • OSHA-trained personnel to collect, transport or store the medical waste

Once treated, the medical waste can be disposed of.

Stage 4 – Disposal
In the US, for solid waste, once medical waste producers have adhered to regulations for collecting, storing, transporting, and treating their waste, they may then use their municipal landfill and sanitary sewer system as their final disposal method.

That’s right, your local municipal landfill is commonly used as the final place of your treated decontaminated biomedical waste.
For fluids such as blood, suctioned fluids, excretions and secretions, almost every state and local government has its own regulations and guidelines to provide the best way to dispose it. In general, there are two recommended ways to handle medical waste fluids:

  1. Collect fluids in a leak proof container, and solidified for autoclave treatment
  2. Thermally (autoclave) fluids then they be disposed into the sanitary sewer system

An extra precaution should be performed before pouring treated fluids in sewer because they may clog and leak.

Medical waste disposal facilities

Hazardous and medical waste disposal facilities receive waste for treatment, storage or disposal. These locations are usually referred to as TSDFs (treatment, storage, and disposal facilities).

Treatment Facilities use several different processes, such as incineration or oxidation, to alter the composition of medical wastes. Some treatment processes allow waste to be recovered and reused for manufacturing, while other treatment methods dramatically reduce the amount of hazardous waste.

Storage Facilities temporarily hold hazardous and medical wastes until they are treated or disposed of. Medical waste is often stored prior to treatment or disposal, and needs to be stored in containers, containment buildings, tanks, drip pads, surface impoundments, or waste piles that comply with the Resource Conservation and Recovery Act (RCRA) regulations.

Disposal Facilities are permanent locations where hazardous and medical wastes are stores. The most common types of disposal facilities are landfills, where waste is disposed of in constructed units designed to protect groundwater and surface water resources.

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Medical waste disposal problems

The most common medical waste disposal problems arise when proper disposal procedures are not followed. Improper disposal can lead to serious consequences, putting facility staff, patients, and communities in danger. Not to mention fines, lawsuits, and the loss of reputation that could ruin your business. That is why it’s crucial to pick the right company to help with your medical waste removal. Here are some of the biggest problems with the disposal of medical waste.

Lack of Training for Staff

Many facilities fail to fully train all staff on procedures and best practices for proper disposal. This leads to problems such as waste being placed in the wrong containers, or hazardous materials being flushed down a drain, or thrown in the regular trash.

Every facility with medical waste should be inspected at regular intervals to ensure proper procedures and training are in place.

Improper or Illegal Dumping of Medical Waste

Some facilities can generate up a tonne of medical waste each and every day. Illegal dumping of waste could potentially expose many people to infections and diseases. Disposing of medical waste via burning is also a dangerous solution, as toxins from waste can circulate in the air. Simply throwing medical waste into the regular trash can also be dangerous for any janitors and the general public. Illegal dumping of medical waste can result in huge fines.

The best way to avoid most problems is to hire a reputable disposal company, like us, to handle your medical waste and ensure you remain compliant.

Contact us now for a quote.

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Conclusion

As you can see from this article, great care goes into disposing of medical waste, and the way it is disposed is dependent on what category of medical waste it is and government regulations. We hope you find it easier to proper dispose of your medical waste.

Dr. Intan Airlina is consulting Director of OSHA Compliance for BioMedical Waste Solutions, LLC (www.BioMedicalWasteSolutions.com). She is an Internist that holds an Internal Medicine Degree from University of Indonesia, learned tropical diseases and infection, also certified in patient safety from a Joint Commission International (JCI) and ISO certified hospital.

FREE GUIDE

The Definitive Guide to Medical Waste Disposal

Read this and avoid the mistakes of locking into a multi-year contract that could cost you up to 83.6% MORE EVERY Year.

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Legal Disclaimer. This guide and medical information on this site is provided as an information resource only, and is not to be used or relied on for purposes or substitute for proper OSHA training. Please consult your OSHA trained provider, or contact BioMedical Waste Solutions for a consultation, before making any biohazardous waste disposal decisions. BioMedical Waste Solutions , LLC expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site. If you do not agree to the foregoing terms and conditions, you should not enter this site.

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