Medical waste includes several classifications and categories and the most dangerous is biohazard waste. Biohazard waste is defined as any item that could transmit or potentially transmit dangerous diseases and in doing so could cause harm to people, the community, and the environment. Those countries with the highest income generate an average of 0.5 kg of biohazard waste per bed each day, with lower income countries generating around 0.2 kg. State and Federal guidelines have been established for the proper handling, storage, and disposal of biohazard waste and compliance is mandatory.
While a majority of biohazard waste is generated in medical facilities, there are other locations that are generators such as coroners, funeral homes, veterinarians, pharmacies, laboratories, tattoo and piercing parlors. In other words, any place that deals with items that involve a potential to transmit a deadly disease with exposure to human or animal fluids, tissues, or body parts.
The policies and procedures established by state and federal governments assist in avoiding the spread of potentially fatal diseases by designating strict guidelines for the generator for segregation, collection, storage, transport, and final treatment of biohazard waste.
State agencies work in conjunction with federal agencies such as the Department of Transportation (DOT), OSHA (Occupational Safety and Health Administration), and CDC (Center for Disease Control) for monitoring all processes of biohazard disposal from the moment it’s generated to rendering it harmless. A break in any of the procedures and guidelines at any point could put people at risk.
Understanding the categories of biohazard waste helps to identify the hazards and the reasons that there are extremely strict laws governing every aspect of this type of waste:
In reviewing the category list of biohazards you can get a better picture of the danger of any of these forms being placed in a landfill or in any manner of exposure to the general public without being treated and/or destroyed. Around 75-90% of medical waste is nonhazardous and can be disposed of in the same way as general waste. However, 10-25% of the remaining waste is hazardous and may pose health and environmental risks.
Any exposure of medical waste that is considered to be hazardous could result in disease, injury, or even death the nature of the biohazard waste can be listed with one or more of the characteristics of:
Infectious wastes could contain any individual or combination of microorganisms that are pathogenic. These pathogens can enter the body via a skin cut, puncture, abrasion, via mucous membranes, through inhalation or digestion. The usual method of transmission is through body fluids. Diseases such as HIV (human immunodeficiency virus) and hepatitis B and C are of great concern as there has been strong evidence of transmission through health care waste, most commonly transmitted from injuries from human blood contaminated syringes.
Additional concerns relate to antibiotic resistant bacteria due to use of chemical disinfectants that are found in medical and laboratory facilities. Research has shown that plasmids from laboratory strains in medical waste used the waste disposal system to transfer to indigenous bacteria. Other antibiotic-resistant bacteria such as Escherichia coli has survived in a sludge plant that was activated, however, this organism did not show a significant transfer under normal wastewater disposal and treatment.
The medical community takes the transmission of biohazard exposures very seriously. While many may be focused on the more high-profile biohazard waste dangers previously mentioned due to exposure, there are many types of infections and disease states due to causative organisms:
Any person that is exposed to an environment that involves biohazard waste carries a potential risk. This includes all staff in a health-care establishment that generates the biohazard waste and all the entities outside of the establishment that handles, stores, transports, and/or disposes of the waste.
In the healthcare group, the main people at risk include medical doctors, nurses, health-care auxiliaries, location maintenance personnel, patients in the healthcare location or those that are receiving home healthcare, visitors to healthcare establishments, workers in the services that support the healthcare establishment, workers in medical waste disposal such as those in incinerators or landfills, and scavengers of landfills.
Small source biohazard waste that are at risk can include but are not limited to home health care workers and patients, as well as those that are involved in illicit drug use such as intravenous.
Many of the pharmaceutical and chemical waste products in healthcare are toxic, flammable, genotoxic, explosive, reactive, and shock sensitive Although a majority of these are found in lesser quantities as biohazard waste, the real dangers occur when there are larger quantities of unwanted, expired, or unused pharmaceuticals or chemicals and are in need of disposal. These quantities can become toxic due to chronic or acute exposure and injuries and poisoning can occur. Intoxication can happen due to absorption through the skin, inhalation, ingestion, or absorption into the mucous membranes. Injuries to the skin and body can happen due to contact with corrosive, flammable, or reactive chemicals; with burns being the most common. Disinfectants that may be used in large quantities are quite often corrosive, and reactive chemicals can be made of very toxic secondary compounds.
Any item deemed as medical waste biohazard can have a direct affect on the environment when it is not stored in the proper containers for the legal length of time allowed. Torn bags or leaking containers can leach into the water system and the ground during heavy rains. Poisoning can occur through vapor inhalation, direct contact, or drinking contaminated water/eating contaminated food.
Inadequate and unlawful disposal can result in contamination of the ground and chemical residues discharged into the sewer systems can have a negative effect on the biology of the sewage treatment plants. Pharmaceuticals as well as heavy metals such as phenols, mercury, derivatives, disinfectants, and antiseptics that aren’t disposed of properly can disrupt an ecosystem.
The danger of genotoxic waste to workers is based on the toxicity substance and the duration of the exposure. This exposure can also occur during the preparation or treatment involving certain chemicals or drugs. Exposure can occur due to inhalation of the dust or an aerosol, skin absorption, consuming food that is contaminated with cytotoxic drugs, waste, or chemicals or through incorrect mouth pipetting. An additional method of exposure can happen with contact with secretions/bodily fluids of chemotherapy patients. Studies have shown that many antineoplastic drugs are mutagenic and carcinogenic and can cause everything from dizziness to dermatitis.
The level of disease due to radioactive waste is determined by both the type and the duration of exposure. Mild exposure to low-activity radioactive waste can cause symptoms such as dizziness, headache, and vomiting. Longer term exposure to more powerful radioactive biohazard waste can cause serious problems. Radioactive waste is genotoxic and may affect genetic material. Both the radioactive waste and the external surfaces and containers are required to be handled according to lawful guidelines.
Given all of the potential dangers of biohazard waste, it quickly becomes obvious that there is a requirement to have a certified medical waste disposal company for proper disposal. The better companies will act as a consultant to work with clients on advice for handling and storage, ensuring that each type of biohazard waste is kept in an FDA-approved container and that the client complies with all local, state, and federal laws. All staff and drivers are trained and certified for safe pickup of biohazard waste material and takes the containers to be processed at a licensed disposal facility.
Mishandling of biohazard waste carries consequences for people as well as the environment. The risk of infection and transmission of potentially deadly diseases is too great. State and Federal laws also indicate that the generator is responsible for the biohazard waste from the moment of creation to proving that it was appropriately disposed of according to legal guidelines. Lack of compliance can result in high fines that are compounded daily. A medical waste disposal company will supply clients with the manifests needed while taking care of all biohazard waste disposal according to all guidelines required. The dangers of mishandling biohazard waste disposal can cause transmission of deadly diseases to people and the environment.
All staff and personnel in every environment that involves biohazard wastes is required to have certification training on the topic. There should also be ongoing analysis and reviews of the methods used by a facility that deals with biohazard waste to ensure that there is the addition of new and updated procedures to keep everyone safe.
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