Medical waste is generated at facilities that involve exposure to body fluids or tissues that may contain contaminants that are potentially infectious to humans, the community, and the environment. Specific laws and guidelines have been established on local, state, and federal levels to identify, store, transport, and treat medical waste so that it is rendered harmless. The State of Illinois the Pollution Control Board adopted regulations in 1993 that prescribed the criteria and standards for handling PIMW (potentially infectious medical waste). Title XV of the Illinois Environmental Protection Act creates statutory requirements to make sure that PIMW is handled safely and responsibly, and compliments existing federal laws and guidelines. The purpose of the regulations is for the reduction of environmental and occupational risks that happen during storage, transfer, transport, treatment, and disposal of PIMW.
Dot regulation 49 CFR 173.22 indicates that all responsibilities involving safe conduct of all regulated waste is assigned to the shipper. This is called “cradle to grave,” which means that the organization generating and shipping the medical waste is accountable for insuring that it is stored, handled, documented, and disposed of according to all guidelines.
Who Generates Medical Waste
Medical waste can be generated in any facility that has exposure to human or animal blood or tissues that could have infectious contaminants. Facilities can be individual businesses such as:
Physician’s offices, veterinary clinics, tattoo parlors, body piercing, dental offices, pharmacies, and mortuaries. Midsized organizations that generate medical waste can include blood banks, university and scientific research and laboratories, the coroner, nursing homes, pharmaceutical laboratories, and multi-physician clinics. Hospitals are some the largest institution type that generates medical waste.
A majority of facilities that generate medical waste coordinate transportation and disposal with a professional and licensed medical waste disposal company. All PIMW which will be shipped, treated and disposed of off-site is required to be placed in containers that are rigid, leak-resistant, impervious to moisture, and strong enough to prevent bursting or tearing under normal use and handling conditions, as well as sealed to keep the containers from leaking at any point. Sharps are those items that can puncture the skin and must be packaged in special puncture-proof containers. Oversized PIMW are required to be packaged or covered so that contact with the public or transport professionals is minimized. Sharps are not allowed to be packaged and transported as oversized PIMW. Containers are required to be labeled with the international “Biohazard” symbol, the word Biohazard, and sharps will have the distinctive “Sharps” label. Inner packages must have the word “Biohazard” or “Sharps” and must also have the international Biohazard symbol label. All containers need to be stored in a location that is segregated so that only the transport professionals will have access.
An additional water-resistant label or tag is required for each container with the following written in indelible ink:
Unless otherwise authorized by the Illinois EPA in the permit, PIMW must not be stored for more than:
72 hours unless the surface temperature of the package is maintained at or below 45 degrees Fahrenheit, and 30 days, regardless of the temperature.
Companies involved in the handling, transport, and disposal of medical waste are required to be licensed and trained professionals according the federal OSHA guidelines. The companies need to be: all staff properly trained, insured, and permitted to handle medical waste, properly trained drivers, understand and comply with both federal and state laws, be able to provide proper paperwork, manifests, and bills of lading, as well as documentation of final treatment and disposal of the medical waste.
The vehicles/trucks/vans for transport are required to be completely self-contained without leaks or gas exposure, well-insulated, well-maintained, enclosed so that putrescence effects are minimized, cannot be accessed by the public, cleaned and sterilized after each use, cannot be used for any other purpose other than PIMW transport, and must be in condition that prevents a breeding place or food source.
State of Illinois transport requirements include:
Transporters are required to put a label to every PIMW package that includes:
According to 35 Illinois Adm. Code 1422, specific destruction methods are required for each type of medical waste. The State of Illinois bans any untreated medical waste from being placed in a landfill.
Incineration: The incinerators used for medical waste operate at temperatures around 1800 degrees Fahrenheit, which reduces the medical waste to harmless ash that can be safely placed in a landfill.
Autoclaving: A method that uses chemicals and/or heat at 300 degrees Fahrenheit to sterilize the medical waste. Some medical waste cannot be autoclaved using chemicals as the addition of the chemicals changes some metallic substances so that they are toxic and/or combustible. In those cases, incineration is the only option for destruction.
Irradiation: A method using gamma rays to disinfect by killing bacteria. It employs radioactive isotope of cobalt and is similar to the same radiation used for cancer treatments.
Medications/Prescriptions: The State of Illinois Health Facilities and Regulation (210 ILCS 150/) Safe Pharmaceutical Disposal Act.
“(210 ILCS 150/10)
Sec. 10. Disposal of unused medications prohibited.
(a)“Except for medications contained in intraperitoneal solutions, intravenous fluids, syringes, or transdermal patches, no health care institution, nor any employee, staff person, contractor, or other person acting under the direction or supervision of a health care institution, may discharge, dispose of, flush, pour, or empty any unused medication into a public wastewater collection system or septic system.”
Many pharmaceuticals do not degrade naturally and contain substances that are harmful for the environment. The State of Illinois does allow for prescription mail-in as well as medication drop off programs that are under the guidance of local police. Professional medical waste disposal companies comply with the State guidelines in the treatment and disposal of unused, used, and expired pharmaceutical medicines.
Parent page – Medical Waste Disposal
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