INSTITUTIONAL POLICY AND PROCEDURE (IPP)
REVIEW DUE REPLACES NUMBER NO. OF PAGES
HAZARDOUS WASTE: HANDLING AND DISPOSAL
To provide guidelines for the handling or disposal of hazardous waste, including infectious waste, radioactive waste, chemical waste, and chemotherapy waste.
infectious waste “Solid or liquid wastes which contain pathogens with sufficient virulence and quantity such that exposure to the waste by a suspectable host could result in an infectious disease.”
RESPONSIBILITY CROSS REFERENCES POLICY
Medical Center staff shall use the following procedures in the safe handling or disposal of hazardous waste. The guidelines of the Environmental Protection Agency (EPA), Centers for Disease Control and Prevention, and other agencies are used in the development of these procedures. Specific Information: A. Infectious Waste 1. The Infection Control Committee/Office is responsible for the definition of infectious waste (See Attachment A) and is responsible for developing guidelines concerning the handling or disposal of infectious waste. 2. Waste items considered infectious include, but are not limited to, needles and sharps, items contaminated with Blood or body fluids, isolation room waste, all microbiological waste, anatomical pathology, and surgical waste (See Attachment A). 3. Handling, Storage, and Transport a. All items defined as infectious waste are segregated from noninfectious waste at the point of generation and handled separately. b. Red bagged waste are placed in secondary containers that will prevent leakage of contents. c. The rooms where potentially infectious waste is stored are identified by signage with the biohazard symbol. d. Infectious waste discarded in red bags is transported by Environmental Services or other designated housekeeping services to the autoclave in closed leak-proof containers with tight fitting covers . e. Sharps containers, pathological waste, and body fluid collection devices which cannot be emptied are managed by incineration or autoclaving according to applicable state and federal regulations by a commercial medical waste vendor.
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a hard copy of the procedures may be obtained by contacting the Environmental Health and Safety. sharps containers. cannot be emptied. Personal protective equipment is used since there is a reasonable likelihood for exposure. such as suction canisters. All needles and sharps are placed in color coded or labeled. Isolyzer gel) is added to these blood and body fluid collection systems and single use suction containers. placentas. 4. (NOTE: Sharps containers are not reusable. Pathologic wastes must be incinerated by an offsite contracted biohazard waste disposal company.g. A solidifying agent (e. Detailed procedures are available from the web site. 7.
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. or commodes in a manner that minimizes splashing and splattering. 6. may be carefully emptied into hoppers.. contact Environmental Health and Safety). Laboratory infectious waste is autoclaved prior to transport to the landfill. organs. (NOTE: If unsure of proper container for transport. Environmental Health and Safety is responsible for developing guidelines concerning the handling or disposal of radioactive and chemical waste. All liquid waste must be in a chemically compatible Container (such as the container it came in). utility sinks. puncture-resistant Sharps containers. Pathologic waste bagged and placed in a designated yellow waste container. The containers are then discarded in red infectious waste bags. For areas that do not have access to the internet. All waste is properly packaged for transport. Faculty and staff in areas that generate chemical and radioactive waste follow the procedure below: a. such as pleura-vacs and blood collection/administration systems. body parts that are removed during the surgery and autopsy. Pathologic Waste is not placed in any regular red bag disposal container. infectious waste discarded in red bags. Closed systems containing blood. 8. Blood and body fluids in easily emptied containers. and free of any residue on the Outer surface of the container. 2.For the offsite practices. Radioactive and Chemical Waste 1.) 5. and Body collection devices which cannot be emptied are managed by incineration or autoclaving according to applicable state and federal regulations by a commercial medical waste vendor. etc. Pathologic waste includes tissues. pathological waste.
f. but are placed in Red bins for disposal and removal by Environmental Services or other designated housekeeping services. All solid waste must be in an approved Environmental Health and Safety bag or box and sealed tape. sealed with a screw-on cap. Environmental Health and Safety will not accept any waste in water bottles. These containers of blood or body fluids which have not been decanted into the Municipal sewer system are not placed in red bags. They are then sealed when full. The bag or box should not be leaking or have any residue on the surface. Sharps containers must be checked and replaced as needed to prevent overfilling. milk jugs. B. household detergent container. causing blood and body fluids to gel prior to being placed in the biohazardous waste container.
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. 4. Chemical waste ii. Items containing lead are packaged separately from all waste. Faculty/staff who have regular contact with preparing. Special instructions are given on the disposal of designated cytotoxic drug waste and cleaning of areas where these medications are in use. Waste is tagged for disposal with the appropriate tag. Cytotoxic waste is picked up by Environmental Services or other designated housekeeping service and transported to an offsite medical waste incinerator. and destroying cytotoxic drugs are oriented to the hazards of handling cytotoxic drugs. 2. Faculty/staff must wear appropriate personal protective equipment when handling cytotoxic drug waste containers. Bulk contaminated cytotoxic drug waste (unsused Ivs and vials of drugs) is returned to the pharmacy For disposal.b. Trace contaminated cytotoxic drug waste includes: a. Radioactive waste (biowaste) Note: Radioactive liquid waste requires both the “Radioactive waste (liquid)” tag and the “Chemical waste” tag. (Note: Sharps may be discarded in cytotoxic waste liners). complete the attached chemical waste or radioactive waste collection form and fax to Environmental Health and Safety. e. Radioactive waste (solid) iii. Waste containers are closed at all times except when adding waste. Items used to prepare drugs b. These items are placed in a securely closed cytotoxic bucket or cytotoxic waste bag prior to transport. Empty bags. IV tubing. For areas that do not have internet access. administering. Items used to clean areas and waste from patient rooms where drug is administered c. Radioactive waste (liquid) iv. Cytotoxic Waste 1. C. 3. etc. c. d. Available tag types are as follows: i. removing. These tags can be ordered free of charge through the Environmental Waste Collection Program. Chemical waste is stored by compatibility in secondary containment until collection. vials. Cytotoxic waste containers are available on units for disposal of waste from patients receiving cytotoxixc drugs. Request a hazardous waste pick-up through the Environmental Health and Safety website.
http://www.epa.mc. Rules of the Tennessee Department of Health and Tennessee Department of Environment and Conservation http://www. http://www.safetyvanderbilt.state.edu.tn.us U. Tennessee Department of Environment and Conservation website.edu/vumcdept/accreditation/camh.nsf?OpenDatabase. http://www.cdc.tn.state. GA: US 1997 Web References: Centers for Disease Control and Prevention website http://www.tdot. Management of the Environment of Care standard from http://www.vandebilt. http://www.vanderbilt.Garner JS. Safety Policy Manual • Handling of Cytotoxic Drugs http://vumcpolicies. Simmons. CDC Guidelines for Isolation Precautions in Hospitals. Environmental Protection Agency website.gov Clinical Policy Manual • Cytotoxic Drugs (Chemotherapy) Administration and Management • Blood Product Administration From http://vumcpolicies.us/environment Tennessee Department of Transportation website.edu/E-Manual/Hpolicy.nsf?OpenDatabase Comprehensive Accreditation Manual for Hospitals.educ/EManual/Hpolicy.pdf.mc.S.mc. Vanderbilt Environmental Health and Safety website.htm.vanderbilt.us/sos/rules/1200/1200-08/1200-08.gov.tn.state. 2005. Atlanta.
Prepared by Reviewed by Approved By Approved By Latest Revision Approved By
ATTACHMENT A JCI Standards CBAHI Page 4 of 8
medical waste contaminated by blood or other body fluids is incinerated or autoclaved to destroy all pathogens prior to deposits in the landfill. 4. defines infectious waste as follows: “Solid or liquid wastes which contain pathogens with sufficient virulence and quantity such that exposure to the waste by a suspectable host could result in an infectious disease.INFECTIOUS WASTE POLICY DEFINITION OF INFECTIOUS WASTE The Department of Health and Environment. Contaminated animal carcasses. Body parts.
MEDICAL CENTER HAZARDOUS WASTE DISPOSAL GUIDELIES JCI Standards CBAHI Page 5 of 8
.” The following categories of waste are classified as infectious: 1.. organs. Human blood. cultures. capillary tubes) used in clinical or research areas. Cultures and stocks of infectious agents. Any medical device or item (blood bags and corresponding tubing. In general. wound dressings. needles. 5. scalpel blade. discarded live and attenuated vaccines. 2. serum. and culture dishes and devices used to transfer inoculate. All solid waste contaminated with body fluids from isolation rooms. All sharps. syringes. blood products. plasma. body parts. and all intensive units. and mix cultures. dialysis lines. production of biological agents. or labor and delivery rooms. and stocks agents from clinical and research labs. or pharmaceutical vaccines. tissues. Pathological wastes. and body fluids removed during surgery or autopsy. animal bedding from animals exposed to pathogens in research. broken glass. pipettes. shall be placed in a sharps container. or in vitro testing. and the like) that are contaminated with blood. Discarded sharps (e. scalpels. and waste blood.g. wastes from the production of biological agents. Other medical devices are summarized in the following table. the emergency department. 6. including those not contaminated with blood or body fluids. Chapter _________________ of the hospital rules and regulations. 3. including specimen cultures collected from medical and pathological laboratories.
biohazard collection co.) Red Bag – may need to double bag if leaks are possible. do not place All path waste is incinerated offsite by Biohazard collection co. etc.e. container prevent overfilling. container as needed to offsite Syringes.For Check and replace Needles. OR tissue. etc
Incinaration Service. JCI
Incineration or autoclave CBAHI
Carefully empty into a hopper.* See sharps section Waste above for disposal
Contaminated patient care services that cannot be emptied
Pleuravacs.TYPE OF WASTE Sharps
CONTAINER DISPOSAL COMMENTS USED METHODS Sharps Autoclave. place pathologic waste in special yellow path waste container Cytotoxic waste bucket or container lined with cytotoxix waste bags Red bin. do not place within red bag. Human tissue (placenta. send blood bag with bag copy of tag and administration tubing to the Blood Bank
Contaminated patient care Standards
Suction canisters. For Offsite practices: biohazard collection co. vacuum bottles. etc.
Return unused drug to pharmacy
Pleuravacs must clamped before discarding. Note: For patients with transfusion reactions.lancets. blood bags. practices: capillary tubes.
Chemotherapy Chemotherapy bags. Incineration or autoclave Service. Red bin. Page 6 of 8
. A solidifying agent (i.scalpels. Small. For Offsite practices: biohazard collection co. wound drainage systems. Isolyzer) is added to containers to cause secretions to solidify prior to being discarded in the biohazardous waste container. etc. unrecognizable pieces of tissue or parts of organs are autoclaved or disposed of as regular red bag waste. clinical sink.
saturated items from ED. magazines. paper towels. Isolyzer) is added to containers to cause secretions to solidifying prior to being discarded in the biohazardous waste container. A solidifying agent (i. IV bags and tubing. Practices: biohazard collection co. OR. etc. Submit online collection request via website. paper wrappings from sterile items.
Clear or tan bag
Do not place these items in red bags even if they are from an isolation room. soda cans. dialysis lines etc.
Grossly contaminated items
Patient care devices (not contaminated with blood) General Waste
Recyclable Soda cans. JP drains). etc.
Yellow bag with special markings
Licensed disposal service
Collection managed by EHS. fast food wrappers. Red bag – may need to double bag if leakage is possible Red bag – may need to double bag if leakage is possible Clear or tan bag
Service. (Chux) urine cup (if no blood). Landfill Any patient item that is not contaminated with blood. flowers. paper Radioactive
Any waste from an isolation room that contains any blood/body fluids or from a VRE isolation room 4x4 saturated sponges all saturated dressings. Practices: biohazard collection co. For human tissue Autoclave For (placenta.
or commode. Foley bags. For Offisite practices: biohazard collection co.e. tan bag or none
within red bag. Use personal protective equipment if there is a reasonable likelihood for exposure due to splashing/splattering. OR tissue) Offsite see pathological waste. Pizza boxes. L&D. Clear. all ICUs etc. newspapers. vaginal speculums. blue pads.
Autoclave for Double bagging is no longer recommended Offsite except in VRE cases. Spills should be Page 7 of 8
.devices that can be emptied
Collodion. Submit online collection request via website. formalin.
Liquid Waste – chemically compatible container (such container it came in) Solid Waste – Approved EHS sealed bag or box
Licensed disposal service
reported to tel. etc. _____________ Collection managed by EHS. xylene. No.
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. No. Spills should be reported to tel.