RESPONSE TECHNIQUE Title Autoclave hospital waste Summary Information on the process of sterilizati on of medical waste, disposal of it, legal

proceedings and the estimated value o f investment. Keywords Trash hospital; decontamination autoclave, investment, le galization, legislation, equipment subject to hazardous waste collection demand information about the process of sterilization of medical waste, disposal of it, legal proceedings and the estimated value of investment. Waste solution present ed Introduction of health services, more commonly known as hospital waste, are t he tailings resulting from activities carried on services related to health care or feed, generated not only in hospitals but also in clinics, laboratories, den tal offices and veterinarians, pharmacies, clinics and other similar, given its characteristics offer risk of contamination and thus require management processe s, requiring no treatment or prior to its final disposition. The hospital waste, also known technically as solid waste from health services, or the initials RSSS, because of its peculiarities and potentially dangerous characteristics. Unfo rtunately, the amount of research on the impact of hospital waste and the variou s techniques used to treat it is still small, even globally, and needs to be fur ther stimulated. The operation of waste disposal hostitalar costs about six time s more than that practiced against the trash, so it is necessary attentive monit oring of the boards of Health Surveillance. Given its potential for transmission of diseases, hospital waste deserves special care at the time of disposal. The septic waste autoclave should go to hospital or septic ditches or be incinerated (incineration is different from burning, as is done in special machines and not just by fire). There is a difference in the final destination and waste treatme nt. Treatment is necessary to final destination, where for each type of waste tr eatment exists and a specific destination. 1 Copyright © Brazilian Service Technical Answers - SBRT - http://www.sbrt.ibict. br The autoclave is a heat treatment is to keep the contaminated material under pre ssure at elevated temperature by contact with water vapor over a period of about 40 minutes to destroy all pathogens. Then, the garbage is ground and can be dis posed in septic ditches, as there is no more danger of contamination. The autocl ave is used for solid waste in Group A as biowaste (culture, inoculations and ot her), blood and blood products, surgical, anatomical and pathological exudates, except for anatomical parts of larger volume, drill cutting waste, and waste res ulting of patient care as secretions and excretions and others. Should be exclud ed from the waste class A.5 infected animal, although the system can be efficien t for small animal parts, the volume and mass of whole animals can prevent prope r sterilization. The system is equally suitable for use in remote production uni ts, consisting of hospitals, blood banks, customs and others, such as centralize d plants for treatment. Garbage must be collected in plastic bags class II, milk y white in color, as specification of standard ABNT, or in appropriate container s in the case of drill cutting. The trash bags are deposited in a specific area under the cover of the treatment area. In the process of handling these bags are placed in boxes (containers) without metal cover, without having to open them. During the sterilization phase, with high temperature in the chamber, these bags are destroyed, allowing the contact of steam with the waste to be sterilized. A utoclaves for up to 1,500 liters, the containers are moved and placed inside the chamber of the autoclave by car with wheels. In systems with higher capacity of handling containers and their placement in the chamber can be made by crawlers. These mats can be moved towards the axis of rotation through the rails, allowin g position them at the entrance of the chamber of autoclaves. After the cycle, t he containers are removed from the chamber and an automatic lifting system, with paddles to fit the handles of the same, will dump the contents in the sterilize d feeding hopper of a crusher blades. Autoclaves in this small action is aided b y manual or mechanical lifting system manual override. The waste is then crushed and is ready to be sent to a landfill for final disposal. In this process,€the volume of waste is reduced by 70-80% of the initial volume. The crusher can dum

p the treated product directly on the containers used to collect trash or carts, if there is a difference in height between the units. Another possible way is m anual loading with the collection of garbage in plastic bags and placed under th e crusher. The waste ground, bagged or in containers must be stored on impermeab le base with trim for collection box to collect the leachate that is formed by c hance and allow their treatment by chemicals. Liquids that result from the washi ng of containers and garbage disposal should be referred to the same collection box. The treated effluent can be directed to the sewage system or septic tanks s ettling. Importantly, these effluents have only organic load, which must be addr essed, but are free of contamination. Sterilization process The process starts w ith pre-pulses of vacuum and pressure, to withdraw the air from the chamber. Thi s air is removed by a 0.1 micron filter of health retaining the bacteria Copyright © Brazilian Service Technical Answers - SBRT - http://www.sbrt.ibict. br 2 present. After this pretreatment the steam is injected into the chamber to allow for proper sterilization. The process concludes with the drying of the cargo th us allowing the removal of it without splashing. Note: The drying will be effect ive depending on the type of load and exposure time. All fluids used during the process have their flow in a closed system, thereby avoiding environmental conta mination. The waste can still pass through a distortion through compression or g rinding. After loading the autoclave, starts the sterilization cycle. Phase wrap ping / Pre-vacuum: this first phase consists of a pulse of vacuum to remove air from the chamber. This pulse of vacuum is achieved by driving the vacuum pump. C am Up: Cut off the excess air in the chamber begins to phase path is made up whe re the increase in temperature in the chamber and the homogenization temperature chosen for the cycle. This phase is accomplished by injecting saturated steam i n the chamber of the equipment. Exposure: In the cycle for garbage provided for a phase of exposure of 15 minutes at 150 º C. The process was validated for a 1 0 minute exposure, 30% less than the exposure time, the cycle being studied were able to reduce the population of a biological indicator in 6.5 to 7 log cycles. The indicator used was Bacillus stearotermóphilus, the most resistant to the a ction of steam. Other methods of treatment are also considered clean (clean) as the microwave, will allow a significantly lower mortality, resulting in a lower security process. Depletion / Drying: In the final phase is made again a vacuum pulse in order to eliminate steam and condensate from the walls of the chamber. Fluid removed from the chamber will be sterile and should be forwarded to collec tion bin and thence to the sewer. Monitoring: The system used for monitoring the process is similar to those used in the control of hospital sterilization. Biol ogical and chemical indicators were developed specifically for the temperature u sed. Complement the treatment system. Containers to load the chamber;. Steam gen erator (in case there is no boiler itself) to the gas for the large autoclaves a nd electric for the small businesses;. Lift Containers (only in large. The eleva tion is manual in small autoclaves). Grinder. Waste management should be made to draw up a set of rules involving:. Waste segregation at source in appropriate c ontainers and labeled in compliance with standards;. internal collection from th e generating source to the temporary storage. pre-treatment (sterilization, deca y, etc.). internal collection of temporary storage to external storage;. recycli ng;. external collection;. final disposition. . professionals in providing maid service hospital waste must be 3 Copyright © Brazilian Service Technical Answers - SBRT - http://www.sbrt.ibict. br trained to work with proper security, to prevent accidents and eliminate the ris k of contamination. packaging waste must be in bags and / or waterproof containe rs, resistant to breakage and leaks, counting identifying the contents;. the int ernal and external storage and transportation of waste must follow the rules of the organs of public sanitation. According to Brazilian Legislation Legislation

CONAMA Resolution No. 385/05 National Council on the Environment,€rests with ge redores RSS and legal guardian waste management, from generation to final dispos al, in order to meet environmental requirements and public and occupational heal th. According to Resolution RDC No. 33/2003 ANVISA National Agency for Sanitary Surveillance, the waste of health care services are classified into five groups. Group A: potentially infectious;. Group B: Chemical;. Group C: Radioactive wast e;. Group D: Common waste;. Group E: sharps. Not all groups that pose a risk of contamination, and are only those that require different treatment. Conclusions and recommendations The investments required will depend upon the amount of wast e being treated, number of employees and number of equipment (the suppliers may inform the value thereof). Before the installation should be consulted: the Depa rtment of the Environment of their city; ANVISA National Agency for Sanitary Vig ilance and do read the legislation (mentioned above). Should also be acquired to the ABNT relevant to the sector (the standards are not paid and are available f or viewing online). FACTBOX sources consulted. Proper disposal of waste. Availab le at: <http://www.cecae.usp.br/recicla/saibaDestinacao.asp.htm>. Acesso em: 10 jan. 2007. DIARY OF THE FEDERAL SENATE. December 2004. Available at: <http://www .senado.gov.br/web/cegraf/pdf/21122004/44472.pdf>. Acesso em: 10 jan. 2007. WAST E MANAGEMENT OF HEALTH SERVICES IN THE INCA. Available at: <http://www.sindhrio. org.br/seminarios/2003/02-1003/Apresentacao%20Sindhrio2.ppt#256,1,Slide1>. Acess o em: 10 jan. 2006. BAUMER. MWTS Waste autoclave treatment system for treating i nfectious waste. Available at: <http://www.baumer.com.br/mwts/Portugues/Mwt_Tecn ico.htm>. Acesso em: 10 jan. 2007. Made by Lilian Warrior Institution Name answe rer REDETEC Technology Network of Rio de January 4 Copyright © Brazilian Service Technical Answers - SBRT - http://www.sbrt.ibict. br Completion date 11 jan. 2007 5 Copyright © Brazilian Service Technical Answers - SBRT - http://www.sbrt.ibict. br