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Disposal of Medical Waste
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Medical waste, produced by hospitals, clinics, doctors' offices, research facilities, and even private homes from self-administered healthcare, is extremely varied in character, and much of it poses a public health hazard. Blood, tissue, soiled bandages and hospital gowns, used rubber gloves, and other used medical supplies are all potentially infectious, and the risk of infection is enhanced by the presence of sharp objects in medical waste such as syringes, scalpels, and lancets. Some medical waste is radioactive. Significant amounts of mercury, which is toxic, can be found in medical waste. Because of the potential hazards posed by medical waste, it is important to public health and the environment to properly dispose of it.
The disposal of medical waste is generally regulated at the state level; however, several federal agencies are involved in certain aspects of medical waste disposal. The Environmental Protection Agency (EPA) regulates emissions from medical waste incinerators and the use of certain chemical technologies for treating medical waste. The Department of Transportation treats medical waste as hazardous material and regulates its transportation. The Food and Drug Administration regulates containers designed to safely hold "sharps," medical implements that can easily puncture the skin such as needles and scalpels. The Nuclear Regulatory Commission regulates some types of radioactive medical waste. The Occupational Health and Safety Administration regulates the handling of medical waste in the work environment. The United States Postal Service regulates the mailing of medical waste.
The most common medical waste disposal method is incineration, which accounts for over 90% of the disposal of medical waste. However, the EPA has instituted stringent emissions regulations aimed at reducing the emission of mercury, dioxins, hydrogen chloride, and particulate emissions from medical waste incinerators. Accordingly, the EPA anticipates that facilities will gradually adopt alternative medical waste treatment methods because of the financial considerations involved in complying with the emissions regulations. Alternative methods for disinfecting medical waste include the use of microwaves; steam; electropyrolysis, which is a type of extreme-heat treatment; chemical treatments; and mechanical treatments. The EPA provides fact sheets, technical assistance, and other guidance to facilitate the evaluation and implementation of alternative treatment methods. In addition, the EPA directly regulates any treatment method that eliminates microbes in infectious waste through the use of a chemical under the Federal Insecticide, Fungicide, and Rodenticide Act.
In response to growing concerns about the potential for the spread of disease from possibly infectious medical waste that was washing up on eastern beaches in the 1980's, the EPA conducted a two-year demonstration program to track medical waste from its generation to its ultimate disposal. The legislation that created the program, the Medical Waste Tracking Act of 1988, also required the EPA to evaluate available and potentially available methods for handling, storing, transporting, and disposing of medical waste. As a result of its studies, the EPA developed Model Guidelines for State Medical Waste Management, which provide suggestions as to how states can improve their medical waste management schemes Copyright 2009 LexisNexis, a division of Reed Elsevier Inc.
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