ME DICAL WAST E RE VIE W AND CL ARIF ICAT IONS Arle e n - - PowerPoint PPT Presentation

ME DICAL WAST E RE VIE W AND CL ARIF ICAT IONS

Arle e n Gurfie ld, MPH, RE HS

Supe rvising E nviro nme ntal He alth Spe c ialist

OUT L INE

• Wha t is a nd wha t is NOT

me dic a l wa ste

• Re d b a g wa ste
• Viva rium wa ste
• Me dic a l wa ste tre a tme nt
• Me dic a l wa ste sto ra g e a c c umula tio n time limits
• Co mmo n vio la tio ns fo r me dic a l wa ste

CURRE NT MWMA:

E nsure yo u a re re fe rring to the mo st re c e nt ve rsio n o f the MWMA

ME DI CAL WAST E DE T E RMI NAT I ON

(1) Is it a waste?

yes = go to question (2) no = not regulated as "medical waste"

(2) Is it exempted? HSC 117700

no = go to question (3) (a) waste generated in food processing or biotechnology that does NOT contain an infectious agent or an agent capable of causing an infection that is highly communicable yes = not regulated as "medical waste" (b) waste generated in biotechnology that does NOT contain human blood or blood products or animal blood or blood products suspected of being contaminated with infectious agents known to be communicable to human or a highly communicable disease. yes = not regulated as "medical waste" (c) urine, feces, saliva, sputum, nasal secretions, sweat, tears, or vomitus, unless it contains visable or recongnizable fluid blood yes = not regulated as "medical waste" (d) waste which is NOT biohazardous, such as paper towels, paper products, articles containing non-fluid blood, and other medical solid waste products commonly found in the facilites of medical waste generators* yes = not regulated as "medical waste" (e) hazardous waste, radioactive waste, or houshold waste, including, but not limited to home-generated sharps waste yes = not regulated as "medical waste" (f) waste generated from normal and legal veterinarian, agricultural, and animal livestock management practices on a farm or ranch unless otherwise specified by law yes = not regulated as "medical waste"

(3) Is it a "medical waste"? HSC 117690(a)

no = not regulated as "medical waste" (a) BIOHAZARDOUS WASTE: HSC 117690(b)(1) waste or reusable material derived from the medical treatment of a human or from an animal with a pathogen that is infectious to humans (zoonotic); waste containing a highly communicable disease; lab wastes that are infectious to humans; contains fluid human blood; waste from isolation control regulated "medical waste" (b) PATHOLOGY WASTE :HSC 117690(b)(2) human body parts (excluding teeth); removed at surgery and surgery speciments suspeced of being contaminted with infectious agents; surgery speciments or tissues fixed in formaldehyde or other fixative; animals parts, tissues, fluids, or carcasses suspected of being contaminated with zoonotic pathogen regulated "medical waste" (c) PHARMACEUTICAL WASTE: HSC 117690(b)(1); 117747 a prescription or over-the counter human or veterinary drug (21 USCA 321(g)(1)) regulated "medical waste" Does NOT include the following:RCRA pharmaceuticals not regulated as "medical waste" pharmaceuticals subject to the Radiaton Control Law not regulated as "medical waste" pharmaceuticals sent to a licensed reverse distibutor not regulated as "medical waste" (d) SHARPS WASTE: HSC 117690(b)(4) a device that has acute rigid corners, edges, or protuberances capable of cutting or piercing (e.g. hypodermic needles, blades, needles with attached tubing, acupuncture needles, root canal files, broken glass used in health care and blood vials contaminated with biohazrdous waste, any item capable of cutting or piercing from trauma scene waste regulated "medical waste" (e) TRACE CHEMOTHERAPEUTIC WASTE: HSC 117690(b)(5) waste that is contaminated trhough contact with, or having previously contained, chemotherapeutic agents (e.g. gloves, gowns, towels, IV solution bags). Bulk chemo = hazardous waste regulated "medical waste" (f) TRAUMA SCENE WASTE: HSC 117690(b)(6) waste that is a "regulated waste" as defined in 8 CCR 5193 and that has been removed, is to be removed, or is in the preocess of being removed from a trauma scene by a trauma scene waste management practitioner. regulated "medical waste"

WHAT IS NOT

ME

DICAL WAST E

DE F INIT ION OF ME DICAL WAST E

*Be a dvise d tha t yo ur fa c ility ma y ha ve mo re string e nt g uide line s impo se d b y o the r a c c re diting o rg a niza tio ns

BI OHAZARD VS. ME DI CAL WAST E

All Bioha za rd = Me dic a l wa ste ; All medical waste ≠ biohazardous

Bio ha za rd wa ste s a re sub sta nc e s tha t a re :

• I

nfe c tio us to humans

• Co nta mina te d with hig hly c o mmunic a b le dise a se
• F

luid huma n b lo o d

RE D BAG WAST E

• I

f yo ur fa c ility is ma na g ing no n- me dic a l wa ste in re d b a g s, yo u a re re q uire d to b e in c o mplia nc e with the MWMA re q uire me nts

• Bio ha za rd symb o l a nd the wo rd

“BI OHAZARD” o n the lid a nd side s so a s to b e visib le fro m a ny la te ra l dire c tio n

• Co mplia nc e with a ll sto ra g e time

limits a nd la b e ling re q uire me nts a t the po int o f g e ne ra tio n (no t whe n the ha ule r a rrive s fo r pic k-up)

VIVARIUM WAST E

• Viva rium wa ste pic ke d up b y a me dic a l

wa ste ha ule r a s re g ula te d me dic a l wa ste , is re q uire d to b e in c o mplia nc e with the MWMA.

• F
• r

e xample : if sto re d within fre e ze rs, the

a nima l c a rc a ss wa ste must b e sto re d a ppro ve d re d b io -ha za rdo us b a g s with g e ne ra to r la b e ls a t the time the y a re pla c e d in the fre e ze r. An a ppro pria te “wa rning ” sig n ma y b e re q uire d a s we ll if the a re a is the de sig na te d me dic a l wa ste a c c umula tio n a re a

*VI OL AT I ON* - Re q uire d to b e la b e le d with g e ne ra to r la b e l *VI OL AT I ON* - Pro pe r re d b io - ha za rdo us b a g re q uire d fo r re g ula te d me dic a l wa ste

GE NE RAT OR ST AT US

• “Sma ll qua ntity g e ne ra tor” (SQG) g e ne ra te s le ss tha n 200

po unds pe r mo nth o f me dic a l wa ste

• “L

a rg e qua ntity me dic a l wa ste g e ne ra tor” (L QG) g e ne ra te s

200 o r mo re po unds o f me dic a l wa ste in a ny mo nth o f a 12-mo nth pe rio d *I t is the fa c ility’ s re spo nsib ility to de te rmine g e ne ra to r sta tus. Me dic a l wa ste dispo sa l do c ume nts a nd me dic a l wa ste ma na g e me nt pla n a re re vie we d b y the inspe c to r fo r ve rific a tio n.

ME DICAL WAST E ON- SIT E T RE AT ME NT RE QUIRE ME NT S

• HSC 118215 Me dic al waste tr

e atme nt to a SOL ID WAST E

• Re q uire s a Me dic a l Wa ste Ma na g e me nt Pla n (MWMP) o nsite a nd sub mitte d to HMD.

–

E nsure a c lo sure pla n is inc lude d fo r the te rmina tio n o f tre a tme nt

• Sub je c t to inspe c tio n (2 ye a rs fo r SQG a nd a nnua lly fo r L

QG)

• Ma inta in do c ume nta tio n fo r individua l tre a tme nt o pe ra ting re c o rds
• T

ra ining do c ume nta tio n a nd re c o rds ma inta ine d fo r thre e ye a rs (SGQ) o r two ye a rs (L QG)

ADDIT IONAL RE QUIRE ME NT S F OR L QG T RE AT ME NT

• Re q uire d to a pply fo r a tre a tme nt pe rmit with HMD
• Re q uire d to sub mit MWMP to HMD
• Re q uire d to de ve lo p a c lo sure pla n c o mple te with c e rtific a tio n sta te me nt

ME DICAL WAST E ACCUMUL AT ION T IME L IMIT S

https:/ / www.sa ndie g o c o unty.g o v/ c o nte nt/ da m/ sdc / de h/ hmd/ pdf/ hm-9214%20(11-16).pdf

F

• r me dic a l so lid wa ste , pe r the SDCC, yo ur

fa c ility is re q uire d to ha ve a se c ure d dumpste r

COMMON ME DICAL WAST E VIOL AT IONS

ME DI CAL SOL I D WAST E NOT SE CURE D T O PRE VE NT UNAT UHORI ZE D ACCE SS ME DI CAL WAST E DI SPOSAL DOCUME NT S NOT RE ADI L Y AVAI L ABL E F OR RE VI E W F

• r SQG = thre e ye a rs o f dispo sa l do c ume nts

F

• r L

QG = two ye a rs o f dispo sa l do c ume nts

MWMP Disposal Re c or ds

COMMON ME DICAL WAST E VIOL AT IONS

PROPE R “WARNI NG” SI GN NOT POST E D OUT SI DE DE SI GNAT E D ME DI CAL WAST E ACCUMUAL T I ON ARE A ME DI CAL WAST E MANAGE ME NT PL AN NOT SUBMI T T E D T O CUPA (L QG)

Me dic al waste must be r e por te d thr

• ugh

CE RS if ge ne r ate d in ANY AMOUNT

This includes biohazardous liquid waste that is treated with bleach solution and disposed to sewer

RE MINDE RS!

• Arle e n Gurfie ld, SE

HS

– a rle e n.g urfie ld@ sdc o unty.c a .g o v – (858) 505-6779

• Ana sta siya Irkhin, E

HS

– a na sta siya .irkin@ sdc o unty.c a .g o v – (858) 518-7388

CONT ACT I NF ORMAT I ON