Hazardous Waste in Healthcare, Part 2: MANAGING YOUR HAZARDOUS WASTE

In Part 1 of Hazardous Waste in Healthcare, we defined hazardous wastes. In Part 2, we will discuss identifying hazardous waste in your facility, as well as proper containment, transport, treatment, recordkeeping, and training.

Hazardous Waste Determination

Proper hazardous waste determination is essential to the success of the healthcare facility’s hazardous waste management program. The RCRA regulations at 40 CFR §262.11 require that any person who produces or generates a waste must determine if that waste is hazardous. These same regulations present the steps in the hazardous waste identification process. All healthcare facilities should have a program in place that manages hazardous waste according to not only federal RCRA regulations but also any local, city, and state regulations that may apply.

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Hazardous Waste in Healthcare, Part 1: DEFINING HAZARDOUS WASTE

One of the biggest challenges for today’s healthcare workers is defining the different categories of waste streams they manage on a daily basis. Even the names can be confusing. There’s hazardous, biohazardous, RCRA, universal, pharmaceutical, regulated medical, red bag, pathological, chemo, infectious, isolation, and the list goes on. Perhaps the most confusing and dangerous wastes facilities deal with is hazardous waste. Hazardous waste in healthcare is much more complicated than biohazardous waste and more often than not, improperly recognized and categorized by healthcare professionals. So, what is hazardous waste?

What is Hazardous Waste?

The first step in identifying hazardous waste is learning to recognize products that will be considered hazardous wastes when discarded or as the U.S. Environmental Protection Agency (EPA) defines it, “no longer of value.”1 This could occur when the material has expired, e.g., drugs or when it is no longer needed, e.g. mercury-containing thermostats. The EPA developed four lists of specific hazardous wastes (Listed Wastes) and four hazardous waste types with defining characteristics (Characteristic Wastes) to help determine specific hazards.

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Is It the Flu?

Flu? Ebola? Enterovirus 68? The fall of 2014 is presenting unique challenges to Americans everywhere as people try to determine if they have a cold, the flu, or even the first symptoms of Ebola. Scheduling time to discuss this with a healthcare professional will help to determine what exactly a person is at risk for, what prevention methods are recommended, diagnosis of the disease based on symptoms, what treatment to use, and even development of a plan to keep you, friends, and family healthy.

The Centers for Disease Control and Prevention (CDC) recommends that everyone six months of age and older get an annual flu shot1. People at high-risk, such as those with heart conditions, diabetes, and asthma, as well as pregnant women and people over the age of 65 need to get their annual flu shot to potentially avoid getting seriously ill from complications of influenza. For more information on the flu vaccine, click here.

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Medication Disposal for Long-Term Care Facilities — Including Controlled Substances

On September 9, 2014, the Department of Justice published the final rules for the Secure and Responsible Drug Disposal Act of 2010 allowing proper controlled substance disposal. The regulations go into effect October 9, 2014. The amended rules (found here) allow registered collectors, such as closed-door and retail pharmacies to place receptacles in long-term care facilities to collect and dispose of controlled substances (Schedules II-V). Before the rule update, solutions for disposal in long-term care facilities were minimal and often messy and environmentally unsustainable.

Flushing Medications

Flushing controlled substances, while acceptable in some states, should be avoided as the long-term effects of pharmaceuticals in rivers and streams are unknown. In 2008, the Associated Press found pharmaceuticals in the drinking water of 24 major metropolitan water supplies. Other studies have shown changes in aquatic life such as gender changes in fish, due to pharmaceuticals in the water.

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When Lighting Goes Dark — Fluorescent Bulb Recycling

Eventually those long fluorescent light bulbs that have been flickering in the ceiling for months will burn out, and when they do, don’t throw them into the dumpster or dispose of them as hazardous waste. Instead, recycle them as Universal Waste. Fluorescent bulbs, including compact florescent lamps (CFLs) or u-shaped lamps and other high intensity discharge (HID) lamps, contain the hazardous material mercury and thus are regulated by the EPA (U.S. Environmental Protection Agency) under the Universal Waste Rule. The EPA created the Universal Waste Rule for certain wastes that are generated in a wide variety of settings including homes and businesses, and are able to have their hazardous components removed for the purpose of recycling. The Universal Waste Rule encourages proper disposal and limits the burdens of storage, handling, treatment, and recordkeeping associated with other types of hazardous waste.

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