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 yes = not regulated as "medical waste" highly communicable disease. (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" waste or reusable material derived from the medical treatment of a human or from an animal with a pathogen (a) BIOHAZARDOUS WASTE: HSC 117690(b)(1) that is infectious to humans (zoonotic); waste containing a highly communicable disease; lab wastes that are regulated "medical waste" infectious to humans; contains fluid human blood; waste from isolation control human body parts (excluding teeth); removed at surgery and surgery speciments suspeced of being contaminted (b) PATHOLOGY WASTE : HSC 117690(b)(2) with infectious agents; surgery speciments or tissues fixed in formaldehyde or other fixative; animals parts, regulated "medical waste" tissues, fluids, or carcasses suspected of being contaminated with zoonotic pathogen (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" 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 (d) SHARPS WASTE: HSC 117690(b)(4) regulated "medical waste" care and blood vials contaminated with biohazrdous waste, any item capable of cutting or piercing from trauma scene waste waste that is contaminated trhough contact with, or having previously contained, chemotherapeutic agents (e.g. (e) TRACE CHEMOTHERAPEUTIC WASTE: HSC 117690(b)(5) regulated "medical waste" gloves, gowns, towels, IV solution bags). Bulk chemo = hazardous waste waste that is a "regulated waste" as defined in 8 CCR 5193 and that has been removed, is to be removed, or is in (f) TRAUMA SCENE WASTE: HSC 117690(b)(6) regulated "medical waste" the preocess of being removed from a trauma scene by a trauma scene waste management practitioner.
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 ; A ll 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. e xample : if sto re d within fre e ze rs, the • F o r 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 *VI OL AT I ON* - Re q uire d to b e “wa rning ” sig n ma y b e re q uire d a s we ll if la b e le d with g e ne ra to r la b e l the a re a is the de sig na te d me dic a l *VI OL AT I ON* - Pro pe r re d b io - wa ste a c c umula tio n a re a 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
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 F o 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 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 o r SQG = thre e ye a rs o f dispo sa l do c ume nts MWMP F o r L QG = two ye a rs o f dispo sa l do c ume nts Disposal Re c or ds
COMMON ME DICAL WAST E VIOL AT IONS PROPE R “WARNI NG” SI GN ME DI CAL WAST E MANAGE ME NT PL AN NOT POST E D OUT SI DE NOT SUBMI T T E D T O CUPA (L QG) DE SI GNAT E D ME DI CAL WAST E ACCUMUAL T I ON ARE A
RE MINDE RS! Me dic al waste must be r e por te d thr ough 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
CONT ACT I NF ORMAT I ON • 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
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