Types of Waste
Certain types of medical waste are regulated by the Occupational Health and Safety Administration (OSHA) and are not allowed to be sent to landfills. These include needles and syringes, human tissues or blood, human infectious and pathological wastes (i.e., biopsy waste, diseased organs). Disposal of medical waste by health care facilities is also controlled by the states to some extent. Medical waste must be separated and processed separately from general trash. Ultimately, the treated medical waste will end up in a landfill. Some states (e.g., Oregon) allow certain amounts of blood to be disposed of into the sewer system, and other states (such as Colorado) allow properly sealed medical waste to be buried in specially designated landfills.
The Role of OSHA
OSHA requires that health care workers dispose of sharps in sharp containers before disposing of the materials in medical waste boxes. The sharp containers must be "closeable, puncture resistant; labeled or color coded; and leakproof on the sides and bottom." Regulated medical wastes must be put into containers that are "closeable, constructed to contain all contents and prevent leakage of fluids, labeled or color coded, [and] closed prior to removal." OSHA also requires regular inspections and decontamination of reusable containers. Bins, refrigerators and freezers containing medical waste must also be carefully labeled with a red or orange biohazard symbol.
In-house Disposal vs. External Processing
Facilities can choose to process waste in-house or send the material out to a waste management company. In-house processing is often the most cost-effective way of handling the waste. Most states (e.g., New York) dictate that medical waste must be made nonrecognizable before it is shipped to a landfill. One way to render waste nonrecognizable is to treat it with an in-house incineration unit. Incineration units vary from small disposal units designed for doctor's offices to larger units in hospitals capable of processing tons of medical waste. The units take about 90 minutes to either grind or heat the waste into ashes; these ashes can then be sent to the landfill. Some waste disposal units heat the waste to a minimum of 210 degrees F; others use bleach or chemical processing. Steam sterilizers that also expose the waste to pressure are sometimes used. Whatever method health care facilities use, many states require that the medical waste be accompanied by a certificate stating which method was used.
Some medical facilities that produce large amounts of medical waste or who do not desire to own and operate an in-house waste processing unit instead contract with an outside company. These waste disposal companies pick up the medical waste, process it into ash in an industrial incinerator or treat the items with heat processing before sending the waste to the landfill.