Cementatious Considerations for Medical Waste Solidification
By Mark A. Ceaser
The most common cause for alarm in the medical field pertaining to waste
disposal is the exposure of the worker to infectious wastes and contraction
of diseases from these wastes. With the increased risk of exposure to
blood borne pathogens in handling body fluids and disposal of items that
have been tainted by these fluids, awareness and education for the prevention
of percutaneous wounds is the highest priority.
The Resource Conservation and Recovery Act (RCRA) controls the manner
in which all forms of hazardous materials are disposed. With amendments
to the regulations enacted on November 8, 1984, landfill burial of free
liquids on absorbents or biodegradable items that release the liquids
under the pressure of the increased garbage levels are prohibited. Untreated
items that are not incinerated, steam sterilized, or chemically treated
for disinfection still have biological activity that can continue unchecked.
RCRA mandates that all characteristics of said wastes be listed on the
manifest and properly treated before final disposal. A low-cost alternative
to existent medical waste disposal methods that meets these treatment
standards and does not draw upon high-energy costs is cementatious solidification.
Solidification processes are used for various hazardous waste disposal
of items that cannot be recycled or disposed of in an effective manner,
such as incineration. By physical and chemical treatment of hazardous
wastes by solidification, the waste is fixated and stabilized in a cement
matrix that will not allow release of the fluids under pressure.
Cementatious solidification incorporates a range of materials such as
gypsum, lime, and portland cement to form a slurry that will fixate the
wastes. In most cases, the cement mixture is added directly over the container
holding the wastes, although direct mixture of the cement and wastes do
occur. As the setting process occurs, the outside oxygen supply and raising
of the pH cause the biological activity to cease.
In most medical wastes, disposal of needles is most commonplace. Having
direct contact with people that have had injections or blood drawn, they
would be the most likely item to need treatment. A number of devices are
available to incinerate the needles; however, many facilities use a common
needle disposal container prior to its being disposed of via a waste management
company.
These containers can still pose a threat to the worker handling the items,
as the needles are still in a free state. In addition, with the containers
holding sharps such as razors, glass, dental devices, and surgical retractors,
open exposure to infectious elements still exists. A person can conceivably
still run the risk of being cut via handling these items. Cement stabilization
is the solution to these preventable incidents.
Double-bagged "red bag" wastes commonly refer to wastes treated
with some form of sterilization. However, the bags still do not prevent
the possibility of the worker being injured and exposed in handling the
items in transfer. Solidification of these wastes on-site provides the
added benefit of safety and increased stabilization of the residue.
With more than 800,000 needle sticks a year occurring in the healthcare
marketplace, the risk of exposure and injury is an alarming certainty.
Treatment of medical sharps should be given utmost priority, and it begins
at the source of its generation. On-site treatment of the wastes will
provide a safe passing down for the handlers of the materials until its
final destination. The solidified mass within the container gives this
security to the handler, as its structural strength provides safety and
security.
The Centers for Disease Control and Prevention (CDC) recommends institution
of preventive measures for work-related infections and use of proper disposal
equipment in handling needles and infectious wastes. Cement solidification
gives additional support to this emphasis on safety. With proper identification
of treated biomedical materials in this manner, exposure and disposal
risks are significantly reduced.
Meeting the conditions of local, state, and federal regulations for waste
disposal will determine final costs and definition of the materials. Guidelines
vary pertaining to designation of what is and is not considered biomedical
wastes; however, there is universal acknowledgment that the dangers of
exposure should not go unnoticed.
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