Given that "medical waste" is frequently used as a catch-all for any waste that originates in a medical environment, it is critical to understand that "regulated medical waste" does not include waste such as disposed pharmaceuticals or chemotherapy waste; rather, it is a single healthcare waste stream defined by OSHA's Bloodborne Pathogen Standard. This waste stream is commonly referred to as RMW, infectious waste, biohazardous waste, or biomedical waste.
OSHA's Bloodborne Pathogens standard specifies regulated medical waste as the following three:
Liquid or semi-liquid blood or other potentially infectious substance.
Contaminated products with the potential to release blood, such as OPIM (liquid or semi-liquid) when crushed.
Items caked with dried blood or OPIM can release these compounds after handling.
Contaminated sharps, pathological and microbiological waste containing blood, or OPIM
It should be noted that the phrase "contaminated" in OSHA rules refers to anything with blood or possibly infectious materials on it, and is not synonymous with "regulated". For example, gauze or PPE that has been marginally contaminated with small amounts of blood is not considered regulated medical waste.
Risks to Healthcare Workers and Waste Handlers
The CDC's estimate of occupational exposure to bloodborne pathogens takes into account many infection risk variables:
The pathogen implicated
The nature and severity of exposure
The quantity of blood used in the exposure
The concentration of the pathogen in the patient's blood at the time of exposure
Needlestick Injuries
Needlestick injuries are one of the most frequently discussed concerns for healthcare workers because they can spread a variety of viruses and germs, including Hepatitis C, Syphilis, Varicella Zoster Virus, and HIV. Red bags and cardboard boxes (which are often used to collect RMW trash in various hospital settings) represent a distinct danger of sharps injuries since they are not puncture-proof or protective of wrongly disposed needles or contaminated glass.
Pathogen Transmission
The reality is that anyone who handles anything tainted with blood or infectious materials puts themselves in danger, which is why hospitals are increasingly searching for ways to reduce the number of waste touches and human handling of bags or possibly contaminated bins. The issue with red bags and boxes from a clinical standpoint is that waste is stored in patient areas in bins that are rarely if ever, cleaned. Waste can convey scents, and whenever there is a smell, there is a source of bacteria and infection. Given the present emphasis in US hospitals on infection control, the last thing any healthcare facility wants in a clinical setting is a potential source of infection.
Occupational Risks
Needlestick injuries and other workplace hazards linked with managing healthcare waste can have a substantial financial and insurance impact on a hospital or clinic. To prevent injuries, healthcare institutions should implement Safety Engineered Devices in the form of both sharps and sharps containers, and OSHA requires personnel to assess their processes and devices on an annual basis to determine whether an exposure risk exists. If a safer gadget becomes commercially available, the employer is compelled by law to analyze it.
With infection transmission and pathogen exposure becoming more of a concern for healthcare facilities, this review of safer devices should extend beyond SED devices or sharps containers to include hospitals and clinics examining the safety and cleanliness profile of regulated medical waste containers, as well as exposure risks during waste handling.
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