OSHAs Perspective on Regulated Waste

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OSHAs Perspective on Regulated Waste

• NH HOSPITALS FOR A HEALTHY ENVIRONMENT
• Concord, NH
• 9/14/06
• Teresa Ferrara, Industrial Hygienist
• NH Dept of Environmental Services
• [phone]

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WHO WE AREEMPLOYED BY NH DEPARTMENT
OF ENVIRONMENTAL SERVICESRECIPIENT OF OSHA
GRANT TO HELP SMALL EMPLOYERSFREE, ON-SITE
ASSISTANCE BOTH SAFETY CONSULTANTS INDUSTRIAL
HYGIENISTSWE OFFER - PROGRAM ASSISTANCE, WALK
THROUGH SURVEY, AIR NOISE SAMPLINGWHAT WE
REQUIRE - ABATE SERIOUS HAZARDS WE ARE NOT
OSHA
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(No Transcript)
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Regulated Waste (OSHA)

• Liquid or semi-liquid blood or OPIM
• Contaminated items that would release blood or
  OPIM if compressed
• Items caked w/ dried blood or OPIM capable of
  releasing these materials under handling
• Other Potentially Infectious Materials.

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OPIM

• Amniotic fluid
• Cerebrospinal fluid
• Pericardial, peritoneal pleural fluids
• Saliva in dental practices
• Semen
• Synovial fluid
• Vaginal secretions
• More

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More OPIM

• All visibly bloody body fluids (includes urine)
• All unidentifiable body fluids
• Unfixed body tissues or human organs
• HIV-containing cell or tissue cultures
• Organ cultures
• HIV or HBV-containing culture media or solutions
• Blood, organs or body tissues from experimental
  animals infected w/ HIV or HBV.

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Regulated Waste (OSHA) contd

• Contaminated sharps
• Pathological microbial waste containing blood
  or OPIM.
• Not animal waste (animal blood only for those
  animals purposely infected with HIV or HBV -
  research lab production facilities.)

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Infectious Waste (not OSHA)

• Waste capable of causing infection or disease in
  humans may include contaminated animal waste.

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Regulated Waste

• Not the actual volume of blood determines
• i.e. 10 mls of blood on a disposable bed sheet
  would appear as a spot (not regulated) same
  amount on cotton ball would likely cause
  saturation dripping (regulated waste).

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Bloodborne Pathogens

• Quiz
• Which virus am I most likely to meet?

• Answer
• Hepatitis-C

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Regulated WasteNo Exposed Needles/Sharps in
Waste

• Priority 1 Eliminate Sharps
• - Blunt suture needles
• - Needle-less IV connectors
• - Plastic capillary tubes
• Priority 2 Sharps Design
• - Self-blunting
• - Self-shielding
• - Retractable
• Priority 3 Sharps Disposal
• - Best container and location

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Safer Medical Devices

• Sharps should be
• designed to prevent
• skin puncture after
• use
• Self-blunting needles
• Shielding needles
• Retracting catheters
• Retracting lancets
• Recessed stylets

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Sharps Containers

• Keep upright so sharps cant fall out.
• Biohazard label.
• Best practice Maximum fill height is 3/4th full.

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Sharps Containers

• Unwinders - generally prohibited (Reusable blood
  tube holders prohibited).
• Allowed only if medical procedure requires needle
  removal only if can be done safely, 1-handed.

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Sharps Containers - Location

• Sharps container should be as close as feasible
  to you when you are using a sharp
• Not down the hall.
• Not behind a closed door.
• Not inside a locked utility room.

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SHARPS CONTAINER

• NEED IN THE LAUNDRY
• NEED IN SOILED UTILITY
• PATIENT CARE AREAS.

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Reusable Sharps Disposal Container NOT THIS
OSHA CITED
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Reusable Sharps Disposal Container

• Requires worker to open the container w/ hex
  wrench
• Remove the white plastic lid clear plastic neck
• Place a polymer disk over contaminated sharps
• Place the unit into incinerator
• OSHA DOES NOT PERMIT MANUAL OPENING OF CONTAINER
  OR MANUAL PLACEMENT OF DISK ON CONTAMINATED
  SHARPS!

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Work Practices

• NOT ACCEPTABLE
• Do Not recap razors.

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Work Practices

• NOT ACCEPTABLE
• Do Not carry sharps in a temporary container.
• Often put in soiled utility sharps container
  rather than patient room.

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Waste Disposal

• Red Bags can be overused
• Not needed for most band aids, dressings from
  small cuts/wounds.
• Not for use in womens bathrooms for feminine
  hygiene waste.
• Deposit these items into plastic bag lined trash
  containers.

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Regulated Waste

• Vaginal speculums do not normally meet the
  criteria for regulated waste as defined by the
  standard.
• Work practice control may be introduced (i.e.,
  rinsing the speculum before discarding).

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BBP Trivia

• Quiz
• How long can HBV survive outside of human
  tissue?

• Answer
• Up to 1 week
• 16 hrs to 4 days for HCV
• While body fluid is wet for HIV.

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Disinfectants

• 70 Ethyl alcohol (better than 100)
• Isopropyl Alcohol
• Bleach (Sodium Hypochlorite) made fresh daily
• Activated glutaraldehyde
• Chlorine dioxide
• Povidone iodine (Wescodyne).

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Disinfectants

• MINIMAL CONTACT TIME SHOULD BE 15-30 MINUTES FOR
  CONTAMINATED SURFACES
• USE IN ACCORDANCE W/ MFG INSTRUCTIONS.

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Hazards Associated w/ Chemical Germicides

• Chorine highly toxic
• Phenolics skin depigmentation
• Glutaraldehyde contact dermatitis
• Formaldehyde potential carcinogen
• Ethanol/Isopropyl alcohol flammable
• Accidental ingestion, poisoning.

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Annual Review

• OSHA requires each facility to conduct an annual
  review of its Exposure Control Plan
• Any new procedures at facility?
• Any new technology available that can reduce or
  eliminate exposure?
• Document the facilitys evaluation of safer
  medical devices and
• Solicit feedback from employees.

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QUESTIONS????
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• NH OCCUPATIONAL SAFETY HEALTH CONSULTATION
  SERVICE 271-2024 SAFETY
• 271-4676 HEALTH
• OSHA WEB SITE www.osha.gov