Biohazardous waste is a problem that is damaging to all life, not just human life. It is defined as something that is hazardous to anything biological. Biohazards become an environmental concern especially in the case of medical waste. These days, it seems as though everyone has, is at risk for, or fears contracting some sort of infectious disease, be it hepatitis, HIV, AIDS, Tuberculosis, or a simple contagious cold. In any case, there is absolutely no reason the general public should ever have a problem possibly coming across a contaminated object of medical waste. Medical waste, an area of concern for communities all over the country, even the world, can take on more than one form: it can be found as solid, liquid, or gaseous waste. This makes it a difficult environmental hazard to tackle. Medical waste can have an adverse affect on plant and animal life, and it can pollute soil, water, and the air (1). It is a crucial aspect of biohazardous waste, but it can be controlled by regulations, laws, procedures, and precautions. The way to control the environmental hazards caused by medical waste is to pinpoint the problem areas, create resolutions and standards for proper waste disposal, and take steps to ensure the future needs for prevention of biohazardous waste.
However, waste products such as liquid spills of chemicals or body fluids, toxic fumes, and solid wastes can create as monumental a problem as the sharps. If any of these materials were to be exposed to the environment, they could create disastrous effects. Toxic fumes can damage the living environment of humans, plants, and animals, and they could be a factor in acid rain precipitation if they are undetected and produced in great amounts.
Human blood and blood products, plasma, serum, intravenous bags, and any container that has held blood are all considered contaminated medical waste. With the scare of HIV and AIDS prevalent in today’s society, the thought of accidental contact with these products is quite frightening. There are many other sources of these infectious diseases: sharps, pathological wastes, contact wastes, isolation wastes, and cultures (4).
Regulated medical waste is most commonly associated with "sharps." Sharps are products which include used and unused hypodermic needles, needles with tubing attached, pipettes, razors, scalpel blades, and glass lab slides, all of which could possibly be contaminated with infectious disease. Body fluids, tissues, and organs are considered pathological waste. Contact wastes are materials such as surgical sponges and gloves, drapes, dressings, and underpads that have been contaminated by surgical procedures. Isolation wastes are regulated materials that surrounded a person with a communicable disease. Cultures are regulated medical waste because they are used to transfer, inoculate, and mix live bacteria and vaccines. Disposable products like gowns, paper sheeting used in examining rooms, and towels are not considered regulated medical waste, except in the case of a patient with a communicable disease (4).
Problems surrounding medical waste contamination entail instances of discovery of hypodermic needles on beaches, wilting and death of plant life in areas of toxic fumes, and spread of infection from blood related products (1). Waste management employees, including janitors, are at specific risk in cases where glass has been thrown out. What happens to materials capable of releasing toxic fumes? Uncontained medical waste of any kind could endanger the lives of any animals that come across it in waste sites or dumpsters. Dumpster waste could also pose a threat to scavengers (3). All of these situations call for an upheaval of regulations concerning medical waste disposal.
A specific example of medical waste in the air is described in an experiment conducted in Seattle Washington. Eight dental offices were selected for testing of mercury vapor in the byproducts of amalgam waste. Amalgam, or sliver filling material, has recently been found to emit mercury vapor. Amalgam scrap is also found in liquid and solid forms that travel "through pipes and tubing to the vacuum pump, where it is eventually discharged into the waste-water line that leads to the municipal sewage system" (2). The results of the study and experiments left some uncertainty about mercury vapor content in sewage systems, but it was found in higher amounts than the Occupational Safety and Health Administration (OSHA) defines as an "acceptable source impact level" (2).
Once biohazardous waste is defined and problems are pinpointed, one can begin to examine regulations and standards, as well as possible solutions to existing problems of medical waste and its effect on the environment. Connie Neal pointed out that "compared to regular solid waste, it costs ten times as much to dispose of infectious waste and a hundred times more to get rid of hazardous waste" (1). Regulations of medical waste are enforced under the jurisdiction of the Environmental Protection Agency and defined under the Resource Conservation and Recovery Act. Hazardous solid wastes not specifically listed by the EPA include those that exhibit one or more of four characteristics: ignitability, corrosivity, reactivity, and toxicity. If mishandled these wastes could "cause death, serious bodily injury, or pollute surface or ground waters, the land, or air" (1).
Currently, the disposal methods in labs consist of collecting all test tubes that contained any type of bodily fluid in glass specimen boxes. They are autoclaved, or placed in a high heat, high pressure steam to kill bacteria, and sent to the landfills in sealed, protective boxes to prevent janitorial injury. Unfortunately, it is more economical to buy new materials and dispose of used ones than to thoroughly decontaminate them. The autoclaving method does not kill viruses, and the cost of non-disposable pipettes and test tubes, and the methods needed for cleaning them effectively, override the costs of disposal and purchase of new materials. Autoclaved items are also sent to separate landfills, particularly for biohazardous waste (3).
As far as hypodermic needles are concerned, one professor from Leeds, England, Dr. H.V. Wyatt, came up with the innovative solution of using empty soda cans as receptacles for their disposal. "Once dropped in the can, the needles would be difficult to extract, and the cans could be buried with little chance of the needles accidentally causing injuries even if exposed," Wyatt said (5). Although this idea eliminates the possibility of a scenario such as the Pakistani health center that kept a battered cardboard box under the table to hold used syringes and needles (5), it may create controversy among aluminum recycling supporters.
Prevention of medical spills is easily outlined in Standard Operating Procedures written specifically for hospitals, nursing homes, doctor and dentist offices, and laboratories. Standards set on biosafety are crucial to the operation of any medical facility or laboratory. Documents such as these provide detailed instructions on what to do in case of a chemical or body fluid spill. Spills as small as a few drops of blood need to be reported to a supervisor, and cleaned up by specifically trained employees (6).
Another method of prevention in medical waste contamination is to require health professionals to be immunized. Most medical facilities support the need to have at-risk employees sign a form stating "I have been offered and will accept/not accept immunization against Hepatitis B Virus" (6). Another common release form in the "Acknowledgment of receiving and reviewing biosafety information on universal precautions in handling human blood, body fluids, and tissues" which states "that the employee is familiar with the "universal precautions" for handling biohazardous materials, as well as the OSHA Standard on Bloodborne Pathogens (6).
Establishing standards for proper waste disposal is crucial to the prevention of problems created by biohazardous waste. Once environmental issues are pinpointed, resolutions can be made, and laws and regulations can be incorporated. Employees in the medical fields, and other professionals working with biohazardous materials must in turn follow the regulations established. Since biohazards can be found in solid, liquid, or gaseous forms, it makes it even more difficult to control their adverse effects on the environment. Only by maintaining strict discipline in biohazardous waste disposal can mankind ensure a safer living environment: one without soil, water, and air pollution, or the spread of disease and infection to humans and animals.
Rubin, P. G.; Yu, M. Mercury vapor in amalgam waste discharged from dental office vacuum units., Arch. Env. Health. 51:335-337; 1996.
Toews, Dr. A. Pers. Int.; 5 February 1998.
Types of regulated medical waste. Brown U. Long-Term Care Qual. Adv. 9:5; 1997.
Using soda cans for syringe disposal. The Lancet. 1998 Jan. 5.
National Research Council. Biosafety on the Laboratory. 1989.