1 HAZARDOUS WASTE HEALTHCARE Special Considerations Minnesota Pollution

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HAZARDOUS WASTE & HEALTHCARE: Special Considerations Minnesota Pollution Control Agency Industrial Division Joshua Burman March 2010 MPCA; Health Care Industry Webpage http: //www. pca. state. mn. us/industry/healthcare. html 2

Dual Waste Issues MPCA #4. 45 a; Evaluating Pharmaceutical Wastes http: //www. pca. state. mn. us/publications/w-hw 4 -45 a. pdf 3

Dual Waste: What is “Dual Waste”? ≠ not Statute or Rule-defined = term of convenience used by MPCA to describe waste that is simultaneously and Infectious Hazardous MPCA; Regulatory Consensus on Health Care Issues, pg. 3 http: //www. pca. state. mn. us/publications/w-hw 3 -35. pdf 4

“Dual Waste” vs. Mixed Waste = Regulation-defined = regulatory term that defines waste that is simultaneously and Radioactive Hazardous EPA; 40 CFR 266, Subpart N [Mixed Waste Conditional Exemption] http: //www. access. gpo. gov/nara/cfr/waisidx_08/40 cfr 266_08. html 5

Dual Waste: Direct Examples n Blood-soaked gauze used to clean up “blown” chemotherapy IV n Used syringes containing excess thimerosal-preserved vaccine n Lab analyzer bubble tape containing heavy metal preservative and patient blood/tissue FDA; Thimerosal in Vaccines http: //www. fda. gov/cber/vaccine/thimerosal. htm 6

Dual Waste: Avoidable Examples n P-Listed drug ampoule placed into infectious sharps container n Mislabeling of hazardous/infectious waste containers and accidental mixing © 2004 Tyco Healthcare Group LP HERC; Checklist for Complying with JHACO Standard ED 3. 10 http: //www. hercenter. org/regsandstandards/jcaho 3. 10. 3. pdf 7

Dual Waste: Storage n Ensure containers are: q closed q able to fully contain the waste q under observation or inspected weekly n Label containers for both traits: and OSHA; Regulated Waste [29 CFR 1910. 1030(d)(4)(iii)(C)] http: //edocket. access. gpo. gov/cfr_2007/julqtr/pdf/29 cfr 1910. 1030. pdf 8

Dual Waste: Disposal n Required to be transported / disposed of by: q Transporter registered/licensed for both traits q Disposal facility permitted for both traits n Decontamination by generator and disposal as hazardous-only waste may be allowed HERC; Treatment and Disposal of Regulated Medical Waste http: //www. hercenter. org/rmw/treatment. cfm 9

Dual Waste: Training/Operations n Train staff in difference between Infectious and Hazardous Wastes n Review procedures to limit generation whenever possible n Ensure Housekeeping/Facilities staff utilize proper collection procedures NIOSH; Guidelines for Protecting the Health and Safety of Health Care Workers 10 http: //www. cdc. gov/niosh/docs/88 -119/

Dual Waste: Reduce Generation n Purchase non-thimerosal vaccines and laboratory reagents when available q q q n FDA NIH Sustainable Hospitals. org Purchase unit-dose injectables for Listed waste pharmaceuticals when possible HERC; Mercury In Health Care Facilities http: //www. hercenter. org/hazmat/mercury. cfm 11

Complex Waste Streams MPCA #4. 45 a; Evaluating Pharmaceutical Wastes http: //www. pca. state. mn. us/publications/w-hw 4 -45 a. pdf 12

Complex Waste Streams: Emergency Department n Emergent patient treatment may disallow waste segregation n Determine best area -specific waste management H 2 E: Waste Reduction Guide; Section VII http: //www. h 2 e-online. org/pubs/wrguide/section 7. pdf 13

Complex Waste Streams: Ambulance Wastes n Minnesota hospitals must accept infectious waste, not hazardous waste, from ambulance services n Common practice: all wastes unsegregated into ‘red bags MPCA; Ambulance Infectious Wastes [Minn. Stat. § 116. 78, Subd. 9] https: //www. revisor. leg. state. mn. us/statutes/? id=116. 78 14

Complex Waste Streams: Ambulance Wastes n Hospitals may accept hazardous waste from ambulance services; however: q Once accepted, hospital is considered the generator q Hospital must treat all ambulance services equally q Ambulance services may also dispose at central garage/station EMS Magazine; Restocking After the Fee Rule http: //www. emscltd. com/articles/gck/PDF/Restocking%20 after%20 the%20 Fee%20 Schedule. pdf MPCA #3. 11; …Waste Generated by Construction and Service Contractors http: //www. pca. state. mn. us/publications/w-hw 3 -11. pdf 15

Universal & Special Wastes MPCA; Hazardous Waste-related Publications http: //www. pca. state. mn. us/waste/pubs/business. html 16

Universal Wastes n Universal Waste Regulations adopted by all states q Batteries q Fluorescent/High-Intensity Discharge Lamps q Mercury-containing Equipment MPCA #4. 62; Managing Universal Wastes http: //www. pca. state. mn. us/publications/w-hw 4 -62. pdf 17

Universal Wastes: Management n Store to prevent damage n Label n Accumulate <1 year n Ship only for: recycling q consolidation q proper disposal q EPA; Universal Waste Resources http: //www. epa. gov/epawaste/hazard/wastetypes/universal/resrcs. htm 18

Universal Wastes: Management n If damaged, Universal Wastes must be stored in: closed, q leak-proof, q labeled containers q H 2 E; Hospital Fluorescent Lamp Recycling http: //cf. h 2 e-online. org/docs/h 2 e 10 stepfluorescent 121802. pdf 19

Special Wastes: Electronic Waste (e-Waste) n Hazardous due to heavy metals n Recycle or manage as hazardous waste n Store intact n Label Used Electronics for Recycling MPCA #4. 15; Managing Electronic Waste From Business Sources http: //www. pca. state. mn. us/publications/w-hw 4 -15. pdf 20

Special Wastes: Electronic Waste (e-Waste) n What are e-Wastes? q Common Indicators: LCD displays x LED displays/lights x keypads x q Common x x x x Healthcare e-Wastes: CRTs/Monitors/TVs Computers/PDAs IV Pumps Patient Monitors Bar Code Scanners Battery Chargers Coffeemakers Microwave Ovens MPCA #4. 15; Managing Electronic Waste From Business Sources http: //www. pca. state. mn. us/publications/w-hw 4 -15. pdf 21

Special Wastes: PCB Ballasts & Capacitors n Fluorescent light ballasts & Small capacitors q Must be assumed to contain PCBs unless: Labeled “No PCBs” x Date of manufacture is known to be post-1979 x n Manage under TSCA requirements q *Must be reported as hazardous waste disposal MPCA #4. 48 f; Managing PCBs in Ballasts and Small Capacitors http: //www. pca. state. mn. us/publications/w-hw 4 -48 f. pdf 22

Special Wastes: Used Oil n Used oil-related wastes include: Used oil q Used oil filters q Oily rags & other absorbents q Used floor dry q n Used oil-related wastes may not: Be placed in solid waste q Be dumped on the ground q Be sewered q MPCA #4. 30; Managing Used Oil and Related Wastes http: //www. pca. state. mn. us/publications/w-hw 4 -30. pdf 23

Special Wastes: Used Oil n Store in closed, leakproof containers n Store on impermeable surface n Label containers n Keep shipment records* MPCA #4. 30; Managing Used Oil and Related Wastes http: //www. pca. state. mn. us/publications/w-hw 4 -30. pdf 24

Special Wastes: Used Oil n Disposing of small amounts of used oil q Generators may dispose of used oil at any business if: transported by generator in ≤ 55 gallons/shipment x receiver agrees in writing to accept x receiver provides receipt x receiver may not burn on-site x w e N MPCA #4. 30; Managing Used Oil and Related Wastes http: //www. pca. state. mn. us/publications/w-hw 4 -30. pdf 25

Special Wastes: X-ray Film n Post-1976 -manufactured waste X-ray film may be assumed non-hazardous q Silver reclamation strongly recommended q Metro Counties may require recycling/reporting MPCA #3. 35; Regulatory Consensus on Health Care Issues http: //www. pca. state. mn. us/publications/w-hw 3 -35. pdf 26

Resources n H 2 E: Hospitals for a Healthy Environment. . . now part of Practice Greenhealth q n MNTAP: Minnesota Technical Assistance Program q n www. mntap. umn. edu HERC: Healthcare Environmental Resource Center q n http: //www. practicegreenhealth. org/ http: //www. hercenter. org/ GGHC: Green Guide for Health Care q http: //www. gghc. org/ MPCA; Healthcare Industry Resource Page http: //www. pca. state. mn. us/industry/healthcare. html 27

Compliance Resources Electronic copies of this presentation and all other MPCA Healthcare Hazardous Waste Presentations available at no cost Joshua Burman, MPCA mailto: Joshua. Burman@pca. state. mn. us 28

Questions? Joshua Burman (507) 344 -5243 Joshua. Burman@pca. state. mn. us Brandon Finke (651) 757 -2358 Brandon. Finke@pca. state. mn. us MPCARegional Offices http: //www. pca. state. mn. us/about/regions/index. html 29

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