Onsite Medical Waste Management and Bloodborne Pathogens

Biological Waste Disposal (Research Laboratories) Sharps Solid Wastes Liquid Wastes Pasteur pipettes, razor blades, scalpels, syringes with attached needles Culture dishes, cultures or stocks gloves, drapes, or other solid materials contaminated with infectious material Blood, tissues culture wastes, growth media, Collect in flask, plastic jugs ect. Collect in approved containers Utilize a rigid biohazard collection container lined with an autoclave liner. Immerse in 10% solution of bleach or 70% isopropanol for 15 minutes Autoclave waste. Be sure to fill out the waste log book. Once waste has been autoclaved, place waste into a white trash bin lined with an opaque liner. Call 713-500-5837 to request collection or place into a medical waste box for disposal Release to sanitary sewer (lab sink) Sharps containers are available for research labs at no cost from EHS

Learning Objectives Gain general autoclave awareness and become familiar with onsite medical waste treatment procedures including: record keeping for waste cycles utilizing the Autoclave Use Log and sterility monitoring procedures Become familiar with regulatory requirements for onsite treatment of biological wastes Document Annual Bloodborne Pathogens refresher training

Biological Waste Regulations Texas Department of State Health Services (DSHS) 25 TAC, Chapter 1, Subchapter K Defines what regulated medical waste consists of and acceptable treatment and disposition methods. Texas Commission on Environmental Quality (TCEQ) 30 TAC Chapter 326 - Medical Waste Management Sets management standards for generators, transporters, and disposal facilities Establishes onsite treatment and efficacy monitoring requirements Requires notification of onsite treatment processes

Steam Sterilization (Autoclaving) Used for sterilization of solid and liquid waste (microbiological, blood, etc.) Autoclave waste should be packaged in heat resistant bags with the opening loosely closed to allow steam to enter bags Sterilization is temperature, pressure, and time dependent minimum parameters 250F, 15 psi, 30 min. Use care when treating infectious waste. Check the volume and configuration of load Avoid overloading autoclave, utilize a secondary containment tray, and keep the sides of the bag from touching the sides of the autoclave chamber Perform quality control on a routine basis (fill out the use log and include a test strip or test vial).

Steam Sterilization

Autoclave Use Log Date Waste type Record on the Autoclave Use Log (for waste cycles only) Date Waste type Conditions of treatment (what pressure, temperature, and time?) Quantity (lbs) Initials and signature of person conducting treatment

AUTOCLAVE USE GUIDELINES 1. Place sterilizing indicator tape on the autoclave bag. Make sure that bags designated for autoclaving are used. 2. Place waste inside autoclave. Use secondary containment (pan) under the bag. If waste does not contain any moisture, put ½ cup of water inside bag for steam generation. 3. Autoclave according to manufacturers instructions for a minimum 30 minutes, at a minimum operating temperature and pressure of 250 deg. F and 15 psig. 4. When cycle is finished, inspect sterilizing tape, and visually check bags to ensure autoclave was working correctly. 5. Place waste in black opaque bags. Seal bag with tape or tie wrap. 6. Place waste in trash cans labeled “Autoclaved Waste Only” . Log activities in the autoclave usage log. Perform routine efficacy monitoring and record results. IMPORTANT! Use heat resistant gloves and keep your face away from the door when loading and unloading autoclave! Biological waste should be stored in rigid leak proof containers such as biohazard boxes, bins, or secondary containment pans. Waste should be stored inside the autoclave room and not in the hallways! Biological waste containing hazardous chemicals (solvents, oxidizers etc.) or Sharps (needles, razor blades, etc. ) should not be autoclaved. Call EPP’s waste line at 713-500-5837 for collection of these items! Biological Waste should not be left for “someone else” to autoclave.

Quality Control Autoclave temperature tape recommended Parameter monitoring (pressure and temperature) Record every load (located on use log) Efficacy monitoring schedule (required by TCEQ regulations) <100 lbs/month - monthly 100 -200 lbs/month - biweekly >200 lbs/month - weekly Routine parameter monitoring maybe substituted for biological monitoring, except on “pinwheel” plot autoclaves

Common Deficiencies Training records incomplete Waste stored in hallway Autoclaved trash not removed routinely by housekeeping 713-500-3498 (FIXT) Food or drink consumed or stored in autoclave area Sterility monitoring not performed Autoclave log incomplete