Waste must be appropriately treated based on its inherent hazards after it leaves the hospital. The following are the various categories of waste that the hospital generates:
- Biohazardous Waste
- Pathological Waste
- Sharps
- Pharmaceutical Waste
- Trace Chemotherapy Waste
- Hazardous Chemical Waste
- Mixed Medical & Chemical Waste
- Radioactive Waste
- Universal Waste
Waste contaminated with recognizable human blood, fluid human blood, fluid blood products, other body fluids that may be infectious, and containers or equipment containing fluid blood or infectious fluids. Biohazardous waste does not include dried blood, urine, saliva, or feces. All biohazardous waste steam is sterilized by an approved medical waste autoclave before being sent to a landfill. Hospitality Services manages the pickup and disposal of biohazardous waste. Requests for pickup can be made through Service Now (MCSS).
Following are the basic requirements for the storage and disposal of biohazardous waste:
- Must be disposed in a red biohazard bag that is marked and certified for puncture and tear resistance.
- Must be disposed in a hard sided container with a lid.
- The container must be labeled with biohazard labels that are visible from all sides of the container.
- The container must be kept closed when not actively adding waste to the container.
Pathological waste includes tissues, surgical specimens, and body parts such as limbs that must be disposed by incineration. Hospitality Services manages the pickup and disposal of pathological waste. Pickup requests can be made through Service Now (MCSS).
Following are the basic requirements for the storage and disposal of pathological waste:
- Must be disposed in a red biohazard bag that is marked and certified for puncture and tear resistance.
- Must be contained in a hard sided container with a lid.
- The container must be labeled with the words “incineration only” and the biohazard label(s) must be visible from all sides of the container.
- The container must be kept closed when not actively adding waste to the container and must be
Sharps waste includes hypodermic needles, hypodermic needles with attached syringes, needles with attached tubing, blades, broken glass, acupuncture needles, and pipettes. All sharps waste must be disposed in an approved hard-sided sharps container. Hospitality Services manages the pickup and disposal of sharps waste. Pickup requests can be made through Service Now (MCSS).
Following are the basic requirements for the storage and disposal of sharps waste:
- Must be stored in an approved hard sided sharps container.
- The sharps container must be labeled with biohazard labels on all visible sides
- Must not be filled past the fill line indicated on the side of the container.
- Sharps containers in patient rooms must be kept locked and secured to prevent unauthorized access.
Pharmaceutical Waste
Pharmaceutical waste is segregated into non-hazardous pharmaceutical waste, trace chemotherapy waste, and RCRA and Bulk Chemotherapy waste. Guidelines for management of pharmaceutical waste is outlined in the Pharmaceutical Waste Management Poster.
Pharmaceutical waste includes, but is not limited to unused, partially used or expired prescription or over-the-counter medications (e.g. vials, tablets, capsules, powders, liquids, creams/ lotions, eye drops, suppositories), IV bags and tubing, full syringes, glass vials and ampules, narcotics and controlled substances in syringes, narcotic patches (cut in half), carpujets, and tubexes. The contents are incinerated and the ash goes to a non-hazardous landfill.
Hazardous Pharmaceutical Waste includes, but is not limited to, syringes, inhalers, tubexes or IV bags/piggybacks with residual hazardous pharmaceuticals (i.e. all cytotoxic drugs). Hazardous waste is disposed in black pharmaceutical waste containers.
Hazardous pharmaceutical waste containers must be dated with the accumulation start date. These containers can be stored for a maximum of 180 days at the point of generation. EH&S manages the collection and disposal of hazardous pharmaceutical waste. Requests for new containers and pickup of full containers can be made through Service Now (MCSS).
Guidelines for managing pharmaceutical waste are summarized in the Managing Sharps, Pharmaceutical, & Hazardous Waste Poster.
Additional Resource:
http://www.pharmecology.com/pedd/jsp/index.jsp
Trace Chemotherapy Waste
Chemotherapeutic waste is a by-roduct of oncology patient care. These are generated from and managed by Pharmacy and dedicated inpatient units and outpatient clinics. Trace chemotherapy waste consists of materials that previously contained or had contact with chemotherapeutic agents including tubing, empty bags, bottles, vials, syringes, gloves, masks, gowns and wipes, and any materials used to clean up spills or otherwise contaminated through incidental contact.
Containers that previously held chemo agents are considered empty if (1) the liquid residue can no longer be poured or (2) the solid material can no longer be removed by scraping. Trace chemo waste should be placed in the yellow containers. The contents of trace chemotherapy waste are incinerated at a medical waste incinerator. Hospitality Services manages the pickup and disposal of trace chemotherapy waste. Requests for pickup can be made through Service Now (MCSS).
Full or partially full containers of chemotherapy waste are considered hazardous pharmaceutical waste and must be disposed in the black container.
Regulations promulgated by the Environmental Protection Agency (EPA) and the California Department of Toxic Substances Control (DTSC) state that waste is considered hazardous if it is a listed as such by the regulations or has the following characteristics:
- Ignitability
- Corrosiveness
- Reactivity
- Toxicity
At UCSF Medical Center, chemical waste includes hazardous pharmaceutical waste, chemical waste generated from clinical and pathology laboratories, expired cleaning solutions and disinfectants, and waste oil from facilities operations. Following are the basic requirements for storage and disposal of hazardous chemical waste:
- All containers must be labeled with a hazardous waste label as soon as waste accumulation starts.
- The hazardous waste label must be dated with the start accumulation date.
- The maximum accumulation time allowed for hazardous chemical waste at the point of generation is 180 days.
- Containers must be compatible with the waste being stored and kept closed when not actively adding waste to the container.
- Wastes must be stored according to compatibility; incompatible waste should be stored in separate locations and separated using secondary containment.
- Any spills on the outside of the container or in the storage area must be cleaned immediately.
Hazardous chemical waste is managed using the online management tool WASTe. WASTe allows waste generators to create hazardous waste labels and arrange for pickup and disposal by EH&S. Once hazardous waste reaches 180 days of accumulation at the point of generation, EH&S is automatically notified to pick up the waste. Waste pick-up before 180 days, if necessary, can also be requested through WASTe.
Waste containing chemicals should not be discarded down the drain; only those chemicals approved in writing by EH&S may be discarded down the drain.
Mixed Chemical & Medical Waste
Medical waste mixed with hazardous chemicals are generated primarily in Pathology and Clinical Laboratory areas. Examples include tissues fixed in formalin. Fixed tissues in formalin should be managed and disposed of a hazardous chemical waste.
Radioactive waste is generated primarily by the Nuclear Medicine Department but can also be generated in some patient care areas where patients receive radiation therapy. All radioactive waste must be properly labeled with “Caution: Radioactive Material” and the Radioactive Trefoil Symbol.
Radioactive waste is picked up by EH&S. Requests for radioactive disposal must be made through RIO .
Universal waste is hazardous waste that has less stringent requirements for management and disposal and includes batteries, electronic waste, and mercury containing products such as fluorescent light bulbs.
All universal waste must be labeled with a Universal Waste Label dated with the accumulation start date. Current regulations allow universal waste to be accumulated onsite for up to a year. Contact Service Now (MCSS) to request collection of batteries and mercury-containing equipment such as thermostat; contact UCSF Surplus for all types of electronic waste.
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Additional information and resources regarding hazardous materials management are available at the Office of Environment Health & Safety.