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LECTURE 1
Introduction to the Management of Infectious
Materials/Waste
Amjad Khan Afridi
What is Infectious Medical Waste
Infectious Medical Waste is defined as medical waste
capable of producing an infectious disease.
Waste is considered Infectious when it is:
• Contaminated by an organism that is pathogenic to healthy humans;
• The organism is not routinely available in the environment; and
• The organism is in significant quantity and virulence to transmit
disease.
Infectious Wastes Specifically Are;
1. Blood and blood products in a free flowing, unabsorbed
state;
2. Contaminated sharps,
3. Isolation Wastes,
4. Laboratory wastes, and
5. Unfixed pathological tissues
Infectious Laboratory Wastes
• Cultures
• Etiological agents (those
microorganisms and microbial
toxins that cause disease in humans)
• Specimens
• Stocks
• Related contaminated wastes
• Vaccine vials
• Gowns
• Cotton/gloves contaminated with
body fluid
• Masks
Pathological Wastes
• Pathological materials are often infectious and require specific
procedures to ensure safe disposal.
• Fixed Pathological wastes are not Infectious Medical Waste
• Unfixed Pathological wastes must be incinerated
• wastes containing pathological items must be appropriately labeled to
ensure they are incinerated
Infectious Isolation Wastes
• Wastes generated from the care of a patient who has or is suspected of
having a disease caused by a CDC Class 4 agent, listed below
1. Smallpox is caused by the Variola virus (VARV). There are two forms of
the virus.
The more dangerous form, variola major, led to smallpox disease that killed about
30% of people who were infected.
Variola minor caused a less deadly type that killed about 1% of those who got it.
2. Monkey pox begins with fever, headache, muscle aches, and fatigue.
The main difference between symptoms of smallpox and monkeypox is
that monkeypox causes lymph nodes to swell (lymphadenopathy) while
smallpox does not.
Cont…
3. Hemorrhagic fever agents, including Crimean hemorrhagic fever (Congo), Junin,
and Machupo viruses. They affect many organs, damage the blood vessels, and they
affect the body's ability to regulate itself.
4. Lassa virus also known as Lassa hemorrhagic fever (LHF), is a type
of viral hemorrhagic fever. Many of those infected by the virus do not develop
symptoms. When symptoms occur they typically include fever, weakness,
headaches, vomiting, and muscle pains.
5. Marburg virus an acute, often fatal, form of haemorrhagic fever. It is caused by a
filovirus ( Marburg virus ) which normally lives in African monkeys.
Other Potentially Infectious Material (OPIM)
• Any body fluid with visible blood
1. Cerebrospinal fluid is clear, colorless liquid that fills and surrounds the brain
and the spinal cord and provides a mechanical barrier against shock
2. Pericardial fluid is excess fluid between the heart and the sac surrounding the
heart, known as the pericardium
3. Peritoneal fluid is a liquid made in the abdominal cavity which lubricates the
surface of tissue that lines the abdominal wall and pelvic cavity
Cont…
4. Pleural fluid is an unusual amount of fluid around the lung
5. Saliva in dental procedures
6. Synovial fluid Synovial fluid is produced in the spaces between certain
joints to help reduce friction and facilitate movement between articular
cartilages
Anywhere body fluids are indistinguishable
Infectious Wastes Do Not Include
•Human remains and body parts being used for medical
purposes, under the control of a licensed doctor or dentist
•Human remains lawfully interred in a cemetery or in
preparation for interment (material that has
been disposed of in the ground but is not as large or
regulated as a landfill. A good portion of waste materials
can break down in the ground but some can be harmful).
Hair, nails, and extracted teeth
Collection of Infectious Waste
• Infectious medical wastes must be collected at the point of generation in
the appropriate color coded bags
1. Orange bags for autoclaved waste, 2. Red bags for all other treatment
methods
• Biohazard bags must be labeled with the international biohazard symbol
and appropriate wording; “biohazard,” “biomedical waste,” “infectious
medical waste,” or “regulated medical waste”
Sharps
 Must be collected at the point of generation, in a leak-proof and
puncture-resistant container
 Containers must bear the international biohazard symbol and
appropriate wording
 Containers should never be completely
filled, nor filled above the full line
indicated on box.
Liquid Infectious Medical Wastes
Liquid Infectious Medical Wastes
1.Autoclaving. The process of
autoclaving involves steam
sterilization.
2.Incineration. The major benefits of
incineration are that it is quick, easy,
and simple.
3.Chemicals. When it comes to liquid
waste, a common biomedical waste
disposal method can be chemical
disinfection.
4. Microwaving.
Liquid Infectious Medical Waste, i.e., the contents of
suction canisters, may be disposed of in several ways:
Packaging and Storage
Wastes shall be collected in a lined, cardboard box or reusable plastic
container that is labeled with the biohazard symbol and appropriate
wording.
• Once the box or container is full, the bag lining it must be sealed and
the container then sealed locked
• Boxes must be labeled with facility name, address, phone and fax
numbers, and the date
• A full, sealed container can be stored on site for no more than 30 days
Shipping and Manifests
Every load of waste shipped off-site for destruction is tracked using a
manifest system
• The manifest is a multiple copy document that accompanies the waste to
the treatment facility
• Every individual who takes possession of the waste, including someone
from your facility, must sign the manifest
• As the waste generator is responsible for the waste until we receive the
proof-of-destruction copy of the manifest
Over Classification
•The improper disposal of solid wastes that do not meet the
definition of infectious medical waste, as if they were
infectious
•It is the most commonly cited violation, with 98% of
permitted facilities being marked
Routinely Over Classified Items
• Paper towels
• Unsaturated dressings and chucks
• Wrappers and packaging
• IV bags and oxygen tubing
• Gloves with no visible contamination
• Urine catheters and bags
• Paper, newspapers, and food containers
• Urine cups and specimen containers with
no visible blood
• Empty Medication vials and broken glass
•When you mix infectious waste and
regular solid waste together, you are not
permitted to separate them
 Once combined,
the entire
contents are
considered
infectious waste!
Be a Professional
21/03/2023

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Hospital Infectious Materials Waste Management

  • 1. LECTURE 1 Introduction to the Management of Infectious Materials/Waste Amjad Khan Afridi
  • 2. What is Infectious Medical Waste Infectious Medical Waste is defined as medical waste capable of producing an infectious disease. Waste is considered Infectious when it is: • Contaminated by an organism that is pathogenic to healthy humans; • The organism is not routinely available in the environment; and • The organism is in significant quantity and virulence to transmit disease.
  • 3. Infectious Wastes Specifically Are; 1. Blood and blood products in a free flowing, unabsorbed state; 2. Contaminated sharps, 3. Isolation Wastes, 4. Laboratory wastes, and 5. Unfixed pathological tissues
  • 4. Infectious Laboratory Wastes • Cultures • Etiological agents (those microorganisms and microbial toxins that cause disease in humans) • Specimens • Stocks • Related contaminated wastes • Vaccine vials • Gowns • Cotton/gloves contaminated with body fluid • Masks
  • 5. Pathological Wastes • Pathological materials are often infectious and require specific procedures to ensure safe disposal. • Fixed Pathological wastes are not Infectious Medical Waste • Unfixed Pathological wastes must be incinerated • wastes containing pathological items must be appropriately labeled to ensure they are incinerated
  • 6. Infectious Isolation Wastes • Wastes generated from the care of a patient who has or is suspected of having a disease caused by a CDC Class 4 agent, listed below 1. Smallpox is caused by the Variola virus (VARV). There are two forms of the virus. The more dangerous form, variola major, led to smallpox disease that killed about 30% of people who were infected. Variola minor caused a less deadly type that killed about 1% of those who got it. 2. Monkey pox begins with fever, headache, muscle aches, and fatigue. The main difference between symptoms of smallpox and monkeypox is that monkeypox causes lymph nodes to swell (lymphadenopathy) while smallpox does not.
  • 7. Cont… 3. Hemorrhagic fever agents, including Crimean hemorrhagic fever (Congo), Junin, and Machupo viruses. They affect many organs, damage the blood vessels, and they affect the body's ability to regulate itself. 4. Lassa virus also known as Lassa hemorrhagic fever (LHF), is a type of viral hemorrhagic fever. Many of those infected by the virus do not develop symptoms. When symptoms occur they typically include fever, weakness, headaches, vomiting, and muscle pains. 5. Marburg virus an acute, often fatal, form of haemorrhagic fever. It is caused by a filovirus ( Marburg virus ) which normally lives in African monkeys.
  • 8. Other Potentially Infectious Material (OPIM) • Any body fluid with visible blood 1. Cerebrospinal fluid is clear, colorless liquid that fills and surrounds the brain and the spinal cord and provides a mechanical barrier against shock 2. Pericardial fluid is excess fluid between the heart and the sac surrounding the heart, known as the pericardium 3. Peritoneal fluid is a liquid made in the abdominal cavity which lubricates the surface of tissue that lines the abdominal wall and pelvic cavity
  • 9. Cont… 4. Pleural fluid is an unusual amount of fluid around the lung 5. Saliva in dental procedures 6. Synovial fluid Synovial fluid is produced in the spaces between certain joints to help reduce friction and facilitate movement between articular cartilages Anywhere body fluids are indistinguishable
  • 10. Infectious Wastes Do Not Include •Human remains and body parts being used for medical purposes, under the control of a licensed doctor or dentist •Human remains lawfully interred in a cemetery or in preparation for interment (material that has been disposed of in the ground but is not as large or regulated as a landfill. A good portion of waste materials can break down in the ground but some can be harmful). Hair, nails, and extracted teeth
  • 11. Collection of Infectious Waste • Infectious medical wastes must be collected at the point of generation in the appropriate color coded bags 1. Orange bags for autoclaved waste, 2. Red bags for all other treatment methods • Biohazard bags must be labeled with the international biohazard symbol and appropriate wording; “biohazard,” “biomedical waste,” “infectious medical waste,” or “regulated medical waste”
  • 12. Sharps  Must be collected at the point of generation, in a leak-proof and puncture-resistant container  Containers must bear the international biohazard symbol and appropriate wording  Containers should never be completely filled, nor filled above the full line indicated on box.
  • 14. Liquid Infectious Medical Wastes 1.Autoclaving. The process of autoclaving involves steam sterilization. 2.Incineration. The major benefits of incineration are that it is quick, easy, and simple. 3.Chemicals. When it comes to liquid waste, a common biomedical waste disposal method can be chemical disinfection. 4. Microwaving. Liquid Infectious Medical Waste, i.e., the contents of suction canisters, may be disposed of in several ways:
  • 15. Packaging and Storage Wastes shall be collected in a lined, cardboard box or reusable plastic container that is labeled with the biohazard symbol and appropriate wording. • Once the box or container is full, the bag lining it must be sealed and the container then sealed locked • Boxes must be labeled with facility name, address, phone and fax numbers, and the date • A full, sealed container can be stored on site for no more than 30 days
  • 16. Shipping and Manifests Every load of waste shipped off-site for destruction is tracked using a manifest system • The manifest is a multiple copy document that accompanies the waste to the treatment facility • Every individual who takes possession of the waste, including someone from your facility, must sign the manifest • As the waste generator is responsible for the waste until we receive the proof-of-destruction copy of the manifest
  • 17. Over Classification •The improper disposal of solid wastes that do not meet the definition of infectious medical waste, as if they were infectious •It is the most commonly cited violation, with 98% of permitted facilities being marked
  • 18. Routinely Over Classified Items • Paper towels • Unsaturated dressings and chucks • Wrappers and packaging • IV bags and oxygen tubing • Gloves with no visible contamination • Urine catheters and bags • Paper, newspapers, and food containers • Urine cups and specimen containers with no visible blood • Empty Medication vials and broken glass
  • 19. •When you mix infectious waste and regular solid waste together, you are not permitted to separate them  Once combined, the entire contents are considered infectious waste!

Editor's Notes

  1. https://oehs.wvdhhr.org/phs/infectious-medical-waste-disease-control/what-is-infectious-medical-waste/
  2. human tissues, organs, body parts, secretions and excretions, and blood and body fluids Pathological waste is defined as any human or animal body parts. This can include organs, tissues, surgical specimens, and bodily fluids removed during surgery or autopsy.
  3. Orthopoxvirus Wastes generated from the care of a patient who has or is suspected of having any disease listed as Class 4 in "Classification of Etiologic Agents on the Basis of Hazard,"  Biohazard Level 4 usually includes dangerous viruses like Ebola, Marburg virus, Lassa fever, Bolivian hemorrhagic fever, and many other hemorrhagic viruses found in the tropics. A pathogen that usually causes serious human or animal disease and that can be readily transmitted from one individual to another, directly or indirectly. Effective treatment and preventive measures are not usually available. Captive monkeys in 1958
  4. Crimean-Congo hemorrhagic fever (CCHF) is caused by infection with a tick-borne virus (Nairovirus) in the family Bunyaviridae. By Slenczka, Marburg virus was first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, Germany and in Belgrade, Yugoslavia (now Serbia).
  5. انسان کو قبرستان میں یا تدفین کی تیاری میں قانونی طور پر دفن کیا جاتا ہے (وہ مواد جسے زمین میں ٹھکانے لگایا گیا ہے لیکن وہ اتنا بڑا یا ریگولیٹڈ نہیں ہے جتنا کہ لینڈ فل۔ فضلہ مواد کا ایک اچھا حصہ زمین میں ٹوٹ سکتا ہے لیکن کچھ نقصان دہ ہو سکتا ہے۔ )۔ بال، ناخن، اور نکالے ہوئے دانت
  6. A suction canister is a temporary storage container for secretions or fluids removed from the body. These fluids or secretions may come from the patient's lungs, stomach or wounds. The suction canister may be seen attached to the wall of the patient's room or resting on the floor next to the patient's bed Blood and other bodily fluids are often considered biohazardous or infectious waste, as they may be contaminated with hepatitis B, HIV and other dangerous pathogens and viruses
  7. A suction canister is a temporary storage container for secretions or fluids removed from the body. These fluids or secretions may come from the patient's lungs, stomach or wounds. The suction canister may be seen attached to the wall of the patient's room or resting on the floor next to the patient's bed Blood and other bodily fluids are often considered biohazardous or infectious waste, as they may be contaminated with hepatitis B, HIV and other dangerous pathogens and viruses
  8. تباہی کے لیے آف سائٹ بھیجے جانے والے کچرے کے ہر بوجھ کو ایک مینی فیسٹ سسٹم کے ذریعے ٹریک کیا جاتا ہے۔
  9. It increases the financial burden on patients and taxpayers in the form of increased disposal costs for health care facilities