Forum Questions and Answers :
(listed chronologically from most recent)
(Click here for a listing sorted by
subject)
Q: Does any type of cleaner kill C-Dif?
A: The CDC recommends the use of a hypochlorite-based, EPA registered product -
where chlorine is the
active ingredient in the disinfectant. For more information, review the
CDC's Clostridium
difficile web site.
The EPA disinfectant registration
program lists products that are registered and labeled as effective in
destroying several specific organisms: Mycobacterium tuberculosis, HIV,
Hepatitis B, Hepatitis C, MRSA & VRE. In West Virginia, spills of
infectious medical waste must be disinfected with a product labeled as effective
against Mycobacterium.
Reviewing List B, you will find that there are numerous products that are
labeled as effective against Mycobacterium and are hypochlorite based.
Unfortunately there is no single hypochlorite-based product that is labeled as
effective against every organism.
Q: Are wound dressings which show visible blood but
are not saturated required to be disposed of as medical waste?
A: The presence of visible blood is not what defines a waste
item. The West Virginia IMW Rule and the OSHA Bloodborne Pathogen Standard
require that items that contain free-flowing, unabsorbed blood; or an amount of
absorbed blood that would drip if the bandage is compressed, be disposed as
infectious medical waste.
Q: Regarding sharps disposal, if the container is not full, what is
the maximum time that is can be kept on a shelf, and should it always be kept
closed?
A: The West Virginia Infectious Medical Waste Rule requires that sharps
containers be snapped shut and replaced before the contents reach the full line
indicated on the box. There are no time requirements for sharps
containers, they can remain in place as long as it takes to fill them (without
overfilling).
The design of most sharps
containers prevents persons from contacting the contents of the container.
However, some models have an open hole that would permit someone to stick their
fingers into the container. It is recommended that these type of
containers not be used for the obvious reason of having someone receive a needle
stick. However, if this type of open container is used, it would be
advisable to close the hole when the container is not in use. There is no
requirement that they be kept closed while in use, but they must be sealed shut
when full, before being changed.
Q: Does biological waste need to be locked in a storage room or is
it okay for the door to have a positive latch?
A: Depending on the location of the storage room, the door may not
require a lock. If the room is located in an area where staff are
routinely present then the room may remain unlocked because the staff's presence
provides security to the area.
If the storage room is
located away from staff (in a storage area, outside, etc.), it must be kept
locked, and appropriate biohazard and authorized personnel only signage must be
provided.
Q: Can latex exam gloves be autoclaved?
A: The appropriate answer to your question depends upon the intent in
autoclaving exam gloves. If the purpose is re-use, then the answer is that exam
gloves are not designed for re-use and cannot be processed through an autoclave
and used again.
If the purpose of autoclaving
the gloves is to render them non-infectious for disposal, the process must be
done in accordance with Section 10.3. of the West Virginia Infectious Medical
Waste Rule, 64 CSR 56, for the treatment of infectious medical waste.
Q: Does a sharp contained in a retractable needleless system device
(i.e., an angiocath post IV insertion or a retractable lancet for a finger
stick) need to be placed in a sharps container?
A: Yes they do. The fact that they are contained within a protective
sheath does not change the fact that they are a sharps. The sheath is an
employee safety device. They must be disposed of as a sharp to protect the
health of everyone who handles the waste from the point of disposal to its final
destination. Furthermore, there have been no changes made to either the West
Virginia Infectious Medical Waste Rule or the OSHA Bloodborne Pathogen Standard
in recent years that would recognize these safety devices as anything other than
a sharp.
Q: Are used urine specimen containers containing urine considered to
be infectious waste? Are the same containers when emptied into the sewerage
system considered to be infectious and are used urine dip sticks considered to
be infectious?
A: The answer is no, unless there was/is visible blood present in the
urine. The West Virginia Infectious Medical Waste Rule and the OSHA Bloodborne
Pathogen Standard both consider urine and feces, without visible blood,
non-regulated body fluids. Therefore, neither urine specimen containers
nor urine test dip sticks would be treated as infectious. If the urine did
contain visible blood, the fluid could be poured down a sanitary sewer; and the
container and dip stick would need to be discarded as infectious medical waste.
Q: The regulation states that IMW cannot be stored for more than 30
days. Does the 30 days start from when an item is placed in a canister in
the doctor's office or from when the bag is sealed and placed in storage for
offsite disposal.
A: The following is the waste storage policy of the West Virginia
Infectious Medical Waste Program:
Waste storage time refers to
the storage of waste in a shipping container. If the container contains
only filled sharps boxes, the storage time begins when the shipping container is
filled. If the container contains infectious medical waste other than just
sharps containers, the container must be shipped off-site every thirty days.
Q: What are the requirements for handling Chemotherapy waste?
Is PPE worn during the preparation and administration of Chemo drugs considered
Chemo waste or can they be disposed of in the regular garbage?
A: Chemical and radiological wastes do not fall under the purview of
the West Virginia Infectious Medical Waste Program and are specifically exempted
in the regulation. Hazardous wastes are regulated by the
West Virginia Department
of Environmental Protection and the United
States Environmental Protection Agency.
The World Health Organization (WHO) indicates that antineoplastic compounds are
destroyed at or above 1000 degrees F. Medical waste incinerators in West
Virginia are required to maintain 1400 degrees F in the primary chamber, and
1800 degrees in the secondary chamber, with a one second exhaust retention time
in the secondary. These parameters are in excess of what is stipulated by
the WHO.
Preventing Occupational
Exposure to Antineoplastic and Other Hazardous Drugs in Health Care Settings,
a NIOSH publication,
indicates that all wastes that have come into contact with hazardous chemicals
should be placed in special waste receptacles for hazardous wastes only.
This would include PPE generated during preparation and administration of
chemotherapy drugs, as well as any chucks or covers, alcohol prep pads, etc.
It is also recommended by the Oncology Nursing Society that any disposable items
contaminated with urine or feces from the patient within 48 hours of
chemotherapy administration should be discarded as hazardous waste. All
bulk P-listed and U-listed wastes should be disposed by via a RCRA permitted
hazardous waste firm.
Q: How should empty glass vials and ampoules that contained a
vaccine for human use be disposed of?
A: The West Virginia Infectious Medical Waste Rule defines vaccine
vials as medical waste that must be disposed of as infectious. The Rule
makes no exceptions for live, dead, or attenuated vaccines. All vials and
ampoules that contain any type of vaccine must be placed into a biohazard
container, and should be placed into a sharps box.
Q: How can razors be safely returned for disposal by inmates in a
correctional facility?
A: In West Virginia when razors are not used in the treatment of a
patient for medical purposes, they are not considered infectious medical waste
and can be disposed of in the regular trash. However, it is the policy of
this Program that razors be collected in a safe manner to protect the employees.
We recommend using a sharps container, or a container with similar
puncture-resistance. Often times a five-gallon bucket is used for broken
glass and this can be used for razors as well, especially if the bucket has a
small opening that can be used to keep people aware from the contents of the
bucket.
Q: Is there a law/regulation set by OSHA governing how frequently
biohazardous waste must be removed from medical offices? (i.e.: every 30 days,
60 days, etc)?
A: OSHA's Bloodborne Pathogen Standard does not address this issue. In
fact, there are no federal infectious medical waste disposal regulations. This
issue was left to each State to regulate.
In West Virginia, health care facilities are required to have packaged
containers of infectious medical waste removed from their facilities within
thirty days. Additionally, hospitals and nursing homes are under other State
regulations that require biohazard and regular trash to be removed from their
facilities every day or sooner if needed. Once the accumulated waste fills a box
it is to be packaged and the thirty day time limit for having the box removed
would begin.
Sharps containers are not
included in the daily removal requirement so that they can remain in place until
they are ready to be changed (just slightly before the level reaches the full
line).
Q: Is there a standard for bio-hazardous waste bags pertaining to the
thickness of the bag?
A: In West Virginia there is a standard pertaining to bag thickness,
but I am not aware of any such federal requirement. Section 6.2.b. of the
WV Infectious Medical Waste Rule requires that bags used for infectious waste be
3 mils thick, or pass the American Society for Testing and Materials drop
test 959-80 using 125 pounds. However ASTM has withdrawn this test and
replaced it with an updated drop test method, ASTM-D5276-98.
Q: What is the actual process inolved in the incineration of medical
wastes?
A: When infectious medical wastes are incinerated the operational
parameters of the incinerator are very closely monitored. Medical waste
incinerators are comprised of two compartments, a lower, primary chamber where
the wastes are combusted, and an upper, secondary chamber that is maintained at
a higher temperature to volatilized gases produced during the combustion of the
waste in the primary chamber. In West Virginia, the incinerator must be
capable of maintaining the primary chamber at 1400o F, and the
secondary chamber at 1800o F.
At the incinerator, wastes are loaded into a hopper. Generally, a door will
close over the hopper, another door into the primary chamber will open, and a
hydraulic ram will activate, pushing the waste into the primary chamber. Once
inside, West Virginia law requires that the waste be in maintained at 1400
degrees F for at least one hour. The gases that travel through the secondary
chamber must remain in the secondary chamber for at least one second at 1800
degrees F.
Once the above requirements have been met you are left with ash. In WV the
ash must be tested quarterly for fixed carbon. This test determines whether the
incinerator was successful in properly combusting the waste. Additionally, the
ash must be tested annually for heavy metals. This test is based on EPA
guidelines and is used to determine if the waste must be discarded as hazardous
waste or whether it can safely be disposed of in a solid waste landfill.
Due to strengthening EPA and in WV, Dept. of Environmental Protection,
regulations there are fewer medical waste incinerators in operation in WV. The
remaining incinerators have been required to install emission scrubbers to
ensure that their emissions are cleaner and meet the new requirements.
Q: Explain "nosocomially transmitted"
A: Nosocomial is defined as: Pertaining to or originating in the
hospital, said of an infection not present or incubating prior to admittance to
the hospital, but generally occurring 72 hours after admittance, the term is
usually used to refer to patient disease, but hospital personnel may also
acquire nosocomial infection.
Nosocomially transmitted
would mean an infection that is transmitted within a healthcare facility. There
are numerous causes for nosocomial infections, the most significant of which
include antimicrobial resistant organisms, improperly cleaned and disinfected
environmental surfaces, failure to follow glove changing and hand washing
procedures, and ill healthcare workers.
Visit these CDC web sites for more information about
antimicrobial
resistance,
disinfection of environmental surfaces,
hand hygiene,
infection control
guidelines for health care personnel.
Q: We are a free standing pediatric clinic. Are we
required to have Biohazard cans in every pt room due to potentially infectious
diarrheal diapers/waste or can the potentially infectious material be placed
into a bag and carried to the red bag in another room. Also, where are the
guidelines that state that every patient room in a clinic needs a biohazard can?
If there is a diaper changing station in a bathroom, do we need a can in this
area also for potentially infectious diarrheal diapers?
A: First, are biohazard cans required in every exam room? In West
Virginia, Infectious Medical Waste is regulated by the Department of Health and
Human Resources' Bureau for Public Health, via the WV Infectious Medical Waste
Rule, 64CSR56. Section 6.2. of the Rule states that infectious medical
waste must be contained and sealed at the point of generation, in a leak-proof plastic bags. The bags
must be red, or orange if the waste will be treated in an autoclave, and must
have the international biohazard symbol and be imprinted with the words
"biohazard," "biomedical waste," "infectious medical waste," or "regulated
medical waste."
OSHA's Bloodborne pathogens standard stipulates that
regulated wastes must be placed in containers that are closeable, constructed to
contain all contents and prevent leakage of fluids, labeled or color-coded
appropriately, and closed prior to removal to prevent spillage or protrusion of
contents during handling, storage, transport or shipping.
Neither of these rules require a biohazard container
to be in the exam room. Both rules allow for the waste to be contained in a bag
inside the room, provided the bag is closed before being taken to an appropriate
waste storage area.
Second, are biohazard cans
required in the vicinity of a diaper changing table. In West Virginia,
diapers are not infectious medical waste pursuant to Section 3.9.c. of the Rule,
which states: 3.9.c. For the purposes of this rule, infectious medical
waste does not include the following materials. 3.9.c.3 Used personal hygiene
products, such as diapers, facial tissues and sanitary napkins.
OSHA's bloodborne pathogens standard defines Regulated
Waste as: liquid or semi-liquid blood or other potentially infectious materials;
contaminated items that would release blood or other potentially infectious
materials in a liquid or semi-liquid state if compressed; items that are caked
with dried blood or other potentially infectious materials and are capable of
releasing these materials during handling; contaminated sharps; and pathological
and microbiological wastes containing blood or other potentially infectious
materials.
The Standard further defines Other Potentially
Infectious Material as: (1) The following human body fluids: semen, vaginal
secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial
fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body
fluid that is visibly contaminated with blood, and all body fluids in situations
where it is difficult or impossible to differentiate between body fluids; (2)
Any unfixed tissue or organ (other than intact skin) from a human (living or
dead); and (3) HIV-containing cell or tissue cultures, organ cultures, and HIV-
or HBV-containing culture medium or other solutions; and blood, organs, or other
tissues from experimental animals infected with HIV or HBV.
Neither rule defines diapers that contain feces with no
visible blood, as infectious medical waste. Therefore there is no need for a
biohazard container in a diaper changing area.
Q: Where can I find a listing of medical wastes that are safe to
dispose of via the sewer system?
A: There is no list of approved medical wastes that are safe to dispose
via a sewer system. Section 10.4. of the West Virginia Infectious Medical
Waste Rule states that liquid infectious medical wastes may be discharged to an
approved sanitary sewer system. Therefore, the only requirement for liquid
waste discharge to a sewer is that the sewer must be approved. See below
for more details on approved sewer systems.
Note: The use of a grinder to reduce infectious solid matter to a size or
consistency which can be discharged to a sewer is prohibited.
Q: What effect does magnetism have on health?
A: The human health effects of Electric and Magnetic Fields (EMF) are
not fully understood. The National Institute for Occupational Safety and
Health (NIOSH), a division of the Centers for Disease Control and Prevention,
has ongoing research in this area. For more information about the findings
of their research, please visit the
NIOSH EMF web site.
Q: Is there a particular statute in the WV code that permits or
describes the circumstances under which liquid IMW can be disposed of into the
sanitary sewer?
A: Section 10.4. of the West Virginia Infectious
Medical Waste Rule addresses disposal of liquid wastes into a sanitary sewer:
Liquid infectious medical waste may be discharged to a sanitary sewer through a drainage
fixture of a size and type adequate to discharge the waste in a sanitary manner to a sewer
system approved by the department according to Sewage System Rules, 64 CSR 9. The use of a
grinder to reduce infectious solid matter to a size or consistency which can be
discharged to a sewer is prohibited.
In order for liquid
wastes to be disposed to a sanitary sewer, the facility's sewage system must
have been: permitted, installed, inspected, and approved by the health department.
It must
be designed and sized appropriately for its current usage, and must currently meet any and all
requirements stipulated for its permitted operation.
Q: How long should speculums be autoclaved?
A: Autoclaving of medical devices is not addressed by
the West Virginia Infectious Medical Waste Program as it is not covered by the
West Virginia Rule. Please visit the
CDC's medical
device website for more information on disinfection of medical devices, or
email the FDA Center for Devices and
Radiological Health.
Q: Do you discard a glass carpal (used medicine
contained in a glass carpal) into the sharps container even though it does not
appear to be broken?
A: Yes, and no. Medicine vials can be collected and
disposed of as regular trash in any facility so long as the employer addresses
employee safety. It is our recommendation that intact glass vials be collected
in a small cardboard box or similar container that can be taped shut and labeled
as glass. However, if the vials contain vaccine in any form, they must be
disposed of in a sharps container just like broken medicine ampoules.
However, if the
facility has a "broken glass collection system," all medicine vials that are not
vaccines can be collected and disposed of in the regular trash. There are
numerous manufacturers of broken glass collection containers, some are reusable
and many are sealed closed and placed directly in the regular waste.
Q: I work in a nursing home. If a resident has C'dif my
understanding is that unless something is drippable/flakable as outlined in the
bloodborne pathogen standard you would not need to red bag items the resident
uses.
A: That is correct. Clostridium difficile infections typically result in watery
diarrhea. Therefore the bacteria are contained in feces, a substance that is not
classified as infectious by the Bloodborne Pathogen Standard nor the WV
Infectious Medical Waste Rule.
The procedures for
handling this contact isolation (recommended until the cessation of diarrhea)
would be to provide ample solid waste containers for the disposal of employee
PPE and patient waste that do not contain visible blood or OPIM (semen, vaginal
secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial
fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body
fluid that is visibly contaminated with blood, and all body fluids in situations
where it is difficult or impossible to differentiate between body fluids).
Any wastes that do
contain visible blood or OPIM in a free-flowing, unabsorbed state should be
disposed in appropriately color-coded and labeled biohazard bags.
For more information about gastro-intestinal infections, such as C. dif., please
visit the CDC's website.
Q: Here at our hospital, we transport specimens in
bags with a biohazard label. If this bag is not contaminated with blood or
fluids, can this bag with the biohazard label be disposed of in the regular
trash?
A: Yes, under one condition. You must have
approval from the landfill servicing your facility in order to dispose of
un-contaminated biohazard sample bags. Your facility should create a
letter that is signed by both the landfill and your facility, in which your
facility certifies that the waste will not be contaminated with biohazardous
waste of any kind, and accepts full responsibility should the landfill discover
biohazardous waste in your facility's solid waste.
There are several medical
facilities that are currently disposing their un-contaminated biohazard sample
bags in the landfill. This practice is subject to the acceptance of the
landfill authority, however.
Q: Is emesis considered infectious medical waste if there is no
visible blood in it?
A: No, emesis without visible blood is not considered infectious
medical waste. Neither the West Virginia Infectious Medical Waste Rule,
nor OSHA's Bloodborne Pathogen Standard consider emesis infectious, so long as
there is no visible blood.
Q: Is the use of solidifiers required in (surgery) suction
canisters, or is it optional?
A: Solidifiers are optional under all conditions. Their use is
beneficial in preventing fluids from leaking when suction canisters are disposed
of. If suction canisters are disposed of as regular trash, one of two
approved solidifiers must be used, and the appropriate hold time must be met in
the facility. For specific information on
approved solidifiers
and hold times, click here.
Q: Who picks up sharp containers from private owned and run
business' such as tattoo shops and piercing studios? Where can you go
online to get this information?
A: Tattoo and body piercing studio businesses are required to dispose
of their waste according to the West Virginia Infectious Medical Waste Rule,
64CSR56. The Rule allows for three methods of disposal for these wastes.
First, the wastes can
be collected, packaged, and shipped off-site for treatment. This website contains a listing of the
permitted waste hauling companies operating in
West Virginia, click on the highlighted words for that information. These
are the ONLY companies authorized to transport infectious medical waste in West
Virginia.
Second, the facility can
utilize a mail-in sharps system. Several companies provide sharps
containers and postage-paid U.S. Postal Service approved mailing containers, as
well as the required waste tracking documents for facilities to send their
infectious medical wastes off-site for treatment. If such a service is
used, the facility must have waste tracking documentation (manifests) and retain
them for 3 years.
Third, the facility can
utilize an autoclave to sterilize their infectious medical wastes.
Autoclaved wastes can be deposited into the regular waste provided that they are
appropriately labeled. For more information about
autoclaving infectious medical waste please visit our page on this topic.
Q: What are the requirements for storage and
disposal of biohazardous medical wastes?
A: Section 8 of the Infectious
Medical Waste Rule, 64CSR56, addresses storage of medical wastes. In
summary it states that wastes: shall not be stored onsite for more than
thirty (30) days, shall be stored at or near the point of pickup or treatment in
a manner that maintains the integrity of the containers (prevents leakage,
provides protection from water, rain, and wind). The storage area shall be:
constructed of easily cleanable, impermeable, durable materials, the floor shall
not be carpeted or have open seams, and floor drains must discharge to a
sanitary sewer disposal system. Storage areas must be kept clean and in
good repair, have access control to prohibit unauthorized entry, and be posted
with the international biohazard symbol.
Disposal of infectious
medical wastes can be achieved by treatment onsite or offsite. Section 10
of the Rule addresses treatment of infectious medical wastes. There are
many approved treatment technologies in West Virginia (for a complete list see
our
Alternative
Treatment Technologies Page), however the most commonly used treatment
method is autoclaving. Facilities that do not treat their wastes onsite
must employ a waste hauling service (for a complete list see our
Permitted Waste Haulers Page).
The transportation of infectious medical wastes is addressed in Section 9 of the
Rule.
Q:
What is C-dif?
A: Please
click here for a
description of
Clostridium difficile.
Q: What happens when C-diff. is left untreated?
A: Death can result if a Clostridium difficile
infection is left untreated. The most common treatment for these
infections is with vancomycin. Most important, however, is the prevention
of disease transmission. This disease is most commonly acquired
nosocomially, in a healthcare facility. Therefore, proper hand washing by
medical staff as well as stringent environmental disinfection of the rooms of patients
with diarrhea, and confirmed C-diff infections are paramount. For
more information, go to the CDC's website on
Gastrointestinal Infections.
Note: CDC environmental
infection control recommendations issued June 6, 2003, stipulate that bleach is
the best disinfectant for environmental cleaning where C. difficile is a
concern. At this time there is no recommendation for use of a specific
EPA-registered hospital disinfectant regarding C. difficile.
Q: What safety precautions have taken place on West Virginia
landfills?
A: The answer to this question may be best discussed by
the West Virginia Department of Environmental Protection who regulate West
Virginias landfills. However, treated infectious medical wastes that are
disposed in landfills in West Virginia pose no biological risk to the
environment. Treatment methods employed in West Virginia are incineration,
autoclaving, and some limited chemical disinfection of liquid wastes.
These methods have been tested, and continue to be monitored, to ensure their
effectiveness at killing pathogenic organisms. Additionally, treated
medical wastes that are intended for disposal into sanitary landfills must be
manifested and documented to make landfill operators aware of the contents of
the waste they are receiving.
Q: What is PPE?
A: PPE is the acronym for Personal
Protective Equipment. PPE is specialized clothing or equipment worn by
an employee for protection against a hazard. PPE such as gloves, masks,
gown or apron, and booties or shoe covers should be worn during an infectious
medical waste spill clean up. General work clothes (e.g., uniforms, pants,
shirts or blouses) not intended to function as protection against a hazard are
not considered to be personal protective equipment. OSHA's Bloodborne
Pathogens Standard requires employers to provide the necessary PPE for employees
to safely complete their normal duties.
Q: How does medical waste affect the public?
A: Medical facilities have policies and procedures in
place to ensure that wastes are properly handled, treated, and disposed of.
As long as these systems are functioning properly, medical waste does not affect
the public. The West Virginia Infectious Medical Waste Program performs
inspections of transport vehicles used to haul waste in West Virginia, annual
inspections of all of West Virginia's large quantity generators (facilities
generating in excess of fifty pounds of infectious medical waste per month), and
monthly inspections of the treatment facility. These inspections assist
facilities in ensuring that their procedures are operating correctly and
provides a means to facilitate changes and updates to infectious medical waste
procedures.
Q: How can medical waste be disposed?
A: Wastes can be disposed of by various methods.
These methods must meet criteria for their effectiveness at inactivating microorganisms
(efficacy). Approved methods may employ one or more
of the following categories of treatment:
chemical, mechanical, microwave, hammer mill, plasma arc, encapsulation,
heat, shredder, grinder, irradiation,
radio wave, or other process
demonstrating efficacy.
There is only one
limiting factor regarding waste treatment in West Virginia, West Virginia law
stipulated that infectious medical wastes can not be commercially incinerated.
This means that a waste treatment business cannot operate an incinerator in West
Virginia. However, a facility that generates waste can treat their wastes
onsite via incineration. The use of this method continues to decline due
to environmental regulation of incinerator exhaust.
The most common method
of treatment for infectious medical waste in West Virginia is autoclaving.
At this time in West Virginia, more healthcare facilities autoclave their wastes
than incinerate them. Additionally, the majority of infectious medical
waste generated in facilities that do not treat their wastes onsite, are sent to
commercial facilities that autoclave those wastes.
Q: What is MRSA?
A:
Q: What type of things are classified under medical waste?
A: Medical waste, definition provided below, includes ALL wastes
generated during a medical procedure and during the research, testing, and
production of biologicals.
Q:
What is the definition of medical waste?
Please click here for a
complete definition.
Q: How much does it cost to dispose of infectious waste?
A: The cost of infectious medical waste disposal varies
and depends on several variables. If wastes are treated at the medical
facility where they are generated, the cost to treat infectious medical waste is
relatively low. Autoclaving costs approximately $0.20 per pound where
steam is readily available. The cost would increase if steam had to be
created for the process. The cost of incineration is similar to that of
autoclaving , but tends to be more expensive due to environmental regulations
that require the operation of scrubbers to clean exhaust emissions.
For facilities that do
not treat their waste onsite, the cost of having their waste disposed of
increases depending on the volume of waste generated. The increased cost
is due to the cost of having the waste shipped offsite for treatment. The
average price per pound to have waste shipped offsite in West Virginia in 2002
was $0.67 per pound. The cost of disposing infectious medical waste, both
onsite and offsite, will continually increase as the costs to haul and
treat waste increase.
Q: What is the meaning of infection?
A: Infection is defined as: an invasion by and
multiplication of pathogenic microorganisms in a bodily part or tissue, which
may produce subsequent tissue injury and progress to overt disease through a
variety of cellular or toxic mechanisms.
Q: Is genital piercing legal in West Virginia?
A: Section 13.1. of the West Virginia Body Piercing
Studio Business Rule addresses this question. It states that:
A
person under the age of eighteen (18) years may receive body piercing provided
he or she is accompanied by his or her parent or guardian. The parent or
guardian shall have valid picture identification. Nipple and genital piercing
is prohibited on minors regardless of parental consent. Persons eighteen
(18) years or older may receive body piercing without parental consent.
Therefore, genital piercing
is legal in West Virginia so long as the person is at least eighteen (18) years
of age.
Q: What is Bio Medical Waste?
A: Bio Medical Waste, Biohazardous Waste and Infectious Medical Waste
are essentially all the same things. They are wastes that have been, or
potentially have been, exposed to a biological agent that is capable of
producing an infectious disease.
Q: What are the requirements for the disposal of sharps generated in
a private residence?
A: Infectious medical waste generated during self
health care or by the provision of health care services within the residence are
exempt from the requirements of the West Virginia Infectious Medical Waste Rule,
64CSR56 (Section 2.2.a.). Except that sharps must be disposed of
in a container with a high degree of puncture resistance.
It is the recommendation of
this office that sharps be collected in a hard-plastic container with a screw-on
lid. The container should be stored where the syringes will be used, but
in a location that is child and animal proof. Needles should not be
recapped, removed, broken, or bent.
When the container is 3/4
full, add one pint of water and one teaspoon of bleach. With a permanent
marker, print "NOT RECYCLABLE - TREATED SHARPS" on the container, place it in a
plastic bag, seal the bag with tape in case leakage occurs, and place it in the
garbage.
Q: Are there health risks for those who live in close proximity of a
facility that autoclaves and shreds medical waste?
A: There are no significant health risks associated
with living in close proximity to a medical waste treatment facility. When
treatment facilities are run properly there should be NO health risks to the
public, nor the employees of the facility. The following factors
contribute to the safety associated with medical waste treatment facilities in
West Virginia.
West Virginia requires
all facilities who generate, store, or treat infectious medical waste to ensure
that any storage areas maintain the integrity of the containers, prevent leakage
of the contents, and protect them from water, rain and wind.
At a medical waste
treatment facility, the waste remains in its packaging until it is autoclaved,
sterilizing the waste, at which point it no longer poses a threat. In
fact, after autoclaving it is essentially less hazardous than ordinary household
waste.
Q: After medical waste has been autoclaved and shredded...does it
pose a health risk?
A: Autoclaved waste, regardless of whether is it
shredded or whether it remains intact, is sterile so long as the autoclave is
functioning properly. In West Virginia, all facilities that employ the use
of an autoclave are required to do regular testing with bacterial spores to
ensure that their autoclave units are functioning properly.
Q: What is c-dif?
A: C-dif is the common name of a bacterium, Clostridium difficile,
which causes a gastro-intestinal infection.
C. difficile, an anaerobic gram-positive rod, is the most frequently
identified cause of antibiotic-associated diarrhea, and is most often
transmitted via the hands of health care personnel who have had contact with
contaminated feces or environmental surfaces.
Patients who are at highest risk for infection are those who: are
currently taking or have recently taken antimicrobials, have had GI
surgery/manipulation, have had a long length of stay in healthcare settings,
have a serious underlying illness, are immunocompromised, or are of advanced
age.
The clinical features of the disease include:
watery diarrhea, fever, loss of appetite, nausea, abdominal pain/tenderness.
Recommendations for
prevention and control of the disease include: judicious use of
antibiotics, contact precautions for the patient until diarrhea ceases, and
adequate environmental cleaning.
Note: this information was obtained from the
CDC website on C. difficile infections. For more information on the subject
please visit their website (click on the link above).
Q: Where does the garbage go in West Virginia?
A: Infectious Medical Waste generated in West Virginia
is disposed in various locations, a large portion of the waste is treated in
state, and the remainder is shipped to treatment facilities in Kentucky,
Maryland, and Ohio; depending on which company is contracted to ship and treat
the waste.
Non-infectious wastes are
sent to solid waste landfills around the state and in our neighboring states.
For more information about solid waste landfills, the appropriate regulatory
agency is the
West
Virginia Department of Environmental Protection.
Q: What are the basic contents in a medical waste disposal program?
A: Effective medical waste management programs must all
consider the procedures for handling, storage, proper separation, and volume
reduction efforts for both infectious and non-infectious medical wastes.
Additionally, procedures for waste treatment, transportation, disposal and
record-keeping must be addressed. But the single most important factor in
any waste management program is employee training.
Q: Once Infectious Waste has been autoclaved, is it still considered
infectious waste or can you dispose of it in the regular garbage?
A: Infectious Medical Waste that has been autoclaved in compliance with
the West Virginia Infectious Medical Waste Rule, 64CSR56, is no longer
infectious and can be safely landfilled. However, chemical, radiological,
and pathological wastes are not properly treated by autoclaving.
The Infectious Medical
Waste Rule stipulates that wastes which are recognizable as medical waste, after
autoclaving, must either be shredded to pass through a 1/2" screen, or the waste
must be accompanied to the landfill with a label stating that the waste was
treated. For more information on the exact requirements of the label,
refer to Section 6.3.b. of the Rule.
Q: Who sends copies of a uniform manifest to the state?
A: The West Virginia Infectious Medical Waste Rule
addresses the requirements of a manifest in Section 12. The Infectious
Medical Waste program reviews the manifests used by permitted waste haulers who
operate in West Virginia. Healthcare facilities that are permitted by our
office are required to submit an Annual Generators Report as well a copy of one
manifest from each month of the year. These copies serve as verification
that waste was removed from the facility every thirty days.
Q: Since it is very common to nick a
patient when shaving, are razors considered a contaminated sharp and should they
be placed in bio-hazardous, puncture proof, leak proof containers?
A: In West Virginia, where
disposable razors are used for patient grooming in a long-term care or nursing
home setting, they do not meet the definition of Medical Waste. The West
Virginia Infectious Medical Waste Rule section 3.13. defines Medical Waste as -
"Infectious and noninfectious solid waste generated in the course of the
diagnosis, treatment or immunization of human beings or animals, or in research
pertaining thereto, or in the production or testing of biologicals. . . ."
Because razors generated in long-term care and nursing home settings are not
used in treatment or diagnosis of patients, they do not meet the definition of
Medical Waste. Therefore, they are not considered Infectious Medical Waste.
However, OSHA's Bloodborne Pathogen Standard requires that razors be collected
in a sharps container.
The WV Infectious
Medical Waste program and OSHA have come to an agreement on handling of
disposable razors in extended care and nursing home settings. Razors can
be collected in any container that meets the definition of a sharps container
(leak-proof, puncture resistant, and bearing the "Biohazard" symbol). The
container must also be labeled for Razors Only. When the container
is full, it must be sealed shut, and the biohazard label removed at the point it
is placed in the general waste stream. This container is also an ideal
location to collect broken glass and empty medication vials, in which case the
label should state Razors and Glass Only.
This container may be carried
from one patient room to the next while patient grooming takes place.
However, infection control issues prevent the use of these procedures for
patients under isolation precautions.
Q: Can red bag waste generated in an Outpatient Clinic in Hagerstown
Maryland be transported in a sealed container to our main facility in West
Virginia and there be disposed of by contract?
A: Section 9 of the West Virginia
Infectious Medical Waste Rule addresses transportation. Section 9.2.
states that a small quantity generator, those generating less than fifty (50)
pounds of Infectious Medical Waste per month, may transport their own waste to a
permitted infectious medical waste management facility.
If the Outpatient Clinic in Hagerstown generates less than fifty (50) pounds of
Infectious Medical Waste per month and transports their own waste, they would be
required to: provide training in the proper handling of infectious medical
waste to the employee who transports the waste, deliver the waste to a permitted
management facility within forty-five (45) days of generation, and the vehicle
shall carry a spill containment and cleanup kit as required by Section 7 of the
Rule.
If the Outpatient Clinic in Hagerstown generates in excess of fifty (50) pounds
on Infectious Medical Waste per month and transports their own waste, they would
be required to obtain a transport vehicle permit and meet all of the
requirements in Section 9 of the Rule, as well as Section 12.5., which states
that a waste manifest must accompany all waste transported from a Large Quantity
Generator. There is no requirement for manifesting waste from a Small
Quantity Generator.
Q:
If we generate less than 50 pounds of infectious waste a
month, how often does our waste need to be picked up?
A: Section 8 of the West Virginia
Infectious Medical Waste Rule addresses storage. Section 8 defines storage
as, any time after packaging (sealing) for transport. It states that
waste, other than sharps, shall not be stored for more than thirty (30) days
prior to transportation, even if refrigerated.
Once the shipping container (box) is filled, it should be sealed and removed from
your facility within thirty (30) days. This section does not give any
exemption to facilities that generate less than fifty (50) pounds of infectious
medical waste per month.
Q: What is the average density
of infectious medical waste used in calculating autoclave size necessary to
treat a specific weight or tonnage of waste?
A: The average density of
infectious medical waste is roughly 3.5 to 5.5 pounds per cubic foot. This information was
obtained from several autoclave design and manufacturing companies.
Q: Where can I find
information about technical specifications of masks, gloves, and shoes for
protecting people on incineration of pathological wastes?
A: Questions regarding the
technical specifications of personal protective equipment may best be addressed
to the individual manufacturers of these products as these specs may vary by
product as well as manufacturer.
Section 7.1.d. of the West Virginia Infectious Medical Waste Rule addresses the
requirements for personal protective equipment to be used in a spill clean up.
It states that overalls, boots, and caps shall be made of materials impermeable
to liquids. Boots may be of thick rubber and gloves shall be of heavy
neoprene or equivalent material.
Q: How can the health of a
worker whose job is incineration of pathological wastes be protected?
A: Employees who work with/around
Infectious Medical Waste must be aware of the hazards they face in their duties.
These wastes are likely to have a high concentration of infectious agents, and
therefore should be handled with caution. Ideally, the handling of
Infectious Medical Waste should be minimized. Other methods of employee
protection include: all employees with reasonable anticipation of exposure to
human blood or blood products receiving the Hepatitis B vaccination series, the
use of barrier items such as face shields, masks, gloves and gowns, and one of
the most important factors is employee hygiene: washing hands after
handling Infectious Medical Waste is a must.
Q: What is the trend in total
volume of IMW since 1998?
A: 1996 was the year of peak
Infectious Medical Waste generation in West Virginia, roughly 9 millions pounds
were generated. By 1998 those numbers had been greatly reduced, to roughly
6 million pounds. This was due to facilities' efforts at reduction and
increased in-service training events. Since 1998, the amount of Infectious
Medical Waste generated annually in West Virginia has continued to decrease.
However, this reduction is very minimal when compared to the 1996 to 1998
reduction. West Virginia's medical facilities generated a little less than
6 million pounds of Infectious Medical Waste in 2001. One factor lending
to this trend might be the increased use of disposable medical devices, rather
than reusable devices.
Q:
It seems that OSHA, the CDC and these rulings
sometimes contradict each other. How are we to know which pathogens are to be
treated as infectious waste and which can go into the main trash stream...and
example is C-Difficile and a "contaminated" diaper.
A. OSHA, the CDC, and the West
Virginia Infectious Medical Waste program generally agree as to what constitutes
Infectious Medical Waste. However, there are no Federal guidelines on
Infectious Medical Waste disposal. Each state was left to decide how best
to handle their Medical Waste. Some states strongly restrict what items
are to be placed in the general waste and other states do not regulate
Infectious Medical Waste at all. In West Virginia, the enforcement of
Infectious Medical Waste disposal is according to 64CSR56 the Infectious Medical
Waste Rule. Our policy is that we do not fine
facilities for over-classification, but at the same time we expect each facility
to reduce over-classification and safely minimize the amount of Infectious Medical Waste they generate.
As far as Clostridium difficile, information
obtained from a
CDC web site stated
that C. difficile infections result in watery diarrhea, fever, loss of appetite,
nausea, and abdominal pain/tenderness. Because of the risk of spread of
this bacterium, Contact Precautions are recommended. Contact Precautions
are just that, precautions used for care givers when treating a patient.
They do not change how waste is to be disposed. They do stress the need
for frequent hand-washing, the use of gloves and other personal
protective equipment, and the proper disinfection with an EPA registered
disinfectant of the patient room and equipment.
Q: What are the medical waste collection
procedures and the types/specifications of containers and bags used.
A. The West Virginia Infectious
Medical Waste Rule outlines the requirements for waste collection and packaging.
These requirements can be found in Section 6.2. of the Rule.
Infectious medical waste
shall be contained and sealed on-site in leak-proof plastic bags capable of
passing the American Society for Testing and Materials drop weight test
(ASTM-D-959-80) using one hundred twenty-five (125) pounds, or in three (3) mil
plastic bags or containers with equivalent containment properties. Free liquids
shall be contained in break-resistant, tightly stoppered containers. Heavier
materials shall be supported in double-walled corrugated fiberboard boxes or
equivalent rigid containers.
Sharps shall be collected at the point of
generation in rigid, leak-proof and puncture-resistant containers clearly marked
as infectious medical waste. Containers shall be compatible with selected
treatment processes to preclude contact with waste materials, and sealed before
handling. Sharps containers shall not be completely filled.
Q: What are the requirements for disposal of
blood tube holders in West Virginia?
A. Blood tube holders would not
be considered Infectious Medical Waste because they are generally not
contaminated with blood after a phlebotomy procedure. However, the reuse
of blood tube holders is not addressed by the West Virginia Infectious Medical
Waste Rule 64CSR56 and therefore is not within our jurisdiction.
Click here for
OSHA's interpretation of the Bloodborne Pathogens Standard on this issue.
Q: What is "Off-Site" waste?
A. In the West Virginia
Infectious Medical Waste Rule 64CSR56, Off-Site is defined as - "a facility or area for
the collection, storage, transfer, processing, treatment, or disposal of
infectious medical waste which is not on the generator's site, or a facility or
area that receives infectious medical waste for storage or treatment that has
not been generated on-site at that facility or area."
Therefore, off-site wastes
are those generated somewhere other than where they are collected,
stored, transferred, processed, treated or disposed.
Q: What dangers are there in building an
autoclave for treating medical waste in an area near three schools and homes?
A. The use of an autoclave
is clean, safe, and a very effective method for treating infectious medical
waste. In an autoclave, waste is treated by high temperature steam in
combination with high pressure for a certain duration of time. Together
temperature, pressure and time kill the infectious agents present in the waste.
After steam treatment the waste is sterile and can be land filled safely.
The drawbacks of autoclaving are the possibility for foul
odors, the inability to treat pathological, chemical and radiological wastes,
and the generation of Volatile Organic Compounds (VOC). VOC's create a
stress on wastewater treatment systems because a greater amount of dissolved
oxygen in the wastewater is required to break down the VOC's. This problem
can be minimized by capturing and recycling the water generated during autoclave
use.
Q: Are vaginal swabs, speculums, etc.,
considered infectious medical waste?
A. The definition of
Infectious medical waste
is: medical waste which is capable of producing an
infectious disease. Medical waste shall be considered capable of producing an
infectious disease if it has been, or is likely to have been, contaminated by an
organism likely to be pathogenic to healthy humans, if such organism is not
routinely and freely available in the community, and such organism has a
significant probability of being present in sufficient quantities and with
sufficient virulence to transmit disease.
Therefore, classification of items such as
vaginal swabs and speculums is subject to interpretation of the definition of
Infectious Medical Waste. If these items contain large amounts of fluids
(...such organism has a significant probability of being present in sufficient
quantities and with sufficient virulence to transmit disease...) then they would be
Infectious Medical Waste. On the other hand, if these items contained a
small amount of fluid, they could be classified as regular waste. OSHA has
given a Standard Interpretation on this issue, more information can be found on
our "Related Sites" page,
under OSHA Standard Interpretation on Regulated Waste Items.
Q: How can I obtain a copy of the West
Virginia Infectious Medical Waste regulations?
A. A copy of the Infectious
Medical Waste Rule, 64-CSR-56, is available for downloading in WordPerfect and
MS Word format from the West Virginia Secretary of
State's office. A printed version can also be obtained from the
Secretary of State.
Q: What are the rules/laws governing sewage in
West Virginia?
A. Sewage Systems Regulations 64-CSR-09, and
Sewage Treatment and Collection System Design Standards 64-CSR-47. A copy
of these, and all Public Health Sanitation,
rules can
be obtained from the West Virginia Secretary of State's website or office.
Q: What is the threat posed by sewage
overflows to the public health and the environment?
A. Sewage can contain large amounts of pathogenic
bacteria, parasites, and viruses. Exposure to these contaminants can lead
to illnesses in humans and animals.
More
information
about the hazards associated with sewage is available from the
Centers for Disease Control. In addition to problems with direct exposure
to the harmful constituents of sewage, overflows of sewage can also lead to the
contamination of drinking water supplies.
Q: What and where are the rules concerning
Medical Waste Incinerator licensing and incinerator operator certification?
A. The Federal Clean Air Amendments of 1990 are the
basis for the authority to regulate incinerators, as well as various rules
promulgated by the West Virginia Department of Environmental Protection: 45CSR16, 45CSR23, 45CSR24, & 45CSR25.
The West Virginia Infectious
Medical Waste Rule, 64CSR56, addresses incineration in sections 10 & 11.
Section 10.2.a. - All owners
and operators of infectious medical waste incinerators are required to comply
with applicable State laws and with rules of the West Virginia Air Pollution
Control Commission.
Section 10.2.f.
- Incinerator operators are required to be registered with the Infectious Medical
Waste program. Operators shall obtain a registration number only after
having completed a course of study approved by the program, obtaining a passing
score on a written examination; and paying the applicable fee.
Section 11.2 - a Commercial Infectious Medical Waste Management Facility, one that
received more than 35% of their total waste from off-site, can not utilize
incineration technology in any form.
Click here for more
detailed information
about incinerator operator training requirements and information about
requirements to install a new incinerator at a medical facility.
In West Virginia, the Department of Environmental Protection, Division of Air
Quality regulates the permitting and operation of incinerators. More
information can be obtained from the
DEP website.
Q: How can liquid infectious wastes be
properly disposed?
A. In West Virginia, liquid Infectious Medical Wastes
can be disposed of in several ways:
Liquid infectious wastes can
be poured down a sanitary sewer, provided that it is approved by the department,
and no grinder is used in the process. There are splash hazards associated
with this method, and the container would still be disposed of as infectious
medical waste.
Liquid infectious wastes can
be contained in a leak-proof container to which an approved disinfectant
solidifier can be added, provided the
appropriate hold time
is adhered to, and
disposed in the regular solid waste. There are chemical hazards associated
with these products, as well as hold time issues that must be addressed.
Liquid infectious wastes can
also be contained in a leak-proof container and disposed of in the biohazardous
waste. This method allows for increased potential for leakage and spills.
Q: What is the meaning of Infectious Disease?
A. An infectious disease is a clinically manifest
disease, one which shows recognizable clinical signs or symptoms, of humans or
animals resulting from an infection.
An infection occurs after the entry
and development (of many parasites) or multiplication of an infectious agent in
the body of humans or animals.
Infection is not synonymous with infectious disease; the result of an infection
may be unapparent (showing no recognizable clinical signs or symptoms) or
manifest (shows clinical signs or symptoms, as in an infectious disease). The presence of living
infectious agents on exterior surfaces of the body, or on articles of apparel or
soiled articles, is not infection, but represents contamination of such surfaces
and articles.
Q: What are the laws governing the burial of the dead in WV?
A. The burial of human remains does not fall under the jurisdiction of the
Infectious Medical Waste rule. The Laws related to cemeteries are: §16-5-21 and
22, §16-9-2 and 3, §35-5-1 through 8, §35-5A-1 through 8, §35-5B-1 through 19,
§37-13-1 through 7, §37-13A- 1 through 6, and §61-8-14. Copies of these laws may
be downloaded from the Legislative web page.
Q: Is PPE worn during Anthrax sampling
considered a medical waste?
A. No. Most of these items can be
decontaminated and reused therefore are not waste. The PPE can be treated by
washing in hot soapy water followed by the application of a 1 to 10 dilution of
household bleach (5.25% available Chlorine). The PPE can also be autoclaved following
cleaning.
Q. Would untreated bulk blood and body fluids be permitted to be discharged
to the sanitary sewer?
A. Yes, if the sewer system is capable
of treating the blood and body fluids. A system is considered capable of treating
liquid infectious medical waste if it’s treatment plant meets secondary or
better discharge standards. If the sewage system does not meet these
standards it will not adequately treat the liquids and other disposal options
must be employed. The system must have been permitted and approved by the
Health Department before discharge of infectious medical wastes is permissable.
Q: Can syringes, with needle
attached, which did not contain blood or
body fluid, be placed in the regular
trash?
A. No. Sharps must be treated before
they can be discarded. The generators of
sharps in the medical community usually
employ a transporter to treat their
sharps. Small quantity generators also
use haulers or transport their sharps to
a permitted facility for treatment and
disposal. Individuals who self medicate
at home may employ a procedure which is
delineated in a pamphlet titled "A
Household Guide for the Proper Disposal
of Syringes and Sharps" available on
this web site under the documents
section. There is also a presentation
that will play on your computer on the
presentations page based on the
pamphlet.
Q: How long can a generator keep
infectious waste prior to disposal?
A. Infectious medical waste,
other than sharps, can not be stored for more than 30 days even if refrigerated.
Infectious waste is not considered in storage until the package is sealed
however. It is therefore possible to accumulate infectious waste in its
transportation package until it is full. When the package is full and sealed the
clock on the storage time starts. Sharps may be accumulated in a sharps
container until they reach the full mark.
Q: What is the process involved
in becoming an IMW hauler?
A. Haulers must register with the
Infectious Medical Waste Program and
obtain a permit for each cargo carrying
portion of the vehicles used to
transport the infectious waste. If they
have a transfer station within West
Virginia that too must be permitted.
They must delineate what treatment
facility they plan to employ on their
application for a permit. The forms
necessary to apply to become a hauler
are available on this web site on the
Applications page, the Documents page,
and the Forms page. After receipt of the
applications and supplemental
documentation the program will review
the information provided and determine
if the proposed operation can operate in
compliance with the rule. If it is
determined that the applicant can comply
with the requirements of the Infectious
Medical Waste Rule a permit is issued.
Haulers are then required to report to
the program quarterly thereafter.
Compliance with the rule is necessary
for keeping a permit.
Q: How does the new WV Body
Piercing rule pertain to ear rings?
A. This is not an infectious medical
waste issue. I refer you to the
Secretary of State’s home page where you
can down load the Body Piercing Studio
Business Rule, 64CSR80, or to your local
health department. Follow this link to download the Rule from the website of the
West Virginia
Secretary of State.
Q. What is the definition of:
medical, medical waste, medical waste
treatment technology, treatment
technology?
A.
Infectious Medical Waste -- click here for
definition.
Medical -- Of, relating to, or
concerned with physicians or the
practice of medicine.
Medical Waste. -- Infectious and
noninfectious solid waste generated in
the course of the diagnosis, treatment
or immunization of human beings or
animals, or in research pertaining
thereto, or in the production or testing
of biologicals. The term "medical
waste" does not include low-level
radioactive waste, any hazardous waste
identified or listed under Subtitle C of
the federal Resource Conservation and
Recovery Act of 1976, 42 U.S.C. § 6921
et seq., as amended, or any household
waste as defined in the regulations
promulgated pursuant to Subtitle C of
that Act.
Medical waste treatment technology
--Any of several methods used to render
infectious medical waste non-infectious.
Medical waste is considered
non-infectious when the process
inactivates vegetative bacteria, fungi, lipophilic/hydrophilic viruses,
parasites, and mycobacterium at a 6 log10
reduction or greater; and inactivation
of Bacillus stearothermophilus spores or
B. subtilis spores at a 4 log10
reduction or greater.
Treatment technology – Any of
several methods employed to inactivate
microorganisms which employs one or more
of the following categories which are
chemical, mechanical, microwave, hammer mill, plasma arc, encapsulation,
heat, shredder, grinder, irradiation,
radio wave, or other process
demonstrating efficacy.
Q. How can I obtain medical and
infectious waste regulations?
A copy of the West Virginia
Infectious Medical Waste Rule 64CSR56 can be downloaded from the website of the
West Virginia
Secretary of State. From there, choose
the format (MS Word or WordPerfect) you wish to download the Rule in.
You may also order a copy of the rule
by contacting the Secretary of State,
note: the Secretary of State charges
a fee for hard copies.
West Virginia Secretary of State
Building 1, Suite 157K
1900 Kanawha Blvd., East
Charleston, WV 25305-0770
(304) 558-6000
Q. Does the body of a rabies specimen fall under IMW rules for
disposal?
A. No. In the West Virginia
Infectious Medical Waste Rule (64 CSR
56) the definition of infectious medical
waste is broken down into several
segments one of which is Animal
Carcasses, body parts, bedding and
related wastes. The definition of Animal
Carcasses, body parts, bedding and
related wastes means: contaminated
animal carcasses, body parts, and
bedding of animals that are known
to have been exposed to infectious
agents during research, production of
biologicals, testing of pharmaceuticals,
or for any other reason. The
definition of medical waste is: Infectious
and noninfectious solid waste generated
in the course of the diagnosis,
treatment or immunization of human
beings or animals, or in research
pertaining thereto, or in the production
or testing of biologicals.
Animal carcasses which were the
subject of a rabies examination do not
fit within the classification of
infectious medical waste because they do
not meet the definition of medical waste
to begin with, and because they do not
meet the definition of infectious
medical waste under the specific
category of animal carcasses, body
parts, bedding and related wastes. The
carcass remaining after the collection
of a sample for rabies was not generated
in the course of the diagnosis,
treatment or immunization of an animal.
The sample submitted for examination
would have been generated in an attempt
to diagnose rabies, however, the
remaining carcass was not so generated
since it was already in existence. Also,
since the carcass was not known to have
been exposed to infectious agents during
research, production of biologicals,
testing of pharmaceutical, or for any
other reason it does not meet the
definition of infectious medical waste.
Q. How many biohazardous waste generators are in West Virginia?
A. Currently there are 159 permitted infectious medical
waste management facilities in West Virginia. These facilities are large quantity generators
of infectious medical waste, which simply means that they generate more than
50 pounds of infectious medical waste per month.
As far as the small quantity
generators within the state, we do not have an exact number. It is almost
impossible to keep track of each doctor, dentist, veterinarian, etc. We estimate
that there are approximately 3000 infectious medical waste generators within West
Virginia.
Q. Are Long term care facilities responsible for updating employees of
contractible diseases a resident has?
A. This question does not fall under the umbrella of the Infectious Medical
Waste Rule. It should be directed to OSHA (304) 347-5937 or the West Virginia
Division of Surveillance and Disease Control (304) 558-5358.