Sarra Borne UID: 000493586
Assignment: Biomedical Waste
VETE 4111: Safety and Regulatory Compliance
October 17, 2014
As the worldwide healthcare industry, both human and veterinary, grows so does the
amount of waste it produces. Steps need to be taken to minimize the amount of biomedical
waste generated by healthcare providers. Steps also need to be taken to find new and better ways
to decontaminate and process the waste so that the population at large is not at risk of exposure
to biohazards.
There are regulations in place from the federal government through OSHA, as well as
state and local governments that define exactly what regulated medical waste (RMW) consists of
and how it must be handled. Texas regulations are pretty specific about how to handle each
category of regulated waste. For instance, sharps must be decontaminated by chemical or heat,
enclosed in a puncture resistant container and disposed of in a sanitary landfill (Texas:
Special/Medical Waste, n.d.). Colorado on the other hand gives only general guidelines and
“leaves it up to the generator to determine what is an appropriate and effective treatment method
for their wastes” (Colorado: Infectious medical waste, n.d.). Even though it seems like Colorado
gives more leeway, they still need to conform to OSHA guidelines which if followed guarantee
that the RMW will be safely handled and contained.
Although some large facilities may have the onsite ability to treat RMW and render it
harmless, I am sure most regular vet hospitals do not have such resources. In most cases they
will have to rely on outside waste management companies. Therefore, setting up a regulated
medical waste reduction program such as the one recommended in the 2014 article 10 Steps to
Implementing a Regulated Waste Management Program will help them reduce the amount of
RMW generated and make it more cost effective to destroy.
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Sarra Borne UID: 000493586
Assignment: Biomedical Waste
VETE 4111: Safety and Regulatory Compliance
October 17, 2014
Some of the steps recommended by every article, website, and video are to create a team
responsible for reviewing the facility and making sure that the staff is aware of what does and
does not constitute RMW. For instance, tossing general trash, like soda cans, into a red bag or
sharps container out of laziness adds to the overall weight and costs the facility money. This
team could also take a close look at inventory and ensure that over ordering of items with
expiration dates is not occurring. It is safe to order dry goods, such as gauze sponges in large
quantities to take advantage of preferred pricing. It is not as prudent to buy a dozen large bottles
of a seldom used antibiotic that will eventually have to be disposed of when they expire.
One suggestion is that instead of stocking each and every medication that might ever be
prescribed, it is more feasible to only carry commonly used items, and those needed for
emergencies and to write prescriptions for the rest. Gone are the days when the pharmacy was
the biggest money maker with the largest mark-up for the practice. Instead we should be
charging appropriately for our services and medical expertise and letting the client price shop
their prescriptions.
In the event that drugs do expire and must be disposed of, never ever flush drugs down
the toilet or pour them in the sink, even tossing them in a trashcan is a poor management
decision. Companies like Stericycle have Pharmaceutical Returns and Disposal programs that
will take outdated medications and dispose of them properly. Other companies, such as
Environmental Pharmaceuticals are DEA authorized Reverse Distributors and will also handle
the destruction of controlled drugs.
It is prudent to dispense smaller quantities of medications, with allowed refills to prevent
clients from ending up with unused medications. It is also prudent to educate clients on what to
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Sarra Borne UID: 000493586
Assignment: Biomedical Waste
VETE 4111: Safety and Regulatory Compliance
October 17, 2014
do with unused or expired medications. Even though it may not be strictly legal, my practice
takes them back as a “donation”. In some cases, if the drugs are not expired, and with the
client’s full knowledge we might “donate” them to a patient whose owners are having financial
difficulties. Otherwise we add them to our box of medications slated for destruction. The DEA
sometimes sponsors a National Prescription Drug Take Back Day where they designate locations
where individuals and small facilities can bring in unused or outdated drugs for destruction.
In my community of Grand Prairie, Texas the city sponsors bimonthly events
where they accept household hazardous waste such as pool chemicals and pharmaceuticals. Fort
Worth, Texas has a similar program the Environmental Collection Center where residents can
bring in hazardous wastes. Programs such as these hopefully minimize the amount of hazardous
chemicals and unused drugs from entering the environment and the water supply.
Manufacturers such as Pfizer have recognized that the pharmaceuticals that they
produce have the potential to get into the water supply. Pfizer has developed a program to assess
and address the issue of pharmaceuticals in the environment. Pfizer has also developed an
advisor for medical professionals called the Pfizer Responsible Disposal Advisor site, which
once one becomes a registered member allows them to look up information on the proper
disposal, storage and transportation of Pfizer products, and provides tips on developing a
hazardous pharmaceutical waste management program (Pfizer, 2014).
Sharps waste is probably the largest category of medical waste produced in any
veterinary facility. We use multiple syringes, needles, scalpels, and other sharp instruments on a
daily basis and each one of them must be disposed of safely. One method for reducing the
amount of waste generated by sharps collection is by using reusable sharps containers. One
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Sarra Borne UID: 000493586
Assignment: Biomedical Waste
VETE 4111: Safety and Regulatory Compliance
October 17, 2014
study showed that a 250-bed (human) hospital could reduce its medical waste stream by 13 tons
per year from just the weight of single use containers (MedSharps, 2014). Companies such as
MedSharps transports the containers, processes the enclosed sharps, and then washes and
sanitizes the containers for reuse. In 1995, OSHA issued a memorandum that stated that
reusable sharps containers are an acceptable alternative to disposable containers and are
permitted if the risk to servicing employees is eliminated (OSHA, 1995).
These are just a few of the many steps and ideas that can be adapted by the veterinary
medical community to not only reduce the amount of hazardous medical wastes that it generates,
but also ensure that generated waste is properly handled and disposed.
Our medical waste stream should look like this:
And not like this:
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Sarra Borne UID: 000493586
Assignment: Biomedical Waste
VETE 4111: Safety and Regulatory Compliance
October 17, 2014
Waste Management Resources
DEA Controlled Drug Disposal for Registrants http://www.deadiversion.usdoj.gov/drug_disposal/dear_registrant_disposal.pdf
DEA Drug Disposal for Consumers http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm101653.htm
Environmental Pharmaceuticals (Reverse Distributor) - http://returnsrx.com/
Fort Worth Environmental Collection Center - http://fortworthtexas.gov/env/ecc/
Grand Prairie Household Hazardous Waste - http://www.gptx.org/index.aspx?page=122
Medical Waste Management News (quarterly newsletter) http://www.medicalwastemanagementnews.com/
Pfizer: Pharmaceuticals in the Environment
http://www.pfizer.com/files/responsibility/protecting_environment/WWP_Purple_PaperPharmaceuticals_in_the_Environment.pdf
Stericycle (Regulated Medical Waste Management Company) http://www.stericycle.com/
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Sarra Borne UID: 000493586
Assignment: Biomedical Waste
VETE 4111: Safety and Regulatory Compliance
October 17, 2014
References
10 steps to implementing a regulated medical waste reduction program. (2014). Retrieved from
Association for Healthcare Resource & Materials Management:
http://www.ahrmm.org/ahrmm/news_and_issues/strategies_solutions_homepage/10steps
_mwr_060410.jsp
Colorado: Infectious medical waste. (n.d.). Retrieved from Veterinary Compliance Assistance:
http://www.vetca.org/rmw/co-rmw.cfm
Medical waste on the beach [photograph ]. (2011). Retrieved from
http://www.hawaiireporter.com/wp-content/uploads/2011/01/Screen-shot-2011-01-19-at12.15.40-AM.png
Pfizer responsible disposal advisor site. (2014). Retrieved from Prifer for Professionals:
http://www1.pfizerpro.com/professional_resources/responsible_disposal
Reusable sharps containers. (2014). Retrieved from MedSharps:
http://www.medsharps.com/our-services/new-reusable-sharps-containers
Sharps container red bag [photograph]. (2014). Retrieved from
http://http://medicalwastefl.net/wp-content/uploads/2013/02/medical-waste.png
Standard interpretation 1910.1030. (1995, February 21). Retrieved from Occupational Safety
and Health Administration:
https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATI
ONS&p_id=21703
Texas: Special/Medical Waste. (n.d.). Retrieved from Veterinary Compliance Assistance:
http://www.vetca.org/rmw/tx-rmw.cfm#
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