Page 612 - Materials Chemistry, Second Edition

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Medical and Infectious Wastes 583
Sources of potentially hazardous chemical wastes include clinical and research laboratories,
patient-care activities, pharmacies (spills and expired items), physicians’ offices (outdated items),
physical plant departments, or building and grounds departments (e.g., pesticides and solvents)
(U.S. EPA, 1991).
If a container holds less than 3% (by wt) of the original amount or capacity of hazardous mate-
rial, it is considered ‘empty’ and does not require disposal as a hazardous waste (40 CFR 261.7).
This exemption does not apply to seven chemotherapy drugs listed by EPA as acutely toxic (40 CFR
261.33f).

20.3.5 RADIOACTIVE WASTE
Radioactive waste, specifically low level, is produced through a number of healthcare activities
including those associated with research laboratories, clinical laboratory procedures, and nuclear
medicine procedures such as diagnostic and therapeutic applications. Low-level waste includes
items that have become contaminated with radioactive material or have become radioactive through
exposure to radiation. This waste consists of contaminated clothing, wiping rags, mop heads, filters,
medical tubes, swabs, injection needles, syringes, and laboratory animal carcasses and tissues.
Liquid radioactive wastes include scintillation fluids and research chemicals. Radioactivity can
range from just above background levels found in nature to highly radioactive. In a study of one
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35
32
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university hospital, radioisotopes included 125 I (25.5%), P (19.1%), H (14.5%), C (8.7%), S
51
(6.2%), 131 I (1.1%), Cr (0.8%), and several others (Emery et al., 1992).
Low-level waste is stored on-site by the generator either until it has decayed sufficiently and
can be disposed of as ordinary trash, or until amounts are large enough for shipment to a low-level
waste disposal site in containers approved by the U.S. Department of Transportation (DOT).
20.3.6 MIXTURES
Mixtures of solid waste and regulated medical waste are also to be regulated as medical waste (40
CFR Part 259.31). Similarly, mixtures of listed or characteristic hazardous waste and regulated
medical waste are considered medical waste.

20.4 MANAGEMENT OF MEDICAL WASTES PRIOR TO TRANSPORT
20.4.1 HANDLING AND PACKAGING
The handling of medical wastes depends largely upon federal and state regulations, the disposal
method, and location of the disposal facility. Medical wastes that are intended for transport off-site
must be segregated into the following categories whenever possible: sharps (used and unused), flu-
ids (greater than 20 mL), and other regulated medical waste (40 CFR 259.40). If other waste is
placed in the container with medical wastes, the generator must label and mark the container and
its entire contents. Generators must ensure that all regulated medical waste is placed in containers
that are:
● Rigid
● Leak-resistant
● Impervious to moisture
● Of sufficient strength to prevent tearing or bursting under normal handling conditions
● Sealed to prevent leakage during transport

In addition, generators must package used and unused sharps in puncture-resistant packaging
(Figure 20.1). Fluids are to be placed into break-resistant and tightly lidded packaging.
If medical wastes (excluding sharps and fluids) are to be incinerated off-site, they are generally
packaged in plastic bags at the point of generation. Bags are usually red or labeled with a biohazard