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Policy No: <strong>2005</strong><br />
Policy No: <strong>2005</strong><br />
Effective Date: <strong>08/25/06</strong><br />
Effective Date: <strong>08/25/06</strong><br />
Revised Date: <strong>10/10/14</strong><br />
Revised Date: <strong>Draft 5-20-19</strong><br />
Reviewed Date: <strong>10/10/14</strong><br />
Reviewed Date: <strong></strong><br />
<br />
<br />
<big>'''Waste Handling Policy'''</big>
<big>'''Waste Handling Policy'''</big>
==Basis==
The University of Nebraska Medical Center (UNMC) is required to manage waste in a manner designed to protect patients, employees, students, contractors, visitors and volunteers, as well as the environment.
==Policy==
==Policy==
It is the policy of The University of Nebraska Medical Center (UNMC) to manage waste in a manner designed to protect patients, employees, students, contractors, visitors and volunteers, as well as the environment. Waste handling is accomplished in a cost effective manner in accordance with all applicable local, state and federal regulations and laws. Waste which cannot be reused or recycled will be disposed of in accordance with this policy.
UNMC’s first priority is to minimize waste whenever possible and has set a [https://livegreennebraska.com/updated-2030-sustainability-goals/ Zero Waste Goal]. The second priority is to recycle as much waste as possible to divert it from the landfill. Waste which cannot be reused or recycled must be disposed of in in a cost-effective manner, in accordance with this policy and all applicable local, state and federal regulations.
==Biohazard Waste==
==Guidelines==
Biohazard waste (infectious waste) is defined as material of biological origin capable of producing an infectious disease in humans or animals and includes at a minimum blood, body fluids, discarded sharps and inoculated culture media.<br />
Please follow the recycling and disposal guidelines below.
<br />
===Recyclable Waste===
Biohazard waste is composed of two broad categories to include sharps and nonsharps, and can be further subdivided by type. See the definitions outlined in [https://info.unmc.edu/safety/safety-office/lab-safety/biohazard-waste/index.html Biohazardous Waste Information] for further details.<br />
Recyclable waste is any material collected on campus that can be recycled. The most common recycled material is listed below.
<br />
====Paper and Cardboard====
Biohazard waste is handled by Environmental Services (EVS) and is disposed through a licensed biohazard waste contractor. Final disposition of biohazardous waste is in accordance with all applicable local, state and federal regulations and applies a process which renders the biohazard waste non-infectious. For further questions, please contact UNMC Safety Office.<br />
It is policy of UNMC and Nebraska Medicine that '''ALL PAPER''' must be placed in a blue desk-side container, large blue bin, locked grey or beige bin, or locked cart. All paper is shredded to ensure HIPAA/FERPA/confidentiality compliance. Even if that paper does not need to be shredded (i.e. newspaper) it is still placed in one of those containers.<br />
<br />
 
Biohazard waste, except for sharps, shall be contained in disposable plastic bags or containers that are tear-resistant, leak-proof, and secured to prevent leakage or expulsion of solid or liquid waste during storage, handling or transport.
Virtually all paper products on campus can be recycled: copy paper, envelopes (including plastic windows), scratch paper, glossy paper, construction paper, clean food packaging, newspaper, receipts, post-its, notebook paper, etc. Facial tissues, napkins, paper towels, etc. '''cannot''' be recycled and should be placed in the trash.<br />
#Biohazard waste will be transported in covered containers designated for biohazardous waste.
 
#Bags will meet current tear and impact resistance requirements, will conform to current maximum size and weight restrictions, and will be labeled as biohazardous (reference requirements in 49 CFR 173.134, 49 CFR 173.197, 49 CFR 173.24, 49 CFR 173.24a). The top of the inner bag must be closed by twisting it closed and tying in a single knot. It is preferred that the infectious waste bags be placed directly into rigid reusable containers supplied by the waste contractor at the site of origin.
If you have large quantities to recycle, please contact Environmental Services (EVS) (402-559-4073) so they can provide you with a larger bin, making it easier for you and safer for your EVS colleague.<br />
#Prior to transport off campus, all biohazardous waste will be placed in an approved leak-proof container such as disposable or reusable pails, disposable or reusable sharps containers, cartons, boxes, drums, or portable bins. These containers will be clearly marked and labeled in accordance with DOT and OSHA regulatory requirements. All containers will be closed and completely sealed. See [https://info.unmc.edu/safety/safety-office/lab-safety/biohazard-waste/index.html Biohazardous Waste Information] for details on meeting DOT and OSHA requirements.
 
#Suction canisters containing blood or other body fluids must be carefully emptied or contents may be sealed and placed in rigid reusable biohazardous waste containers with absorbent material. Personnel must wear appropriate protective equipment to minimize exposure to potential pathogens if contents are emptied. The contents may be solidified and discarded using approved methods if emptying the contents is not practical. The empty suction canisters must be handled and discarded as biohazard waste.
All corrugated cardboard (boxes used for shipping) and standard cardboard (sometimes referred to as paperboard: facial tissue/cereal/frozen meal boxes) can be recycled on campus. Please break all boxes down flat and place them between your paper recycling bin and the wall or at the designated location for your building. You do not need to remove labels or tape. Cardboard that has come in direct contact with food can be recycled as long as it is not dirty/soiled. Do not place any grade of cardboard in the blue/paper recycling container.<br />
#Equipment and linen contaminated with biohazard material or biological agents must be handled and decontaminated in accordance with the guidelines established in the Bloodborne Pathogen Exposure Control Plan (See UNMC Policy No. 2004, [[Bloodborne Pathogens Exposure]]). Equipment and linen are not thrown away as a biohazard. Items are cleaned first and personnel will refer questions to managers or leads to determine if an item must be discarded due to contamination.
 
#Infectious sharps, medical sharps, broken contaminated glass and pipettes contaminated with infectious material must be disposed of in leak-proof, rigid, puncture-resistant and break-resistant containers. Sharps containers must be approved by Safety Operations and/or the UNMC Safety Office. These containers must be sealed shut when they are 3/4 full and placed with the biohazard waste for pick up and disposal. Sharps containers should be bagged and sealed as outlined above if they contain liquids in the form of blood, body fluids or medications. Disposable sharps containers four (4) gallons or smaller are sealed closed and placed in the biohazard waste tub for disposal. Larger disposable sharps containers which will not fit into biohazard tubs for shipping must be in a shippable container, approved by DOT for shipment of sharps with no other packaging required. Reusable sharps containers regardless of size are sealed closed and then transported by the vendor to a facility which handles emptying and disinfecting the containers as well as decontamination of the sharps for disposal.
The recycling program at UNMC must comply with the federal requirement, in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), that all personal health information (PHI) be protected from the time it is created to the time it is destroyed. Recyclable paper containing confidential information is safeguarded from the time of generation through destruction. For guidelines on the proper destruction of confidential materials in the hospital, see IM.14, and UNMC Policy No. 6056, Retention and Destruction/Disposal of Private and Confidential Information. All paper waste, including medical and personal information is considered confidential waste.<br />
#The use of re-usable sharps containers is acceptable with the approval of the UNMC Safety Office (UNMC). Containers will be handled and processed in a manner consistent with acceptable regulatory guidelines.
 
#Non-EPA regulated chemotherapy waste (See [https://info.unmc.edu/safety/safety-office/lab-safety/biohazard-waste/index.html Biohazardous Waste Information] for a list of EPA regulated chemotherapy agents), pathological or other waste requiring incineration (human or animal remains or excised tissue) are marked clearly with the "incineration only" stickers provided by the biohazard waste contractor. The stickers are available from the biohazard waste contractor. Information on obtaining the incineration stickers can be obtained from Environmental Services at 402-559-4073.
EVS is responsible to secure, transport, and store confidential materials from internal customer departments. All paper in the blue containers marked specifically for recycling is considered confidential in the recycling process. Once picked up, this confidential waste is to be secured in locked containers provided by the vendor and locked containers should not be tampered with by unauthorized personnel. EVS will be the keepers of the keys for unlocking these containers and will have access to the contents of the containers through keys signed in and out daily in compliance with the Environmental Services Key Control Policy.
#Special Circumstances in Handling Biohazard Waste
====Plastic and Metal====
#*Placentas for disposal will be labeled for incineration.
Recyclable material can include rigid plastic, tin, aluminum. These items should be placed in the green recycling bins. EVS will empty the bins, collect the waste and prepare it for disposal by the recycling vendor. See [https://livegreennebraska.com/recycling/ LiveGreen Recycling] for additional information.<br />
#*Tissue dissected from surgical pathology or autopsy specimens are disposed by incineration. See #8 above.
 
#*Biosafety-Level 3 containment laboratories shall have all waste generated in such labs either decontaminated prior to removal from the lab or wrapped and placed into a sealed container prior to removal from lab for decontamination on site.
Large metal items can be recycled through Facilities Management and Planning and/or [http://info.unmc.edu/procurement/general-supply/ General Supply/Furniture Stores].
#*Any materials/substances coming out of a laboratory with concentrated infectious agents, such as an HIV/HBV production facility, must be decontaminated on site before leaving the facility.
====Surplus Material====
#*Biocontainment unit biohazard waste will be handled in accordance with acceptable guidelines. Known or suspected Risk Group 4 waste ([https://info.unmc.edu/safety/safety-office/lab-safety/biohazard-waste/index.html Biohazardous Waste Information]) is autoclaved on site before leaving the facility.
'''Surplus''' is any item that you or your department no longer needs. Common surplus equipment includes:
#Only trained and certified individuals shall sign Regulated Medical Waste (biohazardous) transport shipping papers. These individuals are signing for the organization and as such are not held financially responsible for any penalties or fines that may be imposed by regulatory agencies (i.e., OSHA, DOT, etc) so long as they are acting in a reasonable manner, consistent with their training and UNMC policy.
# Computers
==Chemical and Hazardous Waste==
# Printers and cartridges
Chemical and Hazardous Waste is any chemical material for disposal and includes both hazardous and non-hazardous chemicals. Chemicals and chemical materials like lead acid batteries and aerosol cans are disposed of in accordance with the Chemical Safety Manual and are removed from the campus by a licensed contractor. Contact the UNMC Environmental Health & Safety Department at 402-559-6356 for disposal guidelines.
# Electronic Equipment
# Furniture
# Chairs
# Appliances
# Equipment
These materials may be reused within the organization, sold or properly disposed of. Disposition of all surplus equipment shall be the responsibility of the Manager of General Supply/Furniture Stores (402-559-5899) and must be coordinated with the appropriate director or department head. Surplus equipment valued over $5,000 and entered in the UNMC Fixed Asset Inventory System must be handled in accordance with UNMC Policy No. 3000, [[General Accounting]].
====Technotrash====
Electronic trash, such as CD/DVD, barcode lab label printer ribbons, hard drives, and copiers are disposed of using an appropriate channel that can handle the chemical hazards of the item and taking into account the presence or absence of personal health information (PHI). Items containing PHI are disposed of in accordance with UNMC Policy No. 6056, [[Retention and Destruction/Disposal of Private and Confidential Information]]. <br />
 
For additional information on other recyclable material, see [https://livegreennebraska.com/recycling/ LiveGreen Recycling].
====Alkaline Batteries====
These are the typical non-rechargeable batteries that most people use. They are not EPA regulated and can be recycled through the UNMC Alkaline Battery Recycling Program. See [https://livegreennebraska.com/recycling/batteries/ LiveGreen Alkaline Battery (single use) Recycling] for additional information.
===Non-Recyclable Waste===
Non-recyclable waste is any waste, generated at UNMC that cannot be recycled.
====Biohazardous Waste====
Biohazardous waste will be managed and disposed of in accordance with DOT, EPA, OSHA, and State of Nebraska Regulations. Biohazardous waste (infectious waste or medical waste) is waste contaminated with biological material that is infectious or potentially infectious to humans, animals, or plants. Materials contaminated with recombinant and synthetic nucleic acids, as well as genetically modified organisms are also considered biohazardous. Please contact EVS at (402-559-4073) for biohazardous waste containers. Disposable sharps containers must be purchased by the department.
=====General Biohazardous Waste Categories=====
*Microbiological waste includes but is not limited to cultures and disposable culture materials, stocks of infectious agents and associated biologicals, discarded live and attenuated vaccines.  
*Human blood and blood products (dripable or dried blood that can be dislodged during handling).  
*Human tissues, body fluids or other potentially infectious materials including but not limited to unfixed human cell lines, tissues, pathology specimens, and used specimen containers. 
*Contaminated animal waste including carcasses, blood and body fluid, body parts, and excrement/bedding from animals infected with a pathogen.  
*Synthetic or recombinant nucleic acid materials.
'''All biohazardous waste must be rendered non-infectious prior to final disposal per State law [http://deq.ne.gov/RuleAndR.nsf/pages/PDF/%24FILE/T132_5.17.16.pdf (NDEQ Title 132)].''' 
=====Liquid Biohazardous Waste=====
Decontaminate liquid biohazardous waste (such as human blood, aspirated culture media, infectious human or animal body fluids, and liquid bacterial cultures) by steam sterilization (i.e. autoclave) or treatment with an appropriate chemical disinfectant (such as freshly-prepared bleach) for the recommended contact time (20 minutes for 1:10 final dilution with bleach). After decontamination, liquids may be poured down the drain to the sanitary sewer while flushing with cold water. See [sehttps://www.unmc.edu/ehs/FactSheets/SanitarySewerDisposal.pdf Sewer Disposal Fact Sheet] for guidance. Please note: solutions containing biological toxins must be decontaminated in a manner that also inactivates the toxin. Contact Environmental Health & Safety Department (EHS) at 402-559-6356 prior to drain disposal if using disinfectants other than bleach.
=====Solid Biohazardous Waste=====
Solid biohazardous waste is composed of two broad categories to include sharps and non-sharps.
======Sharps======
*Biohazardous sharps waste includes but is not limited to needles, syringes, scalpels, glass microscope slides, cover-slips, glass blood vials, Pasteur pipettes, plastic sharps (serological pipettes and pipette tips), razor blades, and contaminated broken glass. '''''Uncontaminated medical/research sharps (such as needles, syringes, scalpels, serological pipettes, pipette tips, etc.), although not contaminated, may be perceived as infectious when presented for disposal and must be handled as biohazardous sharps waste.'''''
*Biohazardous sharps must be disposed of in leak-proof, rigid, puncture-resistant and break-resistant sharps containers. These containers must be closed when they are 3/4 full. Sharps containers should be bagged and sealed as outlined above if they contain liquids in the form of blood, body fluids or medications. Disposable sharps containers four (4) gallons or smaller are sealed closed and placed in the biohazard waste tub for disposal. Larger disposable sharps containers which will not fit into biohazard tubs for shipping must be in an approved container. Contact EHS for additional information.
*The use of reusable sharps containers is acceptable with the approval from EHS. Reusable sharps containers regardless of size are closed and then transported by the vendor to a facility which handles emptying and disinfecting the containers, as well as decontamination of the sharps for disposal. 
*Pipettes and pipette tips readily puncture biohazard waste bags and must be disposed of in a rigid container (biohazard bag lined cardboard box). Lining pipette disposal box with plastic keeps residual liquids from soaking the box and seeping onto the floor/counter. Once pipette disposal boxes are full, they must be taped shut and placed into biohazard waste bin.         
======Non-Sharps======
*Solid (non-sharps) biohazardous waste including contaminated disposable PPE, culture materials, samples, specimens, shall be placed into tear-resistant, leak-proof, and secured red biohazard bags to prevent leakage or expulsion of solid or liquid waste during storage, handling or transport. Bags will meet current tear and impact resistance requirements, will conform to current maximum size and weight restrictions, and will be labeled with the universal biohazard symbol (reference requirements in 49 CFR 173.134, 49 CFR 173.197, 49 CFR 173.24, 49 CFR 173.24a). The top of the inner bag must be closed by twisting and tying in a single knot. The infectious waste bags should be placed directly into rigid reusable containers supplied by the waste contractor at the site of waste generation.
=====Special Circumstances in Handling Biohazardous Waste=====
*Before generating any biohazardous waste that requires incineration, contact EHS.
*Prion and prion-like wastes require special treatment before disposal, contact EHS for additional information.
*BSL-3 and ABSL-3 containment laboratories must decontaminate all wastes using agent-appropriate methods prior to removal from the lab. 
*Any materials/substances coming out of a laboratory with a larger volume of concentrated infectious agents, such as an HIV/HBV production facility, must be decontaminated on-site before leaving the facility. 
*Wastes generated from diagnostic sample analysis containing a known or suspected Risk Group 4 organism must be decontaminated using agent-appropriate methods before leaving the facility and then subsequently incinerated. 
*Suction canisters containing blood, other body fluids, or other infectious materials must be carefully emptied, or contents may be sealed and placed in rigid reusable biohazardous waste containers with absorbent material. Personnel must wear appropriate protective equipment to minimize exposure to potential pathogens if contents are emptied. The contents may be solidified and discarded using approved methods if emptying the contents is not practical. The empty suction canisters must be handled and discarded as biohazardous waste.
*Non-disposable or reusable items such as equipment, glassware, or linens that are contaminated with biohazardous material must be handled and decontaminated in accordance with the guidelines established in UNMC Policy No. 2004, [[Bloodborne Pathogens Exposure]]. Items are decontaminated as appropriate for the specific biohazardous material and personnel will refer questions to managers or leads to determine if an item must be discarded due to contamination. 
 
 Biohazardous waste that is decontaminated on-site via steam sterilization (i.e., autoclave) before disposal must undergo a process that includes quality assurance testing to verify that the decontamination process is adequate. Please see the IBC Autoclave Operation and Safety policy for additional information. 
 
 Biohazardous waste that has been mixed with a radioactive material or a regulated chemical (mixed waste) requires additional guidelines for disposal. Please contact EHS prior to generating these types of waste.
 
 Extracted Teeth at the College of Dentistry are handled as follows:
1. Virgin teeth are placed into a sharps container and disposed of as biohazardous waste.
2. Teeth with gold restoration are placed into a sharps container and eventually sent to a gold recovery company.
3. Teeth with amalgam restoration are placed into a sharps container and eventually picked up and handled as hazardous waste by UNL Environmental Health and Safety due to the mercury content.
4. Extracted teeth stored at the College of Dentistry for use by students in pre-clinic laboratory are stored in dilute hypochlorite solution (generally a 1:10 dilution). This leaches the mercury from the restorations and the solution is picked up by UNL Environmental Health and Safety when the teeth are disposed of at the end of the year.
 
 
 
 
 
 


==Radioactive Waste==
Radioactive waste is any material with detectable radioactivity above background levels. These materials are handled in accordance with Radioactive Materials and Waste policies and procedures. Contact the UNMC Radiation Safety Office at 402-559-6356 for disposal guidelines.
==Recyclable Waste==
#Recyclable waste includes mixed paper, cardboard, plastic, tin, scrap metal, aluminum. and blue wrap. Questions concerning recycling can be addressed by calling 402-559-4100.
#Recyclable material containing confidential information is safeguarded from the time of generation through destruction. For guidelines on the proper destruction of confidential materials in the hospital, see IM.14, and UNMC Policy No. 6056, [http://wiki.unmc.edu/index.php?title=Confidential_Information Retention and Destruction/Disposal of Private and Confidential Information]. All paper waste, including medical and personal information is considered confidential waste.
#The recycling program at UNMC must comply with the federal requirement, in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), that all personal health information (PHI) be protected from the time it is created to the time it is destroyed.
#Environmental Services is responsible for the securing, transporting, and storage of confidential materials from internal customer departments. All paper in the blue containers marked specifically for recycling is considered confidential in the recycling process. This confidential waste is to be secured in locked containers provided by the vendor and locked containers should not be tampered with by unauthorized personnel. EVS will be the keepers of the keys for unlocking these containers and will have access to the contents of the containers through keys signed in and out daily in compliance with the Environmental Services Key Control Policy.
#EVS picks up recyclables from departments as needed, on a schedule agreed between the department and EVS. Recyclables are removed from campus Monday thru Friday.


==General Waste==
General waste is anything which does not fit into other waste categories and is transported and disposed via a contracted service using normal waste handling methods.
#Broken uncontaminated glass is placed in rigid containers and labeled as to the contents.
#Compressed gas cylinders are returned to the vendor when empty. Contact UNMC Safety at 402-559-7315 to arrange disposal of single use disposable cylinders.
#Asbestos must be disposed in accordance with all applicable state, federal and local guidelines. Contact Facilities Management to arrange for disposal of items containing asbestos. A Construction Risk Assessment shall be required for asbestos removal in hospital areas.
#General Waste Disposal
#*It is the responsibility of Environmental Services to empty all trash and recycling receptacles as scheduled based on customers’ needs. Timing of trash removal is generally on a predetermined schedule, but can be upon request, based on customer needs. 
#*In order to avoid mistakenly disposing of items of value, anything which is to be considered ‘trash’ and taken to a dumpster, must be:
#**Placed directly in a trash can.
#**Verbally indicated by the customer, to Environmental Services management or staff, that the item(s) is trash and may be disposed. 
#*The following will not be disposed of by Environmental Services:
#**Items placed next to or near a trash can without contacting EVS office.
#**Items marked with a sign as “Trash”, unless request has been submitted to the ES office.
#**EVS employees should abstain from discarding items perceived as trash. Items should be in a waste receptacle or designated as trash by your leader, manager or at the direction of office.
#*General trash compactors are emptied three times per week. Other dumpsters on campus are collected on a schedule based on the location and container size.
==Universal Waste==
Universal wastes are any of the following hazardous wastes subject to the State of Nebraska universal waste requirements. Questions concerning disposal of universal waste can be addressed by calling 402-559-6356.
#Batteries - Nickel cadmium (rechargeable), button (calculator, watch) or lithium batteries
#Mercury containing lamps - light emitting bulbs containing mercury, including fluorescent, high pressure sodium, mercury vapor and metal halide lamps
#Mercury containing items (thermostats, switches, manometers, sphygmomanometers, etc)
#Electronic items (circuit boards, computer monitors)
#Pesticides
==Extracted Teeth==
Extracted teeth at the College of Dentistry are handled as follows:
#Virgin teeth are placed into a sharps container and disposed of as biohazardous waste.
#Teeth with gold restoration are placed into a sharps container and eventually sent to a gold recovery company.
#Teeth with amalgam restoration are placed into a sharps container and eventually picked up and handled as hazardous waste by UNL Environmental Health and Safety due to the mercury content.
#Extracted teeth stored at the College of Dentistry for use by students in pre-clinic laboratory are stored in dilute hypochlorite solution (generally a 1:10 dilution). This leaches the mercury from the restorations and the solution is picked up by UNL Environmental Health and Safety when the teeth are disposed of at the end of the year.
==Technotrash==
Electronic trash is disposed using an appropriate channel that can handle the chemical hazards of the item and taking into account the presence or absence of personal health information (PHI). Items containing PHI are disposed in accordance with hospital policy IM14 and UNMC Policy No. 6056, [http://wiki.unmc.edu/index.php?title=Confidential_Information Retention and Destruction/Disposal of Private and Confidential Information](Examples: CD/DVD, barcode lab label printer ribbons, hard drives, copiers, etc.).


==Additional Information==
==Additional Information==
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*UNMC Policy No. 6056, [http://wiki.unmc.edu/index.php?title=Confidential_Information Retention and Destruction/Disposal of Private and Confidential Information]  
*UNMC Policy No. 6056, [http://wiki.unmc.edu/index.php?title=Confidential_Information Retention and Destruction/Disposal of Private and Confidential Information]  
*UNMC Policy No. 2005, [https://info.unmc.edu/safety/safety-office/lab-safety/biohazard-waste/index.html Biohazardous Waste Information]
*UNMC Policy No. 2005, [https://info.unmc.edu/safety/safety-office/lab-safety/biohazard-waste/index.html Biohazardous Waste Information]
*[https://livegreennebraska.com/recycling/ LiveGreen Recycling].
*The Nebraska Medical Center Policies and Procedures, IC13, Bloodborne Pathogens Exposure Control Plan<br />
*The Nebraska Medical Center Policies and Procedures, IC13, Bloodborne Pathogens Exposure Control Plan<br />
This policy maintained by [mailto:dpanowic@unmc.edu dkp].
This policy maintained by [mailto:dpanowic@unmc.edu dkp].
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