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Policy No: 2005
Effective Date: 08/25/06
Revised Date: 10/09/14
Reviewed Date: 10/09/14

Waste Handling 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.

Biohazard Waste

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.

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 Attachment I for further details.

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.

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.

1. Biohazard waste will be transported in covered containers designated for biohazardous waste.
2. 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.
3. 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 Attachment II for details on meeting DOT and OSHA requirements.
4. 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.
5. Equipment and linen contaminated with biohazard material or biological agents must be handled and decontaminated in accordance with the guidelines established in the hospital Bloodborne Pathogen Exposure Control Plan (See The Nebraska Medical Center Policies and Procedures, IC13, Bloodborne Pathogens Exposure Control Plan; 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.
6. 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 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 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.
7. The use of re-usable sharps containers is acceptable with the approval of Safety Operations (Hospital) or UNMC Safety Office (UNMC). Containers will be handled and processed in a manner consistent with acceptable regulatory guidelines. Areas looking for help with the regularly scheduled pick-ups in their area should contact the Support Operations Manager at 2-3153. If a re-usable sharps container is full and cannot wait until the next scheduled rounds for pick-up, contact Environmental Services at 402-888-3877 (UT) or 402-888-3876 (CT).
8. Non-EPA regulated chemotherapy waste (See Attachment 2 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 ext. 9-4073.
9. Special Circumstances in Handling Biohazard Waste
   • Placentas for disposal will be labeled for incineration.
   • 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.
   • 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.
   • Biocontainment unit biohazard waste will be handled in accordance with acceptable guidelines. Known or suspected Risk Group 4 waste (Attachment 1) is autoclaved on site before leaving the facility.
10. 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.

Chemical and Hazardous Waste

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 Chemical Safety Office at ext. 9-6356 for disposal guidelines.

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 ext. 9-6356 for disposal guidelines.

Recyclable Waste

1. Recyclable waste includes mixed paper, cardboard, plastic, tin, scrap metal, aluminum. and blue wrap. Questions concerning recycling can be addressed by calling ext. 9-4100.
2. 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, Retention and Destruction/Disposal of Private and Confidential Information. All paper waste, including medical and personal information is considered confidential waste.
3. 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.
4. 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.
5. 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.

1. Broken uncontaminated glass is placed in rigid containers and labeled as to the contents.
2. Compressed gas cylinders are returned to the vendor when empty. Contact UNMC Safety at ext. 9-7315 to arrange disposal of single use disposable cylinders.
3. 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.
4. 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 ext. 9-6356.

1. Batteries - Nickel cadmium (rechargeable), button (calculator, watch) or lithium batteries
2. Mercury containing lamps - light emitting bulbs containing mercury, including fluorescent, high pressure sodium, mercury vapor and metal halide lamps
3. Mercury containing items (thermostats, switches, manometers, sphygmomanometers, etc)
4. Electronic items (circuit boards, computer monitors)
5. Pesticides

Extracted Teeth

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.

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, Retention and Destruction/Disposal of Private and Confidential Information(Examples: CD/DVD, barcode lab label printer ribbons, hard drives, copiers, etc.)

Additional Information

• Contact UNMC Safety
• Contact Chemical Safety Office at ext. 9-6356
• Contact Radiation Safety Office at ext. 9-6356
• UNMC Policy No. 2004, Bloodborne Pathogens Exposure
• UNMC Policy No. 6056, Retention and Destruction/Disposal of Private and Confidential Information
• http://info.unmc.edu/safety/safety-office/biohazardous-waste/2005-waste-handling-attachments-2014.pdf Attachments I-V]
• The Nebraska Medical Center Policies and Procedures, IC13, Bloodborne Pathogens Exposure Control Plan
  

This policy maintained by dkp.