SOLID WASTE MANAGEMENT PLAN Peoria County September 3, 2013 Medical Waste Background

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1 SOLID WASTE MANAGEMENT PLAN Peoria County September 3, 2013 Medical Waste Background

2 Medical Waste The proper handling and disposal of medical wastes (syringes, medical instruments, vials, pathological wastes, etc.) has long been a challenge of great proportions for federal, state, provincial and local public health agencies. Some of the issues surrounding medical waste attributes to the size and decentralized nature of the medical and health care community, diversity of handling and disposal practices, and mismanagement of waste due to lack of education or disregard of consequences. The medical waste with infectious properties, those wastes that have the capability of transmitting diseases, are of particular concern. Regulations and Guidelines Environment Protection Act The State of Illinois regulates what it considers hazardous or infectious hospital waste under the Illinois Environmental Protection Act, which was amend was first amended in 1979 and 1980 to define and regulate infectious waste. The state prohibits hazardous hospital waste from all landfills, and places emphasis on treatment, such as incineration, and tracking waste from generation to disposal. Potentially Infectious Medical Waste (PIMW), Title 35 of Illinois Administrative Code, Subtitle M, Chapter 1, Subchapter B, Part 1420 The Potentially Infectious Medical Waste regulations were passed in the State of Illinois in 1993 after numerous accounts of needles and other medical waste was found washing up on beaches in the 1980s. According to regulations, PIMW is waste generated in connection with the diagnosis, treatment, or immunization of human beings or animals; research pertaining to the provision of medical services; or the provision or testing of biologicals. All PIMW must be treated to eliminate the infectious potential, and sharps must be treated and either made unrecognizable or packaged properly prior to disposal. All PIMW must be transported by a licensed PIMW hauler to a permitted transfer, storage, or treatment facility. Finally, once PIMW has been treated and the sharps have been packaged properly, all materials can be placed in the landfill. Regulated Facilities Illinois regulations apply only to hospitals, which does not include nursing homes, offices of human or animal health care providers, out- patient clinics, or veterinary hospitals. Generators of 220 pounds of hazardous waste or less a month are exempt from permit and manifest requirements. Storage and Containment The Illinois regulations do not contain any specific requirement for containment and storage of infectious waste, except that all vehicles used to transport special waste and packages used to contain special waste should be labeled or marked. Treatment and Disposal Regulations Medical waste must be rendered safe by sterilization in an autoclave or ethylene oxide unit or incinerated. All facilities which treat this waste on a commercial basis must obtain a state operating permit. Medical waste is regulated as a special waste in Illinois, requiring that a) the receiving facility must obtain a special waste stream permit prior to receiving the waste; b) vehicles used to transport the waste must have current, valid special waste hauling permits; and c) special wastes must be manifested between the generating and receiving sites. Peoria County Medical Waste Background 9/4/2013 Page 1

3 EXISTING PROGRAMS Home Collection The Illinois Environmental Protection Agency is continually trying to find convenient and environmentally responsible ways for residents to manage pharmaceutical waste. Waste pharmaceuticals found at home come in the form of solid pills and capsules, creams, liquids and aerosols. Pharmaceuticals intended for pets are often identical to prescriptions for humans and should be disposed of in the same manner. The IEPA advises residents to save all old or unwanted medications for an IEPA sponsored household hazardous waste collection day. In addition, unwanted or expired medications can be taken to long- term household hazardous waste facilities in Naperville, Rockford, Chicago, and Lake County. Below are a list of medical disposal locations in Peoria County. Residents with medications needing disposal can drop- off materials at one of the six locations provided by the county. If one of these designated sites are not near a resident, drop offs can then take place at a city s annual event or at one of the permanent hazardous waste locations. Peoria County Medical Disposal City Address Locations Bartonville Police Department Bartonville 5918 S. Adams Street Chillicothe Police Department Chillicothe 823 N. 2nd Street Peoria County Sheriff s Office Peoria 301 N. Maxwell Road Peoria County Courthouse Peoria 324 Main St. #215 Peoria Police Department Peoria 600 Southwest Adams St. Peoria Heights Police Department Peoria Heights 4901 N. Prospect Rd. #1 RECOMMENDATIONS In addition to the annual collection day sponsored by the IEPA, the County could consider having a collection day a few times each year. This would prevent residents from storing these substances for a whole year, and most likely disposing of them improperly because of the long wait. A collection day can help residents dispose of medical waste, however, a discussion surrounding the waste generated by medical facilities should also take place. In accordance with goals within the 2011 Peoria County Sustainability plan, the plan states a goal to establish a comprehensive pharmaceutical waste collection program which encompasses all medical units and pharmacies including waste from Bel- wood Nursing Home, Peoria County Animal Protection Services (PCAPS), the jail and Health Department. To protect the public and the environment from potentially infectious disease causing agents, a Medical Waste Management Program must be created in order to regulate generation, handling, storage, treatment, and disposal of medical waste specific to your County. This Management plan should encompass environmental regulations as well as requirements by the Health Department. The most comprehensive part of a Medical Waste Management Plan includes the requirements for medical waste generators such as hospitals, pharmacies, nursing homes, etc. The second part will include collection of home medical waste and systems for residents to dispose of home generation. There are seven main sections to include in any management plan: Peoria County Medical Waste Background 9/4/2013 Page 2

4 1. Determine Medical Waste Generators 2. Identifying Medical Waste 3. Containment and Storage 4. Transportation 5. Treatment and Disposal 6. Registration/Permits 7. Home Generation Waste Medical Waste Generators A requirement for medical waste generators will be the first step to estimating how much medical waste is generated in the County and will determine the type of management plan the County will need in place. Generators can, include but are not limited to, medical and dental offices, clinics, hospitals, surgery centers, research labs, veterinary offices, vet clinics, vet hospitals, and trauma scene practitioners, as well as other medical facilities. In addition, it will be necessary to determine the quantity and the type of medical waste each medical practitioner generates. Depending on the quantity of generation of each facility will determine if they are a Small or Large Generator. Identifying Medical Waste Under the Federal Resource Conservation and Recovery Act of 1976, medical waste can be identified as the following: Biohazardous waste Pathology waste Chemotherapy waste Sharps waste Pharmaceutical waste Trauma Scene waste Containment and Storage Medical waste should be contained and stored separate from other waste at the point of origin at each generator facility. Certain medical waste specified by state regulations must be incinerated or taken care of by an approved alternative technology. Each type of waste has a certain type of container, storage type and labeling procedure. For instance, Biohazardous waste must be contained in red bags, labeled as Biohazardous waste and stored in a rigid container that is leak resistant. Transportation All medical waste shall be transported by either a registered hazardous waste transporter or by a limited quantity hauling exemption which is required for small quantity generators. Transportation requirements are determined by federal and specific state laws. In addition to transporting by vehicle, some state medical facilities have used a mail- back system. Using an approved mail- back system, medical waste generators can dispose of their medical waste and possible save costs at the same time. Companies who offer such services must be approved by the state and health department. Treatment and Disposal All medical waste must be treated by a method that has approval by the Department of Health. Treated medical waste is rendered solid waste and, if not otherwise hazardous, may be disposed of at a sanitary landfill. Treatment methods will depend on the type of waste but can include incineration, discharge to a public sewage system, chemical disinfection, and steam sterilization (autoclave). Many vendors will Peoria County Medical Waste Background 9/4/2013 Page 3

5 take care of treatment and disposal depending on the type of medical waste. The appropriate transportation permits and licensing are required to be submitted for this process. Registration and Permits All medical waste generators are required to register their facility. The type of registration will be dependent upon the quantity of medical waste generated. Registration and permits are commonly required for the following: Large Quantity Generators Small Quantity Generators On Site Medical Waste Treatment Facilities Common Storage facility Home Generated Waste Similar to the current Peoria County collection system, the County should designate a point of consolidation for the collection of home- generated sharps waste. In the case of Peoria County, these consolidation points are local Police stations. All consolidation points should properly contain all sharps, hold a sharps container ready for disposal for more than seven days, and finally, all sharps should be treated at a permitted medical waste treatment facility. Peoria County Medical Waste Background 9/4/2013 Page 4