UNIVERSITY OF OTTAWA Subject: Biomedical Waste Disposal Procedures No.: 1 Issued by: Office of Risk Management (ORM) Revised: Sept 2007 Target Group: Faculties and Services Effective: Oct 2004 Biomedical Waste Disposal Procedures 1. PURPOSE The purpose of this document is to define biomedical waste and to provide information on the handling and disposal of this waste stream. These guidelines are intended to ensure the proper and safe management of biomedical waste at the University of Ottawa. A summary of this document is provided in Appendix B. Both provincial and municipal regulations, by-laws and consultative documents were referenced when drafting these procedures. This document will cover the following areas: 1. Purpose 2. Definition 3. Roles & Responsibilities 4. General Guidelines 4.1. Segregation 4.2. Containment & Labelling 4.3. Treatment 4.4. Handling/Transport 4.5. Collection 4.6. Storage 4.7. Disposal 4.8. Re-supply 4.9. Records 5. Special Wastes 5.1. Mixed Waste (Radioactive Carcass Disposal) 5.2. Cytotoxic Waste 5.3. Ethidium Bromide 6. Links/Resources 7. Appendices - Appendix A: Faculty/Department Contacts - Appendix B: Overview of Biomedical Waste Disposal Procedures The information found within this document can be found on the Office of Risk Management (ORM) web page; http://www.uottawa.ca/services/ehss/biosafety.htm 1
2. DEFINITIONS Many terms are used to identify and characterize biomedical waste, such as: biohazardous, pathological, and infectious. These terms are often used interchangeably without clearly defining their subtle differences and similarities. To assist the reader these terms are defined below. For the purpose of this document biomedical waste will be used as the general term. Where the waste may be defined more specifically and require special treatment, this procedure will specify the requirements. Biomedical waste: Discarded biological material from teaching, clinical and research laboratories and operations. Examples of biomedical waste include but are not limited to; Animal Waste - Animals carcasses, tissues and body parts, blood and bodily fluids and infectious bedding. Biological Laboratory Waste - Cultures, stocks or specimens of microorganisms, live or attenuated vaccines, human or animal cell cultures and laboratory material that has come into contact with these (solid and liquid). Human Anatomical Waste - any part of the human body, including tissues and organs but excluding extracted teeth, hair, and nail clippings. Human Blood and Body Fluid Waste Human fluid blood and blood products, items saturated or dripping blood, body fluids contaminated with blood and body fluids removed for diagnosis during surgery, treatment or autopsy. This does not include urine or feces. Material with minimal amounts of non-infectious blood (i.e. does not release blood if compressed) are not considered biomedical waste. Sharps - Needles, syringes with needles, lancets, scalpels, razor blades, and precision knives. Contaminated broken glass, pipettes, test tubes, microscope slides, blood vials or any other material capable of causing punctures or cuts. Biohazardous waste: Waste that is known or suspected to contain infectious material or which because of its physical or biological nature may be harmful to humans, animals, plants or the environment Infectious waste: Waste which contains microorganisms in sufficient quantity which could result in the multiplication and growth of those microorganisms in a host. Pathological waste: Any waste which contains microorganisms capable of causing disease. 3. ROLES AND RESPONSIBILITES Principal Investigators: 2
Ensure all lab staff/students have received proper training to deal with biomedical waste. Communicate these guidelines to key personnel. Ensure labs are equipped with the proper containers and or bags and that they are ideally located. Users (students, lab or clinic personnel): Practice due diligence at all times when handling biomedical waste (i.e. wear protective equipment) Ensure familiarity with the handling, treatment and disposal procedures of the waste you generate. Service or Faculty/Department Biomedical Waste Representative: Arrange for pick-up/drop off of waste with users. Transport or assist in transport of waste to designated storage areas. Log waste information in the appropriate log. Contact ORM to arrange for pick up of full containers and for re-supply (where applicable) Office of Risk Management (ORM): Pick up all biomedical waste from designated storage areas and arrange for off-site disposal. Maintain records regarding the amount of waste generated. Ensure Principal Investigators, users, and representatives are complying with guidelines. Provide guidance regarding the handling treatment or disposal of biomedical waste. 4. GENERAL GUIDELINES 4.1 Segregation Biomedical waste must be stored in a secure environment at all times. Whenever possible, biomedical waste must not be mixed with chemical, radioactive or other laboratory trash. This may be unavoidable (i.e. radioactive carcasses) and in such instances special handling may be required. For further information contact ORM. The various types of biomedical waste should be segregated from each other. Fluid waste should be contained separately from solid waste. 4.2 Containment & Labeling Containers for biomedical waste must be appropriate for its contents. There are several different kinds of containers and bags available for the containment and disposal of biomedical waste. Containers and bags are available through your faculty/service stores, your hazardous waste Biohazard 3
representative or the ORM. The various types of packaging and associated labelling used for different types of biomedical waste are outlined below. All containers for biomedical waste must display the biohazard symbol and the words Biohazard in a colour contrasting the container. Sharps must be rigid, leak proof, puncture resistant and sealable University currently uses 4.5L yellow containers 22.5L containers are available upon request Label: University of Ottawa Hazardous Waste label Anatomical/Animal Waste Place waste in a red biohazard bag or a black garbage bag if the waste will immediately be stored in a barrel lined with red biohazard bags. Barrels are approved heavy duty rigid cardboard. Label: Each bag must be tagged with a completed yellow incineration (necropsy) tag. Biological Laboratory Waste Review of current practices indicates biological laboratory waste is treated in-house (autoclaved or chemically treated). If in-house treatment is not suitable, contact ORM to discuss other means of disposal. Solid Collect waste in a red or orange autoclavable biohazard bag Label: University of Ottawa Hazardous Waste label For more info see the Autoclave Guidelines Liquid Use leak-proof containers which are able to withstand thermal or chemical treatment Label: University of Ottawa Hazardous Waste label Blood & Bodily Fluids Vials Deposited in approved sharps container Label: University of Ottawa Hazardous Waste label 4
Fluids Use rigid leak-proof container Label: University of Ottawa Hazardous Waste label Saturated Items same as solid waste or anatomical waste The following are some guidelines to remember when packaging waste; Double bag if necessary to prevent perforations. Add absorbent material if the possibility of large volumes of liquid exists. Ensure the bags are well sealed Do not overfill the containers/bags If the outside of the bag is contaminated, double bag. Secondary containment should also be labeled with the biohazard symbol. Labels University of Ottawa Hazardous Waste label University of Ottawa Incineration (necropsy) tag 4.3 Treatment If not sent off-site for disposal, all biological waste should be decontaminated prior to disposal (including level 1 agents). Decontamination of waste results in the destruction or removal of microorganisms to a lower level, such that there is no danger of infection to others. The two main choices for waste decontamination at the University of Ottawa are autoclaving (preferred) and chemical disinfection. Waste that has been decontaminated or disinfected is no longer considered biomedical waste. Therefore, once the waste has been treated it can be disposed of in the regular waste stream. Any waste that cannot be 5
treated (i.e. sharps, carcasses, tissues and body parts) remains biomedical waste and must be incinerated off site. For more information on decontamination/disinfection methods please see one of the following documents or contact the ORM; A Guideline for the Safe Use of Autoclaves Decontamination 4.4 Handling/Transportation Untreated waste should be handled as little as possible. Avoid contaminating exterior surface of waste container, or ensure exterior surfaces are decontaminated. Avoid transport of untreated waste through non-lab or high traffic corridors. Secondary containers must be used when transporting waste (especially for liquids). The secondary containers should be decontaminated after use. Whenever possible use carts with raised sides for transport. Ensure containers or bags are tightly closed or taped shut during transport. 4.5 Collection Collection of biomedical waste varies for different services or faculty/departments depending upon waste generation practices, available resources or management approaches. For more specific information contact your service or faculty/departmental representative (Appendix A). 4.6 Storage Although biomedical waste should be treated as promptly as possible it can be held temporarily. Treatable waste should not be allowed to accumulate. Waste that is to be disposed off-site should be stored in designated areas which are secure and access is limited to delegated individuals. To prepare for off-site disposal the following measures must be undertaken. Sharps Sharp containers must be placed in a defined cardboard box, double lined with two yellow bags, which displays the biohazard symbol. When boxes/containers are full they should be closed, taped shut on all sides (with a tape that withstands condensation). Boxes should be held in designated biomedical waste cages 6
Anatomical/Animal Waste Drums, either while filling or when full must be held in cold storage at a 4 minimum. Once full, drums should be closed and the lid should be taped securely. All barrels which contain carcasses or anatomical waste must have an Anatomical sticker affixed. These may be applied by ORM or the waste generator. 4.7 Disposal The service or faculty/department representatives will contact the ORM to arrange for a waste pick-up from the storage area. Any further preparation for transport (i.e. labelling, monitoring, and paper work) will be conducted by ORM. Biomedical waste is currently picked up every week at Roger-Guindon Hall and bi-weekly at the Main Campus. 4.8 Re-supply New and/or replacement supplies may be requested through the service or faculty/department representative or through faculty stores. Those who produce relatively low volumes of waste will have labels for their waste containers which have contact information for disposal or re-supply. For disposal or additional containers contact the Office of Risk Management at 562-5800 x 3153 Disposal/Re-supply label 4.9 Records As biomedical waste is potentially hazardous, it is important to document the nature of the waste. Labels attached to waste bags or sharps containers should detail the contents. While the ORM maintains records of the type of waste (tissue or sharp), the weight and the corresponding cost for disposal, each waste generator should have a system to track their own waste. The following forms are used for tracking biomedical waste at the University of Ottawa; Sharps Waste Container Disposal Log - log is kept at the biomedical waste cage. Radioactive Carcass Disposal Log - log is kept with disposal container and at the decay freezer. 7
5. SPECIAL WASTES 5.1 Mixed Waste Mixed waste may consist of any combination of biohazardous, chemical and radioactive waste. These combinations present various challenges and inactivation and disposal will be considered on a case-by-case basis or as required. As a general rule, the biological component should be inactivated first. Radioactive Carcass Disposal: All carcasses labeled with radioisotopes must be disposed of separately from biomedical waste. Carcasses must be placed in a black garbage bag and tagged with a yellow incineration tag Carcasses must be held in a designated container which displays the radioactive trefoil and the words Radioactive as well as the Biohazard symbol. The container must be held in a temperature controlled room/freezer (contact your hazardous waste representative or ORM for locations). The Radioactive Carcass Disposal log must be completed. 5.2 Cytotoxic Waste Cytotoxic waste is any material that may have come into contact with a cytotoxic drug. Cytotoxic waste has the potential for causing carcinogenic, mutagenic or teratogenic effects. Therefore, this waste must be handled with caution and ORM must be consulted. Waste of this nature cannot be treated by autoclaving and must be incinerated off-site. While cytotoxic waste is handled similarly to other biomedical waste there are some important differences; Cytotoxic waste must be segregated from other biomedical waste Sharps containers or red biohazard bags used to contain cytotoxic material must be labeled as Cytotoxic Waste Packaging for disposal (boxes or barrels) must also be labeled as Cytotoxic Waste Cytotoxic waste must not be refrigerated * Note when the waste consists or both cytotoxic and anatomical components (i.e. tissue from chemotherapy treated patient or animal) the anatomical classification assumes priority. 5.3 Ethidium Bromide While ethidium bromide (EtBr) is not a regulated waste per say, due to its properties it may present a hazard if it is poured down the drain or placed in the regular garbage untreated. Correct procedures for the disposal of EtBr depend on the nature of the waste materials and the concentration of EtBr that they contain. Therefore, due to its many 8
uses, it is not possible to have one all encompassing mode of disposal. Please contact the ORM to discuss disposal approaches which are tailored to the characteristics of your waste. 6. LINKS & RESOURCES University of Ottawa Sharps Waste Management Procedures University of Ottawa Hazardous Waste Guide Radioactive Materials Waste Management A Guideline for the Safe Use of Autoclaves Block, S.S. (Ed.). (2001). Disinfection, Sterilization, and Preservation, (5 th Ed.). New York: Lippincott Williams & Wilkins. 9
APPENDIX A Faculty/Department Contacts FACULTY/DEPARTMENT REPRESENTATIVE CONTACT INFORMATION BIOLOGY Yves Genest Lab Technician x 6343 ygenest@science.uottawa.ca 141 BioSci Phase II CHEMISTRY EARTH SCIENCES Daniel Lafleur Chief Technician, Undergraduate Labs x 6813 dlafleur@science.uottawa.ca 308 MRN GEOGRAPHY Jean Bjornson Laboratory & Field Resource Technician x 1039 bjorn@uottawa.ca 005-B SMD HUMAN KINETICS Francois Haman Francois Beaulieu Lab Co-ordinator x 4262 x 4249 fhaman@uottawa.ca fdbeauli@uottawa.ca 344 MNT 346 MNT MEDICINE (all departments) NURSING Nancy Delcellier Environmental, Health and Safety Officer x 8046 ndelcell@uottawa.ca 2160 RGN PSYCHOLOGY Sylvie Emond Animal Care Technician x 4553 x 4546 semond@uottawa.ca 018 VNR ORM Tina Preseau Biosafety Compliance Inspector X 3153 tpreseau@uottawa.ca 306 BRS * If your faculty/department is not represented here please contact the ORM. 10
Office of Risk Management Oct 04 Appendix B - Overview of Biomedical Waste Disposal Procedures Identification Biological Lab Waste Sharps Anatomical/Animal Waste Blood an Bodily Fluid Waste Cultures, stocks or specimens of microorganisms, live or attenuated vaccines, human or animal cell cultures and laboratory material that has come into contact with these (solid and liquid). Needles, syringes with needles, lancets, scalpels, razor blades, and precision knives. Contaminated broken glass, pipettes, test tubes, microscope slides, blood vials or any other material capable of causing punctures or cuts. Animals carcasses, tissues and body parts, infectious bedding, liquid or semi-liquid blood and blood products, body fluids, items contaminated with blood bodily fluids Fluid blood and blood products, items saturated or dripping blood, body fluids contaminated with blood and body fluids removed for diagnosis during surgery, treatment or autopsy. This does not include urine or feces. Segregation Solid Liquid Radioactive carcasses Saturated items Vials Fluids Containment Orange autoclavable biohazard bag Rigid, leakproof container (i.e flask) Approved sharps container Black garbage bag Black garbage bag Approved sharps container Rigid, leak-proof container Labeling University of Ottawa Hazardous waste label University of Ottawa Hazardous waste label University of Ottawa yellow necropsy label (individual bags) University of Ottawa yellow necropsy label (individual bags) University of Ottawa Hazardous waste label University of Ottawa Hazardous waste label Treatment Autoclave or chemical decontamination Autoclave or chemical decontamination Packaging for disposal Once treated affix a nonhazardous waste sticker Place inside a sealed black garbage bag Place inside approved cardboard box double lined with 2 yellow biohazard bags Place inside designated Place inside approved cardboard drum double lined with 2 red biohazard bags Place inside approved cardboard drum double lined with 2 red biohazard bags Place inside approved cardboard box double lined with 2 yellow biohazard bags For larger volumes (+ 300ml) contact ORM Storage Designated biomedical waste cage Records Sharps disposal log Store in designated cold storage (at least 4 C) Allow to decay in designated freezer Radioactive carcass disposal log Store in designated cold storage (at least 4 C) Designated biomedical waste cage Sharps disposal log Disposal Regular garbage Pour down drain* Picked up by ORM sent off-site ORM will arrange for offsite disposal Picked up by ORM sent off-site for incineration Picked up by ORM sent off-site Pour down drain* * In accordance with the sewer use by-laws Detailed information is available in the Biomedical Waste Disposal Procedures 11