Medical waste--declining options in the 90s

Cost appropriateness: can we $afford$ another Medical Waste Tracking Act?

Medical waste has, with each passing year, become a subject of greater and greater concern for the general public, legislative bodies, and the healthcare industry. Regulations have been passed and governing organizations created to set the problem right. These actions have cost the healthcare industry (and thus the public) exorbitant amounts of money. But is the panic wrongly focused, and is money being spent on the wrong things? This article discusses these issues and makes some eye-opening revelations about the medical waste crisis.

Inactivation of human immunodeficiency virus by a medical waste disposal process using chlorine dioxide

OBJECTIVE

To study the ability of a medical waste disposal process using chlorine dioxide to inactivate human immunodeficiency virus type 1 (HIV-1).

DESIGN

Stock HIV-1 (HTLV-IIIB strain) was treated with chlorine dioxide under the following settings: cell culture medium alone, culture medium with 25% blood, culture medium with medical supplies treated by the Condor machine (Winfield Environmental Corp., Escondido, CA). MT-2 cells in 96-well tissue culture plates were inoculated with serial tenfold dilutions of treated and untreated HIV-1. Cytopathic effect was read on day five, and the TCID50 (50% tissue culture infectious dose) was calculated.

RESULTS

Treatment of HIV-1 with chlorine dioxide in culture medium alone resulted in a 5.25 log10 reduction in TCID50. Treatment of HIV-1 with chlorine dioxide in the presence of 25% blood caused a 6.25 log10 reduction in HIV-1 infectivity. Treatment of HIV-1 with chlorine dioxide in the presence of medical supplies treated in the Condor machine resulted in a 4.75 log10 reduction in HIV infectivity.

CONCLUSIONS

Chlorine dioxide inactivated HIV-1 in vitro. Chlorine dioxide inactivated HIV-1 in the presence of blood and in the presence of medical supplies under conditions that simulated the conditions existing in the Condor machine.

Barrier materials. Their influence on surgical wound infections

Aseptic technique can best be described as an aggregation of reasonable practices performed in the surgical suite as part of the overall methodology in controlling or minimizing the possibility of infection. The key words in this definition are aggregation and reasonable. The real question is whether the surgical nursing community is prepared to reconsider and reassess the importance of a theoretical and reasonable, but not proven, practice that it has been advocating for almost two decades. From the evidence, it appears that a departure from the universal application of the barrier principle would not compromise the quality of care rendered to the surgical patient while at the same time prove to be economically and environmentally advantageous.

Medical waste: a minimal hazard

Medical waste is a subset of municipal waste, and regulated medical waste comprises less than 1% of the total municipal waste volume in the United States. As part of the overall waste stream, medical waste does contribute in a relative way to the aesthetic damage of the environment. Likewise, some small portion of the total release of hazardous chemicals and radioactive materials is derived from medical wastes. These comments can be made about any generated waste, regulated or unregulated. Healthcare professionals, including infection control personnel, microbiologists, public health officials, and others, have unsuccessfully argued that there is no evidence that past methods of treatment and disposal of regulated medical waste constitute any public health hazard. Historically, discovery of environmental contamination by toxic chemical disposal has followed assurances that the material was being disposed of in a safe manner. Therefore, a cynical public and its elected officials have demanded proof that the treatment and disposal of medical waste (i.e., infectious waste) do not constitute a public health hazard. Existent studies on municipal waste provide that proof. In order to argue that the results of these municipal waste studies are demonstrative of the minimal potential infectious environmental impact and lack of public health hazard associated with medical waste, we must accept the following: that the pathogens are the same whether they come from the hospital or the community, and that the municipal waste studied contained waste materials we now define as regulated medical waste.(ABSTRACT TRUNCATED AT 250 WORDS)