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Transforming medical waste disposal practices to protect public health: worker health and safety and the implementation of large-scale, off-site steam autoclaves.

Authors
Sutton-P; Quint-J; Prudhomme-J; Katz-E; Deems-M; Flattery-J; Harrison-R
Source
Richmond, CA: California Department of Health Services, 2006 Feb; :1-104
NIOSHTIC No.
20032042
Abstract
Regulatory and public recognition that burning medical waste in incinerators produced major sources of dioxins and other hazardous emissions led to signifi cant changes in medical waste disposal practices. In 1997, there were approximately 2,400 hospital/medical infectious waste incinerators operating in the United States, whereas in 2004, 110 such incinerators remained. However, alternative approaches to improve medical waste disposal practices have primarily been directed towards ensuring treatment effi cacy and reducing the environmental impacts of disposal technology. The potential worker health and safety concerns common to the implementation of all medical waste treatment technologies, i.e., the handling and transport of infectious sharps and other hazardous materials, have received limited scrutiny. In December 2002, representatives of the Center for Environmental Health, the American Nurses Association, and Greenaction brought the issue of potential health impacts of the medical waste disposal work process to the attention of the California Department of Health Services Occupational Health Branch (CDHS/OHB). As part of Health Care Without Harm, these organizations advocate for medical waste management practices that minimize the impact on the health of workers, communities, and the environment. Specifically, these organizations were concerned about the potential occupational health hazards of large-scale, off-site steam autoclaves that have been implemented to treat medical waste in lieu of incinerators that were shut down due to improved environmental regulations. Primary prevention of occupational injury and illness involves ensuring that the implementation of alternative technologies to address environmental concerns also protects the health of workers. However, there was limited information about what hazards workers at steam autoclave or other treatment facilities actually encountered in practice, and how, or if, workers' exposures were controlled. Although the potential for worker hazards was not unique to steam autoclave technology, off-site steam autoclaves were of particular importance. An estimated 90 percent of California hospitals manage essentially all of their regulated medical waste off-site, and nine of 12 off-site medical waste treatment facilities in California utilize steam sterilization technology. In response to this concern, CDHS investigated the potential occupational hazards associated with a large-scale, off-site steam autoclave to make recommendations to prevent illness and injury.
Keywords
Occupational-diseases; Epidemiology; Risk-analysis; Risk-factors; Work-analysis; Occupational-hazards; Risk-factors; Work-analysis; Waste-disposal; Waste-disposal-systems; Waste-treatment; Exposure-assessment; Exposure-levels; Exposure-methods; Hazardous-materials; Hazardous-waste-cleanup; Health-hazards
Contact
California Department of Health Services Occupational Health Branch 850 Marina Bay Parkway, Building P, Third Floor Richmond, CA 94804
Publication Date
20060201
Document Type
Book or book chapter
Funding Type
Cooperative Agreement
Fiscal Year
2006
NTIS Accession No.
NTIS Price
Identifying No.
Cooperative-Agreement-Number-U60-OH-008327
Source Name
Transforming medical waste disposal practices to protect public health: worker health and safety and the implementation of large-scale, off-site steam autoclaves
State
CA
Performing Organization
Public Health Institute
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