Waste management for the clinical lab

Dec. 1, 2009

Click here to download a waste-management
program audit checklist.

Laboratory waste streams are often taken for granted or
overlooked entirely. After all, the cost of waste disposal does not come out
of the lab budget — or does it? What once was a simple way to dispose of
blood and body fluids (and the equipment and supplies that came into contact
with them) has now been replaced with a sophisticated mechanism for the
disposal of various waste streams within the lab setting.

Categories of waste include chemical, infectious,
radioactive, controlled substances, pharmaceutical, multihazardous, sharps,
and non-hazardous. Each has its own characteristics and requirements for
removal. Waste can be governed by the Environmental Protection Agency/EPA,
the Occupational Safety and Health Administration/OSHA, the Resource
Conservation and Recovery Act/RCRA, the Department of Transportation/DOT,
the Nuclear Regulatory Commission/NRC, and the Drug Enforcement Agency/DEA,
as well as state and local agencies. It is prudent to contact the local
municipality for its requirements.

The first step in developing a waste-management program
is to perform an audit of the laboratory. This may require cooperation among
the lab, environmental health and safety, and housekeeping departments. All
applicable waste streams must be identified and plans made for appropriate
removal. Waste streams associated with the laboratory can contain:

  • sharps including scalpels, broken glass, needles, and
    other items that must be placed in a rigid sharps container. Once the
    container is three-quarters full, it must be closed and disposed of
    according to local requirements;
  • infectious waste materials including anything
    contaminated with blood or body fluids, such as gloves or pads covering
    the lab bench;
  • chemicals like alcohols, acids, flammables,
    pesticides, and caustic housekeeping materials;
  • controlled substances or other pharmaceuticals
    including chemotherapy waste and narcotics used for standards;
  • radioactive substances including implanted devices
    used for treatment.;
  • recyclable material including paper, glass, aluminum,
    and plastics; and
  • regular trash.

Waste should be examined to determine if there are any
hazardous materials. Such waste must be disposed of according to EPA
guidelines. Waste streams should never been mixed (e.g., regular trash mixed
with infectious red-bag waste) as it must be disposed of according to the
more strict of the two (e.g., as infectious waste).

A recycling program that meets with local codes should be
instituted and appropriate containers made available for use. A key practice
for managing waste is to promptly remove it from the facility. For good
infection control, weekly waste pickup should be the minimum.

The ideal plan is one that meets regulatory requirements,
reduces liability, is cost effective, and is workable within the facility.
The goals and objectives of the waste-management program must be defined and
must protect the health of the employees and patients, as well as the

Before contracting for services, obtain proposals from at
least three different vendors, if possible. The following are guidelines for
selecting a firm for waste removal:

  • Identify hazardous waste streams and estimate
  • Contact both large and small waste-management firms
    to discuss specific waste streams and how they would be handled to final
    disposal, and request a proposal.
  • Conduct a site visit for each of the finalists and
    require an audit packet, which includes permits detailing what each firm
    can legally accept as well as insurance, liability coverage, and
  • Contact the DOT about specific transportation
    regulations at 202-426-2075.

Minimize the amount of waste generated. In today's
disposable world, “going green” is considered exemplary. Here are some

  • Source separation: Use
    multiple waste-collection containers to keep waste types separate, so
    each waste type can be optimally managed. In offices, use separate
    receptacles for recyclable paper.
  • Waste segregation: Keep
    waste types segregated during collection, storage, transport, treatment,
    and disposal. Keep needle boxes out of red bags.
  • Source reduction: Make
    purchases in small, manageable quantities. Use non-hazardous or
    less-hazardous materials whenever possible.
  • Recycling: Aluminum, paper,
    plastic, glass, and other items should be recycled. Recycle solvents
    where appropriate.
  • Process changes: Substitute
    non-hazardous cleaners for caustic ones. Use ozone-friendly spray
  • Hazard reduction: When
    possible, reduce the hazard of the waste to make it easier or less
    expensive for disposal.

Additional help in establishing a waste-management plan
can be found in the Clinical Laboratory Standards Institute/CLSI Document
GP05-A2 (GP05-A3 will be released in 2010).

Best-selling author, professional speaker, and safety
consultant Terry Jo Gile, MA Ed, MT(ASCP). The Safety Lady, designs
educational DVDs and computer-based games to make laboratory safety training
informative as well as fun. Her book, Complete Guide to Laboratory Safety
– Second Edition
, is considered the consummate
safety-reference tool that is specific for clinical laboratories. For
more information, visit www.safetylady.com .