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2011 UF Biomedical Waste Training

2011 UF Biomedical Waste Training. Biological Safety Office Environmental Health & Safety 352-392-1591 www.ehs.ufl.edu bso@ehs.ufl.edu. Biomedical Waste Training. State regulations require that all employees who may have contact with BMW receive: initial training at time of hire

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2011 UF Biomedical Waste Training

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  1. 2011 UF Biomedical Waste Training Biological Safety Office Environmental Health & Safety 352-392-1591 www.ehs.ufl.edu bso@ehs.ufl.edu

  2. Biomedical Waste Training • State regulations require that all employees who may have contact with BMW receive: • initial training at time of hire • annual refresher training • Training shall cover: • Identification, handling, use of protective clothing, segregation, storage, labeling, transport, procedures for decontaminating BMW spills, contingency plan for emergency transport, and procedure for containment and treatment of BMW. • Training must be facility and site specific • Training Log/roster must be kept for a minimum of 3 years • Documentation of individual employee training is to be kept in their department.

  3. What is Biomedical Waste (BMW)? • Any solid or liquid waste which may present a threat of infection to humans • Includes but is not limited to: • Non-liquid human tissue and body parts • Blood, blood products and OPIM (as defined in OSHA BBP standard) from humans and other primates • Laboratory/clinical waste containing/contaminated with blood, tissue, cell cultures & other potentially infectious body fluids • Laboratory/veterinary wastes containing human disease-causing agents • Discarded sharps (medical items intended to cut or puncture skin, e.g. needles, syringe/needle combinations, lancets, scalpels)

  4. Biomedical vs. Biological vs. Hazardous Waste • Biomedical waste – specifically regulated by the State of Florida Dept. of Health • BMW is infectious for humans & a subset of biological waste • Various regulations affect biological waste (NIH, USDA, etc) • Biological waste includes rDNA, animal, & plant pathogens • Hazardous waste is a non-specific term. At UF, most often used to describe chemical waste or chemically-contaminated waste (pharmaceutical waste also handled as chemical waste).

  5. Examples of BMW? • Used, absorbent materials saturated with blood, body fluids, or secretions/excretions contaminated with blood & absorbent materials saturated with blood or blood products that have dried (bandages, gauze, sponges, wound care material). • Non-absorbent disposable devices (flexible tubing, disposable gloves, intact glass and hard plastic, etc) contaminated with blood, body fluids, or secretions/excretions contaminated with blood but have not been sterilized or disinfected by an approved method. • Other contaminated solid waste which represents a significant risk of infection b/c they are generated in medical facilities which care for persons suffering from diseases requiring isolation criteria.

  6. State Requirements • Described in Chapter 64E-16 FL Administrative Codehttp://www.doh.state.fl.us/environment/community/biomedical/pdfs/64E16_1.pdf • Segregation, handling, labeling, storage, transport & treatment are regulated. Prescribe specific: • Sanitary practices • Training • Biomedical waste plan – provides guidance & describes requirements for proper management of biomedical waste at the generating site or facility • Permits req’d to generate, store, treat, & transport BMW • Inspections by the state • Enforcement

  7. Biomedical Waste Plan • Content of this presentation closely follows the UF Biomedical Waste Plan which is located in EH&S Biosafety Office. Contact 352-392-1591. • The BMW plan for Shands UF is located in the Environmental Services Dept., Room G137 (South Tower) and Room B301.8 (North Tower). Contact 352-265-0480. • Other departments at UF/Shands may create and maintain a BMW plan for their area using the following template: http://www.doh.state.fl.us/environment/community/biomedical/index.html

  8. How is BMW identified? • International biological hazard symbol on the container • The phrase “Biomedical Waste”, “Infectious Waste” or “Biohazardous” must be on the container • Bagged waste must be in red bags.

  9. Segregation of BMW at UF/Shands • Segregated at point of origin into its proper container • “Point of origin” is the lab, patient/exam/procedure room or other area where the BMW is generated • Choices for proper BMW container: • Red biowaste bag • Labeled fiberboard box lined with a biowaste bag • Sharps container – puncture resistant container specifically designed for sharps

  10. Segregation: Do not mix BMW with radioactive or chemical waste! • Chemically or radiologically contaminated gloves, tubes, etc. do not go into a biomedical waste box. They go into their appropriate waste container. • Call EH&S (352-392-1591) before putting hazardous (chemical) or radioactive warning stickers on biomedical waste containers. • Remember – the biomedical waste box is not a universal disposal container!

  11. Segregate medical sharps into sharps containers • Never Re-Cap Needles or Scalpels • Don’t bend, break, or detach from syringe • Discard directly into a leak-proof, puncture resistant container • Replace container when ¾ full • Label container with facility’s name and address prior to offsite transport • UF labs - date, PI name, room and phone #

  12. Sharps • Container should be located where the sharps are used: patient rooms, procedure areas, exam rooms, lab, etc. • UF uses disposable containers transported for disposal by Stericycle • Shands uses reusable containers which are supplied & serviced by Bio Systems • Only sharps should go into sharps containers • Soft items quickly overfill containers and may cause sharps to stick out of the top of the box. Sharps boxes containing items other than sharps and syringes need to be replaced ASAP, but definitely within the 30 days of first use

  13. What do we do with non-sharp BMW? • RED autoclave bags – must meet certain documented standards of State of FL, BBP & DOT • e.g. Fisher #01-828E (Medical Action Industries) • Red bags are to be available where needed • No liquid waste in red bags! • Once sealed, containers must stay sealed. If container breaks or is punctured, put the whole broken container in a new one. • Infectious/potentially infectious waste must be stored in a covered, leak-proof container

  14. BMW Storage • BMW must be staged in an area away from general traffic & accessible only to authorized personnel. Storage area must be: • Labeled with biohazard sticker • Secure (locked/non-accessible) • Easily cleanable & tidy • Waste cannot be stored > 30 days • “The 30 day period shall commence when the first non-sharps item of biomedical waste is placed into a red bag or sharps container, or when a sharps container containing only sharps is sealed.” • Packages must be labeled as biomedical waste with the biohazard symbol, lab name, location, phone & date • Some locations stage the waste & then transport it to outdoor containers removed for disposal by a designated hauler

  15. BMW Staging Locations at Shands • Staging locations provided on each floor/as needed • In some areas, BMW is picked up from the “point of use” location • North & South Tower staging: the Soiled Holding Room on each nursing unit • South Tower: Rm 1172 ED Soiled Hold, Rm 1185 ED Soiled Hold, Rm 1236 Radiology Soiled Hold, Rm 8219 Soiled Hold, Rm 7121 Soiled Hold, Rm 2136 OR Soiled Hold, G316 Biowaste Staging, etc. • North Tower: Soiled holding areas on patient care and treatment areas, CSS and OR soiled holding area such as 3236, 2426, 3522, 6445, 9515 or 11-532, etc

  16. Handling BMW • Wear appropriate PPE (gloves, clothing cover, safety glasses) when handling non-inactivated waste • Use Universal Precautions – assume all BMW is infectious • Transport waste in leak-proof containers • Know how to handle spills

  17. Supplies for Handling and Containing BMW • At UF: • Labs must furnish their own PPE and red bags (Fisher #01-828E) • Sharps containers and BMW boxes are available from Building Services custodians or from AG133 at the Health Science Center (call 392-5775) or from Physical Plant Stores, Bldg 705 near the Motor Pool (call 392-1115) • At Shands, staff may obtain any of the supplies by: • Contacting Environmental Services at 352-265-0480 or • Speaking to an Environmental Services staff associate on the unit they are working

  18. Who Picks Up/Transports BMW for Shands/UF? • Transportation of BMW is provided by the following registered BMW transporter: Stericycle, Inc. 4245 Maine Ave Eaton Park, FL 33840 407-361-5454 State of Florida Permit # 53-64-00911

  19. Contingency Plan • Stericycle has a number of other sites in the state that they can pull transport equipment from to facilitate emergency situations

  20. Treatment of BMW • BMW shall be treated by heat, incineration, or other equivalent method suitable for hazard inactivation acceptable to the State of Florida. • Shands/UF BMW is treated by Stericycle, Inc. • Autoclave which sterilizes the waste or • Incineration which destroys the waste • Note: CJD BMW must be marked for incineration per hospital policy by the area that has filled the container. See ICP 03-15, Guideline for the Management of Patients with Suspected or Confirmed Creutzfeldt-Jakob Disease (CJD) or other prion disease

  21. Pretreatment of biological waste from UF labs prior to disposal by Stericycle • At UF, all lab waste handled by UF custodial staff • UF Policy: • Laboratory waste containing infectious, potentially infectious, or rDNA organisms must be inactivated prior to disposal • Properly performed autoclave or bleach treatment is acceptable • Storage of all non-inactivated waste in this category is restricted to within the generating laboratory • Specific requirements apply for waste containing biological toxins. Contact the Biological Safety Office at 352-392-1591

  22. Autoclaving • Requirements: • Biological indicator testing every 40 hrs of use (every 6 mos if autoclaving non-infectious material exclusively) • Log book • Regular maintenance • 250°F/121°C, 15-20 lb pressure • Large loads/resistant pathogens need more time • Typical bag of Biohazardous Waste = 60 min • Transport BMW to autoclave in closed bag and leak-proof container

  23. Bleach Inactivation of BMW • Acceptable for liquid material if done correctly • Add full strength household bleach to final concentration of 10% (5000 ppm available chlorine). • Mix. Contact time should be at least 30 minutes. • Pour down drain to sanitary sewer. • Beware of other disinfectants = “hazardous chemicals”, harmful work with and can’t go down drain, must be picked up by EH&S

  24. BMW Spills & Surface Disinfection • Proper spill handling: • Notify people in the area • Don appropriate PPE • Place absorbent material on spill • Apply appropriate disinfectant – allow sufficient contact time (30 min) • Pick up material (watch for glass – use tongs or dust pan); dispose of material into biomedical waste • Reapply disinfectant and wipe • For large/high hazard spills, call the Biosafety Office (352-392-1591) • For routine disinfection of surfaces where BMW is handled, use a 1:10 solution of freshly diluted bleach or a tuberculocidal disinfectant (ethanol evaporates too quickly!) • Shands uses VIREX, a hospital level disinfectant/germicidal cleaner (Didecyl dimethyl ammonium chloride) to clean and disinfect surfaces.

  25. Questions? Contact: The UF Biological Safety Office 352-392-1591 bso@ehs.ufl.edu www.ehs.ufl.edu

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