BUMEDINST 6280.1C, MANAGEMENT OF REGULATED MEDICAL WASTE Flashcards
What’s the instruction for Management of Regulated Waste?
BUMEDINST 6280.1c
What’s the purpose of BUMEDINST 6280.1c Management of Regulated Waste?
To provide standards for management of regulated medical waste (RMW) generated from processes at Bureau of Medicine and Surgery (BUMED) facilities prior treatment and disposal.
What is solid material intended for disposal which is produced as the direct result of non-infectious patient diagnosis, treatment, therapy, or medical research other than those characterized as RMW?
Non-regulated medical waste
What is generated during diagnosis, treatment, or immunization of humans or animals
and is capable of causing disease or would pose other adverse health risks to individuals or the
community if improperly handled?
Regulated Medical Waste
Regulated Medical Waste Group 1?
Cultures, stocks, and vaccines
Group 2
Pathological waste
Group 3
Blood and blood products
Group 4
Used Sharps
Group 5
Animal Waste (from animals exposed to infectious agents during research, production of biologicals, or testing of pharmaceuticals)
Group 6
Isolation Wastes (including bedding from patients or animals from BioSafety Level 4 (BSL 4) agents)
Group 7
Unused sharps
Group 8
Other (including fluids that are designated by the local infection control authority)
Group 9
Chemotherapy Trace Wastes
What is animal waste
This category is specific to infectious animals, contaminated animal carcasses, body parts, and bedding of animals known to have been exposed to infectious agents during treatment, research, productions of biologicals, or testing of pharmaceuticals.
Which is designed to minimize exposure of workers and the environment to infectious agents?
Bio Safety Level
How many Biosafety Level are there?
There are four levels (1-4)
What is the most stringent and applies for work with dangerous and exotic agents that pose a high individual risk of life threatening diseases, which may be transmitted via the aerosol route and for which there is no available vaccine or therapy.
Bio Safety Level 4.
Free-flowing liquid human blood, plasma, serum, and other
blood derivatives (e.g., blood in blood bags or bloody drainage in suction containers); absorbent
materials soaked or dripping with blood; and items caked with dried blood, capable of releasing
blood if handled.
Blood and blood products
Infectious agents and associated biologicals, including those from medical and pathological laboratories, as well as dishes and devices used to transfer, inoculate, and mix cultures.
Cultures and stocks
Waste that qualifies as both a RMW and hazardous waste (HW). Examples may include a syringe used to administer a medication that classifies as a pharmaceutical HW or
dental amalgam waste.
Dual Waste.
A HW is a solid waste (SW), or combination of SW, which, because of its quantity, concentration, or physical, chemical, or infectious characteristics, may (a) cause or significantly contribute to an increase in mortality or an increase in serious irreversible or incapacitating reversible illness or (b) pose a substantial present or potential hazard to human
health or the environment when improperly treated, stored, transported, disposed of, or otherwise
managed.
Hazardous Waste.
Wastes, including bedding, from patients or animals from BSL 4 areas.
Examples include biological waste and discarded materials contaminated with blood, excretion
exudates, secretions from humans who are isolated to protect others from highly communicable
disease, and secretions from isolated animals known to be infected with highly communicable
diseases caused by BSL 4 agents including pox viruses and arboviruses.
Isolation wastes
Waste generated in the health care setting
which is non-infectious and requires no additional treatment before disposal.
Non regulated medical waste non(RMW)
Examples include used personal hygiene products (e.g., diapers, facial tissues, and sanitary napkins not originating from post-partum suites or gynecological surgical wards) and
absorbent materials containing very small amounts of blood or other body fluids (e.g., bandaids).
Organs, tissues, body parts other than teeth, products of conception,
and fluids containing tissue removed by trauma or during surgery or autopsy or other medical
procedure. These wastes are typically not considered pathological waste if they have been fixed
in formaldehyde and should then be disposed of per state, local, or FGS regulations.
Pathological waste
Waste generated during diagnosis, treatment, and
immunization of humans or animals and is capable of causing disease or would pose other
adverse health risks to individuals or the community if improperly handled.
Regulated Medical Waste
What wastes must be classified as empty less than
Chemotherapy Waste, less than 3%.
(1) Formulate and disseminate Navy Medicine policy and guidance related to the management of RMW.
(2) Coordinate RMW policy, roles, and responsibilities with Defense Health Agency, Chief of Naval Operations, Office of the Secretary of Defense, and Naval Facilities Engineering
Command.
Chief, BUMED
1) Ensure an echelon 3 Environmental Program Manager (EPM) has been appointed per BUMED Notice 5090 of 8 June 2016.
(2) Execute requirements as set forth in this instruction and coordinate with command EPMs to ensure that they are properly implementing a compliant RMW management program.
(3) Respond to BUMED requests for information including compliance data, budget and execution, contracting, and inspections.
Commanders, Navy Medicine Echelon 3 Activities
(1) Support compliance with applicable regulations or status of forces agreements regarding RMW and ensure guidelines in this instruction are adopted and implemented
accordingly.
(2) Ensure an EPM has been appointed at commands determined to be Environmental Management System (EMS)-appropriate or that have subordinate commands generating RMW, or appoint an Environmental Point of Contact (EPOC) at commands determined not to be EMS appropriate
and without subordinate commands. The EPM and EPOC must be designated in writing and have responsibility to manage environmental programs, including the management
of RMW. Refer to BUMED Notice 5090 of 8 June 2016 for additional guidance on EMSappropriate
commands and templates.
Commanding Officer and Officer in Charge
Sharps must be collected in?
rigid, red, or clear containers that are puncture-resistant
and manufactured specifically for the collection of sharps.
Pathological waste must be immediately refrigerated upon generation. If the waste is to be maintained on-site longer than than 24 hours, it must be what?
Frozen in storage
Extracted teeth are
not considered pathological waste; however, they are
considered RMW.
Extracted teeth with amalgam are considered
dual waste as they contain HW (amalgam) and potentially infectious waste (extracted tooth).
Extracted teeth without amalgam are to be placed in compliant RMW bags for disposal.
Placentas are considered pathological waste if
managed by the facility
Unless prohibited by more stringent regulation, bulk blood may
be disposed via sanity sewer.
Breakable containers of bulk blood and blood products are to be disposed
in rigid, puncture-proof, leak-proof RMW container (such as a sharps-like container dedicated solely to the disposal of these specific wastes and not comingled with sharps).
These designated fluids would be RMW when free-flowing, dripping, or saturated on substrates.
semen, vaginal secretions, cerebrospinal fluid, synovial
fluid, pleural fluid, peritoneal fluid, pericardial fluid, and amniotic fluid.
Place chemotherapy trace waste in
yellow sharps-like containers
Minimize human exposure to RMW during transport to interim and final RMW storage areas. Do not transport RMW in
Chutes or dumbwaiters. If possible, avoid busy patient
areas or use freight elevators.
If frozen, pathological waste may remain in storage on-site up to
30 calendar days.
Non-pathological RMW may be placed unrefrigerated in final storage (i.e., the location where RMW is held to await off-site transport or disposal) for up to
7 calendar days unless the waste becomes putrescent within a shorter storage duration
The entrance(s) to the storage area must be labeled as
“BIOHAZARD” and marked with the universal biohazard symbol.
If the biohazard signage cannot be placed on the door, it must be placed on
the wall directly adjacent to the entry.
The signage must be?
fluorescent orange or orange-red with lettering and symbols in a contrasting color such as black. The signage must be legible from a distance of at least 5 feet.
may be either incinerated, thermally inactivated, chemically
disinfected (liquids only), or treated by steam sterilization followed by incineration or grinding.
Group 1: Cultures, stocks, and vaccines
Wastes from this group as described in paragraph
4b(3) of this enclosure, may be either incinerated or treated by steam sterilization followed by incineration or grinding. Ethical considerations may dictate using alternate means of disposal
such as cremation or burial by a licensed mortician.
Group 2: Pathological waste
Non-liquid wastes from this group or those liquid wastes not allowed to be discharged to
the sanitary sewer may be either steam sterilized or incinerated.
Group 3: Blood and blood products
may either be incinerated or steam sterilized followed by
incineration or grinding.
Groups 4 and 7: Used and unused sharps
In the absence of manufacturer recommendations, steam sterilization requires temperatures of
at least 121° C (250° F) for at least 90 minutes at 15
pounds per square inch of gauge pressure, and Geobacillus stearothermophilus spore strips must
be used weekly to test the sterilization process.
Initial training (Class 6-Division 6.2 hazardous materials) is required as soon as possible, but not longer than
90 days upon assuming duties. This training must be refreshed every 24 months.
Medical Waste Management Plan Documentation
This plan must be reviewed
Annually and modifications must be made within 90 days of the annual review or following a significant process change.
All training records must be retained for at least
3 years from the date of training.
In the event that this documentation is not received within 60 days, the EPM must notify the contracting officer representative for the RMW disposal contract to determine appropriate means of contacting the transporter and receiving facility to trace the disposal. These records must be maintained with the original shipping documents and manifests by the facility for?
at least 2 years.
