BUMEDINST 6280.1C - Management of Regulated Medical Waste Flashcards
Which instruction provides standards for management of regulated medical waste (RMW) generated from processes at Bureau of Medicine and Surgery (BUMED) Budget Submitting Office (BSO) 18 facilities or received by BUMED facilities prior to treatment and disposal?
BUMEDINST 6280.1C, Management of Regulated Medical Waste
Personnel conducting activities outside of the Continental United States, Hawaii, Alaska, and its territories will adhere to their host nation _____ _________ _________.
Final Governing Standards (FGS)
If a host nation Final Governing Standards (FGS) does not exist, what is adhered to?
Overseas Environmental Baseline Guidance Document (OEBGD)
Regulations provided in 29 CFR Part 1910.1030 and the policies in which other reference describe the processes that BUMED facilities will implement to protect personnel from occupational exposures to blood and other potentially infectious material?
BUMEDINST 6220.14, Bloodborne Pathogen control Program
Wastes generated from the management of biological select agents and toxins must be managed per which reference?
BUMEDINST 6210.3, Handling and Shipping of Potentially Hazardous Biological Materials, Diagnostic
Specimens, and Etiologic Agents
Shipboard personnel are governed by what guide?
Afloat Medical Waste Management Guide
Regulated medical wastes generated by non-BUMED facilities or received by non-BUMED facilities for management are governed by the requirements of which reference?
OPNAVINST 5090.1D, Environmental Readiness Program
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 Regulated Medical Waste (RMW)?
Non-Regulated Medical Waste
Non-Regulated Medical Waste requires no further treatment and is disposed as?
general waste and trash
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 (RMW)
How many groups is Regulated Medical Waste (RMW) organized into that are managed based on associated risks?
9
How many primary groups of Regulated Medical Waste (RMW) are there each with specific management, treatment, and disposal criteria?
9
Which group of Regulated Medical Waste (RMW) deals with cultures, stocks, and vaccines?
1
Which group of Regulated Medical Waste (RMW) deals with pathological waste?
2
Which group of Regulated Medical Waste (RMW) deals with blood and blood products?
3
Which group of Regulated Medical Waste (RMW) deals with used sharps?
4
Which group of Regulated Medical Waste (RMW) deals with animal Waste (from animals exposed to infectious agents during research, production of biologicals, or testing of pharmaceuticals)?
5
Which group of Regulated Medical Waste (RMW) deals with isolation Wastes (including bedding from patients or animals from BioSafety Level 4 (BSL 4) agents)?
6
Which group of Regulated Medical Waste (RMW) deals with unused sharps?
7
Which group of Regulated Medical Waste (RMW) deals with other (including fluids that are designated by the local infection control authority)?
8
Which group of Regulated Medical Waste (RMW) deals with Chemotherapy Trace Wastes?
9
Which category of Regulated Medical Waste (RMW) 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?
Animal Waste
How many Bio Safety Levels are there with specific combination of work practices, safety equipment, and facilities, which are designed to minimize the exposure of workers and the environmental to infectious agents?
4
Which Bio Safety Level is the most stringent and applies for work with dangerous and exotic agents that pose a high individual risk of life threatening disease, which may be transmitted via the aerosol route and for which there is no available vaccine or therapy?
Level 4
Which type of waste is a 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
What are defined as 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
Which type of waste qualifies as both Regulated Medical Waste (RMW) and hazardous waste? For example a syringe used to administer a medication that classifies as a pharmaceutical Hazardous Waste (HW) or dental amalgam waste be an example of?
Dual
What is a Solid Waste (SW), or combination of Solid Waste (SW), which, because of its quantity, concentration, or physical, chemical, or infectious characteristics, may cause or significantly contribute to an increase in mortality or an increase in serious irreversible or incapacitating reversible illness or 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 (HW)
Which type of waste would 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
Which type of waste would 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)?
Non-Regulated Medical Waste (RMW)
Which type of waste would include 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?
Pathological
These wastes are typically not considered pathological waste if they have been fixed in ________ and should then be disposed of per state, local, or Final Governing Standards (FGS) regulations.
Formaldehyde
What is a devise or item to be worn, used, or put in place for the safety or protection of an individual or the public at large, when performing work assignments in or entering hazardous areas or under hazardous conditions? Equipment includes an article of clothing, hearing and eye protection, respirators, etc.
Personal Protective Equipment (PPE)
Which type of waste is 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 (RMW)
Which type of waste are used or unused hypodermic needles, syringes (with or without the attached needles), Pasteur pipettes, scalpel blades, blood collection and vials, test tubes, needles attached to tubing, dental burs, endodontic files, culture dishes (regardless of presence of infectious agents), glassware (broken or unbroken), damaged dishes, dishes with sharp edges that were in contact with infectious agents, microscope slides, and cover slips?
Sharps
Chemotherapy trace waste is defined as needles, empty vials, syringes, gowns, and tubing that contained chemotherapeutic pharmaceuticals or were exposed to chemotherapeutic pharmaceuticals during treatment of the patients. These wastes must be classified as empty (less than what percent of its full capacity remaining) to meet this definition?
3%
Chemotherapy trace wastes that are not classified as empty must be managed as?
Bulk chemotherapy waste
Who is responsible for formulating and disseminating Navy Medicine policy and guidance related to the management of Regulated Medical Waste (RMW)?
Chief, BUMED
Who is responsible for ensuring that Regulated Medical Waste (RMW) is identified and managed according to existing regulations and policies, including adherence to the most stringent requirements applicable to a site are followed?
Environmental Program Manager (EPM)
How many years after being appointed must the Environmental Program Manager (EPM) take environmental training?
1 year
How often at a minimum must the Environmental Program Manager (EPM) visit each subordinate command to assess the environmental compliance posture and provide assistance as required?
Annually
Who is responsible for providing overall management of the Regulated Medical Waste (RMW) program for the site, including proper segregation, collection, storage, preparation for transport, and recordkeeping?
Environmental Point of Contact (EPOC)
How often must employees handling Regulated Medical Waste (RMW) receive environmental refresher training?
Annually
Within the facility, all non-sharps RMW must be placed in containers appropriate for the waste that are clearly marked with the universal biohazard symbol, labeled with the word “BIOHAZARD”, and what in color?
Red
Containers used for the collection of non-sharp RMW must be lined with plastic RMW bags that are marked and certified by the manufacturer to meet the 165 gram (g) Impact Strength American Society for Testing and Materials (ASTM) D 1709-01 and the how many grams Tear Strength ASTM D 1922-00a standards?
480g
Sharps must be collected in rigid, red, or clear containers that are ________-________ and both the container and exterior container (i.e., wall mount) must be marked with the international biohazard symbol.
puncture-resistant
Per Occupational Safety and Health Administration (OSHA) interpretation, all Regulated Medical Waste (RMW) containers must remain what when not in use?
Closed
What are vaccines containing thimerosal managed as?
Hazardous Waste (HW)
What type of waste must be placed in a rigid Regulated Medical Waste (RMW) container lined with a compliant RMW bag or double-bagged and labeled appropriately?
Ethical considerations may dictate using alternative means of disposal such as cremation or burial by whom?
Pathological Waste
Licensed mortician
Pathological waste must be placed in frozen storage if it is to be maintained on-site longer than how many hours?
24 hours
Which type of waste are extracted teeth considered to be?
Regulated Medical Waste (RMW)
Which type of waste are extracted teeth with amalgam considered to be?
Dual
Which type of waste are placentas considered to be if managed by the facility?
Pathological
Which Regulated Medical Waste (RMW) group may include but are not limited to semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid, and amniotic fluid?
** This group includes fluids that are designated as Regulated Medical Waste (RMW) by the local Infection Control (IC) authority **
Group 8
Generally, what color are the chemotherapeutic trace waste containers?
** Do not mix chemotherapy trace wastes with non-chemotherapy Regulated Medical Waste (RMW) or Hazardous Waste (HW) **
Yellow
What should not be used to transport Regulated Medical Waste (RMW)?
** Avoid busy patient areas or use freight elevators **
Chutes and Dumbwaiters
If frozen, pathological waste may remain in storage on-site up to how many calendar days?
30 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 how many calendar days unless the waste becomes putrescent within a shorter storage duration?
7 days
Interim and final Regulated Medical Waste (RMW) storage areas must be constructed to prevent pest access, and to allow for easy cleaning, especially of spills. The entrance(s) to the storage area must be labeled as “BIOHAZARD” and marked with the universal biohazard symbol. If the signage cannot be placed on the door, it must be placed on the wall directly adjacent to the entry. Per BUMEDINST 6220.14, 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 how many feet?
5 feet
What type of vehicles are authorized for use to transport Regulated Medical Waste (RMW) between locations and are easily cleaned and disinfected? It contains a spill kit with appropriate PPE.
Designated government-owned vehicles
Regulated Medical Waste (RMW) that will be transported over public roadways to an off-site treatment and disposal facility is typically removed by a Regulated Medical Waste (RMW) disposal contractor. This waste must be packaged per which reference including labeling requirements?
49 CFR 100-185, Hazardous Waste Regulation
Which type of waste is treated or disposed by being incinerated, thermally inactivated, chemically disinfected (liquids only), or treated by steam sterilization followed by incineration or grinding?
Group 1: Cultures, stocks, and vaccines.
What type of waste is treated or disposed by being discharged to the sanitary sewer or if not allowed, be steam sterilized or incinerated?
Group 3: Blood and blood products
Steam sterilization must be achieved per equipment manufacturer recommendations, including equipment maintenance and testing. 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 how often to test the sterilization process?
Weekly
Command and job specific training must occur prior to beginning work, and how often thereafter for all employees with occupational exposure to Regulated Medical Waste (RMW)?
Annually
Employees in continental United States locations responsible for packaging the Regulated Medical Waste (RMW) for off-site transport or signing the shipping documents and manifests must complete training that is specific for Class 6-Division 6.2 hazardous materials and compliant with the requirements of 49 CFR 100-185. Initial training is required as soon as possible, but not longer than how many days, upon assuming duties?
How often is this training refreshed thereafter?
90 days
24 months
What document outlines the cradle-to-grave management of RMW specific to the generating processes at the facility and must include a contingency plan for the management of RMW should the primary means become unavailable or should environmental conditions temporarily prevent the removal of RMW from the facility?
Medical Waste Management Plan
How often is the Medical Waste Management Plan reviewed?
Annually
Each facility must develop a site-specific Medical Waste Management Plan. Modifications to the plan must be made within how many days of the annual review or following a significant process change?
90 days
How many years from the date of training must all training records be retained for?
3 years
Facilities must maintain Regulated Medical Waste (RMW) shipping documents and manifests for at least how many years after the waste was accepted by the transporter?
2 years
If Regulated Medical Waste (RMW) is transported off-site, the receiving facility must provide written documentation certifying proper treatment and disposal to the generating facility. In the event that this documentation is not received within how many days, the Environmental Program Manager (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?
60 days
What departments are consulted for additional information about potential occupational exposure to RMW?
Safety Department and Occupation Health Department
