Transcript Environmental Services Professional Training Course

Environmental Services
Professional Training Course
Morning Schedule
(15 min.) Introductions
(15 min.) Course Development and
Objective, Pre-test, Overview of
Occupational Hazards, Definitions
(60 min.) Microorganisms & Infectious
Agents (show 27 min. video before
lecture/discussion)
(15 min.) Break
(75 min.) Infectious Waste (includes 22 min.
video)
Morning Schedule
(40 min.) Cleaning for Health
(50 min.) Lunch
Afternoon Schedule
(40 min.) Hazardous Material Safety
(40 min.) Needlestick and Injury Prevention
(15 min.) Break
(30 min.) Spill Response
(60 min.) Regulated Medical Waste
Transportation Requirements
(45 min.) Post Test and Course Evaluations
Course Objective - to provide environmental
services professionals with the information
they need to do their jobs safely.
Occupational hazards associated with
handling infectious waste, disinfecting
contaminated surfaces, and responding to
infectious materials incidents
•
• Infection control on the job
• Material Safety Data Sheets and hazards
associated with the use of chemical
disinfectants
• Selection of proper personal protective
equipment
• Housekeeping and spill response
procedures
• The American Hospital Association’s
infectious waste reduction initiative
sponsored by the EPA
• Requirements for packaging and
transporting infectious or regulated medical
waste
Occupational Hazards
1.0 Overview of Occupational Hazards
When they enter patient
rooms, they may become
exposed to infectious diseases.
They risk exposure to
bloodborne pathogens from
dirty needles that are
occasionally thrown away in the
biohazard and general waste
streams.
They work with chemicals that
are often corrosive and
dangerous if not handled
properly.
They are a category of worker
at risk of latex allergy from
ongoing latex exposure.
They may become injured from
slips, trips, and falls, or heavy
lifting.
Microorganisms & Infectious
Agents
2.0 Microorganisms & Infectious Agents
1. Bacterial agents - Tuberculosis (TB),
Staphylococcus (staph), or Legionella
2. Fungal agents - Aspergillus (mold), Tinea
(ringworm)
3. Viruses - Hepatitis B, Hepatitis C, HIV
4. Parasitic agents - Giardia and
Trichomoniasis
5. Prions - Kuru and Creutzfeldt-Jakob
Disease
6. Rickettsial agents - Rocky Mountain
spotted fever and Lyme Disease
In order for an infectious agent to make a
person sick, it must first come into contact
with that person. This contact is called an
exposure.
EXAMPLE 1 - Tuberculosis
In a 1995 publication, CDC researchers
reported the results of a study that found
the annual risk of contracting TB was
higher for hospital housekeepers than
nurses.
EXAMPLE 2 - Hepatitis B
There are two ways to reduce the rate of
HBV transmission from needlestick injuries
and they are:
1) To get a Hepatitis B vaccination
2) To report all needlestick injuries to the
infection control nurse and accept postexposure treatment.
Environmental services professionals can
prevent the spread of infectious agents
among patients and healthcare workers by
protecting themselves in the following
ways:
• Wearing puncture resistant gloves while
handling any form of hospital waste to
include biohazard bags, infectious waste
containers, and trash bags of any color
• If puncture resistant gloves are worn,
wash gloves between patient rooms to
avoid transfer of microorganisms from one
patient to another
• Wear proper personal protective
equipment when cleaning up spills of
potentially infectious material
• Use an antibacterial soap to wash gloves
immediately after contact with blood
and/or body fluids, soiled linen, or
contaminated equipment
• Immediately report needlestick and
other sharps-related injuries to the
infection control staff
• Follow any recommendations made by the
infection control staff after a potential
exposure to prevent infection
• Follow recommended infection prevention
practices to include receiving the hepatitis B
vaccination
• Participate in OSHA bloodborne pathogen
training
• Wash hands immediately after removing
gloves
• Wash hands before and after eating,
smoking, applying cosmetics, or preparing
food
• Stay home to rest when feverish and sick
with a cold, flu, or other infection
Infectious Waste
3.0 Infectious Waste
• Isolation wastes are those made in
isolation rooms where patients with
infectious diseases are cared for.
• Cultures and stocks are wastes generally
made in the laboratory and may include
specimen cultures, discarded vaccines,
culture dishes, and devices used to transfer,
inoculate, and mix cultures.
• Human blood and blood products are
wastes that can be found anywhere in the
health care facility but most often they are
found in the laboratory, operating rooms,
and labor and delivery areas - these wastes
include blood, serum, plasma, and other
blood products.
• Pathological wastes are wastes generally
found in the pathology labs and autopsy
suites - these wastes include tissues, organs,
body parts, and body fluids that are removed
during surgery and autopsy.
• Contaminated sharps are wastes that can
be found in areas where patients are treated
and the laboratory - these wastes include
hypodermic needles, syringes, glass
pipettes, broken glass, and scalpel blades.
• Contaminated carcasses, body parts, and
bedding are wastes that can be found in a
medical research laboratory where animals
are exposed to infectious microorganisms.
• Miscellaneous wastes are those items that
are probably contaminated with infectious
microorganisms - they include contaminated
materials found in the dialysis units, surgery
and autopsy suites, and laboratory areas.
If an item has come in to contact with blood
or body fluids, it is considered contaminated
and probably infectious, therefore, it should
be treated as infectious waste.
All infectious waste must be disposed of
properly in accordance with a federal law
known as the OSHA Bloodborne Pathogens
Standard. Proper disposal means the
following:
• All needles and other contaminated
sharps must be placed in a closable,
puncture-resistant, leakproof, red or
biohazard-labeled container.
• All other infectious wastes must be placed
in closable, leakproof, red or biohazardlabeled bags or containers.
Red Bag
Biohazard Label
Biohazard Labeled Bag or Container
Hospitals produce approximately two million
tons of solid waste per year. Of this amount,
ten to fifteen percent is categorized as
infectious and the rest is general waste made
up of paper and paper board, plastics, food
waste, metal, glass, wood and other
materials. All of the solid waste is sent to
landfills or incinerators for disposal.
If 100% of hospital solid waste is disposed
of in red bags...
Only about 10% of the waste is actually
infectious ...
And 2% of the waste is pathological,
requiring incineration.
• According to the EPA, medical waste
incinerators are the fourth largest known
releasers of mercury to the environment.
• Mercury waste is being improperly
disposed of in biohazard bags along with
other solid wastes that are not considered
infectious.
• Mercury cannot be destroyed by
incineration.
• Thirty nine states have issued over 1,600
warnings against eating mercury
contaminated fish found in their waterways.
Because of all of the environmental health
problems caused by medical waste
incinerators, the American Hospital
Association and the EPA have reached an
agreement to work together to reduce the
amount of waste within the hospital system
by half by the year 2010.
A number of actions can be taken to reduce
the amount of solid waste within the hospital
system that is sent in biohazard bags to
medical waste incinerators for disposal.
• Work with hospital administrators to
develop policies that support biohazard bag
reduction efforts.
• Provide information to all hospital staff
about the toxic contaminants created by
medical waste incineration.
• Educate staff about different categories of
infectious waste and teach them to place
only infectious wastes in biohazard bag
containers.
• Place and maintain biohazard bag
containers only in those areas where
infectious wastes are likely to be made.
• Place and maintain special biohazardlabeled containers in areas where
pathological wastes are likely to be made and
teach staff to only place pathological wastes
in them.
• Keep pathological wastes separate from
the other infectious wastes.
• Send only pathological wastes to a
medical waste incinerator for disposal.
• Make alternative arrangements to
properly treat and dispose of all other
infectious waste (e.g. autoclaves,
microwaves, chemical treatment).
Cleaning for Health
4.0 Cleaning for Health
The goal of a health care facility cleaning
program is to prevent the spread of
infectious agents among patients and
healthcare workers and to maintain a
healthy indoor environment. A healthy
indoor environment is one that is free of
hazardous pollutants.
• Organic Pollutants - chemical compounds
such as formaldehyde, pesticides, and
disinfectants
• Inorganic Pollutants - particles such as
asbestos and lead
• Radiation - pollutants include both ionizing
(e.g. radon) and non-ionizing (e.g.
electromagnetic fields) types.
• Complex Mixtures - examples include soot
and tobacco, both of which contain organic
and inorganic matter.
• Biological Contaminants - referred to as
bio-pollutants. Examples include bacteria,
viruses, algae, fungi, ragweed, mites.
Biological contaminants are the most
hazardous pollutants found in the indoor
healthcare facility environment.
They are living organisms, or come from
living organisms, and can be found under
certain environmental conditions:
1. There must be a comfortable home or
reservoir in which to hang out which is just
about anyplace, and
2. They need nourishment just like us in the
form of food and water.
What kind of food do these organisms “eat?”
Aspergillus is a fungus
found in dust and is an
example of a common
biological contaminant
that lives well in soil,
water and decaying
material. In health care
facilities, it may be found
in the building ventilation system in areas
where organic matter (dust) and water are
present. Where would you expect to find this
organism in a health care facility? Can this
organism kill a patient?
Another deadly biological contaminant found
in the healthcare facility is a bacteria named
Vancomycin-resistant enterococci. (VRE).
The reason why this bacteria is deadly is
because it cannot easily be killed by
antibiotics and many patients die once they
become infected with it.
How do you think patients become infected
with this bacteria?
If someone comes into the hospital carrying
the VRE bacteria, then whatever that person
touches may become contaminated with
VRE. Deadly VRE can survive for weeks on
environmental surfaces.
Patients may become infected with VRE by
touching contaminated surfaces such as
bedrails, sinks, faucets, and doorknobs, or
coming into contact with health-care
workers who do not wash their hands.
Environmental services professionals play a
key role in controlling the spread of VRE
throughout the healthcare facility by
washing hands and wearing gloves properly,
and diligently cleaning and disinfecting all
environmental surfaces.
Surfaces with regular hand-contact are
called high touch surfaces. High touch
surfaces in patient care areas include
items such as telephones, doorknobs,
bedrails, light switches, faucets, and wall
areas around the toilet. These surfaces
must be cleaned and disinfected daily to
protect the patient and reduce the spread
of nosocomial diseases such as VRE.
Nosocomial diseases are illnesses that
patients acquire during their stay in the
hospital.
Clostridium difficile
The primary goal of a health care facility
cleaning program is to prevent the spread of
nosocomial disease among patients and
healthcare workers. Environmental services
professionals play an important role in
achieving this goal.
Daily cleaning reduces the amount of
microorganisms in the patient care
environment.
Suggestions for improving the general
cleaning and disinfecting process:
• When selecting a disinfectant for use,
choose the least toxic and most effective
cleaning product you can find.
• Always clean from least soiled to more
soiled areas and from top to bottom in the
patient rooms.
• Always change the disinfecting solution
when it appears dirty (usually after every 34 patient rooms).
• Use a clean cloth or mop head each time a
bucket of detergent/disinfectant is emptied
and replaced with fresh, clean solution.
• Dusting reduces potential food for
Aspergillus and prevents infection in
hospitalized patients and allergies in
employees.
• Dust can be removed without making
patients sick by using a chemically treated
cloth/mop or a cloth dampened with
approved disinfectant.
• When dusting, it is important NOT to
shake the cloth/mop because dust and
fungal spores will then get in the air. If
patients breathe in these spores, they may
get sick and die.
• While dusting ceilings and vents, report
any stains and/or wet areas immediately for
repair. Fungus will start to grow on wet
ceiling tiles within 72 hours.
Special care areas need additional attention.
What are special care areas?
Process improvement for special care areas :
• Use a bucket method for cleaning each
special care area, where a clean cloth is
dipped into a bucket filled with approved
disinfectant and items are cleaned and left
wet for ten minutes.
• Daily cleaning should include the washing
and disinfecting of walls around light
switches, doorknobs, and other high touch
surfaces.
• Use CLEAN mops and CLEAN mop water for
cleaning and disinfecting the floor in each
special care or isolation room.
• When a patient is discharged from a
special care area, throw away all disposable
items, change any cubicle curtains, and
disinfect all surfaces including chairs, tables,
ledges, call lights, telephones, sinks,
showers, and toilets.
• Avoid the use of cleaning equipment that
produces mists.
• If a vacuum is needed to clean the floor in
a special care area, use one with a clean
HEPA filter on the exhaust. Keep the door to
the special care area closed when
vacuuming.
It can not be emphasized enough.
Environmental services professionals play a
key role in preventing the spread of
infectious agents among patients and
healthcare workers.
Diligent housekeeping keeps
microorganisms and other bio-pollutants
under control and reduces the spread of
nosocomial disease.
What is nosocomial disease?
Hazardous Material Safety
5.0 Hazardous Material Safety
Environmental services professionals
routinely use chemical disinfectants to clean
surfaces and kill infectious agents in patient
rooms and other areas of the health care
facility. If not handled properly, these
chemicals can cause serious injuries such as
eye damage, respiratory problems, chemical
burns, or severe skin irritation. To prevent
such injuries, the OSHA Hazard
Communication Standard requires all health
care employers to provide information and
training to their employees about the
hazards associated with the chemicals in
their workplace.
Employers must provide training to their
employees on the following topics:
• Ways or how to detect the presence or
release of a hazardous chemical in the
workplace
• The physical and health hazards of the
chemicals in the workplace and the
measures that can be taken by
environmental services staff to protect
themselves from these hazards, including
safe work practices, emergency procedures,
and personal protective equipment to be
used
• The facility’s hazard communication
labeling system, the hazard information
provided by the MSDS, and how personnel
can obtain and use the hazard information
on the MSDS
In order to understand the hazard
information provided by the MSDS,
environmental services professionals must
first learn something about the nature of
chemicals. Chemicals are made up of single
or multiple elements.
Oxygen - one element, two molecules of
oxygen (02)
Water- two elements, two molecules of
hydrogen and one molecule of oxygen (H20)
The most common chemicals in use are
made up of three elements - carbon,
hydrogen, and oxygen.
What are some chemicals used everyday in
healthcare facilities?
Chemicals also come in different forms solids, liquids, gases, or vapors, and can
even be radioactive.
H-3, also known as Tritium, is an example of
a radioactive material which is made up of
three hydrogen molecules. It is often used
by scientists in biomedical research
laboratories.
Chemicals change from one form to another
depending on temperatures and pressures.
Water turns to ice when the temperature
drops below 32 degrees F. When water is
heated to the boiling point, it evaporates
and turns into a vapor. Some chemicals
evaporate at or below room temperatures
becoming airborne vapors.
Gasoline is a common chemical that
becomes an airborne vapor at and below
room temperature. It is very flammable
with a flash point of -45 degrees F.
In addition to being flammable, gasoline
vapors are very dangerous because they are
harmful to human health.
Any chemical can be harmful to human
health. How harmful a chemical is depends
on how much of it gets into the body and
how toxic it is.
Chemicals can enter the body in one of
four ways:
• They can be inhaled (breathed in);
• They can be ingested (swallowed);
• They can be absorbed through the skin
or eyes; or
• They can be injected.
When a chemical enters the body, an
exposure has taken place. The effects of
the exposure can be either sudden or long
term.
Example: The effects of formaldehyde
exposure can either be sudden or long
term. Formaldehyde is both corrosive and
a suspected carcinogen.
It is very important to wear Personal
Protective Equipment (PPE) when working
with corrosive material.
OSHA has set guidelines for safe levels of
exposure to many airborne contaminants
including mists, gases, vapors, dusts, and
fibers. These are known as Permissible
Exposure Levels or PELs. The American
Conference of Governmental Industrial
Hygienists (ACGIH) has also set guidelines
for safe levels of exposure to many
contaminants. These are known as
Threshold Limit Values or TLVs. If a safe
exposure level has been identified by OSHA
or the ACGIH for a particular material, then it
will be provided on the MSDS.
Unsafe levels of exposure may occur in the
work place at any time in the event of a spill
or release of a hazardous material. It is
therefore very important that workers know
where hazardous materials are stored or
used and how to detect a spill or release in
their work place.
Some hazardous materials have warning
properties that alert the worker to a
potential exposure in the event of a release.
Examples of warning properties include odor,
headache, burning or tearing eyes, or
coughing.
Not all hazardous materials have warning
properties and in some cases the warning
properties do not occur until after the
employee has been exposed to a dangerous
amount of material. In such cases,
employers may install alarm systems that go
off when levels of exposure are immediately
dangerous to life and health.
Example: Ethylene oxide is a toxic gas that is
used in many healthcare facilities to sterilize
surgical instruments. It is considered a
carcinogen and a reproductive hazard.
Some hospitals have eliminated the use of
ethylene oxide altogether. They have found
a less hazardous material to use in their
sterilizers. Using a less hazardous material
to do the same job is known as
“substitution.”
If a substitute material cannot be found to
do the job, a toxic or other hazardous
material can be used safely in the work
place as long as precautions and procedures
are in place to protect the worker from
exposure.
Safe work practices or precautions for
using a particular chemical may be found
in the MSDS or on the product label.
Below are some common precaution
statements found on product labels:
• Use with adequate ventilation;
• Keep away from sources of ignition (e.g.
heat, flame);
• Wear chemical splash goggles;
• Wear rubber gloves to avoid skin
contact.
The MSDS will state what type of PPE the
worker needs to wear to prevent exposure
while handling the material. If an exposure
does occur, the MSDS also provides health
hazard and emergency first aid information.
To summarize, manufacturers must develop
a Material Safety Data Sheet (MSDS) and
provide it to people and organizations that
purchase their products. Employers such as
hospital organizations are then required to
train their employees on the hazard
information provided by the MSDS.
Needlestick and Injury
Prevention
6.0 Needlestick and Injury Prevention
It is estimated that 600,000 to 800,000
needlestick and other percutaneous injuries
occur annually among health care workers in
the United States. About half of these
injuries go unreported. Data suggests that at
an average hospital, approximately 30
needlestick injuries occur per year for every
100 beds.
How many beds are in the hospital that you
work at?
Of the reported needlestick injuries,
approximately 41% occur for the following
reasons:
• Improperly disposed sharp;
• Disposal-related causes;
• Collision with health care worker or
sharp; and
• Cleanup.
To reduce the risk of needlestick and other
injuries, the following control measures are
recommended to protect the environmental
services professional:
• Always wear whatever personal protective
equipment is necessary to do the task safely
to protect your skin, work clothes, and
mucous membranes from contact with
potentially infectious materials (e.g. gloves,
masks, face shields, gowns, and aprons).
• A gown or apron should be worn if there is
a possibility of contact with infectious
materials on your work clothes.
• A mask and goggles or eye protection
should be worn if there is a possibility of
contact with infectious materials in your eyes,
nose, or mouth.
• Gloves should be worn to protect your
hands from contact with chemicals and
potentially infectious materials.
• Wear puncture resistant gloves when
performing high risk tasks (e.g., changing out
needle boxes, cleaning up broken glass,
handling infectious waste containers).
• Report to management any needles or
other sharp items not properly disposed of by
the health care providers.
• Locate puncture resistant leak-proof
containers for sharps and needle disposal in
areas where they are convenient and likely to
be used by health care providers.
• Ensure that sharps and needle disposal
containers are emptied before they become
full.
• Report to management any sharps
containers that are mounted too high or are
not easily accessible to health care providers.
• Use a brush and dust pan to pick up broken
glass which may be contaminated with blood
or other body fluids.
• Handle contaminated laundry including
sheets as little as possible. Do not shake out
these items. Hold them away from your body
and place in the linen hamper without
pressing down on them.
• Carry red bags or other containers of
medical waste away from your body.
• When cleaning up contaminated areas,
minimize splashing, spraying, and spattering.
• Bandage any cuts on your hands before
putting on gloves.
• If latex gloves are worn, always wash and
remove them after cleaning a patient’s room
or any other potentially contaminated area.
• Dirty gloves should never be worn after the
cleaning job is done - wearing them around
the hospital contaminates surfaces and
spreads disease among the patients.
• Always wash hands after removing gloves
and whenever they are dirty.
• Always wash hands in between patient
rooms.
• Follow safe work practices (e.g., do not eat,
drink, smoke, apply lip balm, or handle
contact lenses where there might be
exposure to blood or other potentially
infectious materials).
• Keep food and drinks away from areas
where blood or other potentially infectious
materials are present.
• Report needlestick injuries and other
potential bloodborne pathogen exposures to
the infection control staff at your health care
facility.
• Follow any recommendations made by
the infection control staff after a potential
exposure.
• Ask the infection control staff at your
health care facility about the free Hepatitis
B vaccine that is provided to environmental
services professionals
Spill Response
7.0 Spill Response
Environmental services professionals
routinely respond to calls for assistance in
cleaning up spilled materials on the patient
wards and other areas of the hospital. The
spilled materials often consist of human
body fluids such as urine, blood, and feces
that may or may not be infectious.
Regardless of whether or not the material
is actually infectious, any human body
fluid must be considered potentially
infectious.
The environmental services professional
should receive training on the following
topics:
• The health care facility emergency
response plan for hazardous materials spills
(e.g. notification, personal protective
equipment (PPE), spill response and
equipment maintenance procedures, etc…);
• The different types of micro-organisms
potentially found in their workplace to which
they are susceptible (e.g. E. coli, MRSA, VRE)
along with definitions and symptoms of
exposure;
• Spill site security and control;
• The measures that environmental services
professionals can take to protect themselves
to minimize their risks of exposure during
cleanup operations to include wearing
proper PPE;
• Contaminated surface cleaning
procedures;
• Disinfectant selection and effective
decontamination procedures;
• Proper disposal procedures for potentially
infectious waste materials;
• Removing PPE, decontamination and/or
disposal procedures; and
• The health care facility exposure control
plan for bloodborne pathogens and
employee health and medical surveillance
program.
Do environmental services professionals
require special training to clean up
hazardous material spills in the hospital
environment?
Depends on whether or not the spill is
considered “incidental.”
An incidental spill is a release of hazardous
material which does not have the potential
to become an emergency within a short time
frame. Incidental releases are limited in
quantity, exposure potential, or toxicity and
present minor safety or health hazards to
employees in the immediate work area or
those assigned to clean them up. An
incidental spill may be safely cleaned up by
an employee who is familiar with the hazards
of the material.
It is up to management personnel to decide
whether or not a spill is incidental.
Medical Waste Transportation
8.0 Regulated Medical Waste Management,
Disposal, and Transportation Requirements
There is a great deal of concern about the
proper management of health care facility
wastes. Environmental services professionals
are responsible for picking up the waste at
each point of generation and transporting it to
the designated place of disposal or storage at
the facility. If certain wastes are mishandled
or improperly disposed of, health care
facilities may be subject to fines. Some of the
waste generated in the health care setting
could be infectious and transmit disease if
improperly handled or disposed of.
It is important that environmental services
professionals receive training on the
following topics:
• The health care facility waste management
plan
• The different types of waste streams at the
facility for which they will be responsible
• The definition and/or designation of
infectious waste including where it is likely
to be generated and how it is to be
segregated from the other waste streams
• Proper segregation, containment, and
labeling of wastes in the health care
facility
• Department of Transportation (DOT)
shipping regulations for infectious and/or
regulated medical waste transported off-site
for treatment/incineration
• State or local regulations for medical
and/or infectious waste disposal
OSHA regulates infectious waste in the
workplace by enforcing the requirements of
the Bloodborne Pathogens Standard. When
environmental services professionals pick
up infectious waste at each point of
generation in the healthcare facility and
transport it to the designated place of
treatment or storage at the facility they
must do so “in accordance with OSHA
regulations”. What does this mean?
The infectious waste may or may not be
treated on-site at the health care facility
prior to shipment off-site for final disposal.
If the waste is treated on-site at the facility
so that it no longer poses the hazard of an
infectious substance, then it is no longer
considered infectious and may be
transported off-site as general waste to a
solid waste disposal facility (e.g. landfill,
transfer station) regulated by state or local
authorities.
If the waste is not treated on-site, then it is
considered infectious and a DOT hazardous
material, and it must be transported off-site
in accordance with DOT shipping
regulations for hazardous materials.
DOT regulations require that all infectious
substances, including regulated medical
waste, be prepared for shipment off-site by
trained personnel. Specifically, personnel
must receive initial and recurrent training
(every two years) that meets the DOT
training requirements in three subject
areas.
1. General awareness/familiarization
training to enable the employee to recognize
and identify regulated medical waste as
defined by DOT;
DOT Definition of Regulated Medical Waste a waste, or reusable material, that contains
an infectious substance and is generated in
the diagnosis, treatment, or research of
humans or animals
2. Function-specific training to familiarize
the employee with the DOT shipping
requirements related to the job that he/she
performs;
3. Safety training concerning the specific
hazards associated with regulated medical
waste, safe handling of packages
containing regulated medical waste, and
the emergency response procedures and
information required by DOT for every
regulated medical waste shipment in the
event of an accidental release.
DOT requires that personnel be tested after
receiving the training on the three subject
areas.
A record of current training must be kept by
the health care facility for each employee
that prepares regulated medical waste for
shipment off-site to a treatment facility.
Each record must include the employee’s
name, the most recent training date, a copy
of the training materials, the name and
address of the trainer, and a certification
that the employee was trained and tested.
In accordance with DOT shipping
regulations, regulated medical waste must
be shipped in packages that are properly
labeled and marked (see DOT brochure).
A shipping paper must also be prepared
for every regulated medical waste
shipment that leaves the health care
facility.
A description of the regulated medical
waste shipment must be included on the
shipping paper as well as the name of the
health care facility and an emergency
response telephone number.
The description of the waste shipment on the
shipping paper must include:
• The proper shipping name, Regulated
Medical Waste;
• The hazard class, 6.2;
• The identification number, NA 3291; and
• Packing group, II.
The total quantity of the medical waste
being shipped off-site for treatment must
also be entered on the shipping paper (see
example).
It is important for environmental services
professionals to understand that untreated
regulated medical waste is considered an
infectious substance and a DOT hazardous
material. It must be transported from the
health care facility in accordance with DOT
shipping regulations.
If untreated regulated medical waste is
improperly disposed of in the general solid
waste stream and transported off-site to a
transfer station or landfill, the healthcare
facility will be subject to fines levied by
the local government and the federal DOT.
$25,000.00