Hazardous Materials Disposal/Accident Documentation and Investigation

DISPOSAL OF HAZARDOUS MATERIALS

The safe handling and disposal of chemicals and other materials require a thorough knowledge of their proper ties and hazards. Generators of hazardous wastes have a moral and legal responsibility, as defined in applicable local, state, and federal regulations, to protect both the individual and the environment when disposing of waste.

There are four basic waste-disposal techniques: flushing down the drain to the sewer system, incineration, landfill burial, and recycling.

Chemical Waste

In some cases, it’s permissible to flush water-soluble substances down the drain with copious quantities of water. However, strong acids or bases should be neutralized before disposal. Foul-smelling chemicals should never be disposed of down the drain. Possible reaction of chemicals in the drain and potential toxicity must be considered when deciding if a particular chemical can be dissolved or diluted and then flushed down the drain. For example, sodium azide, which is used as a preservative, forms explosive salts with metals, such as the copper, in pipes. Most institutions ban the use of sodium azide due to this hazard.

Other liquid wastes, including flammable solvents, must be collected in approved containers and segregated into compatible classes. If practical, solvents such as xylene and acetone may be filtered or redistilled for reuse. If recycling is not feasible, disposal arrangements should be made by specifically trained personnel.

Flammable material also can be burned in specially designed incinerators with afterburners and scrubbers to remove toxic products of combustion.

Also, before disposal, hazardous substances that are explosive (e.g., peroxides) and carcinogens should be transformed to less hazardous forms whenever feasible.

Solid chemical wastes that are unsuitable for incineration must be buried in a landfill. This practice, however, has created an environmental problem, and there is now a shortage of safe sites.

Radioactive Waste

The manner of use and disposal of isotopes is strictly regulated by the NRC and depends on the type of waste (soluble or nonsoluble), its level of radioactivity, and the radiotoxicity and half-life of the isotopes involved. The radiation safety officer should always be consulted about policies dealing with radioactive waste disposal. Many clinical laboratories transfer radioactive materials to a licensed receiver for disposal.

Biohazardous Waste

On November 2, 1988, President Reagan signed into law The Medical Waste Tracking Act of 1988. Its purpose was to (1) charge the Environmental Protection Agency with the responsibility to establish a program to track medical waste from generation to disposal, (2) de fine medical waste, (3) establish acceptable techniques for treatment and disposal, and (4) establish a department with jurisdiction to enforce the new laws. Several states have implemented the federal guidelines and incorporated additional requirements. Some entities covered by the rules are any health care-related facility including, but not limited to, ambulatory surgical centers; blood banks and blood drawing centers; clinics, including medical, dental, and veterinary; clinical, diagnostic, pathologic, or biomedical research laboratories; emergency medical services; hospitals; long-term care facilities; minor emergency centers; occupational health clinics and clinical laboratories; and professional offices of physicians and dentists.

Medical waste is defined as special waste from health care facilities and is further defined as solid waste that, if improperly treated or handled, "may transmit infectious diseases." (For additional information, see the TJC: jointcommission.org). It comprises animal waste, bulk blood and blood products, microbiologic waste, pathologic waste, and sharps. The approved methods for treatment and disposition of medical waste are incineration, steam sterilization, burial, thermal inactivation, chemical disinfection, or encapsulation in a solid matrix.

Generators of medical waste must implement the following procedures:

¦ Employers of health care workers must establish and implement an infectious waste program.

¦ All biomedical waste should be placed into a bag marked with the biohazard symbol and then placed into a leakproof container that is puncture resistant and equipped with a solid, tight-fitting lid. All containers must be clearly marked with the word biohazard or its symbol.

¦ All sharp instruments, such as needles, blades, and glass objects, should be placed into special puncture resistant containers before placing them inside the bag and container.

¦ Needles should not be transported, recapped, bent, or broken by hand.

¦ All biomedical waste must then be disposed of according to one of the recommended procedures.

¦ Potentially biohazardous material, such as blood or blood products and contaminated laboratory waste, cannot be directly discarded. Contaminated combustible waste can be incinerated. Contaminated noncombustible waste, such as glassware, should be autoclaved before being discarded. Special attention should be given to the discarding of syringes, needles, and broken glass that also could inflict accidental cuts or punctures. Appropriate containers should be used for discarding these sharp objects.

ACCIDENT DOCUMENTATION and INVESTIGATION

Any accidents involving personal injuries, even minor ones, should be reported immediately to a supervisor.

Under OSHA regulations, employers are required to maintain records of occupational injuries and illnesses for length of employment plus 30 years. The record keeping requirements include a first report of injury, an accident investigation report, and an annual summary that is recorded on an OSHA injury and illness log (Form 300).

The first report of injury is used to notify the insurance company and the human resources or employee relations department that a workplace injury has occurred.

The employee and the supervisor usually complete the report, which contains information on the employer and injured person, as well as the time and place, cause, and nature of the injury. The report is signed and dated; then, it’s forwarded to the institution's risk manager or insurance representative.

The investigation report should include information on the injured person, a description of what happened, the cause of the accident (environmental or personal), other contributing factors, witnesses, the nature of the injury, and actions to be taken to prevent a recurrence.

This report should be signed and dated by the person who conducted the investigation.

Annually, a log and summary of occupational injuries and illnesses should be completed and forwarded to the U.S. Department of Labor, Bureau of Labor Statistics OSHA injury and illness log (Form 300). The standardized form requests information similar to the first report of injury and the accident investigation report.

Information about every occupational death, nonfatal occupational illness, biologic or chemical exposure, and nonfatal occupational injury that involved loss of consciousness, restriction of work or motion, transfer to an other job, or medical treatment (other than first aid) must be reported.

Because it’s important to determine why and how an accident occurred, an accident investigation should be conducted. Most accidents can be traced to one of two underlying causes: environmental (unsafe conditions) or personal (unsafe acts). Environmental factors include in adequate safeguards, use of improper or defective equipment, hazards associated with the location, or poor housekeeping. Personal factors include improper laboratory attire, lack of skills or knowledge, specific physical or mental conditions, and attitude. The employee's positive motivation is important in all aspects of safety pro motion and accident prevention.

It’s particularly important that the appropriate authority be notified immediately if any individual sustains a needle puncture during blood collection or a cut during subsequent specimen processing or handling. For a summary of recommendations for the protection of laboratory workers, refer to Protection of Laboratory Workers from Occupationally Acquired Infections; Approved Guideline, Third Edition, M29-A3 (Clinical and Laboratory Standards Institute).

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