Treating Medical Waste: Enhancements Help Autoclaves Answer Today's Challenges

By Lorenzi, Neal | Health Facilities Management, July 2014 | Go to article overview

Treating Medical Waste: Enhancements Help Autoclaves Answer Today's Challenges


Lorenzi, Neal, Health Facilities Management


Using a well-tested technology that already treats a large portion of regulated medical waste (RMW) generated by hospitals, waste-handling autoclaves can safely be called a mature technology. Despite the equipment's lengthy history, however, vendors are still adding features to make RMW autoclaves safer and more efficient.

"The technology is tried and true. It works," says Laura Brannen, senior associate, materials and waste management prevention strategies, Mazzetti, San Francisco. "Recent improvements in technology have been in the handling of the waste. The equipment once was loaded manually. Today's systems are more automated. Material is conveyed directly into waste compactors."

Autoclaving still has limitations, according to Brannen. It does not take care of such hazardous materials as chemical waste, pharmaceutical waste and chemotherapy waste. However, autoclave technology continues to dominate the market because it is "approved by rule" in most states and the process is well-understood.

"Autoclave processing of RMW is economical and effective when properly managed. It is also safe, both in terms of operation and environmental impact," says Timothy Barrett, vice president and COO, OnSite Sterilization LLC, Pottstown, Pa. "Autoclave processing on-site allows hospitals to better control waste streams, reduces risks associated with the transportation of potentially infectious waste, and eliminates the cost and environmental impact of trucking."

On-site processing

Invented by French microbiologist Charles Chamberland in 1879, autoclaves use steam under pressure to eliminate the biological hazard of the waste in accordance with state regulatory requirements. By applying appropriate time, temperature and pressure conditions, the waste is heated sufficiently to render it safe for final disposal in an approved landfill.

Back in the 1990s, thousands of medical waste incinerators were used by hospitals. In 1995, Congress issued reports stating that incinerated medical waste was releasing mercury and dioxins into the atmosphere. That triggered a major shift in thinking.

After Congress passed the Clean Air Act in 1997, thousands of incinerators were forced to shut down nationwide, says Angel Aguiar, PE, vice president, Bondtech Corp., Somerset, Ky. Various non-incineration technologies then entered the market to fill the necessary capacity to replace the shuttered incinerators.

"Since the late 1990s, the trend has been to ship waste off-site," Brannen says. "However, the cost of shipping has increased. As a result, many hospitals are considering processing that waste on-site again. New technologies have come on board, but autoclave technology is what most hospitals will use."

On-site treatment can save thousands of dollars, lowering risk and decreasing dependence on third-party, off-site haulers. In addition, treating waste at the point of generation gives the hospital more control of its regulatory compliance.

"Many vendors are offering to bring their technology on-site to reduce costs," Brannen says. "The cost of shipping medical waste off-site can be as high as 45 cents per pound, compared with 1 to 2 cents per pound for shipping conventional garbage. Minus the shipping, it actually may cost less to do the processing on-site, despite the labor costs involved. Hospitals just have to weigh the total overall costs."

Arthur I. McCoy, senior vice president, San-I-Pak Inc., Tracy, Calif., touts many advantages to processing medical waste on-site. "From a clinical perspective, sterilizing potentially deadly pathogens at the point of generation is much safer than trucking this material to another location. From an environmental perspective, sterilizing infectious waste on-site produces fewer carbon emissions than does trucking the waste off-site.

"From an operational perspective, an in-house program to sterilize infectious waste can provide the hospital with operational sustainability during pandemiccrisis mode, especially if the transportation infrastructure is compromised. …

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