The Wrong Solution

Red Bag Waste, What is it?

There are multiple definitions used for Red Bag Waste (which is also referred to as regulated, infective, infectious, and biohazardous waste).  A definition from OSHA defines biohazardous waste as:

• Any liquid or semi-liquid blood or other potentially infectious materials;
• Contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed;
• Items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling;
• Sharps (including needles, scalpel blades, glass, pipettes) contaminated with blood and body fluids;
• Pathological and microbiological wastes containing blood or other potentially infectious materials.

Other Methods of Red Bag Waste Disposal

Haul Away Method
There are many different companies that offer this solution to medical facilities, local or national companies but how they handle the waste can be drastically different.  Some companies are taking the bio-hazardous material to special landfills, while others are taking the material to an approved disposal facility.  These approved facilities either incinerate or use chemicals to sterilize the waste.  There are problems with these methods such as burning plastics polluting the atmosphere, and the chemical treatment method is harmful to the environment while some items such as syringes may not be sterilized.  Another major issue with the haul away method are ethics. If the company that is disposing of the waste does not follow the best practices, it opens the facility to lawsuits as well as exposing the public to health risks.  The medical facility is also at the mercy of these companies as government regulations, fuel costs and other added expenses are passed on to the customer.

What is Incineration?
Incineration is the process of the destruction of waste by converting the organic material to carbon dioxide and water vapors by fire.

Advantages of Incineration
Incineration remains a prevalent treatment method throughout the United States despite growing concern for the environment. There are advantages to incinerating medical waste which primarily include the fact that medical waste, once incinerated is reduced by about 90% in volume. Additionally, incineration assures the completed destruction and sterilization of medical waste. Another advantage to incineration is that almost any type of medical waste can be incinerated with the exception of items that contain mercury and plastics that contain PVC.

Disadvantages of Incineration
There are many disadvantages to incineration, such as potential pollution risks due to large amounts of emissions that result from the burning of regulated medical waste. Recently, many states have imposed very strict guidelines on pollution emissions which have caused the need for upgrades and many changes to medical waste incinerators in order to comply with emissions regulations. These changes have greatly increased the cost of incineration.

Incineration Being Supplemented by New Technologies
Chances are that incineration, though a widely used practice of medical waste treatment in the United States, will soon become obsolete to other treatment technologies. Today, about 80% of hospitals in California already use various alternatives to incineration as a result of emissions regulations within the state. Various factors account for medical facilities to decrease their dependence on incineration including:

• Increased cost of incineration as a result of the increased equipment needs for facilities to meet emission standards and regulations

• Permitting difficulties associated with finding new incineration facilities

• Uncertainty associated with the various incineration requirements on a federal, state and local level

• Increased availability of other medical waste treatment options (alternatives to incineration) that have been deemed safer, more effective or cleaner for the environment.

Advantages of Chemical Treatments
There really are none, while you are treating biohazardous waste, the question looms of risk versus reward

Disadvantages of Chemical Treatments
The obvious disadvantage of chemical treatment systems is that they consume chemicals. In addition, even if they are effective in rendering the waste noninfectious, the products of the chemical reactions they undergo are present in the waste, and may pose problems of their own. However, chemical treatment systems are convenient, and may be suitable in some situations, particularly when small quantities of waste are involved.

One of the most common constituents of chemical treatment systems is chlorine, either in the form of sodium hypochlorite solution (common bleach), or as the more powerful (and correspondingly more hazardous) gas, chlorine dioxide. These compounds are relatively cheap and effective. However, in the course of reacting with organic compounds, they tend to form objectionable byproducts such as chloroform and other persistent toxins.

The chlorine compounds work by “oxidizing” (stripping electrons from) organic compounds, including the constituents of pathogenic microorganisms. The original “oxidizer” is, of course, atmospheric oxygen. Although it is, in fact, a fairly powerful oxidizing agent, ordinary oxygen is not harmful to, and is in fact essential for the survival of, many organisms including most of the pathogens in medical waste. However, when oxygen (O2) is converted to ozone (03), a much stronger oxidizer, it becomes toxic to most life forms. Ozone can readily be generated by passing an electric arc through ordinary oxygen gas. When used in a medical waste treatment system, ozone acts as an effective sterilizer, without the tendency to generate the types of by-products found with chlorine compounds. The major problem encountered with ozone systems is the need to avoid exposure to anyone in the vicinity of the treatment system, since ozone is highly injurious to lungs.

Alkaline agents are also used in medical waste treatment, either in highly corrosive form (sodium hydroxide, or lye), or in somewhat milder form (calcium oxide, or quicklime). Alkali tends to hydrolyze (decompose) proteins, among other effects. Apart from the cost of the reagents, the major disadvantage is the risk of contact, since alkaline solutions damage skin and lungs.

Disinfectants like glutaraldehyde and peracetic acid are also used for small-scale medical waste treatment.