Syringes and Sand Castles: A History of Healthcare Waste
by Ashlee Homer BSN, RN, CPN, PSNA Environmental Health Committee
Beaches would not be a popular destination if littered with syringes, medications and other healthcare waste. The general public does not often see healthcare waste in their backyards. Yet, in the 1980s, waste began washing ashore on the eastern coast of the United States.
An alarm sounded that medical waste should be regulated and properly handled. The Medical Waste Tracking Act of 1988: outlined guidelines for defining medical waste; created a waste tracking system; created standards for separating, packing, storing and labeling of waste; and imposed penalties for not maintaining records of the waste (Medical Waste Tracking Act of 1988, 2016). This program was voluntary and four states (New Jersey, New York, Rhode Island and Connecticut) participated. After two years, the federal program ended and states were tasked to set up their own programs to maintain medical waste standards.
Most states adopted plans similar to the initial federal act. In Pennsylvania, the Department of Environmental Protection created a hazardous waste division. Pennsylvania’s Article VII was enacted in 1990. The article includes identifying and labeling, transporting, treatment and storage of hazardous waste at disposal facilities and a permit program (Article VII, 2016).
Today, according to BBC Research (2012), the U.S. creates 2.6 million tons of medical waste every year. Sources for the waste include hospitals, physician offices, dental practices and veterinary care. The World Health Organization (WHO) states that most of the waste is non-infectious and deemed not harmful to the general public. However, it is required that the material be processed.
Although not infectious, there are concerns with the waste’s environmental impact. More landfills need to be constructed and used to contain household, business and healthcare waste. Communities around the landfills are vulnerable to contaminated water if the facilities are improperly run or maintained (Healthcare-waste, 2015).
Most healthcare workers aren’t informed about what happens after waste leaves the bedside of a patient’s room. Employees move the waste from the bedside to storage areas until it is processed by the healthcare facility or transported to a processing facility. Vatovec, Senier, and Bell (2013) highlight this point: “Downstream of the point-of-care, waste disposal practices have potential adverse health consequences that may affect individuals ranging from housekeepers just downstream from the moment of waste generation, to entire communities living near landfills and incinerators” (p. 261).
Incinerating waste is more cost effective than separating and sterilizing it (Komilis, Fouki, & Papadopoulos, 2012). Incinerating waste dramatically decreases the amount of material that can be recycled or repurposed. Waste Management is one company that helps hospitals save money and expand sustainability by increasing the amount of material that can be separated, sterilized and repurposed (Sustainability Services, 2016). Increased recycling and reclamation is the future of medical waste.
Hospitals in Pennsylvania are working toward creating sustainable institutions. For instance, decreasing the amount of waste per patient is an initiative at Thomas Jefferson University Hospital. The hospital has decreased the amount of waste per patient by three pounds (Sustainability, 2015).
Every employee can help reduce waste by responsibly using required materials in the practice setting. Practice Green Health (2016) works with hundreds of hospitals to improve environmental health and sustainability. Hopefully, the future healthcare environment will produce zero waste and improve the lives of patients in health systems, as well as the surrounding communities.
Article VII. Hazardous waste management. (2016). Retrieved March 2016 from http://www.pacode.com/secure/data/025/articleIDVII_toc.html
Health-care waste. (2015).World Health Organization. Retrieved March 2016 from http://www.who.int/mediacentre/factsheets/fs253/en/
Healthier Hospitals Initiative. (2016). Practice Green Health. Retrieved March 2016 from https://practicegreenhealth.org/initiatives/healthier-hospitals-initiative
Komilis, D., Fouki, A., & Papadopoulos, D. (2012). Hazardous medical waste generation rates of different categories of health-care facilities. Waste Management, 32, 1434-1441.
Medical Waste Tracking Act of 1988. (2016). United States Environmental Protection Agency. Retrieved March 2016 from https://www3.epa.gov/epawaste/nonhaz/industrial/medical/tracking.htm
Sustainability. (2015). Thomas Jefferson University Hospitals. Retrieved March 2016 from http://hospitals.jefferson.edu/about-us/sustainability/
Sustainability Services. (2013). Waste Management. Retrieved March 2016 from http://www.wm.com/enterprise/healthcare/healthcare-facility-solutions/sustainability-services.jsp
U.S. Market for Medical Waste Treatment, Containment, Management and Disposal to Reach Nearly $3.2 Billion in 2017. (2012). BBC Research. Retrieved March 2016 from http://www.bccresearch.com/pressroom/env/arket-medical-waste-treatment-containment-management-disposal-reach-nearly-$3.2-billion-2017
Vatovec, C., Senier, L., & Bell, M. (2013). An ecological perspective on medical care: Environmental, occupational, and public health impacts of medical supply and pharmaceutical chains. EcoHealth, 10, 257-267.