Glossary of Medical Waste Terms

Hygiene Glossary
Antineoplastic
Inhibiting the development of abnormal tissue growth. Anti-cancer drugs are antineoplastic.
Autoclave
Device used to sterilize laboratory and clinical medical equipment. Usually a closed chamber in which items intended for reuse - not waste, but things like scalpels - are placed for heating through either wet or dry means. The autoclave is usually a pressure vessel - meaning a metal enclosure that can be sealed and pressurized with no leaks.
BACT
Nest Available Control Technology - used in assessment of end-of-pipe pollution control processes and systems. No universal definition; determined on a case-by-case basis
BDAT
Best Demonstrated Available Technology (also BAT) - Most effective commercially available means of treating waste. BDAT is different for different types of waste and may change over time.
Biological indicator (BI)
A standardized sample of nonpathogenic microorganisms that resist sterilization methods. BIs are used during the sterilization process to validate that the method was effective.
Biological Safety Cabinet
Cabinet or hood that enables scientists and technicians to work without unintentional microorganisms invading their workspace.
Biological waste
this term is not used in medical waste management circles and is too imprecise to be used in the larger waste community. It is a layman’s term, not a professional one.
Biosafety Level
Management techniques and symptoms intended to minimize the exposure of workers and the environment to pathogens. Industry and regulators have agreed on four classifications: Biosafety level 1, level 2, level 3, and level 4.
BMP
Best management practice
BMW
Biomedical waste. Same as medical waste
Bowie-Dick test
Test used in autoclave operations to ensure air has been removed from the chamber before the sterilization process begins.
BSI
Body substance isolation - Policy of containing fluids from a sick person to reduce chances of spread of infection or of hazardous medicines and tissue
Biological safety cabinets
Similar to a fume hood for handling chemicals, except for biohazards. Generally an enclosed workspace with dedicated ventilation that prevents release of materials. Protects employees from pathogens.
Bloodborne Pathogens (BBP)
disease-causing microorganisms in blood, blood products, or materials that had been exposed to blood.
Blackwater
Stuff normally flushed down the toilet. Contains feces, soiled toilet paper, urine. Probably contains pathogens such as e.coli so must be kept away from people. Different from graywater, which is rinse water from cleaning, but likely free of pathogens.
CACI
Compounding aseptic containment isolator
carcinogenic
capable of causing cancer or of causing existing tumors to grow
CESQG
Conditionally exempt small quantity generator. In some jurisdictions, small producers of medical waste may avoid the paperwork generation required of larger generators. Consult your regional regulatory agency.
Chemical treatment
Application of chemicals (possibly with high temperatures or pressures) with the intent of changing the waste to make it less hazardous or more stable.
ClO2 - chlorine dioxide
highly active oxidant gas. Dissolved in water it is used as a disinfectant.
clean (as a noun)
free or dirt or unwanted material. Subjective term because it does not specify a level of acceptable dirt.
clean (as a verb)
to remove dirt or unwanted material. Makes no claim about level of effort
Clean Room
Room kept free from dust. While the focus on clean is usually on particulate matter rather than pathogens, clean rooms are usually sterile also.
Clinical Waste
Medical waste. In some countries (e.g. UK, Hong Kong) the preferred term (and written in government regulations) is clinical waste.
Comminution
Mechanical shredding or pulverizing of waste.
CSR wrap (Central Supply Room Wrap)
Standard piece of fabric many hospitals employ for handling of medical equipment. Made of tear-resistant material that lets chemicals and radiation in for sterilization.
cytostatic
Suppressing the growth and multiplication of the cell. Most chemotherapy drugs are cytostatic.
cytotoxic
toxic to the cell. Traditional "old-style" chemotherapy drugs are cytotoxic.
D-value
Decimal reduction value - time required to reduce active microbial population by 90 percent. The D-value is lower at higher temperatures.
Dangerous waste
A general term (not in laws as far as we know) to encompass all waste that poses a hazard to humans and the environment. Includes radioactive waste, RCRA hazardous waste, infectious waste, and pathological waste.
desechos medico
Spanish for "medical waste". You might see this on warning signs or labels.
Disposal
Placement of waste in place for long-term (indefinite, presumably permanent) disposal.
Environmental Monitoring System
Building surveillance and information and alarm system that keeps tabs on environmental conditions. Modern systems are integrated with security and access control.
EPA
Environmental Protection Agency
EPP - environmentally preferable purchasing
aka Green procurement. Policies in buying for the enterprise or facility with an eye toward reducing long-term negative impact on the environment. These include purchasing materials made with recycled content, that can be recycled in the future, that come with little extra packaging, and that do not include hazardous components if feasible.
ETO sterilization
Use of the gas ethylene oxide to sterilize or disinfect. Often used on equipment which would be damaged by high temperatures or harsh chemicals. More on EtO.
FMEA
Failure mode and effects analysis
FMECA
Failure mode, effects, and criticality analysis
FD-value
Time at a given temperature for a given percentage of microbes to be deactivated equivalent to that of the percentage deactivated at 121 degrees C.
FTA
Fault tree analysis
Genotoxic
Can destroy or damage DNA or RNA and thereby cause mutations.
Hazardous waste
Waste that poses a credible risk to people and/or the environment. Different jurisdictions have different definitions, as specified either by law or regulations. RCRA (Resource Conservation and Recovery Act) hazardous waste is the most widely used definition, being defined as waste that is corrosive, reactive, ignitable, or toxic.
HCGW
Healthcare general waste waste produced at medical facilities that haven't been in contact with patients and does not need to be managed as a medical waste. The HCGW stream typically includes paper, plastic, and food waste.
HCRW
Healthcare risk waste. Waste from medical facilities that poses a risk to human health and the environment. Aka medical waste.
HEPA Filter
High-efficiency particulate air. HEPA filters are employed in certain facilities to control distribution or release of small particles or bacteria.
HP2
Hospital Pollution Prevention Program - A California state-coordinated program to reduce rate of medical waste generation.
HMIWI
Hospital, Medical, and Infectious Waste Incinerators
HAZOP
Hazard and operability study
Hazardous waste
Waste that can have a harmful effect on human health or the environment. RCRA defines hazardous waste as either (1) containing materials enumerated in the federal register ("listed waste") or (2) "characteristic waste" - being ignitable, corrosive, highly reactivity, or toxic
Healthcare associated infections (HCAIs)
Infections patients pick up while getting treatment. One reason to keep healthcare facilities clean and to manage waste safely is to reduce the odds of HCAIs.
Incineration
Burning to completion with excess oxygen
Incinerator
Any of many pieces of equipment or processes (groups of equipment) in which combustion takes place. Medical waste incinerators are operated with the intent to burn anything that is present to completion.
Infectious Substance
Material that contains (or can be expected to contain) a microbe or particle that can cause disease.
Infectious Waste
Medical waste that is capable of causing disease in another human if that person comes into contact
Isolation Waste
Medical waste from patients with certain highly communicable diseases identified by the Centers for Disease Control and Prevention. Isolation is the word used in the clinic to describe systems and practices to care for these patients
LD50
Lethal dose to 50 percent of the subjects (adult humans unless otherwise specified) who ingest it. Measured in mg/kg, mg of material per kg of body
log 6 kill
describes aftermath of disinfection or sterilization process where fewer than on in a million microbes survived.
LDR
Land Disposal Restrictions
LAER
Lowest Available Emission Rate - used in assessment of end-of-pipe pollution control processes and systems. No universal definition; determined on a case-by-case basis.
LLMW
level mixed waste - waste that contains low level radioactive waste (LLRW) and hazardous waste
LLRW
Low-level radioactive waste - waste contaminated with radioactive materials but at a radiation level low enough that the waste is not classified as intermediate-level waste or high-level waste. Almost all radioactive waste generated in medical facilities is LLRW.
LQG
Large Quantity Generators - facilities that produce 1,000 kilograms per month or more of hazardous waste
MSHG
Manufacturer’s safe handling guidance
Municipal Solid Waste
Solid waste other than hazardous wastes comprised of commercial, and household waste that doesn’t fall in the categories of hazardous, radioactive, or infectious waste.
MTTF
Mean time to failure
MW
Medical waste
MWTA
Medical Waste Treatment Act - 1988 federal law that gave the EPA authority to regulate medical waste in a few states - Connecticut, New York, New Jersey, and Puerto Rico - for two years. It was a response to medical and other waste washing up along the shore in New Jersey and New York. The hope was federal leadership by the EPA would produce model regulatory frameworks and rules that state could emulate.
Medical Pathological Waste (MPW)
pathological waste
Microorganism
Living being too small to be seen with the naked eye. Often single-celled or smaller. Includes bacteria, viruses, and some fungi. A challenge to those who disinfect or sterilize equipment and places because they cannot be seen easily.
MRHD
Maximum Recommended Human Dose
MSDS
Material Safety Data Sheet - document - usually one or two pages - summarizing potential hazards of materials stored at a facility. An important part of hazards communication to employees and visitors to a building or operating site. In recent years these are sometimes calls SDS (safety data sheets.)
mutagenic
Causes mutations at the genetic level
NGO
Non-governmental organization
NIMBY
Acronym for Not In My Backyard. Political opposition at local level to the siting of objectionable things such as medical waste treatment or storage facilities.
NIOSH
National Institute for Occupational Safety and Health
OEL
Occupational exposure limit - highest concentration in air permitted in the workplace for a given compound, to protect worker health
Other Potentially Infectious Material (OPIM)
Term used in management of blood safety and prevention of infections to refer to body parts or (usually) fluids that might harbor pathogens. These can include Amniotic fluid, semen, saliva, vaginal secretions, any fluid with visible blood in it, human cell cultures, and fluids normally inside the body (e.g. cerebrospinal, synovial, pleural).
OSHA
Occupational Safety and Health Administration - US federal agency that promulgates standards and rules around workplace safety
Organic waste
Waste with organic (carbon-containing) materials. Usually refers to waste that is biodegradable and comes from either a plant or animal. Much of medical waste is organic waste, but the term organic waste is too broad to be of use in most management scenarios.
P-listed waste
Acutely toxic waste containing compounds specifically enumerated in the federal register under RCRA “p list” auspices. Includes some medicines.
PP
Pollution prevention. Systematic work and operational processes to reduce creation of pollution.
Pathogen
Living organism - usually a single-celled organism or virus - that causes disease in a larger organism.
Pathological waste
Recognizable human or animal body part, organs and tissue that is waste. Definition has been expanded to include bodily fluids generated during surgery or autopsy. Sometimes recognizable body parts are called "anatomical waste".
PEP
Post-exposure prophylaxis
POTW
Privately owned treatment works
PPE
Personal Protective Equipment - Phrase used in industrial hygiene circles to describe equipment to protect employees from hazards. PPE includes gloves, safety glasses and shoes, earplugs or muffs, hard hats, respirators, or coveralls, vests and full body suits
Precautionary Principle
When an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically.
Process Challenge Device (PCD)
An indicator that the conditions for sterilization have been met.
Process Validation
Determining that a treatment process works to the desired level of efficacy reliably. Validation is a step in starting operation of a new process and is done periodically as a check.
Putrescible Waste
Waste that contains organic matter which decomposes by microorganisms, resulting in strong odors. This organic material often includes food waste, used diapers, and pet waste. This term is not used by medical waste professionals.
Pyrolysis
Heat treatment process sometimes used for waste. Raises temperature of waste with insufficient oxygen to allow complete combustion. Heat nevertheless alters chemical constituents.
Q-listed waste
Hazardous waste containing compounds specifically enumerated in the federal register under RCRA “q list” auspices. Includes some medicines.
RACT
Reasonably Available Control Technology.
Regulated medical waste
See regulated waste.
Regulated waste
OSHA's term for blood, blood product, and blood-contaminated waste generated in healthcare facilities, and for some other potentially infectious material. This includes sharps and pathological and microbiological wastes containing bodily fluids.
Reusable Medical Device
A device use for diagnosis or treatment on more than one patient at different times. It is relevant here because the device usually requires disinfection or sterilization between uses.
RCRA
Resource Conservation and Recovery Act - 1976 US Federal law that defined hazardous waste and gave some rules on management.
RMW
Regulated medical waste
RPRA
Reliability and Probabilistic Risk Assessment
SAL
Sterility Assurance Level. Percentage probability that a process has rendered an item or surface sterile.
SDS
See MSDS
SQG
Small Quantity Generator - facility that produces less than 1,000 kilograms of non-acutely hazardous waste in that month
SWIFT
Structured What If Technique
Spore
Dormant, reproductive cell formed by certain organisms. Hard to kill because it evolved to survive harsh conditions. Most spores are not pathogenic, but some are. Food poisoning is sometimes produced by spores
Standard precautions
Methods and practices for controlling release of bodily fluids to prevent transmission of infection.
Sterilization Process Indicator
A device that goes through the sterilization procedure with the waste or item being sterilized for reuse. The indicator makes it easy for the human operator to tell if the sterilization process has worked.
TSDF
Treatment, storage, and disposal facility
teratogenic
capable of causing birth defects
thermolysis
process whereby chemical structure is changed through heat. A more general term than pyrolysis. Strictly speaking pyrolysis refers only to thermal treatment of organic materials.
Throughput
The amount of waste a system or process moves from creation to disposal in a period of time. Maximum possible throughput is called capacity.
Toxin
A substance that can cause death or incapacitation at low exposure levels. Many classes of chemicals and materials are toxic, including some produced by living organisms.
unregulated solid waste
Another term for municipal solid waste. MSW is commonly used in the United States. Unregulated solid waste may be a more global designation.

Glossary of Hygiene Terms

Antibacterial
Material or cleansers that kill bacteria. Note that products that advertise as antibacterial are not required to destroy all bacteria, just to kill most with proper use.
Antifungal
Material or process that destroys fungus and fungus spores.
Antimicrobial
A chemical or mixture that kills or sup­presses the growth of microorganisms.
Antiseptic agent
Antimicrobial liquids that medical personnel apply to the skin to reduce the number of bacteria. The swab of alcohol on the arm before an injection of use of an antiseptic.
Communicable disease
A disease that spreads from one organism to another
Cumulative effect
Term used in cleaning/disinfecting/sterilizing. The decrease in the numbers of microorganisms that survive after repeated applications of cleaning.
Detergent
Chemical compound that acts as a surfactant and can aid cleaning by facilitating mixing of organic and aqueous solutions. Detergent can be classified into four groups: anionic, cationic, amphoteric (zwitterionic), and nonionic.
Disinfectant
Chemical that is applied to kill microorganisms. Often in liquid form and often applied to solid surfaces although liquid wastes are mixed with liquid disinfectants in some cases.
Disinfected
Disinfected means almost all the pathogens are gone. Implies a level of cleanliness lower than that of sterile; hardy spores may survive the disinfection process.
Germicide
An agent (usually a liquid solution) that destroys pathogenic microbes.
Infectious disease
A disease that spreads from one human being to another
Persistent activity
General term for how long the cleaning works. Also called "residual activity." Persistent activity is defined as the prolonged or extended antimicrobial activity that prevents or inhibits the proliferation or survival of microorganisms after application of the product.
Prion
Disease-causing agents defined by the Centers for Disease Control and Prevention as "abnormal, pathogenic agents that are transmissible and are able to induce abnormal folding of specific normal cellular proteins."
Sanitize
to clean. This word is used in food regulations. It generally means to remove visible dirt and evidence of animal, fecal, and urine waste, It makes no claim about viruses,
Sterilant
A chemical solution or time-temperature regiment that destroys all viable forms of life, including spores.
Sterile
Cleaned to remove living organisms and spores. Implies cleanest level normally achieved in commercial operations and a standard in some management schemes for medical waste.
Sterility Assurance Level (SAL)
Process parameter describing expected level of sterility. An SAL of 10-6 means only one in a million pathogens will survive and this level is generally accepted for pharmacopoeial sterilization procedures,
Sterilize
To kill living organisms or at least to disable their ability to reproduce. The most extreme form of cleaning as far as leaving biological residues.
Universal precautions
Methods and practices for controlling release of bodily fluids to prevent transmission of infection.
Virulent disease
An infectious disease that is easily transmitted and that is deadly or produces severe illness in a large percentage of patients. The virulence of a pathogen is how sick the pathogen makes people.
Virus
Infectious agent that typically consists of DNA and/or RNA in a protein coat, A virus replicates only within the cells of living hosts which can be bacteria, plants, or animals.
Zoonotic disease
A disease that spreads from animals to humans