Reuse of Medical Materials as a Way to Control Waste

Reuse is a main goal in the waste management hierarchy. It’s a way of NOT making a waste and all other things being equal it saves money because you don’t have to buy more of the thing you are reusing. Medical instruments are usually designed to be reused, but they need to be adequately cleaned before use on patients. How clean is a matter for the medical community to determine for each procedure or device.

Instruments that touch the body’s skin (stethoscope, electrodes) usually have to be only disinfected with alcohol. Instruments that are invasive usually have to be sterile. Hospitals have equipment to sterilize reusable equipment and procedures to keep items sterile until they are used. Can this sterilization apparatus be used to treat and deactivate waste? It probably could in a pinch, but for a bunch of prudent management conditions, the two systems are kept separate. Autoclaves used to sterilize scalpels are not used to deactivate pathology samples. Chemical baths used to expose specula to hydrogen peroxide are not used to treat colonoscopy bags.

Automated Endoscope Reprocessors are common equipment in hospitals and clinics. They are approved by the FDA for cleaning "reusable endoscopes by exposing their outside surfaces and interior channels to chemical solutions."

The United States Food and Drug Administration publishes a list of approved sterilants for cleaning reusable medical and dental devices -

Dry heat - Many labs and hospitals have ovens on site for sterilization of equipment. Many suppliers sell the popular “Poupinel” oven. These are electric and not substantially different from an oven in a kitchen except that the vent may be connected to a more complex filter. A common routine for sterilization is heating to 160 °C for 120 minutes or 170 °C for 60 minutes.

Indicator strips change color to indicate the oven has been at a certain time and temperature.

Wet heat - Autoclaves are also ubiquitous at labs and hospitals. They sterilize with steam; a common regimen is heating to 121 °C for 30 minutes as a sterilization technique. Manufacturers have recommendations for their units. A spore strip test validates that the autoclaving process sterilizes adequately.

Chemical sterilization and disinfection is accomplished with many commercial preparations, but the preparations generally are made of a few active compounds

Sterilization of Materials Used for Medical Care

Hospitals have equipment to sterilize instruments and devices used in surgery. Before it goes to the operating room, equipment that will be used to cut open or get inside the body is sterilized with steam. It is customary to wrap these items in blue polypropylene plastic wrap for transport to the OR. (Actually, the wrap may be applied before sterilization in some cases) When the blue wrap is removed it is waste, but in most cases it can go into the MSW or recycle stream. Unless the plastic has come into contact with a bodily or bodily fluids or a drug or chemical, it is clean waste.