Specific Wastes


Mercury

The medical industry has used mercury-containing equipment over the decades, but uses less today. A big reason for the decline has been the recognition that mercury is toxic to humans and its disposal is very difficult and expensive. Further, alternatives that do not employ mercury have been developed (new types of thermometers and sphygmomanometers: digital thermometers and aneroid blood-pressure gauges). However, the medical waste manager may run into mercury containing waste either periodically or on a regular basis. Be sure to segregate this waste (it might be worth having a separate waste stream for mercury waste). You almost certainly want to have this waste taken away by a hazardous waste disposal company, but the economics will probably dictate that you are better off with a dedicated mercury stream.

Dentists offices are known as generators of hazardous waste with mercury and lead.

Mercury Spill Kits

Facilities with mercury should have a special mercury spill kit. Mercury spills are hazardous waste releases and pose risk to employees, patients, anyone in the facility, and potentially the environment. If a facility has a good deal of mercury on site, it should materials for collecting mercury in additional to normal spill kit items.

These materials include

  • Mercury Suppressant - a solution that will prevent vaporization of elemental mercury.
  • Mercury Indicator - a powder that changes color to indicate the presence of mercury.
  • Absorbent - a material that combines with the mercury. Sometimes the combination of absorbent and mercury is called an amalgam, although technically that refers to an alloy of mercury, which may not be produced here. It doesn’t matter though, so long as specific with mercury to facilitate

Don’t use a conventional vacuum cleaner on mercury. There are special vacuums designed for mercury. Small facilities can probably not afford them; if you work at a place that cannot afford a special vacuum, find a facility in your area that has one and ask if you can borrow or rent it in the future in the case of a spill. It is best to get this planned out in advance before you have a spill. Put this information in your emergency plan.

Silver

The medical industry is phasing out the use of mercury - or at least finding alternatives. Sometimes silver is used as an alternative and it is problematic, too. Although silver is useful for killing pathogens, thinkers worry that over time bacteria will develop resistance to silver (and indirectly other antibiotics). Large doses of silver to people can cause argyria (silver poisoning), and even in low amounts, silver in waste going to disposal is of concern. Silver is one of the RCRA 8 metals.

Glutaraldehyde

Glutaraldehyde is one of the common chemicals around the operating theater. It is a liquid disinfectant used on equipment, and while it is not as failsafe as autoclaving, it can do a damn good job. The FDA approves the chemical as a “high-level disinfectant,” meaning it does not sterilize but it does kill more microorganisms than most disinfectants.

Glutaraldehyde is dangerous to work with as its fumes can cause asthma and it can irritate the skin. Workers must wear appropriate PPE and the liquid is usually handled in a fume hood.

OSHA put out a best practices manual https://www.osha.gov/Publications/glutaraldehyde.pdf

Glutaraldehyde is sold under the trade names Cidex®, Sonacide®, Sporicidin®, Hospex®, and Omnicide® .

Waste glutaraldehyde cannot be incinerated because it is diluted with water. It arrives at the medical facility typically as a 50 percent solution in water and/or methanol. However, waste glutaraldehyde is a hazardous waste and must be disposed of accordingly. It will probably not be classified as an infectious waste by regulators, but it might be a RCRA waste and certainly more of a collection and storage challenge than solid wastes.

Formaldehyde

Formaldehyde is fairly ubiquitous, but not like it once was. This chemical is used as a cleaner and disinfectant as well as to preserve biological specimens (including bodies). It is often called formalin in commercial preparations.

Many solutions are feasible; pure formaldehyde is gaseous. The formalin that arrives at medical facilities is often 30 percent to 50 percent formaldehyde (by weight) and 10 percent to 15 percent methanol. Formalin solutions are toxic to humans and animals. Fumes (formaldehyde is volatile) are particularly dangerous for workers. The fumes are a fire risk. The liquid solution is corrosive to skin. The EPA classifies it as a “probable carcinogen”.

OSHA has rules for people who work with formaldehyde and any waste solution with a formaldehyde concentration over 10 percent is a RCRA hazardous waste.

Even more dilute formaldehyde solutions merit attention. Lab workers are often tempted to flush it down the drain. Don’t do that unless you have cleared it with the wastewater treatment authorities in you locale.