New Avenues in Biomedical Waste Management Developed

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By: Maura Keller

This year is the 30th anniversary of the Medical Waste Tracking Act of 1988.

The Act addressed the closing of numerous beaches in New Jersey and New York with an enormous, nearly 30 mile long mass of medical and household waste that overtook the shore. Eventually it was determined that the medical waste mass originated from sealed plastic garbage bags at the New York City marine transfer stations as well as the Southwest Brooklyn incinerator and transfer station. The sealed bags were deliberately opened and dumped into the ocean. As a result, the Medical Waste Tracking Act was established to monitor the process of medical waste disposal – from generation to transportation to destruction.

Since 1988, the management of biomedical waste has become an integral part of our health care system and has undergone significant changes in recent years. Proper biomedical waste management is the mainstay of hospital hygiene, cleanliness, patient wellbeing, and overall facility maintenance activities. While inroads are being made within the biomedical waste management industry, traditional disposal techniques typically include drains, sewage, incineration and landfills.  

Of course, improper management of biomedical waste poses high health risks to individuals during handling or disposal. According to statistics by the World Health Organization (WHO), an estimated 16 billion injections are administered every year worldwide. Not all needles and syringes are disposed of safely, creating a risk of injury,  infection and opportunities for reuse.

Zion Research recently published the report, “Medical Waste Management Market by Type and by Treatment - Global Industry Perspective, Comprehensive Analysis and Forecast, 2014 – 2022.” According to the report, the global medical waste management market accounted for $11.36B in 2014 and is expected to reach $16.72B by 2022.

According to Christine Uri, chief legal and human resource officer at ENGIE Insight, “The biomedical waste industry has undergone massive change over the last few years. The government has tightened restrictions in various regulations that govern the disposal of sensitive materials, and has also increased enforcement and random audits.” These stringent policies can result in escalating multi-million dollar fines, costly corrective action plans, and public relations nightmares.

“Because of this, medical facilities can no longer afford to make careless disposal errors, and an efficient waste management plan is essential to an organization’s success,” Uri said.

Whether biomedical waste management happens on-site or off-site, there are basic methods for processing. Incineration is still the key method for treating pathological medical waste. Other wastes are increasingly managed by autoclaving or microwaving. In some cases, chemical treatment is appropriate.

According to WHO, while incineration of waste has been widely practiced, inadequate incineration or the incineration of unsuitable materials results in the release of pollutants into the air and in the generation of ash residue. Incineration of heavy metals or materials with high metal content (in particular lead, mercury and cadmium) can lead to the spread of toxic metals in the environment.

That’s why the WHO stresses that only modern incinerators operating at 850-1100°C and fitted with special gas-cleaning equipment are able to comply with the international emission standards for dioxins.

Other methods for disposal include autoclave, whereby non-pathological waste can be rendered non-infectious through steam-sterilization. Afterward, it can be taken to landfills as regular non-biomedical waste.

High powered microwaves can also neutralize non-pathological biomedical waste for disposal in solid waste landfills. Biological treatment as an experimental method treats some biomedical waste with enzymes, though it’s still in the developmental phase.

In order to truly understand their waste streams, medical institution’s staff conduct regular waste audits. This  process provides in-depth information about what’s being disposed and exposes any risky disposal activity that could lead to company fines or personal harm.

“Once companies fully understand their waste output, they can take the necessary strategic actions to prevent further misuse,” Uri said. “Whether the organization corrects their biomedical waste disposal methods through employee training, company signage on containers, or a total strategic overhaul, waste audits serve as a multi-use tool to increase sustainability, save money and prevent violations that could seriously affect day-to-day operations.”  

Advancements Aplenty
Biomedical waste management was regulated by the EPA throughout the 1980s. Now, most regulation has passed to states oversight. Apart from state and local agencies, several federal bodies also govern biohazardous medical waste management. These include the Department of Transportation (DOT), the Centers for Disease Control (CDC), the Occupational Safety and Health Administration (OSHA), and the U.S. Food and Drug Administration (FDA).

In the U.S. there are a wealth of strategies that recycling companies use to manage biomedical waste. Besides conventional technologies being deployed, many companies also focus on microwave technologies, autoclaving, electro-pyrolysis and chemical mechanical systems.

One of the latest advancements is Triumvirate Environmental’s process at its Jeannette, Pennsylvania facility. According to Jacqueline Ignacio, global manager, customer sustainability solutions, MilliporeSigma, the company’s procedure is a combination of a fully permitted and approved processing – known as sterilize and shred – with plastic lumber manufacturing.

“Other companies have started to address the biomedical waste from hospitals and medical clinics with front-end processes similar to sterilize and shred,” Ignacio said. “While these systems aren’t as robust and are more portable for smaller labs and clinics, they aren’t effective for the larger volumes produced in the biopharma manufacturing industry.”

Ignacio added that his process sounds simple, but no one else has tried it.

“Instead of viewing the shred as something that could go to landfill, they recycle it into an industrial grade plastic lumber,” Ignacio said. “This makes the plastic in the waste more valuable and provides a more sustainable business model.”

MilliporeSigma is working with Triumvirate through its Biopharma Recycling Program. What they have seen in the biomedical waste management industry is that customers are slow to switch to recycling due to lower costs associated with traditional disposal methods.

“However, other smaller disposal and engineering companies are working on technologies that could handle the waste,” Ignacio said. “The recycling component, however, is still a problem for them as the shredded plastic has other materials mixed with it – making it less valuable.”

A Complicated Process
The mixture of the materials found within the biomedical waste stream is the biggest challenge facing the recycling industry. For the most part, biopharma manufacturing is using a high percentage of plastic in the single-use devices utilized during the process. However, as Ignacio explained, there are multiple types of plastics within each of the devices that are hard to separate using current recycling technologies. This mixture makes the shredded material less valuable on the recycled plastics commodity markets.

“There’s also the challenge of materials that don’t melt properly during the plastic lumber manufacturing and molding process,” Ignacio said. “For example, silicone tubing has been seen as a challenge when the concentration on the waste stream is too high.”

What’s more, some of the biomanufacturing processes classify the waste as biohazardous.

“Current plastic recyclers are not permitted – nor do they want to try – to process a biohazardous waste stream,” Ignacio said.

On the Horizon
The biggest change within the biomedical waste industry must be a process that can sterilize the waste first and then prepare it for further high-value recycling. “There are many new separation technologies that have the potential to work well once the stream has been sterilized, but these have yet to come down in price,” Ignacio said. “Other changes will need to come from behaviors, especially at the point of generation. Far too much non-hazardous material ends up in the biohazardous bin – especially in hospitals and medical clinics. Behavior change is a huge challenge for any recycling program, but the biohazardous element makes this aspect more challenging.”

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