Decreasing the Amount of
Environmental Medical Waste
Rebecca Denson MD, Sonia King MD and Kayser Enneking MD
Dept of Anesthesiology, University of Florida
Intro
Medical, as well as popular literature, has focused recently on
the disposal costs for contaminated medical waste and its
negative impact on the environment. Decreasing the amount of
waste designated as contaminated, without endangering the health
of the community, will increasingly become necessary to the
environmental and economic well-being of any community. Even the
smallest of medical facilities can have an impact by limiting
the amount of contaminated waste that they generate.
Purpose
The purpose of this study is to discover ways in which to
decrease the production of contaminated medical waste thereby
decreasing the cost of disposal. By decreasing this waste,
medical facilities will also lower the subsequent costs
associated with disposal - $0.16/lb for contaminated waste
versus $0.04/lb for uncontaminated waste.
Methods
Four operating rooms were identified, off site from a large
university based practice, for this study, because we could
contain the targeted variables – education, room structure and
equipment selection. The first step taken was the education of
staff into the definition of contaminated versus uncontaminated
waste. This was accomplished by lectures, literature and posted
reminders on the doors of all OR suites. Prior to this, it was
left to personal discretion as to what was considered
contaminated. In addition, the room structure was altered by
placing a smaller than normal red bag for contaminated waste in
each room. All red bags were placed away from the major traffic
flow to make their use less convenient. Large white bags (40
gallon) were also placed in each OR to promote the correct
placement of uncontaminated trash. These were placed closer to
the flow of traffic. The second step was to reduce the weight of
the contaminated trash. Thinner contaminated trash bags (1.5 mm
instead of 5 mm) were utilized. However, primarily, the weight
was reduced by the disposal of contaminated arthroscopy fluids.
The fluids were decontaminated by washing with bleach in a
disposal unit, thus allowing routine sewage disposal. (Dornoch
Medical Systems, Inc*)
Results
Data collected during the six month study period showed a 77%
decrease in total weight of contaminated garbage. The raw weight
of red bag trash prior to study was 5,164 kg; it fell to 1,166
kg at lowest during study. Total cost of trash disposal was
lower by 71% - from $849/month to $245/month.
Discussion
Previous investigators discovered that education alone did not
lend to a permanent reduction in medical waste. We found that by
focusing on education as well as permanent room changes, such as
structure and disposal systems, there was a more lasting effect.
Conclusions
We found that by taking very simple measures, we could lessen
the amount of material collected in contaminated waste
recepticals. However, in order to maximize the effect of this
study, more investigation is needed into recycling, reusing and
sterilizing anesthesia and surgical equipment. This could
further decrease the amount of medical waste thereby saving
healthcare dollars while lessening the negative impact of
medical waste on the environmental.
References
1) Goldberg-ME; Vekeman-D; Torjman-MC; Seltzer-JL; Kynes-T;
“Medical Waste in the Envirionment: Do Anesthesia Personnel Have
a Role to Play?”; J-Clin-Anesth. 1996 Sept; 8(6): 475-9.
2) Proctor-J; Raym-C; “A Team Approach to OR Environmental
Issues”; J-Healthc-Mater-manage. 1994 Jul; 12(7):16, 20-2.
3) Hooper-DM; “One’s Hospital’s Road to Waste Minimization”;
Med-Waste-Anal. 1994 May; 2(8): 1, 3-5.
