When talking with healthcare facilities about Regulated Medical Waste (RMW) or Sharps Waste, I’m frequently asked the question, “So what do you do with medical waste when you take it away?”
It’s a common question... but to be fair, there’s not just one quick and easy answer.
Over the years, several different methods have emerged as safe and viable options for medical waste disposal. Here we’ll provide a high-level overview about some of the more common methods: what they are, how they work, and the pros and cons of each.
Innovation Leads to a Changing Mindset
Before we take a deeper dive on the technologies themselves, let’s take a quick look at the current state of medical waste disposal. Proper handling of RMW and Sharps Waste is not a new concept; in fact, it’s been a much talked-about topic for more than three decades. While this attention has given rise to tighter regulatory standards, it has also helped pave the way for the number of medical waste technologies that exist today -- many of which are deemed as safe and effective. And thanks to these practices that are now well-established by many healthcare and waste management professionals, public concerns or negative stigma over “what medical waste is” has faded substantially.
The following medical waste technologies are among the most well-known and widely used:
Autoclave or High Heat Steam Treatment
This is the most commonly used treatment method for medical waste in 2018. Waste is put into a very large pressure chamber and a steam injection is used to bring the waste to a temperatures starting around 121 degrees Celsius. Then, waste is typically shredded or compacted and sent to an incinerator or landfill for final disposal.
PRO: This treatment is a tried-and-true technology and a valid means of disinfecting the waste prior to final disposal. It is also the most cost-effective technology to implement.
CON: The bi-product post treatment is still a waste item that goes into landfills or gets incinerated as a treated solid waste. Some companies may claim to send the waste to a recycler, but this doesn't necessarily mean the waste is accepted as a recycled product. Often it is rejected and ends up landfilled anyways.
Incineration/Waste to Energy
This process is another tried-and-true method of destruction. All pathological and chemotherapeutic waste, along with many non-RCRA (Resource Conservation and Recovery Act) hazardous medications should be processed via incineration as a viable zero landfill initiative. This is called bypass waste or diversion waste. The actual process is somewhat straightforward: the waste is burned at a high temperature.
PRO: Energy captured off of modern incinerator plants (waste to energy), coupled with the fact that the resulting byproduct is ash, make this waste treatment environmentally friendly. There are little to no emissions, energy is produced as a by-product, and the relatively small amounts of ash reduce the landfill impact.
CON: One of the major drawbacks with incineration is the cost of this waste destruction method, which due to the current regulatory environment, we’ve seen become more expensive in recent years. For starters, medical waste treatment and disposal facilities must be permitted by the state and federal government in order to accept regulated medical waste. This process is restrictive by design and leaves the industry with few disposal options.
Compounding this challenge is that incinerator facilities must also meet the EPA’s clean air requirements on partial-to-zero emissions standards, which adds significant operational costs for such facilities.
Although a relatively older technology, plasma gasification is starting to gain popularity. Like an incinerator, the gasifier utilizes an arc torch to gasify waste. The arc is incredibly hot and is similar to what happens with welding applications but on a larger scale. This arc burns at temperatures as hot as the sun and turns matter into its fourth state: plasma gas.
The gasification process creates syngas (synthesis gas) which can be used as a fuel source, thereby making the plasma torch a self-sustaining operation. The excess syngas can then be sold or used to create electricity. The heavy metals seperate for easy extraction and the result is a carbon-rich obsidian glass that can be used as an aggregate for roadways.
PROS: This method is a fully renewable, zero-landfill option, making it the most environmentally friendly technology available today. There are zero emissions because the waste is not burned, it is gasified so all of the gases are captured and reused as fuel.
CONS: It is a relatively capital-intensive technology, which is daunting for many organizations. (For context, the U.S. military uses this technology on navy ships, and there are a few investors around the country developing this technology for waste treatment.)
Other Treatment Options
Additionally, there are some medical waste treatment options as well that should be mentioned, including chemical treatment and microwave technology. These are effective but not always efficient technologies, and not nearly as common as an autoclave. Other legacy systems used by some older medical waste companies include tissue digesters and chemical treatment, both of which can help those companies avoid the costs of shipping and processing via incineration.
Finally, there are some on-site treatment options and small autoclave systems for large and mid-sized generators, but these require a hefty capital investment so several healthcare systems are steering clear. This method places all the risk on the generator, and the generator still needs to send treated medical waste off site. While these systems are designed with practicality in mind. they often fail to account for the many other variables involved in medical waste management.
Want to Discuss Your Options?
At the end of the day, there are many viable means of destruction -- and that should serve as welcome news for healthcare facilities. And even better, as the medical waste industry matures, companies are getting better at implementing renewable treatment technologies which is driving the cost down and reducing environmental impact.
Deciding which treatment option best serves your facility is by no means an easy task. Do you have other questions for a medical waste expert? We’re more than happy to help. Just connect with us here, and we’ll get back to you quickly!