UCLA Infection Control Manual

Dr. Andy Wong

A. Regulated Medical Waste: This includes infectious and biohazardous waste defined as a solid or liquid that contains pathogens in adequate numbers and with sufficient virulence to cause infectious disease in susceptible hosts exposed to the waste. This waste could pose a threat to human health or the environment, and includes:

1. Micro biological waste - cultures and discarded live and attenuated viruses.

2. Pathological waste - human tissues, with the exception of teeth, removed surgically.

3. Blood and blood by-products.

4. Absorbent materials containing large volumes (greater than 20 ml of blood and blood products, saliva, nasopharyngeal secretions, etc.) which are liquid and are relatively slow to dry.

5. Sharps - hypodermic needles, syringes and scalpel blades, Endodontic files/reamers, matrix bands, etc.

6. Anesthetic carpules will be considered "sharps" and infectious waste due to their potential to transmit disease if they become broken.

B. General waste: General waste which does not pose a significant risk of causing or transmitting communicable disease or infection under ordinary circumstances. This type of waste includes:

1. Absorbent materials containing blood, saliva, nasopharyngeal secretions, etc. and which are non-liquid and dry relatively fast.

2. Infectious waste which has been sterilized.

3. All solid or liquid waste generated during patient care not classified as infectious.

4. Shall include, but not limited to, waste such as empty specimen containers, bandages, dressings and absorbent materials containing non-liquid blood, surgical gloves, decontaminated biohazardous waste, and other materials which are not biohazardous.

5. All waste must be disposed of according to applicable federal, state and local recommendations.

A. Disposal of regulated waste can be accomplished in two ways:

OPTION I - Contain and use a Biohazard Disposal Service; keep records and manifests of pick up and disposal.

OPTION II - Contain, sterilize and dispose in general waste.

B. All waste that is designated as regulated shall be bagged in biohazard red bags. Sharps are to be in sharps containers.

C. The routine procedure of autoclaving medical/dental waste prior to disposal is indicated only for those items considered infectious (biohazardous) waste. The only dental operatory waste identified as infectious are waste products saturated (relatively slow to dry) with blood or blood products or other secretions. These products can be autoclaved before disposal in the regular trash system, or if liquid, disposed of according to E. below. Gauze saturated, but not oozing upon compression, is considered non-infectious since it does dry within a short period of time. Even when a known, high risk patient is being treated, the waste generated from this case is not considered infectious unless it is with blood or secretions, oozing upon compression. In these cases, this waste must be autoclaved prior to disposal.

D. Red bags shall be used only for the storage and disposal of regulated medical wastes.

E. Liquid infectious waste (e.g. liquid from self-contained suction apparatus) will be disposed of by pouring the liquid into the sanitary sewer system through clinical sinks, not handwashing sinks. Personal protective attire (gloves, masks, and eye protection) will be worn during the handling and disposal of liquid infectious waste and follow-up cleaning processes.

F. Sharps Containers

1. Disposable needles, syringes, scalpel blades and/or other sharp items and instruments shall be placed in puncture resistant containers for disposal.

2. Sharps containers are considered full and need to be replaced when they are 3/4 full to prevent the "sharps" from sticking out of the container. Do not overfill!

3. Needles shall not be bent or broken prior to disposal.

4. All materials disposed of in Sharps-tainers shall be managed in the manner prescribed for biohazardous wastes whether or not the materials are actually biohazardous wastes.

5. Anesthetic carpules are disposed of as infectious (biohazardous) waste by placing carpule into a Sharps container. This is due to their potential to transmit disease if they become broken.

III. DISPOSAL OF GENERAL WASTE

A. Even though practically all waste generated on our dental clinics will be considered non-infectious, certain obvious precautions should be taken by all individuals handling trash. All general medical solid waste removed from patient treatment operatories is to be bagged and sealed before disposal in the designated receptacles. Medical solid waste shall be stored outside in a locked dumpster (at night), in a totally enclosed locked room, or totally inside the clinic.

B. Teeth without attached tissue are considered non-infectious and may be thrown away as general waste. If the extracted teeth are deemed as infectious or biohazardous waste by the attending surgeon or dentist (with attached tissue, broken restorations, etc.), they are to be disposed of as regulated medical waste. Alternatively, they may be disposed of by double wrapping in paper, sterilized by autoclaving (except teeth with amalgam restorations), and thrown away as non-infectious waste.

IV. GOWNS

Cover gowns used as personal protective equipment shall be placed within designated laundry hampers, or if disposable, disposed of as general waste.

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