Infectious Waste Management

Regulated waste is defined to be consistent with the published OSHA standard, as follows:

Class A waste as defined as infectious by CDC and Kentucky infectious waste regulations for hospitals, nursing homes and special clinics:

• Bodily fluids (blood and cervical/vaginal fluids are the most likely fluids to be encountered in the health center setting.)

• Used disposable sharp items (such as needles, blades and broken tubes.)

• Microbiologic laboratory waste – this consists of viral, bacterial, fungal, or parasitic cultures in which the biologics have multiplied to higher levels than would be seen in a person.

• Pathological waste – any unfixed tissue or organ, other than intact skin, from a human, living or dead.

Class B waste:

• Contaminated items that would release blood or other bodily fluids if compressed.

• Items that are caked with dried blood or other liquids and are capable of releasing these materials during handling (this means enough caked blood to cause a dusty aerosol if shaken, NOT an item like a gauze pad which has been used to cover a finger stick or antecubital venipuncture.)

Class A sharps will be placed in sharps containers which will be located in each room of the NKY Health’s locations where venipuncture or injections are performed, or other places where sharps are expected to be used. The containers will be maintained upright during use and will not be allowed to overfill.

The sharps containers are constructed so as to prevent leakage during handling, storage, transport or shipping and must be closed prior to transport. A contract or arrangement (to be filed with this plan) will be executed with a hospital, medical facility or waste transporter to take the sharps containers to a site where they will be incinerated or treated by one of the approved alternative technologies.

Blood and other bodily fluids will be carefully poured down the sanitary sewers.

Pathologic wastes (if any) will be placed in bags that are properly labeled, closeable and prevent leakage, and will then be transported to incineration.

When Class A infectious wastes are generated in a home setting during a visit by a NKY Health employee, the same standards for storage, labeling, transport, treatment and disposal will be observed as if the wastes were generated in a clinic setting. The employee will be responsible to transport the waste containers, when filled, to a NKY Health worksite or a medical facility for treatment or pickup. Receptacles not yet filled may be left in the home between visits, provided residents of the home are instructed regarding potential hazards. For liquids, sewer disposal in the home is permitted if the home is connected to a municipal or community sewer system, or to on-site sewage disposal which meets the standards described in 902KAR 10:085.

When Class A infectious wastes are generated in a setting (such as correctional facility) where sharps containers cannot safely be left, one will be carried by the employee for immediate use and removed when the employee leaves the site. 

Class B Infectious wastes must be double bagged, placed in closeable, leak proof containers, and be labeled. They will be transported (as described for a Class A) at the option of NKY Health, or will be grouped with ordinary solid waste. They are not required to receive special treatment prior to disposal.

Class B infectious wastes generated in the home setting must be bagged and labeled as if generated in the clinic setting; however, no special requirements for transport, treatment or disposal apply. This plan applies to waste generated in the home only if generated by the activities of NKY Health staff.

NKY Health will ensure that the worksite is maintained in a clean and sanitary condition. A written schedule for cleaning and decontaminating the worksite will be followed based on the following criteria:

• Type of surface to be cleaned

• Type of soil present

• Tasks and procedures being performed in the area

Contaminated work surfaces will be decontaminated with an appropriate disinfectant, which is any EPA- registered disinfectant labeled as effective against HIV and HBV:

• After completion of procedures

• Immediately, as soon as feasible when surfaces are overtly contaminated

• After any spill of blood or other potentially infectious materials.

• At the end of the work day

Protective coverings, such as plastic wrap, aluminum foil or imperviously-backed absorbent paper used to cover equipment and environmental surfaces will be removed and replaced as soon as feasible when they become overtly contaminated or at the end of the work day if they may have become contaminated during the day.

All trash receptacles intended for reuse which have a reasonable likelihood for becoming contaminated with blood or other potentially infectious materials will be:

• Inspected and decontaminated on a regularly scheduled basis

• Cleaned and decontaminated immediately or as soon as feasible upon visible contamination

Broken glassware which may be contaminated will not be picked up directly with the hands. It will be cleaned up using mechanical means, such as a brush and a dust pan, tongs or forceps.

Reusable sharps that are contaminated with blood or other potentially infectious materials will NOT be stored or processed in a manner that requires employees to reach by hand into the containers where these sharps have been placed.

Contaminated laundry will be bagged or placed in leak proof container at the location where it was used. It will not be sorted or rinsed in the location of use.

Contaminated laundry will be placed and transported in bags or containers labeled or color-coded as described in Warning Sings/Labels of the Communication of Hazards section below. When the NKY Health utilizes standard precautions in the handling of all soiled laundry, alternative labeling or color-coding is sufficient if it communicates the information that the containers require compliance with standard precautions.

When contaminated laundry is wet and presents a reasonable likelihood of soak through or leakage from the bag or container, the laundry will be placed and transported in bags or containers which prevent soak through and/or leakage of fluids to the exterior. 

NKY Health will ensure that staff who have contact with contaminated laundry wear protective gloves and other appropriate personal protective equipment (i.e., gown or apron.) 

When NKY Health ships contaminated laundry off-site, NKY Health will place the laundry in bags or containers which are labeled or color-coded as described in "Warning Signs/Labels" subsection of the "Communication of Hazards" sections of the main page of this Plan.  NKY Health will provide laundry services for contaminated laundry which will comply with these standards. Services will be arranged with the Employee Health Nurse.