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The Controversy of Medical Waste Disposal

At a garbage dump in Russia, six children were playing with glass vials containing expired smallpox vaccine. All six of these children became ill with a mild form of smallpox after being exposed to the expired smallpox vaccine. Thank goodness they recovered but the vials should have been inactivated properly before being disposed.

Although smallpox has been eradicated, there are two laboratories that still hold stock of the smallpox virus (variola). One is in Koltsovo, Russia and the other is the WHO Collaborating Centers in Atlanta, Georgia, USA (not to confuse it with Russian Georgia). In 1980, WHO announced the eradication of smallpox. The vaccine that has been used for centuries was not made from actual smallpox but from a virus called vaccinia. Vaccinia is a member of the same virus family. WHO recommends that the countries that still possess the vaccinia vaccines keep them and not destroy them for two reasons. Reason number one, is sometimes laboratory personnel who handle the vaccinia virus need to be vaccinated against it. Reason number two, is if an enemy decides to use germ warfare the vaccine will be needed.

Our health care systems have blossomed and succeeded in alleviating and treating potentially life-threatening ailments. Hospitals, clinics and laboratories are state of the art facilities in many countries especially the United States. People from all over the world come to our country to be treated for various diseases. Ironically, however, by the very treatment of the sick, medical waste disposal causes serious illness to innocent bystanders, if not discarded and treated properly. More accurate and detailed lab tests and the more often they are given, increases the medical waste output by these respected institutions. Urgent Care facilities have opened successfully all over the country and are amazingly efficient in diagnosing and aiding their patients in successfully recovering from various ailments. I know a man in his forties whose symptoms were diagnosed as a heart attack at his local Urgent Care facility. He was saved by the doctor at the facility who immediately called an ambulance to rush him to the hospital. Although, the healthcare facilities are giving excellent medical care we must check up on their medical waste disposal methods. This way we will be partners in safe medical waste disposal and not partners in the crime of dangerous substances and medical equipment coming in contact with healthy people.

Here’s the question. Should we increase pathological laboratory testing that could save lives or decrease the amount of medical waste from testings and vaccines by less testing?

The answer is both. Medical waste does have a high risk of carrying microorganisms that could infect people exposed to it. Many of these infections can be avoided by safe disposal of needles from vaccines and syringes used for medical tests. Reuse of disposal needles and syringes is common in certain Central and Eastern European countries as well as in Africa and Asia. In developing countries, medical waste is often manually sorted and the workers themselves are exposed to hazardous germs. By introducing and implementing safe disposal methods medical professional can go further in their research and testing while at the same time not compromising the health and wealth-fare of the general population.

Medical waste has a high risk of carrying microorganisms that can infect people who are exposed to syringes, vials and needles that have not been disposed of safely. WHO (the World Health Organization) claims that millions of new infections including hepatitis B & C, and HIV occur due to needle prick injuries. WHO conducted studies and reported on additional specific infections caused by the improper medical waste disposal.

1) Meningitis – can be either viral or bacterial and both forms can be transmitted by contamination by body fluids. Pathogens contained in medical waste may contain Meningitis. Meningitis is a serious disease caused by inflammation of the membranes surrounding the brain and spinal cord.

2) Bacteremia – (blood poisoning) is a life-threatening disease. Sharps, for example can introduce pathogens into the bloodstream if not disposed of properly. Bacteremia can progress to sepsis and septic shock which are extremely dangerous and toxic.

3) Parasitic Infections – pathogens from diagnostic laboratories that test for parasitic infections and test positive can still thrive in the medical waste and cause infections.

4) Diseases – from improperly disposed vaccine waste are made from weakened pathogens. Even though their effectiveness is reduced, they are still live and possess potential to cause disease.

5) Skin infections – although rare, Anthrax vaccine-producing labs, may stimulate actual Anthrax contaminated medical waste. The spores of Anthrax are very infectious and virile so any release of exposed medical waste can be very dangerous.

6) Candida infection – is a disease caused by a Candida yeast. It can be life threatening to the elderly, pregnant mothers, and people with reduced immune systems.

7) Infections of the reproductive organs – easily transmitted sexual infections such as herpes and syphilis can enter the body through minor breaks in the skin.

8) Ebola, Lassa and Marburg – these diseases, are transmitted by viruses that cause very high fever and internal hemorrhaging. Since these diseases are so serious hospitalization is required and ebola waste management is of utmost importance to prevent the spread of the virus.

9) MRSA – ( Methicillin resistant Staphylococcus aureus) is a bacterium that causes specific infections in different body parts. Treatment is challenging since it is resistant to some customarily used antibiotics. Any person, especially those who have weaker immune systems, just has to touch a piece of medical waste that has the bacteria on them and they can become infected by MRSA.

Even the correct method of disposal of medical waste can be the cause of transmission of pathogens. For example, incineration while reducing potential of human infection can lead to the production of dangerous toxic chemicals. By products of medical waste incineration such as, dioxin and similar composites, are sent into the air during burning. These compounds are ultimately deposited in the soil near and around the waste incineration plant. WHO calls dioxins highly toxic causing reproductive and developmental problems, damage the immune system, interfere with hormones and also cause cancer. Mercury, a dangerous neurotoxin is a common chemical that is released by incineration of medical waste. It would be stringent for the global world environment to work on new technological advances of waste disposal that do not involve incineration. The World Health Organization (WHO) has taken a major role in the development of specific guidelines for decreasing the hazards to the environment and spread of infection to world citizens from disposal of medical waste. In fact, it has written a manual entitled, Safe Management of Wastes from Health-Care Activities”. In chapter 8, there is a detailed guide on some keys to follow and what to avoid when dealing with medical waste.

The path to safer medical waste disposal lies with the waste producer – the very health care provider who is saving lives by treating sick people. Here are some of the disposal methods of medical waste commonly used.

1) Incineration is a controlled combustion where the medical waste is completely destroyed under high temperatures.

2) Autoclaving is a low heat process using steam that is brought in direct contact with the medical waste and disinfects it.

3) Microwaving inactivates the pathogens boy electromagnetic radiation.

4) Shredding is the process that the medical waste is cut into such small pieces that it cannot even be identified.

Each of these processes must be carefully monitored by professionals so they are used correctly and destroy the materials or pathogens of the medical waste. Government monitoring is helpful. However, each health care facility must do its own monitoring to assure safe disposal of medical waste even if it is financially challenging. Simultaneously it’s important that the heads of healthcare facilities make sure that its staff is fully compliant with OSHA and take the proper steps to get certified. One mistake can affect a whole community.

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