Studies have compared microbial load and diversity of microorganisms in residential waste with waste from multiple healthcare settings. It was shown that general waste (gloves, masks, gowns, lightly soiled gauze or cotton and environmental barriers) are not more infective than residential waste. These are considered non-regulated medical waste.
Although any item that has had contact with blood, exudates or secretions might be infective, treating all such waste as infective is neither necessary nor practical.
Infectious waste that carries a substantial risk of causing infection during handling and disposal is regulated medical waste. A complete definition of regulated waste in included in OHA's blood-borne pathogens standard.
Regulated medical waste is only a limited subset of waste: 1% to 2 % of total waste in dental offices. Regulated medical waste requires special storage, handling, neutralization and disposal, and is covered by national or local rules and regulations. Examples of regulated waste found in dental practice settings are solid waste soaked or saturated with blood or saliva (eg, gauze saturated with blood after surgery), extracted teeth, surgically removed hard and soft tissues, and contaminated sharp items (eg, needles, scalpel blades and wires).
Regulated medical waste requires careful containment for treatment or disposal. A single leak resistant biohazard bag is usually adequate for containment on non-sharp regulated medical waste, provided the bag is sturdy and the waste can be discarded without contaminating the bag's exterior. Exterior contamination or puncturing of he bag requires placement in a second biohazard bag. All bags should be securely closed for disposal. Puncture-resistant containers with a biohazard label, located at the point of use (ie, sharps containers), are used as containment for scalpel blades, needles, syringes and unused sterile sharps.
Dental healthcare facilities should dispose of medical waste regularly to avoid accumulation. Any facility generating regulated medical waste should have a plan for its management that complies with national and local regulations to ensure health and environmental safety.
Recommendations
Regulated Medical Waste
1. General Recommendations
a. Develop a medical waste management program. Disposal of regulated medical waste follow national and local regulations.
b. Ensure that DHCP who handle and dispose of regulated medical waste are trained in appropriate handling and disposal methods and informed of the possible health and safety hazards.
2. Management of Regulated Medical Waste in Dental Healthcare Facilities
a. Use a color-coded or labeled container that prevents leakage (eg, biohazard bag) to contain non sharp regulated medical waste.
b. Place sharp items (eg, needles, scalpel blades, orthodontic bands, broken metal instruments and burs) in an appropriate sharps container (eg, puncture resistant, color-coded and leak proof). Close container immediately before removal or replacement to prevent spillage or protrusion of contents during handling, storage, transport or shipping.
c. Pour blood, suctioned fluids or other liquid waste carefully into a drain connected to a sanitary sewer system, if local sewer discharge requirements are met and the state has declared this an acceptable method of disposal. Wear appropriate PPE while performing this task.