Eliminating mercury use in hospital laboratories: a step toward zero discharge.
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In 1996, the Western Lake Superior Sanitary District initiated a Zero Discharge Project to work toward the goal of zero discharge of persistent toxic substances from its wastewater treatment plant. This multifaceted project focuses on mercury, lead, dioxin, polychlorinated biphenyls, and hexachlorbenzene. Here, the author describes a collaboration with local hospitals to eliminate the use of mercury-containing fixatives by histopathology laboratories. Three primary roadblocks to change were identified: (a) technicians' belief that pathologists would be resistant to change; (b) lack of time to research alternatives; (c) lack of awareness of the hospital's role in polluting the environment. (+info)
Solutions to health care waste: life-cycle thinking and "green" purchasing.
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Health care waste treatment is linked to bioaccumulative toxic substances, such as mercury and dioxins, which suggests the need for a new approach to product selection. To address environmental issues proactively, all stages of the product life cycle should be considered during material selection. The purchasing mechanism is a promising channel for action that can be used to promote the use of environmentally preferable products in the health care industry; health care facilities can improve environmental performance and still decrease costs. Tools that focus on environmentally preferable purchasing are now emerging for the health care industry. These tools can help hospitals select products that create the least amount of environmental pollution. Environmental performance should be incorporated into the evolving definition of quality for health care. (+info)
Hazardous materials: revision to standards for infectious substances. Final rule.
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RSPA is revising transportation requirements for infectious substances, including regulated medical waste, to: adopt defining criteria and packaging requirements consistent with international standards; revise the current broad exceptions for diagnostic specimens and biological products; and authorize bulk packaging options for regulated medical waste consistent with requirements in international standards and DOT exemptions. These revisions will assure an acceptable level of safety for the transportation of infectious substances, and facilitate domestic and international transportation. (+info)
Development of source testing, analytical, and mutagenicity bioassay procedures for evaluating emissions from municipal and hospital waste combustors.
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Incineration is currently being used for disposal of about 10% of the solid waste generated in the United States, and this percentage will likely increase as land disposal declines. Siting new incinerators, however, is often controversial because of concerns related to the possibility of adverse health effects and environmental contamination from long-term exposure to stack emissions. Specific concerns relate to the adequacies of a) stack emission testing protocols, b) existing regulations, and c) compliance monitoring and enforcement of regulations. U.S. Environmental Protection Agency laboratories are cooperatively conducting research aimed at developing new testing equipment and procedures that will allow a more comprehensive assessment of the complex mixture of organics that is present in stack emissions. These efforts are directed specifically toward developing source testing equipment and procedures, analytical procedures, and bioassay procedures. The objectives of this study were to field test two types of high-volume source dilution samplers, collect stack samples for use in developing analytical and mutagenicity bioassay procedures, and determine mutagenicity of organics associated with emission particles from two municipal waste combustors and a hospital waste combustor. Data are presented for particle concentrations and emission rates, extractable organic concentrations and emission rates, and Salmonella (Ames) mutagenic potency and emission rates. The mutagenic emission rates and emission factors are compared to other incinerators and combustion sources. (+info)
The findings of the Agency for Toxic Substances and Disease Registry Medical Waste Tracking Act report.
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The Agency for Toxic Substances and Disease Registry (ATSDR) report "The Public Health Implications of Medical Waste: A Report to Congress" has been finalized and submitted to Congress. The report is a comprehensive review of all available data and information on the subject. Based on the data developed in the report, ATSDR concludes that the general public is not likely to be adversely affected by medical waste generated in the traditional health setting. However, the increase of in-home health care and other sources of nonregulated medical waste (e.g., intravenous drug users) provides opportunities for the general public to contact medical waste. In addition, ATSDR concludes that public health concerns exist for selected occupations involved with medical waste. These populations include janitorial and laundry workers, nurses, emergency medical personnel, and refuse workers. The ATSDR report also defines what material should be managed as medical waste and identifies research needs related to medical waste. (+info)
Resistance in the environment.
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Antibiotics, disinfectants and bacteria resistant to them have been detected in environmental compartments such as waste water, surface water, ground water, sediments and soils. Antibiotics are released into the environment after their use in medicine, veterinary medicine and their employment as growth promoters in animal husbandry, fish farming and other fields. There is increasing concern about the growing resistance of pathogenic bacteria in the environment, and their ecotoxic effects. Increasingly, antibiotic resistance is seen as an ecological problem. This includes both the ecology of resistance genes and that of the resistant bacteria themselves. Little is known about the effects of subinhibitory concentrations of antibiotics and disinfectants on environmental bacteria, especially with respect to resistance. According to the present state of our knowledge, the impact on the frequency of resistance transfer by antibacterials present in the environment is questionable. The input of resistant bacteria into the environment seems to be an important source of resistance in the environment. The possible impact of resistant bacteria on the environment is not yet known. Further research into these issues is warranted. (+info)
Hospital wastewater genotoxicity.
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Hospitals represent an incontestable release source of many chemicals compounds in their wastewaters, and which may have an impact on the environment and human health. Indeed, some of the substances found in wastewaters are genotoxic and are suspected to be a possible cause of the cancers observed in the last decades. To study the toxicity and the risk associated with these releases biological tests, such as genotoxicity tests, can be used. An evaluation of the genotoxic potential of the wastewaters from a university hospital was performed with the SOS chromotest and the Salmonella fluctuation test. The samples were taken for six 1-week periods between May 2001 and April 2003. Out of a total of 38 samples tested, 31 were positive in at least one assay (82%). Distribution, proportion and intensity of the genotoxic response were different among the six sampling periods. The two genotoxicity tests had different sensitivities. It must be emphasized that whatever the sampling period, Monday samples were always genotoxic in at least one assay. This work shows that this hospital wastewaters samples are very often genotoxic, the response intensity being inflected by rain levels. Efforts must be undertaken by hospitals to integrate the knowledge and the control of their wastewaters in infection and environmental control programs. (+info)
PFGE-based epidemiological study of an outbreak of Candida tropicalis candiduria: the importance of medical waste as a reservoir of nosocomial infection.
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Between November 2002 and March 2003, an outbreak of candiduria occurred in the surgical intensive care unit (SICU) of a university-affiliated hospital in South Korea. This outbreak affected 34 patients and was caused by Candida tropicalis. To determine the source of the epidemic and the risk factors, surveillance cultures from the SICU, genotyping of Candida isolates by pulsed-field gel electrophoresis (PFGE), and a case-control study were performed. The surveillance cultures revealed that 6 environmental samples related to the urine disposal route were positive for C. tropicalis. The PFGE analysis of genomic DNA demonstrated identical band patterns for all of the C. tropicalis isolates obtained from SICU patients and the 6 environmental samples during the outbreak period, while epidemiologically unrelated strains showed unique PFGE band patterns. Although no risk factors were identified by the case-control study, this epidemiological investigation involving the use of molecular techniques suggests that improper disposal of infectious medical waste led to the cross-transmission of a single clone that was responsible for the outbreak of C. tropicalis candiduria in this SICU. After implementing a better urine disposal system and thorough hand washing procedures, no further clusters of candiduria were detected in the SICU. (+info)