Health Sciences Center - Kuwait University

What is the HSC Medical Waste Management System?

It is a system that covers management of both hazardous and nonhazardous medical wastes produced within HSC faculties and facilities:
 Faculty of Medicine (FOM)
 Faculty of Allied Health Sciences (FOAHS)
 Faculty of Pharmacy (FOP)
 Faculty of Dentistry (FOD) including KU Dental Clinic
 Animal Resources Center (ARC); formerly known as Animal House
 Research Core Facility (RCF)

What does the HSC Medical Waste Management System consist of?

 Collection
 Treatment either on-site (when possible) or off-site
 Safe Disposal
of all types of medical wastes

What are the different types of medical wastes that are covered by the HSC Medical Waste Management System?

They are:
 Chemical
 Pharmaceutical (Therapeutic Chemical)
 Biological or Biohazards
 Animal
 Dental
 Decayed Radioactive
 Glassware
 Expired or Dead Dry Cell Batteries
 Other Wastes

Note that the radioactive wastes collected from HSC will be in a decayed stage and are exempted from MOH ACT No. 553 for the Year 2003. For a full record of the ACT please refer to Guidance Documents on Environmental Health and Safety

What is Chemical Waste? How is it managed?

Chemical waste produced in laboratories should be disposed in separate containers, sealed properly. The following waste streams should always be separated:

1. Flammable liquids
3. Acids
5. Bases
7. Chromerge
9. Halogenated organic compounds
11. Photographic waste
13. Aqueous heavy metal solutions
15. Air-reactive materials
17. Berlyllium (from X-ray tubes)

2. Oxidizers
4. Oils
6. Ethidium bromide
8. Formalin/Formaldehyde
10. Non-halogenated organic compounds
12. Lead (from radiographic films)
14. Mercury and Mercury compounds
16. Water-reactive materials

Chemical waste should always be compatible with its containers. Placing a waste in an inappropriate container may lead to container disintegration or rupture. The following are major chemical wastes that should be placed in GLASS containers. These chemicals CANNOT be placed in plastic containers.

1. Amyl chloride
3. Aniline
5. Benzyl alcohol
7. Bromine
9. Bromobenzene
11. P-Dichlorobenzene
13. Diethyl benzene
15. Diethyl ether
17. Ethyl chloride, liquid
19. Nitrobenzene
21. Perchloroethylene
23. Nitric acid
25. Vinylidene chloride

2. Butyric acid
4. Carbon disulfide
6. Concentrated acids
8. Cinnamon oil
10. Cresol
12. Thionyl chloride
14. Trichloroethene
16. Trichloroethylene
18. Vinylidene chloride
20. Brominated and fluorinated solvent
22. Thionyl chloride
24. Trichloroethene
26. Brominated and fluorinated solvent

Note that a chemical should always be compatible with its container. Also, a respiratory and eye protection equipment must be always worn when collecting and treating chemical wastes.

Which Chemical Waste is hazardous? How is it managed?

Liquid Mercury Waste
Elemental Mercury and Mercury compound solutions must be disposed in leak-proof containers, sealed tightly. Moreover, it should not be incinerated under any circumstance.
Solid Mercury Waste
Solid Mercury waste including Mercury-contaminated gloves, contaminated towels and spill cleanup material should be double-bagged and tightly sealed before disposal. Moreover, it should not be incinerated under any circumstance.
Broken Fluorescent Light Tubes
Broken fluorescent light tubes are hazardous waste. These broken tubes should be collected, double-bagged and tightly sealed. The bag should then be placed in a box/container and sealed for disposal.
Mercury-containing Thermometers, Thermostats, Switches
Wastes from Mercury-containing thermometers, thermostats and switches should be collected in a large container, zip-lock plastic bags or wide-mouthed jars with lids before disposal. Moreover, they should not be incinerated under any circumstance
Ethidium Bromide
Aqueous solutions containing > 10 µg/mL Ethidium Bromide should be first filtered or deactivated before disposal in special containers using:
- Charcoal Filtration (Funnel Kit, Green Bag)
- Chemical Neutralization (Armor Method, Lunn and Sansone Method, Quillardet and Hoffnung Method)
Dried gels containing Ethidium Bromide or any contaminated solid waste e.g. gloves, microfuge tubes, etc should be disposed in hazardous waste containers.

Solutions containing heavy metals, organics, cyanides or sulfides should be disposed in special containers as hazardous waste.

Note that personal protection e.g. eye protection, respiratory protection, Nitrile gloves ONLY, lab coat must be worn all the time when handling Ethidium Bromide.
Silica Gel, Molecular Sieves and Desiccant
Used silica gel, molecular sieves and desiccants that are contaminated with solvents or other hazardous chemicals must be disposed as hazardous waste. They should be first placed in brown hazardous bags then in a container. The container should be disposed when it is ¾ full.
Note that only unused silica gel, molecular sieves or desiccants that have not been in contact with hazardous chemicals may be disposed of in the regular trash within a sealed container.
HEPA Filters
Contaminated High Efficiency Particulate Air filters (HEPA filters) with chemicals in biological safety cabinets should be treated as a chemical waste. These contaminated filters should be disposed per to the manufacturer’s recommendations. It is important that an appropriate eye and respiratory protection should be worn while performing this task.

Note that Beryllium containing materials, in any form, should not be incinerated or allowed for dispersal as dust or fume under any circumstances.

What is Pharmaceutical Waste? How is it managed?

Pharmaceutical Waste is known, also, as Therapeutic Chemical Waste. The term refers to a diverse group of chemicals including, but not limited to, prescription and over-the-counter human drugs, veterinary drugs, diagnostic agents, nutritional supplement etc

Nonhazardous Pharmaceutical Waste
Nonhazardous pharmaceutical waste includes the following:
1. Unused or partially used vials, ampoules, or bottles
2. Unused or partially used IV bags (intravenous) and tubing containing drugs
3. Unused or partially-used decayed radiopharmaceutical vials or bottles
4. Discontinued medications that are not suitable for reuse
5. Tablets and capsules that have been dropped or spit out by a patient
6. Outdated drugs being discarded
7. Discontinued medications that patients have brought from home and left
Nonhazardous pharmaceutical waste should be processed by a medical waste incinerator or a properly permitted municipal waste incinerator. An exception is IV (intravenous) solutions without drug additives. These solutions can be placed in sewer systems. Moreover, disposal of devices used to administer nonhazardous medications, such as inhalers that use propellants should be performed as recommended by the device manufacturer.
Hazardous Pharmaceutical Waste
In this section, hazardous pharmaceutical waste is classified based on to the US Environment Protection Agency (EPA) federal regulations.
 P List (Acutely Toxic)
1. Epinephrine
2. Phentermine
3. Physostigmine
4. Nicotine
5. Nitroglycerin
6. Warfarin > 3%
Both the drug and the container that held the drug are considered hazardous and must be disposed in an appropriate container.

 U List (Toxic)
1. Phenol
2. Lindane
3. Choral hydrate
4. Selected antineoplastic (antitumor antibiotics) waste e.g. Oxaliplatin (Eloxatin)
 D List (Chemical Characteristic)
The D list items are pharmaceuticals that cause wastes with any of the following characteristics: ignitability, corrosivity, reactivity, and toxicity.
Ignitability
Applies to an aqueous solution that contains 24% alcohol or more by volume and has a flash point < 140°F/60°C e.g. Rubbing alcohol, Topical preps, Benzoin, Paclitaxel.
Corrosivity
Applies to an aqueous solution having a pH ≤ 2 (acidic) or ≥12.5 (basic) e.g. Glacial acetic acid, Sodium hydroxide.
Reactivity
Applies to waste with properties that are normally unstable and readily:
 Undergo violent changes without detonating
 React violently with water
 When mixed with water generate toxic gases, vapors, or fumes in a quantity sufficient to cause human and environmental harm e.g. certain Nitroglycerin formulations

Toxicity
Applies primarily to heavy metals that may be above maximum concentration or regulatory levels e.g. Barium, Cadmium, Selenium, Thimerosal.
Cytotoxic Waste
Cytotoxic waste is material that is/might be contaminated with a cytotoxic drug during the preparation, transport or administration of chemotherapy. Cytotoxic drugs are toxic compounds known to have carcinogenic, mutagenic and/or teratogenic potential. Examples of Cytotoxic waste include:
- Cytotoxic pharmaceuticals passed recommended shelf life, or returned from patients
- Sharps and syringes used in cytotoxic drug therapy
- IV infusion sets and containers used in cytotoxic drug therapy
- Contaminated ampoules and vials with cytotoxic drugs
- Cotton wool from bottles containing cytotoxic drugs
- Remaining cytotoxic solutions, expired or contaminated stock
- Contaminated HEPA filters with cytotoxic drugs
- Personal Protection Equipment (PPE) e.g. gloves, disposable gowns and shoe covers, etc contaminated with cytotoxic drugs
- Swabs and materials use to clean cytotoxic spills
- Contaminated dressings and bandages with cytotoxic drugs
- Contaminated cleaning equipment (mops, cloths) with cytotoxic drugs
3.1. Management of Waste at Source
Cytotoxic drugs must be managed as follows:
- The bags/bins shall be removed from the initial collection containers and sealed before transferring to the contractor supplied brown-240 Liter-wheelie (wheeled vehicle) bins/containers for collection from a dedicated storage area.
- Glass bottles with liquid waste should be wrapped in bubble-wrap and/or absorbent material to avoid breakages.
- Cytotoxic waste bins/containers should be located as close as practicable to the site of generation to minimize the handling and transport of cytotoxic waste from the site of generation.
- Bins/containers should be emptied at least weekly or before the volume in the bin/containers exceeds two thirds the volume of the liner or 6 kilograms (Kg).
3.2. Bins and Containers
All cytotoxic drugs must be placed in brown sharps containers and/or brown liners and waste bins/containers with the white telophase cytotoxic symbol. The bins/containers should be identified as ‘Cytotoxic waste – incinerate at 1100ºC.’
3.2.1. Storage
All bins/containers used to store cytotoxic drugs must be:
- Placed in such a manner as to reduce the risk of spill and/or contamination.
- Stored in a dedicated storage area with adequate lighting and ventilation.
- Capable of being secured so that are not to be re-opened on-site once they have been secured.
3.2.2. Collection for Disposal
Cotoytxic drugs must be:
- Collected in purple liners and transferred to the brown-240 Liter-wheelie bins/cotainers.
- Collected within 7 days of generation. Wastes should not exceed the 7-day limit to fill the bin/container.
Pharmaceutical waste is considered dangerous if it contains any of the following:
- More than one P- or U-listed drug
- Chemotherapy agents (cytotoxic)
- Drugs meeting US National Institute for Occupational Safety and Health (NIOSH) or US Occupational Safety and Health Administration (OSHA) criteria
- Drugs with LD50 (lethal dose in 50% of test animals) less than or equal to 50 mg/kg
- Endocrine disrupters
- Immunosuppressants
- Vitamins and mineral preparations with potential toxicity due to Chromium, Selenium or Cadmium
Note that landfills are the ultimate destination of pharmaceutical waste. Solid pharmaceutical waste including pharmaceutical packaging, empty or partially empty vials, empty or partially empty glass and plastic bottles, ointments etc can be disposed in a municipal incinerator. Incineration of chemotherapy sharps and chemotherapy soft waste must take place in a medical waste incinerator.

What is Biological Waste? How is it managed?

The term infectious waste is synonymous with biohazard; it does NOT include chemical agents, such as carcinogens, which affect living organisms through chemical means. Infectious waste or biohazard is a liquid or solid waste that contains pathogens in sufficient numbers and with sufficient virulence to cause infectious diseases in susceptible hosts exposed to that particular type of waste.

Microbiological Waste
Microbiological waste includes cultures and stocks of disease producing agents containing microbes that are known to cause disease in humans such as:
- Specimens from medical and pathology laboratories
- Discarded live vaccines
- Wastes from biological testing
- Cultures and stocks of infectious agents from clinical laboratories
- Disposable culture dishes
- Devices used to transfer, inject, and mix cultures
Microbiological waste should be placed into biohazard bags (YELLOW) and treated before disposal by either:
- Chemical Disinfection
- Steam Disinfection (Autoclaving)
Pathological Waste
- Human tissues and organs
- Amputated limbs or other body parts
- Similar tissue from surgery procedures
- Bedding exposed to pathogens
Pathological waste must either be preserved or kept frozen until pick-up for disposal. They should be placed into biohazard bags (YELLOW) when waste is ready for pick up.
Human Blood and Blood Products Waste
- Human blood or body fluids
- Components or products of blood
- Plasma
- Serum
- Items saturated or dripping with human blood
- Items saturated or dripping with human blood that are now caked with dried human blood
- Devices used to contain blood or other body fluids, excluding urine that does not have visible blood in it
Human blood and blood products waste should be placed into biohazard bags and/or containers (YELLOW) when waste is ready for pick up for treatment before disposal.
Sharps
- Hypodermic needles
- Specimen
- Syringes
- Slides
- Scalpel blades
- Cover slips
- Pasteur pipettes
- Glass Petri plates
- Broken glass contaminated with infectious material
All sharps must be placed into sharps containers with cover. These containers should be picked up when they are ¾ full.
HEPA Filters
Biologically contaminated HEPA filters in biological safety cabinets should be treated as biohazards. These contaminated filters should be placed into biohazard, autoclavable bags (RED) and treated before disposal by steam sterilization or autoclaving. It is important that an appropriate respiratory protection should be worn while performing this task.

What is Animal Waste? How is it managed?

Carcasses and Body Parts of Animals
Carcasses and body parts of animals that have not been preserved must be double bagged to prevent leakage and kept frozen until transferred to the HSC Animal Resources Center (ARC). Carcasses and body parts of animals that have been preserved, on the other hand, must be first separated from the preservative and double bagged to prevent leakage. Both should be placed in a box for incineration at an approved disposal facility.
Whole Blood, Serum, Plasma, and/or other Blood Components from Animals
Whole blood, serum, plasma and/or other blood components from animals should be placed into a non-breakable, closeable container. They should be treated as human blood and blood products waste.
Bedding of Animals Intentionally Exposed to Pathogens
Bedding of animals intentionally exposed to pathogens should be double bagged (using biohazard bags) and placed in a box for incineration at an approved disposal facility.
Animal carcasses, body parts, and bedding containing radioactive material e.g. Tritium (3H), Radiocarbon (14C), etc should be treated as follows:
- If the concentration of the radioactive material < 0.05 µCi/g (microCuries per gram) i.e. 1850 Bq/g (Becquerel per gram) of waste or the radioactive material has a half life < 65 days, waste should be first stored for decay in a freezer approved by the HSC Radiation Safety Officer for 10 half-lives before it becomes solely an infectious waste. Then, it should be disposed as an infectious waste with no regard to its radioactivity.
- If the concentration of the radioactive material ≥ 0.05 µCi/g (1850 Bq/g) of waste or the radioactive material has a half-life > 65 days, waste must be managed as a special low-level radioactive waste.
Animal carcasses, body parts, and bedding containing and/or contaminated with hazardous chemical materials can be disposed as infectious waste as long as it does not have any of the characteristics of a hazardous waste which include ignitability, corrosivity, reactivity, or toxic characteristic leachate procedure (TCLP) waste in excess of certain quantities.

Note that animal waste must be incinerated.

What is Radioactive Waste? How is it managed?

Radioactive waste within HSC faculties originates from:

Laboratory research
Clinical research, diagnosis and therapy

Radionuclides or radioisotopes that are commonly used for medical/clinical research and/or therapy are grouped into 3 groups as shown below.

	Class A	Class B	Class C
Nature	- Long-lived - α emitters	- Long-lived - β or γ emitters	- Short-lived - β or γ emitters
Examples	- ²²Na - ²⁴Na - ⁶⁰Co - ⁶⁵Zn - ¹²⁴Sb - ¹⁹²Ir - ¹⁸²Ta	- ^74As - ⁵⁹Fe - ¹¹¹In - ⁴⁶Sc - ⁸⁵Sr - ¹⁹⁸Au - ⁶⁷Ga - ¹¹⁴mIn - ⁷⁵Se - ⁹⁰Sr - ⁸²Br - ¹⁵³Gd - ⁹⁵Nb - ¹⁵³Sm - ⁵⁸Co - ²⁰³Hg - ⁸⁴Rb - ¹¹³Sn - ¹⁸F - ¹³¹I - ⁸⁶Rb - ¹²³Sn - ¹⁴C - ³H	- ¹⁹⁵mAu - ³⁶Cl - ⁸¹Kr - ¹⁸⁸Re - ²⁰¹Tl - ⁵⁷Co - ⁹⁸Nb - ¹⁰³Ru - ¹²⁷Xe - ⁴⁵Ca - ⁵¹Cr - ⁶³Ni - ³⁵S - ¹³³Xe - ¹⁰⁹Cd - ³²P - ⁸⁹Sr - ⁹⁰Y - ¹³³Ce - ¹²³I - ³³P - ⁹⁹Tc - ¹⁶⁹Yb - ¹⁴⁴Ce - ¹²⁵I - ¹⁸⁶Re - ⁹⁹mTc

Classification of common radionuclides or radioisotopes used in medical research and/or therapy.

Note that the radioactive wastes that are produced/generated in HSC laboratories are of low concentrations and are exempted from MOH Act No. (553), and will be collected when they are in decayed stages.

Dry Solid
Dry solid radioactive waste should be placed in sealed, labeled wet bags, ⅔ full. These bags should be placed inside a red plastic bag and tied with a cable tie. Any sharps must be in a container that will prevent them piercing the bags.
Liquid-water Soluble
Liquid-water soluble radioactive waste is categorized by half life. It should not contain hazardous chemicals or solvent. Liquid radioactive waste < 0.002 µCi/g (74 Bq/g) is not considered radioactive. It can be disposed of via the regular drain. However, it is illegal, after an experiment is over, to further dilute liquids in order to meet the regulations.
Scintillation Waste Vials
The liquid scintillation vials must be tightly capped with concentration of 3H and/or 14C only < 0.05 µCi/g (1850 Bq/g). These vials must be disposed using the same 5 Gallon (20 L) steel pails normally used for some solid waste. Pails should be lined with a plastic bag.
Bulk Scintillation Waste
The scintillation fluid should be first segregated from other liquid wastes. The empty scintillation vials may be disposed as dry waste if they contain NO residual scintillation fluid.
HEPA Filters
Contaminated HEPA filters with radioactive materials in biological safety cabinets should be treated as a radioactive waste. These contaminated filters should be first placed inside poly bags or wrapped in plastic sheeting to maintain containment of the radioactive material when transferred to the disposal container. They should then be disposed per to the manufacturer’s recommendations. It is important that an appropriate eye and respiratory protection should be worn while performing this task.
Animals Contaminated with Radioactive Waste
Please refer to the Question “What is Animal Waste? How is it managed?”

Radioactive waste should be placed in special containers before disposal. Note that some radioactive waste may need to be stored for decay before disposal, if the dose rate at the bag/container surface ≥ 5 µSv/hr (microSieverts per hour). On the other hand, if radioactivity of the waste takes more than 168 days (24 weeks) to decay to non-radioactive status, it should be disposed of as radioactive waste.

What is Glassware Waste? How is it managed?

Broken glass, empty bottles or used Pasteur pipettes, not used for biohazardous or infectious material, must be put only in either specific, sturdy cardboard boxes lined with regular trash bags or plastic buckets with lid labeled ‘For Broken Glass ONLY’. These broken glass bins are in turn placed into special bins and are then removed. Note that these bins CANNOT be used to dispose: (These items have a special disposal method)

Contaminated laboratory glassware or plasticware
Sharps
Biohazards or infectious materials
Radioactive materials
Liquid waste

Always note that, broken glass or any sharps should NOT be placed in normal waste bins (trash).

What is Battery Waste? How is it managed?

Dry cell batteries come in different types as shown in the table below.

Battery Type	Description	Format	Use	Remarks
Alkaline and Carbon Zinc	- Small - Sealed - Non-rechargeable - Labeled general purpose or heavy duty	- AA - AAA - D-cell - C-cell - 9V - Button cells	- Camera - Handheld electronics	- Can leak with age - Non-toxic - Non-spillable
Hybrid Automotive	- Large - Most common: NiMH & Li-ion - Sealed - Rechargeable	- Large pack of small cells	- Hybrid automobile	- Non-spillable
Lead Acid Gel	- Small to medium - Sealed - Rechargeable	- Rectangular - Custom sizes in hard plastic case	- Wheel chairs - Portable tools and instruments	- Non-spillable gelled electrolyte - Toxic - Can cause fire if short-circuited
Lithium (Primary)	- Small - Sealed - Non-rechargeable	- Button cells - AA - AAA - 9V - Small-cylinder - Custom sizes	- Camera - Handheld Electronics - Alarms - Memory backup - High-temperature applications - Pacemakers	- Non-spill-able - Non-toxic - Can overheat or explode if short-circuited
Lithium-ion (Li-ion)	- Small - Sealed Rechargeable	- Custom sizes in hard plastic case - Small-cylinder - Button cells	- Laptop computers - Power tools - Hybrid automobiles - Video camera - Handheld electronics	- Non-spillable - Non-toxic
Mercury	- Small - Sealed - Non-rechargeable	- AA - 9V - Small-cylinder - Custom sizes	- Camera - Medical devices	- Non-spillable, - Toxic - Never incinerate - Produces highly toxic vapors
Nickel-Cadmium (NiCd)	- Small - Sealed - Non-rechargeable	- AA - AAA - C-cell - D-cell - Small-cylinder - Poly-wrapped cell packs - Custom sizes in hard plastic case	- Laptop computers - Power tools - Handheld electronics - Medical equipment	- Non-spillable, - Toxic - Never incinerate - Produces highly toxic vapors
Nickel Metal Hydride (NiMH)	- Small - Sealed - Rechargeable	- AA - AAA - C-cell - D-cell - Poly-wrapped cell packs - Small-cylinder - Custom sizes	- Laptop computers - Power tools - Hybrid automobile - Camera - Handheld electronics	- Non-spillable - Non-toxic
Silver Oxide	- Small - Sealed - Rechargeable	- Button cells - High-voltage - Small-cylinder - Large custom sizes	- Hearing aids - Camera	- Non-spillable - Non-toxic
Zinc Air	- Small - Sealed - Non-rechargeable	- Button cells - 9V - Custom sizes	- Hearing aids - Mechanically Recharged Electric vehicles	- Non-spillable - Non-toxic

The different types of dry cell batteries.

Each battery type should be placed in a special container then collected for a proper disposal or recycling outside KU. Note that under any circumstances, all types of batteries should not be crushed as some may ignite or explode.

What is Dental Waste? How is it managed?

Amalgam
1.1. Non-contact Dental Amalgam
Non-contact dental amalgam (containing Mercury) should be disposed in an appropriately labeled container for each amalgam mixing station in the clinic. The container should be a wide-mouth and made of High Density Polyethylene (HDPE) plastic with tight-fitting, screw-on caps, preferably 1-gallon in size. Once the container is 90% full, it should be treated as a biohazard waste. Note that these containers will be used exclusively for recycling non-contact dental amalgam scraps and no water is to be placed in them.
1.2. Contact Dental Amalgam
Contact dental amalgam (containing Mercury) should be disposed in an appropriately labeled container. The container should be a wide-mouth and made of HDPE plastic with tight-fitting, screw caps. The container should be pre-filled with a regular, full strength household bleach solution up to half of its capacity. Bleach should be added as necessary to keep the waste covered. When it reaches 90% capacity, the container must then be removed from the clinic area within three (3) days and treated as a biohazard waste.
Methyl Methacrylate
Methyl Methacrylate (MME) is an extremely flammable liquid. Thus, waste or spilled liquid MME should be disposed as a hazardous waste. Any materials used to clean up a spill of liquid MME (paper towels, absorbent pads, etc.) are also considered hazardous waste.
Note that:
- When liquid MME has been mixed with the powder component and polymerized into the acrylic, the acrylic does not exhibit the flammability characteristic and is therefore not a hazardous waste. Waste acrylic can be discarded in the regular trash.
- Liquid MME has a strong pungent odor even at very low and safe exposure levels. Symptoms of exposure to high concentrations of MME vapors include eye irritation, headache, drowsiness, dizziness, difficulty in breathing, and loss of consciousness. Liquid MME can cause considerable irritation or burns to the skin and eyes. For a safe treatment and disposal of liquid MME, the waste collector must wear respiratory and eye protection.
X-Ray Processing Wastes
3.1. Lead Foils
Lead foils from the X-ray film (potentially toxic material) must be placed in lead foil recycling containers. These containers should be sent for recycling when full, and should never be used for disposal of the plastic component of the film or the film itself.
3.2. Spent Fixer Solution
Spent fixer solution should to be collected in a labeled waste container beneath or close to the developer unit. The container must have tight-fitting caps, and kept closed at all times except when adding the fixer. When the container is 90% full, it is should be treated as a hazardous chemical waste.
3.3. Used Developer Solution
Used developer solution may be poured down the drain with copious amounts of water. However, once mixed with spent fixer, the mixture should be treated as a chemical hazardous waste.
3.4. Lead Shields and Aprons
Worn-out lead shields and aprons should be collected and returned to the manufacturer or recycled as hazardous waste. They should not be disposed in the regular trash or biohazard bags.
3.5. Extracted Teeth
Extracted teeth that do not contain dental amalgam should be discarded into red sharps containers, labeled as biohazards. On the other hand, extracted teeth that contain dental amalgam (containing Mercury) should be disposed in an appropriately labeled container. The container should be a wide-mouth and made of HDPE plastic with tight-fitting, screw caps. The container should be pre-filled with a regular, full strength household bleach solution up to half of its capacity. Bleach should be added as necessary to keep the waste covered. When it reaches 90% capacity, the container must then be removed from the clinic area within three (3) days and treated as a biohazard waste.

What is the color code used for medical waste bags and containers at HSC?

HSC follows the World Health Organization (WHO) color code for medical waste bags and containers.

Waste Type	WHO Color Code
Biological Waste (including Pathological and Infectious)	YELLOW
Sharps	YELLOW
Pharmaceutical Waste (including Cytotoxic)	BROWN
Chemical Waste	BROWN
Radioactive Waste	None

The WHO color code for medical waste bags and containers.

How should medical waste be transported?

Transporters of infectious waste must:

Transport infectious waste separate from other waste unless the waste is contained in a separate, fully enclosed leak-proof container within the vehicle compartment or unless all of the waste in the vehicle is to be treated as infectious waste.
Transport infectious waste using equipment that will contain all waste so that there are no releases of infectious waste to the environment.
Provide training for drivers in waste handling and spill cleanup methods.
Label vehicles by either Kuwait Ministry of Interior Affairs- Department of Transportation and Traffic standards or international standards.
Have spill kits available.
Transport wastes in refrigerated transport vehicles throughout the year.
Clean all surfaces of transport vehicles when spills have occurred.
Store waste no longer than 7 days without refrigeration and no longer than 30 days total at the waste collection points before disposal.

Does the HSC Medical Waste Management System follow local and international regulations on environmental health and safety?

Yes. The different services of the System are complied with standards and regulations of:

Kuwait Ministry of Health (Kuwait MOH)
Kuwait Environment Public Authority (Kuwait EPA)
Kuwait Public Authority for Industry
Kuwait Ministry of Interior Affairs- Department of Transportation and Traffic
World Health Organization (WHO)
US Environmental Protection Agency (US EPA)
US National Institute for Occupational Safety and Health (US NIOSH)
US Occupational Safety and Health Administration (US OSHA)

What is your role in the HSC Medical Waste Management System operations?

You are to:

Abide to safe laboratory practices.
Collaborate with your faculty representative(s) in the HSC Laboratory and Environmental Safety Committee to ensure that the System is running as it should be e.g. reporting, documentation, etc.

What should be documented?

The amount (in Kg or in L) of each type of medical waste generated at HSC various departments should be documented Every department chief technician or in-charge has to complete the Medical Waste Manifest Form on a daily basis. The signed, completed Form should be forwarded to your faculty representative(s) in the HSC Laboratory and Environmental Safety Committee on a monthly basis.

How and to whom should you report a problem, a complaint or a suggestion?

Reporting of breach of contract incidents, complaints or recommendations should be addressed directly in writing via e-mail to your faculty representative(s) in the HSC Laboratory and Environmental Safety Committee.

Who is in the HSC Laboratory and Environmental Safety Committee?

Committee Members (Academic Year 2011/2012):

FOM (including ARC & RCF) Representatives

Mohamed A. Sakr mohsakr@hsc.edu.kw
T. S. Srikumar srikumar@hsc.edu.kw

FOAHS Representative

Leina S. Ibrahim leina@hsc.edu.kw

FOP Representative

Sulaiman M. Al-Sulaiman zergi@hsc.edu.kw

FOD Representative (including KU Dental Clinic)

Subhadra Surana surana@hsc.edu.kw

VPO Representative & Committee Officer

Hanan A. Al-Awadhi halawadhi@hsc.edu.kw