A shot in the arm

When it comes to waste management, you’d be hard-pressed to find a market that is more reliant on regulations and adherence to proper disposal methods than the medical sector. Health care facilities across the country ranging from hospitals, doctors’ and dentists’ offices, blood banks, veterinary clinics and medical research facilities and laboratories are governed by state environmental and health departments to ensure compliance when disposing of blood, body fluids or other potentially infectious materials.

Since 1991, Curtis Bay Medical Waste Services in Baltimore has answered the call to help clients throughout the eastern United States with their medical waste collection needs. According to Jack Perko, CEO of Curtis Bay, the 225-person company got its start helping ease the burden of area facilities having to process their own regulated waste.

“Curtis Bay Medical Waste Services was conceived, designed and built in cooperation with members of the Maryland Hospital Association in 1991 to provide a regional solution to medical waste management requirements with the goal of building a facility to provide local specialty waste services and eliminate the need of each facility to provide their own incineration services,” Perko says.

Boasting route-based hauling services, transfer and product distribution with autoclave and the largest medical waste incinerator processing capabilities in the country, Curtis Bay specializes in medical waste collection, transfer, transportation, recycling, waste reduction, sharps management, disposal, compliance training and consulting services.

In addition to medical waste, Curtis Bay offers disposal solutions for pharmaceutical waste, pathological waste, chemotherapeutic waste, hazardous waste, Drug Enforcement Administration- (DEA)-controlled substance waste, Animal and Plant Health Inspection Service (APHIS) waste and third-party document and private material destruction.

Since its inception more than 25 years ago, Curtis Bay has expanded to serve more than 10,000 customers in the United States and Canada, ranging from single medical practices to large integrated delivery networks and hospital systems throughout Ohio, Pennsylvania, Delaware, Maryland, the District of Columbia, West Virginia, Virginia, North and South Carolina, Tennessee and Georgia. Additionally, the company’s incineration waste-to-energy services can accommodate customers in 48 states and Canada.

Meeting the needs of the market

Among the biggest challenges of serving the disposal needs of its clients is the assortment of state-specific regulations and the variety of medical waste facilities the company accommodates, Perko says.

“Medical waste management is a highly regulated and complex process,” Perko says. “Each medical waste generator may have a unique set of internal processes and reporting requirements. Coordination of collection, storage and disposal requires significant planning. There are ongoing trainings and reporting that is required by many regulatory agencies to ensure proper waste management and disposal compliance.”

Perko says that as a customer’s facility increases in size and scope, so do the challenges of handling its waste.

“Generally, the larger the organization, the more complex the requirements for medical waste disposal,” Perko says. “A doctor’s office may only require basic regulated medical waste box pickup service, while a large hospital system may have a service need for regulated medical waste; disposable sharps wall and floor systems; chemotherapeutic, pathogen, hazardous and nonhazardous pharmaceutical and controlled substance waste; as well as a staffing requirement for in-house service technicians.”

Medical waste service providers not only help their clients dispose of these potentially hazardous wastes, they also can be a go-to resource for ensuring compliance. According to Perko, medical waste generators should thoroughly vet potential partners prior to service to find a management company that can meet its needs.

“The selection of a medical waste disposal company should be taken very seriously,” Perko says. “Medical organizations should look for companies who have proven experience handling, packaging, hauling and treating all types of regulated waste. They should also look for a company that understands the importance of compliance and can be their compliance partner to train their employees on waste regulations, segregation, packaging and compliance. Companies that offer full-service solutions provide added value and expertise that will prove beneficial when seeking potential service providers.”

Training all employees thoroughly on waste identification segregation is the most effective method to ensure all waste is properly disposed, packaged, transported and processed.” - Jack Perko, CEO, Curtis Bay Medical Waste Services

Staying compliant

There is little room for error when it comes to medical waste collection and disposal, which is why training is a fundamental component of Curtis Bay’s service offerings.

“Training all employees thoroughly on waste identification segregation is the most effective method to ensure all waste is properly disposed, packaged, transported and processed,” Perko says. “Medical waste identification should be part of all employees’ initial training and updated at least every year. This makes it easy for everyone to know what should and should not be put in a specific container through the proper labeling and color coding of all containers.”

The company offers a compliance suite to its customers that includes 15 training courses, safety plan builders, Occupational Safety and Health Administration (OSHA) 300 log and material safety data sheet (MSDS) database oversight, ICD-9 to ICD-10 code conversion, federal regulation database management and more than 70 interactive sample audits.

According to Perko, medical waste generators should make a variety of different training opportunities available to their staff to remain in compliance with various regulatory agencies. Some of these trainings include:

• Bloodborne pathogen (BBP) training: This training provides information on bloodborne pathogens and diseases, methods used to control occupational exposure, hepatitis B vaccines and medical evaluation and postexposure follow-up procedures.
• Department of Transportation (DOT) regulated medical waste (RMW) training: This training helps teach employees to accurately classify and name medical wastes and package, mark, label and complete shipping paper documentation for these shipments. This training is required to be taken at least once by anyone who prepares RMW for transportation, packages and/or marks the waste, as well as those who sign the medical waste manifest and shipping papers and/or supervise any of these functions.
• Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health Act (HITECH) training: This helps employees understand the requirements pertaining to patient privacy and security and how to store and dispose of patients’ personal and health information given to a facility.
• Hazard communication (HazCom) training: This training provides information for employees who work with, or may be exposed to, hazardous chemicals in the workplace. This training deals with the revised OSHA standard requiring the use of new labeling and a standardized format for safety data sheets (SDSs).

Taking the time to engage employees in initial and ongoing training can help a medical waste producer keep its staff safe and protect its customers, its business, the general public, the environment and its bottom line.

“Medical waste can be very hazardous—hence the strict regulations around it,” Perko says. “If a medical professional decides not to comply with disposal best practices or regulations, and they dispose of their medical waste improperly, the medical waste could end up in our environment. This puts every individual that could potentially come in contact with that medical waste in harm. Second, training is important to help companies avoid fines and protect their businesses. There are countless fines, across many regulatory agencies, that an organization can get hit with if they are out of compliance. Sometimes those fines can be hefty, which can hurt a business or even shut it down.”

Although staying on top of ongoing medical waste regulations can be a lot to deal with for a company, Perko says taking the time to train employees can yield a positive impact that reverberates throughout a company, its affiliates and its community.

“Being vigilant about observing training best practices allows for a safer, more compliant and sustainable solution for the future of a company’s organization, its patients, the community and the planet,” Perko says.

The author is the editor for Waste Today and can be contacted at aredling@gie.net.