Frequently Asked Questions

  • Does adding bleach or other disinfectant to the collected waste stream make it safe for direct discharge in the municipal sewer system?

    No. The addition of bleach (~3% to 6% sodium hypochlorite) or other commercially available disinfectants to the collected waste stream will only have a limited efficacy on the infectious agents in the waste stream, determined by concentration level and exposure time. The discharge of disinfectants into sewer systems will pose an additional hazard to the municipal wastewater treatment works and disinfectants will have no effect on pharmaceutical compounds present in the waste stream.

  • How does adding bleach to a collected waste stream present a potential human health hazard?

    Common household bleach (sodium hypochlorite) may cause only temporary effects as a localized skin or eye irritant and will readily degrade to sodium chloride in a sewer system and the environment. The human health and environmental hazard from normal bleach discharges is virtually non-existent. For more information, reference the "Risk Assessment Report for Sodium Hypochlorite" Scientific Committee on Health and Environmental Risks (SCHER), Directorate-General for Health and Consumer Protection, European Commission, Europa 2008.

    The human health hazard from mixing bleach into a collected fluid medical waste stream prior to direct discharge into a sewer system is the potential for the sodium hypochlorite in the collected waste stream mixture to react with other organic compounds also present in the sewer system.

    Common hard surface cleaners and disinfectants employed in hospitals contain active ingredients that can react to produce chlorinated volatile organic compounds that pose a highly toxic inhalation hazard. One of the most common inhalation exposure hazards is the accidental reaction of sodium hypochlorite and ammonia in drain traps producing chloramines and nitrogen trichlorides. These are airborne reaction byproducts that can be both an eye and lung irritant and highly toxic. Sodium hypochlorite can also react with sodium bisulfate found in common drain cleaners to release chlorine gas. The toxicity of these reaction by-products is dependent on temperature, mixture and concentration levels.

  • Why is the use of disinfectants to treat collected medical waste streams prior to direct discharge a potential human health hazard?

    The limited efficacy of disinfectants/biocides against the biological and pharmaceutical constituents found in collected medical waste streams is coupled with the emerging concern that antibiotic-resistant bacteria may be incubated in municipal sewer systems.

    There is growing scientific awareness that disinfectants/biocides may be a contributing factor in "...the worldwide increase of antibiotic resistance in bacterial pathogens and the accompanying treatment failures in human and animal infectious diseases..." and "...current scientific evidence does indicate that the use of certain active substances in biocidal products may contribute to the increased occurrence of antibiotic-resistant bacteria, both in humans and in the environment.” ADOPTION of the SCENIHR opinion concerning the antibiotic resistance effects of biocides (27-01-2009) "Assessment of the Antibiotic Resistance Effects of Biocides", Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR), Directorate-General for Health and Consumers, European Commission, Europa, 2009.

  • What is the Med-San® Process?

    Med-San® is a patented process that combines the bactericidal qualities of copper and silver with a wet oxidation process that destroys biological agents and pharmaceutical compounds such as endocrine disruptors and other chemical compounds found in medical waste streams. The waste stream discharged from the Med-San® Process is disinfected and chemically inert making it safe for discharge into municipal sewer systems or directly into the environment.

  • How does the Med-San® Process ensure that the discharge is "chemically inert"?

    The Med-San® Process wet oxidation cycle destroys pharmaceutical compounds beyoud regeneration followed by a post treatment cycle that ensures inert effluent, preventing further reactions with other elements or ions.

  • How does the Med-San® Process ensure that the discharge is “disinfected”?

    The Med-San® Process uses a copper/silver ion infusion of the waste stream to catalyze the wet oxidation process. The combined ion/oxidation process employs variable exposure times and concentration levels capable of producing a ≥ 6 log10 reduction in biological pathogens that may be found in medical waste streams.

  • What is a source point generator of fluid medical waste streams?

    A source point generator is any installation or facility that collects and disposes fluid medical waste streams. The most common source point generators are hospitals, surgery centers, veterinary and dental clinics, medical laboratories, mortuaries and other medical treatment facilities.

  • How are source point generators currently disposing of their fluid medical waste streams?

    Source point generators rely on direct discharge into municipal sewer systems, incineration and landfills for the disposal of untreated fluid medical waste streams. There are no commercially available fluid medical waste treatment systems that will destroy both biological and pharmaceutical compounds found in fluid medical waste streams.

  • How do source point generators collect their fluid medical waste streams?

    Hospitals, surgery centers and other treatment clinics use suction canister collection systems that are either "two-stage"" consisting of a mobile collection canister and a separate dumping station that transfers the liquid waste to the municipal sewer system or "single stage" consisting of a disposable canister in which the liquid waste is "solidified" in the canister and placed in a "Red Bag" for disposal.

  • How is fluid medical waste "solidified" for red bag disposal?

    Fluid medical waste solidifiers are represented by well-established technologies, which include fine particulate polymer absorbents and granular gelatins which initiate a bulk phase change in the liquid waste to a solid gelatinous mass. These solidifiers are poured directly into the collection canister employing a volume-to-volume ratio and residence time determined by the manufacturer. The solidified waste/canister is then placed in a red bag for disposal.

    Solidifiers do not treat the infectious or potentially infectious hazard of liquid medical waste; unless they are combined with a disinfectant such as chlorine or gluteraldhyde to "sanitize" the solidified waste. State regulations determine whether the "sanitized" solidified waste must still be classified as a biohazard.

  • What is "Red Bag" waste?

    "Red Bag" is a common expression for the red biohazard waste bags used to contain regulated medical waste from source point generators including hospitals, laboratories, emergency rooms, nursing homes, clinics, doctor's offices and other medical facilities. 

  • What is the meaning of the term "regulated waste"?

    The Occupational Safety and Health Administration (OSHA), "Occupational Exposure to Bloodborne Pathogens Standard", defines "regulated waste" to include "...blood and items contaminated with blood or other potentially infectious materials (OPIM)."  While OSHA provides guidance for the determination of regulated waste, it is the responsibility of the source point generator to determine the existence of regulated waste.

  • What is the meaning of the phrase "fluid medical waste stream"?

    The phrase "fluid medical waste stream" is used to describe the liquid waste stream collected by a source point generator during surgical or other treatment procedures. Fluid medical waste streams contain blood and other body fluids along with procedural chemicals and have the potential to contain infectious agents and pharmaceutical compounds.

  • Who determines regulated waste disposal practices?

    Regulated medical waste must be disposed of in accordance with applicable State regulations established by the individual States.

  • How is waste disposal handled in austere environments such as foreign theaters of war?

    Combat Support Hospitals (CSH), Forward Surgical Teams (FST), dental units and other mobile medical units and treatment facilities operating in primitive, austere environments presently do not have a field deployable pre-treatment system that will inactivate/sterilize fluid medical waste streams prior to direct discharge into the environment.

    The most commonly employed treatment method in forward deployment areas is open pit burning with a fuel accelerant source. Open pit burning produces both ground and air emission by-products; which are hazardous to human health and the environment. Autoclave sterilization may be available on a limited basis; however, it is not an effective pre-treatment for the disposal of liquid medical biological and non-biological waste products. Chemical treatment (1:10 bleach solution) efficacy is dependent on mixture and concentration and will not inert pharmaceutical compounds. In addition, the practice of "bag and bury"" provides an unreliable management over the environmental fate of medical waste streams by allowing for the uncontrolled release of "bagged" medical waste into the environment.

  • What hazards do current medical waste disposal practices create for our water supply?

    National reconnaissance studies are documenting the growing emergence of pharmaceutical products in our treated drinking water and our watersheds. "In streams and rivers across the Nation, scientists are finding detectable concentrations of pharmaceuticals and other organic wastewater chemicals..." and "...native fish populations were found to exhibit endocrine disruption, including low male-to-female sex ratio and fish having both female and male reproductive organs...", Toxic Substances Hydrology Program, U.S. Geological Survey.

    The Endocrine Disruptor Screening Program conducted by the U.S. Environmental Protection Agency has documented developmental and reproductive problems in fish and wildlife.

    An investigative study completed by the Associated Press reported on March 16, 2008, "...pharmaceuticals - including antibiotics, anti-convulsants, mood stabilizers and sex hormones - have been found in the drinking water supplies of at least 41 million Americans,..." and "Drugs have been detected in the drinking water supplies of 24 major metropolitan areas...".

  • Why is medical-waste incineration hazardous to human health?

    High temperature incineration of medical waste produces air emissions including highly toxic dioxins and other particulate matter that are an inhalation hazard. A number of emission studies have also documented heavy metal pollutants from medical-waste incineration. These air emission studies have led to tighter emission standards imposed by the United States Environmental Protection Agency (EPA) and to a decline in the number of medical-waste incinerators in the United States over the past decade. For more information regarding EPA's air emission regulations for hospital medical waste incineration, see "Hospital/Medical/Infectious Waste Incinerators", Air Toxics Website, Technology Transfer Network, United States Environmental Protection Agency.

  • What is being done about the human health threat from incineration?

    Tighter air emission standards and the growing awareness of the pollution hazards have led to a substantial reduction in the number of medical-waste incinerators currently operating in the United States and worldwide. There is a growing international collaborative effort to ban medical-waste incineration represented by initiatives such as the "International POPs Elimination Project" led by The International POPs Elimination Network (IPEN) a global network of more than 600 public interest non-governmental organizations working together for the elimination of persistent organic pollutants (POPs) in the environment.

  • How does the Med-San® Process destroy viruses?

    Viruses are the most abundant type of infectious agent found on Earth and one of the many biological contaminants found in infectious fluid medical waste streams; examples include Methicillin-resistant Staphylococcus aureus (MRSA), SARS coronavirus (SARS-CoV), and Ebola virus.

    Med-San® is a patented process that combines the bactericidal and virucidal qualities of copper and silver with a wet oxidation process that destroys infectious agents and pharmaceutical compounds such as endocrine disruptors and other chemical compounds found in infectious fluid surgical waste streams. The combined ion/oxidation process employs variable exposure times and concentration levels capable of producing a 6 - 12 log10 reduction in biological agents that may be found in medical waste streams.

    The Ion Infusion stage of the Med-San® process, employed in the Gauntlet™ Disinfection System, is based on the established science of copper (Cu) and silver (Ag) ionization for the disinfection of pathogens, including harmful bacteria and viruses. Both copper and silver poses a broad-spectrum of bactericidal and virucidal capabilities. The Gauntlet™ Disinfection System generates a lethal dose of these charged copper and silver ions through a patented, continuous flow and energy efficient process. The combined impact of copper and silver ions provides for a synergistic disinfection. The positive charge of the copper and silver ions enables them to bond with the negatively charged virus protein surfaces or nucleic acid cores; here they can “alter enzyme structure and function or facilitate hydrolysis or nucleophilic displacement,” (Gerba, Charles P. & Gabriel Bitton. “The molecular mechanisms of copper and silver ion disinfection of bacteria and viruses,” Critical Reviews in Environmental Control, Volume 18, Issue 4, 1989). Additionally, exposures to copper and silver are known to “destroy the replication and propagation abilities,” of viruses. (Han, J, and L. Chen.Efficient and quick inactivation of SARS coronavirus and other microbes exposed to the surfaces of some metal catalysts,” Biomed Environmental Science, Volume 18, Issue 4, 2005.

  • What is a bloodborne pathogen?

    The Occupational Safety and Health Administration (OSHA) defines bloodborne pathogens as microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV).