Release Date: 2000, February

Release Date: 2000

In the healthcare environment, regular trash is referred to as solid waste—materials that have not been soiled by blood of any other potentially infectious material.  RMW is any waste that contains an infectious substance generated in the diagnosis, treatment, or immunization of people or animals.  In the case of sharps and needles, mismanagement is a uniquely dangerous issue with people being injured and even dying each year.  According to the Department of Transport (DOT), it is the waste generator’s responsibility to ensure that RMW is always segregated from solid waste.

Herein lies the problem:  much of the material that is being treated as RMW is actually solid waste.  Of the millions of dollars that US hospitals spend annually on the handling and disposal of RMW, and estimated 40% is being spent unnecessarily.  Poor segregation, along with being costly, is also potentially dangerous.

There is an assumption among some people that if medical waste disposal were free then we would simply classify everything as RMW and end up with a very safe system, no chance of red bag waste getting into the landfill, less work all around, and reduced chance of infecting people within or outside the hospital.  This assumption is wrong.  Research indicates that hospitals that routinely allow, or even encourage solid waste into their RMW also have the most problem with bloody materials ending up in their solid waste stream.  Conversely, a hospital with a strict, legal, and enforced RMW policy that limits the users to only true RMW would have fewer instances of bloody or infectious material in their solid waste.  While the costs to this hospital could be much less, they, ironically, could end up with a much safer system.  They also avoid the cost of fines for improper disposal of RMW and the devastating press following bloody material being found in a landfill.  The issue is people understanding the difference between RMW and solid waste.

Infection control personnel are one of the key players in the definition, enforcement, and management of RMW.  Those who are too cautious, believing that “most is safer” may be doing themselves, the hospital, and the general public a disservice.  Not only is the definition costing their employer thousands of dollars in unnecessary waste disposal costs, it may be exposing workers and the public to increased risk.

Since the late 1980s, increased attention has been focused on medical waste and how it is handled.  Various public and environmental health regulations have been enacted at the federal, state, and local level to govern the proper handling and disposal of medical waste.  These regulations include the OSHA Blood borne Pathogens Standard, the EPA Infectious Waste Guidelines, the CDC’s Standard Precautions and Isolation Guidelines, and DOT’s Hazardous Materials Regulations, just to name a few.

The overriding aim of these regulations is to protect innocent people from exposure to infectious diseases or direct injury. However, the tendency among waste generators to take a blanket approach to these policies has resulted in soaring RMW disposal costs.  Through a more acute understanding of what RMW really should be on a generator-by-generator basis and adopting a common sense approach to the interpretation of these regulations, the RMW produced would cause fewer problems, disposal costs would fall, and overall health and safety within the hospital would increase.

Those handling RMW in the hospital—generally housekeepers—are bound by all of the aforementioned regulations but are also forced to deal with the problems caused by improper segregation or packaging of waste at the generator level, bags that leak blood or other fluids, and dangerous loose needles.

Since US law prohibits employers from forcing employers from forcing employees to work in unsafe conditions, this is a potentially explosive situation.  It is up to infection control professionals to ensure that waste handlers are protected adequately against such risk.  This means being aware of the day-to-day realities of how RMW is actually being generated and disposed of within the hospital and ensuring that practice meets policy.

In 1998, the EPA issued a Memorandum of Understanding (MOU) for the establishment of a Mercury Waste Plan aimed at the virtual elimination of mercury-containing waste from the healthcare industry waste stream by the year 2005.  The MOU also calls on all parties to develop a Model Waste Volume Reduction Plan that will assist in reducing the total volume of all healthcare-related wastes (both regulated and non-regulated) by 33% by 2005 and by 50% by 2010.  This MOU could force as many as 80% of hospital-operated incinerators to shut down within the next few years unless hospitals are prepared to invest the dollars on pollution-control systems.  This MOU is a significant push for hospitals to reduce waste and eliminate targeted materials.

When disposing of RMW, there are two main objectives: first, to render it unable to transmit disease and second, to make it unrecognizable.  Although dozens of alternative technologies have been tried, none have established themselves as economical alternatives to incineration or autoclaving.  However waste is disposed and whether it is by the hospital or by an outside contractor, waste production should be minimized.

Hospital personnel who are involved in generating or handling waste must deal with the medical waste stream as they would any potentially dangerous or expensive material.  This includes infection control, nurses, doctors, and clinical staff.  For example, paper for the photocopy machine costs two cents per pound and follows a strict set of material management rules.  Medical waste, which costs 25 cents per pound to dispose of and is dangerous is a material management free-for-all.  Why?  Because it is garbage, and no one pays attention to the cost and end result.

To cut their RMW disposal and handling costs, hospitals have two options.  The first is to lower the total cost per pound of their medical waste stream; the second is to reduce the number of pounds of RMW.  Generally, reducing the cost per pound is done when the RMW contract is signed.  Often alternative technologies appear to be very cost effective.  If alternative technologies are being considered, do the homework.  Talk to the hospitals that have been using the systems for the last five years and ask pointed questions.  Really check it out because once a hospital has committed to an expensive waste handling technology, internal political realities suggest that there is no going back.

The second cost cutting initiative is for hospitals to reduce the pounds of medical waste they produce altogether.  This is done through proper segregation at the point of generation. No matter how low you get your costs, still focus on reducing volumes.  These are not mutually exclusive strategies.

There are several waste-reduction steps that infection control personnel can take, hand-in-hand with their colleagues in environmental services.  First and foremost, conduct a waste audit.  This will allow you to identify key areas that require improvement, either because of excessive expenses or potentially dangerous practices. Then review the RMW policy.  Next, meet with hospital management and gain their agreement on what level of improvement they envision.  Given this bottom-line goal, determine what steps must be taken to achieve it and implement a marketing program to sensitize those that generate and dispose of RMW.

Case Study, New York City, 1999

In an aim to cut costs and improve overall health and safety, one of New York City’s most prestigious hospitals, the Weill Cornell Medical Center of New York Presbyterian  Hospital, carried out an Infection Control Policy review and implemented a structured program of medical waste reduction.  The 700 + bed hospital also started to track each department’s RMW performance and provide ongoing feedback to department heads.

Using the Walsh Waste Auditor, the hospital personnel determined that approximately 120,000 lbs. Of the 200,000 lbs. of RMW generated on a monthly basis was actually solid waste.  Using the auditor’s hand-held computers with digital cameras, housekeeping personnel noted any situations of non-compliance.  A comprehensive e-mail message and digital photo was sent to the appropriate manager of the non-compliant department.  The waste audit determined that hospital was producing 9.6 lbs. of waste per bed per day, almost double the national average of 4.5 lbs., and four times the EPA and AHA target levels.  As the hospital was spending close to $1 million per year to dispose of RMW, there were significant potential savings to be had.

Following the audit, the hospital instituted a shared savings program using the Walsh Waste Tracker.  Within one month of implementing this waste reduction program, RMW was reduced by 36%.  The keys to the success of this program are people, policy, hardware, marketing, and follow up.

The most important factor in any waste reduction program is the people running it.  The Director of Environmental services understood that the expenses did not have to be so high and that a better system would reduce the risk for his employees and the public.  He took the initiative to outsource the work on a shared savings basis.  The outsourcing company then sent one of its waste management professionals to the hospital to deliver ten separate three-day training and in-service sessions.

The director assigned his two top people to work with the company and ensure the cooperation of housekeeping, epidemiology, nursing, labs, etc.  This team was also responsible for the day-to-day use of the tracker computer touring the hospital, taking digital photos, and tracking each department’s performance.  Without professional and dedicated people, long term, meaningful change is virtually impossible.

The policy is the next most important item.  In this case, the hospital redefined the RMW as it applies to isolation cases.  Previously, all waste from an isolation patient was considered RMW.  Upon review, the hospital decided that this was not necessary.  Today, if the patient is CDC class 4, then all waste is considered RMW; otherwise, it is to be treated as it would from any other patient:  material saturated with blood or body fluid; waste from CDC Class 4 patients; animal waste and body parts; cultures and stocks of infectious agents; and pathological waste.

Sharps are handled through a separate system.  While only about 10 % of the RMW is from isolation rooms, the policy change was a terrific way to get people interested and involved in the improvements that were wanted.

And important reason for non-compliance is that people don’t have the correct bins for their waste.  We took an inventory of which bins were available and where and ensured that there were enough solid waste containers and not too many RMW containers in each department.  From here, Walsh developed a waste reduction for the hospital.

When the hospital agreed to install and use the tracker system, Walsh supplied all of the handheld computers, cameras, PCs, software, installation, setup, and training.  Each day, e-mails were sent to every department that had been visited, alerting them to instances of non-compliance or congratulating them on waste reduction.  This final step is what differentiates long term solutions from a short term fix.  With a program of structured follow up, the hospital was able to attain objectives and maintain them.  The hospital learned that while reducing waste once is not a problem, keeping it down is the real challenge.

Then, about six months ago, his team began using the Internet to do this work.  The staff found that most manufacturers had all the necessary Y2K information posted on their Web sites.  They could find out which equipment was compliant, how to upgrade, and when to discard.  The team has since managed to track down all but three of the manufacturers.  “The Internet really cut our man-hours down.  Once you’ve started using it, depending on it, you wonder how you ever got along without it,” says Grady.

Not just a new toy

A lot of facility managers are singing the same tune. The Internet, once a novelty item among tried-and-true management tools, has quickly become an essential mode of doing business in hospital engineering and environmental services departments.  Managers are now using it for everything from troubleshooting to committee meetings to shopping for energy.  And its uses continue to grow.  One of the most basic, of course is e-mail.  “Busy people can be very difficult to get in touch with,” says Grady.  “I e-mail other ASHE board members and committee members since it can be really hard to contact them by phone.  Even if you have phone mail, you get these long, drawn-out messages, but e-mail people tend to be brief and to the point.”

And the Internet takes person-to-person communication even further.  Sometimes a manager just needs to talk with someone without knowing who that someone is.  Profession-specific bulletin boards and chat rooms provide a place for managers to pose questions to their peers, seek advice on particularly thorny problems, or simply share their successes and frustrations with like-minded colleagues.

“If people are concerned about medical waste or recycling, they can say, ‘What are you doing in this area?  Are you recycling this or that?  Are you getting paid for your recycling?  How are you handling medical waste?  Are you using autoclave systems?  Do you find it cheaper to have a contractor haul it away or handle it yourself?’” says Patricia Hosckenberger director of environmental services at St. Clair Memorial Hospital, Pittsburgh.  As president-elect of the American Society for Healthcare Environmental Services, Hockenberger is partial to the ASHES Web site (www.ashes.org), where members use bulleting boards on a variety of housekeeping related topics.  “If you are debating laundry and linen issues—whether to go with an in-house laundry or use contracted services, whether to have your own linen or rent linen—there are a lot of options open to you, and you can just get on the Internet and say, ‘Is anybody out there running their own laundry?’  And before you know it, you’ll have a whole group of people jumping right in,” says Hockenberger.

A similar function exists on the ASHE site, where facility managers find bulletin boards on topics ranging from Y2K compliance to utility costs to fire safety.  Of course there are other ways to obtain this kind of information:  publications, conferences, and the old-fashioned phone call.  But going online offers several advantages.  It is centralized immediate, and can expose users to peers they might not know personally or meet at conferences.  “I went online and asked, ‘What kind of recognition programs do you do?’  And I got a lot of responses,” says Martin Shafer, operations manager of facility operations housekeeping at the University of Iowa Hospital and Clinics, Iowa City.  “It’s easier than sending a letter or calling somebody.”

Regs resource

Codes and standards can rule a facility manager’s life, and having the most up-to-date information is the first way to keep this rule in check.  The Internet is now playing a big part in providing that information.  At the JCAHO site (www.jcaho.org), users find resources relating to performance measurement and accreditation, as well as e-mail links for answers to standards-related questions.  At the OSHA site (www.osha.gov), users can access the actual text of codes and standards, as well as a vast library of manuals, directives, and statistics.  Having this information centrally available online beats searching for it in books or trying to find a human voice in the vast offices of a regulatory organization.  “When I was giving a presentation to the state epidemiology nurses association, I wanted to verify some information I was going to give them from OSHA,” says Shafer.  “It was a lot easier than looking in some manual.  I just logged onto the OSHA site and found the definitions I needed.”  Facility managers have also begun to shop online.  “You might need a new type of filter, a floor surface covering a piece of machinery, a new recycling device, or just anything that would be unique and new,” says Robert Loranger, director of facilities at the New England Medical Center Hospitals, Boston, and president of ASHE.  “And you can usually find it on the Web.”

At St. Joseph Regional Medical Center, Lewiston, Idaho, the facilities department frequently uses the Internet for equipment research.  Just yesterday one of my engineers came to me trying to find some info on a piece of equipment—a monitoring system for an underground storage tank—that we didn’t have any service manuals on, and we searched the Internet and found something right away,” says Curt Hibbard, director of facilities management at St. Joseph.

The same has proven true at Memorial Regional Hospital, where Grady and his staff do a lot of their equipment research and purchasing online.  “It’s difficult to keep up with the advances in technology, and the Internet can help you do that.  We go online to see what is the latest and greatest,” says Grady.  His facilities department now does a lot of its ordering through distributors on the Internet.  “They’re online, we’re online.  It has actually made the visiting salesman obsolete, and there’s no question that saves time.”

In many hospitals, particularly those in a large health network, the purchasing function is handled by a purchasing department or is under shared-services contracts, so facilities managers are not likely to spend a lot of time shopping themselves.  The Internet plays a role in these situations, too.  At the James H. Quillen VA Medical Center, Mountain Home, Tenn., for example, environmental managers were preparing their equipment lists for next year and wanted to include the most recent equipment offered by each vendor they used.  “We were able to go to several sites and look at more up-to-date equipment than what our old catalogs had.  It was real easy to just for to the Web for that,” says Larry Collins, the hospital’s chief of environmental services and president of ASHES.

At St. Clair Memorial Hospital, shared services contracts specify companies from which the environmental services department must but its products.  “They may indicate that you get rebates or bonuses through purchasing 3M products, for example, and if you’ve never used 3M, you might get on the Internet and check with people to see if they’ve used them and how they are working in their hospital,” Hockenberger points out.

Watch your waste

Online communication has an added dimension at the University of Iowa Hospitals and Clinics, where Shafer and his team have been using e-mail to document and notify staff of red bag waste violations in the 850-bed facility.  Armed with a digital computer and camera system from Walsh Waste Tracking, Montreal, the environmental services staff roams the facility's 2.5 million square feet examining red bags for trash that doesn't belong, such as cups or papers.

When they find a violation, they go to the computer, which brings up a form allowing the user to enter the type of waste, its percentage of contamination, the location of the violation, and any other relevant information.  It then allows the user to take a digital photograph of the waste.  All the information is stored on the computer.  At the end of the survey, Shafer downloads this information to his PC, which is already programmed with the names of supervisors in each area.  An e-mail documenting the violation, along with a picture of the waste, is sent to every department where a problem has occurred.  "Our hope is that they will use this as an educational tool, and say, "Hey, here's what housekeeping found."  Then they can correct these problems in the future, Shafer says.

The system has been in place since January, and Shafer is certain that it has helped to heighten awareness among the staff-no small feat considering that the staff already had a heightened awareness about waste; before the introduction of the waste tracking system, the facility had reduced its red bag waste by 50 percent since 1993.  "And we're still finding things.  We actually generate two to three e-mails a week," Shafer says.  "If I had people constantly doing this, I'd probably have a lot more. If you can imagine a hospital that hasn't done anything in the waste area, it would be invaluable.  You could pay for the system pretty quickly.  At least I hope to.

A day at the (energy) mall

Facility managers struggling with how to take advantage of the rapidly changing deregulating electricity industry now have an Internet solution.  A joint project between ASHE and Healthcare Circuit News, called the Energy Initiative Network (www.energyinitiative.com), enables them to track their energy use, then post that data online, where it is available to utilities that wish to bid for that energy supply.  Each morning at 6 a.m. the network’s server dials up hospitals and downloads information on all energy used during every 15-minute period of the previous day, including electricity, gas, water, and steam.

Each hospital’s load profile is then posted on the network anonymously (revealing only the region in which the hospital is located) and utility managers interested in taking on that load submit a proposal into a blind inbox, from which facility managers retrieve the proposals and select the best one.  “This is a win-win situation for both facilities and utilities because the facilities can do their shopping online and the utilities don’t have to have their  salespeople in the field collecting data every day,” says Dan Chisolm, executive editor of Healthcare Circuit News, which is published by the Motor and Generator Institute (www.mgi-hcn.com), Winter Park, Fla.

Facilities sign up for this service through ASHE for $150 a year while utilities pay according to their level of participation.  ASHE membership is required to participate, but nonmembers receive a discount on ASHE membership when they sign up for the network.  Some hospitals buy their energy daily, some yearly, depending on their contracts.  But the system benefits all types.  “Even if you have long-term contracts, you still need to keep a check on what’s going on in the marketplace,” says Chisolm.

And size is relative.  “We have all sizes signing up, from 50-bed hospitals to 50-hospital systems.  A 7 percent saving for somebody spending $30 million a year is $2 million, and for somebody spending half a million, it’s $35,000.  It seems like a lot either way,” Chisolm says.  Utilities, too, find value in smaller facilities.  “If a utility has most of its revenue tied up with one customer and that customer leaves, there’s a downside to the bigger-better deal.  I’ve had utilities tell me they’d rather have 20 $1 million customer than five $4 million dollar customers,” says Chisolm.

What’s up next?

Buying energy online?  It’s just one of the amazing business practices the Internet has made possible in a very short time.  There’s no telling what the Internet will bring next, but if the past few whirlwind years are any indication, it is sure to be transformational.  “It wasn’t that long ago that many of us didn’t even have Internet access from work,” says Memorial Regional Hospital’s Grady.  “And now I can’t imagine not having it.  What was life like before?”

Proper disposal of hospital refuse is important not only for the obvious reason--the health and safety of all who handle it--but also because it is expensive, and we all help pick up the tab for it in the end, through increased health care costs.  Furthermore, the federal government is getting stricter about how hospitals dispose of medical waste, driving up costs even more.

Consider this: it costs approximately two cents per pound to have regular rubbish hauled off to the landfill.  Medical waste, on the other hand, is much more expensive to handle, costing anywhere from 20 to 50 cents per pound to ship and destroy.  Which means that nearly all hospitals have policies that direct staff members to segregate true medical waste, such as (deep breath) discarded body parts and fluids, used dressings, blood bags, and needles, from more mundane trash such as newspapers, soda cans, and pizza boxes. Trouble is, mandatory segregation of the two types of trash is difficult to enforce, and a lot of basically harmless stuff that could simply be buried ends up being incinerated.

Failure to separate the good from the bad and the ugly also has another downside.  All too often, really hazardous waste, such as needles and contaminated broken glass (called "sharps," for good reason), is not stored in the correct containers for disposal.  The result is that members of the housekeeping staff who collect the waste daily are put at serous risk of infection from puncture wounds and cuts, or from exposure to contaminated material.

Such a Waste

"Anywhere from 35 to 70 percent of the medical waste stream in North America is not actually medical waste", said Stephen Walsh, president of Walsh Integrated Environmental Systems, a six-year-old company based in Montreal.  "It's just junk:  paper, packaging, and all this other stuff. The reason why this is so is because hospital nursing staffs are generally poorly informed about waste handling; there's no feedback to users."

The Walsh firm specializes in medical waste management and has developed a bar code-based system called Waste Tracker^TM that introduces control and accountability into environments that traditionally have not been closely watched.  The results can be extraordinary.  At one of the firm's first installations, a Montreal hospital, bio-hazardous waste volume was reportedly cut by 36 percent, saving $200,000 a year.  In another facility in the same city, there was a 40 percent reduction in volume of infectious waste, and Waste Tracker^TM paid for itself in four months.

"Our background is in recycling, "said Mr. Walsh," and that's how we got into this business.  We were performing a waste audit for a large hospital, and we learned they were spending about $500,000 a year for waste disposal, but they should have been spending only about $150,000."  Together with his brother David, vice president of the firm, Mr. Walsh began development of Waste Tracker^TM, installing the first system in 1993.

Waste Tracker's concept is simple: Establish a means of identifying each waste collection point in the hospital, provide a way of quickly and accurately quantifying the waste and noting any infractions of waste disposal procedures, and create the ability to rapidly weigh containers of waste.  Once this information has been captured, it can then be uploaded into a host PC, where it can be evaluated and used to generate reports.

The front-line tool of this system is a handheld bar code scanner, programmed with application software developed by Walsh.  Equipped with a small display and keyboard, the device guides the employee through the trash pick-up process via screen prompts. For instance, when making a waste pick-up, the program asks the user to select the type of waste being collected (such as "Human, non-anatomical") and enter the selection.  The handheld terminal, a Symbol Technologies LDT 3805, is equipped with a laser scanner and can store all transactions in its memory until the end of the shift or round, when the data is uploaded into the host PC.

Nurses and other care givers usually place medical waste in red garbage bags.  They put non-hazardous waste, such as newspapers and disposable paper products, in green garbage bags, and a member of the housekeeping staff later collects both types of bags in boxes or bins that they roll around the hospital on hand trucks.  As a means of recording misbagged waste, each bin carries a bar coded sheet of comments.  This laminated list contains about a dozen standard comments and accompanying bar code, designating such as items as "Newspapers" or "Leaking Blood."  When the pick-up person discovers ordinary trash in a medical waste bag, he or she simply scans in the appropriate comment and the infraction is recorded in the bar code scanner.  This method of notation is much faster, more accurate, and less cumbersome than trying to record infractions on a clipboard.  It also avoids the necessity of reentering the comments later, via the computer keyboard.

A bar code label is also affixed to each rolling trash bin.  Bags from patients' rooms, operating rooms, nurses' stations, and other pick-up points are collected and placed in the containers.  By scanning in the location point where the bag is picked up (the label is usually placed near the light switch or other convenient point) and then scanning the ID label of the bin into which it is placed, it is possible to later weigh the bin's contents to determine how much waste is generated by any given area of the hospital.

Since effective waste disposal management relies on regulating the weight of the refuse, the Waste Tracker system incorporates a Weigh-Tronix electronic scale into the waste stream.  Usually, the stationary scale is located in the waste storage area in the basement of the hospital. Containers of trash are placed on the scale, and a telephone-type, plug-in cable is used to connect the handheld to the scale so the terminal can automatically collect the bin's weight.  Then the handheld scans the box's bar code, completing the transaction.

The Waste Tracker^TM systems installed to date require only one handheld per hospital, though Mr. Walsh foresees applications in which more than one scanner might be required. Inserting the handheld into a Symbol docking station (which also recharges the terminals' batteries) uploads information from the handheld to the PC.  In a typical setup, the docking station is connected directly to the PC, though it is also possible to upload data via a built-in modem, as is the case where one host serves multiple docking sites.

Walsh Systems strongly recommends that a new, dedicated PC support the system.  "The reality is that when we try to use other people's hardware, we can easily spend more money getting it to work than we would have if a new PC had been purchased at the outset.  So it's rare that we don't demand all new hardware with the installation," explained Mr. Walsh.

Walsh developed the software for the Waste Tracker system.  It consists of three main pieces:  data acquisition programming, which is loaded into the handheld scanner; extensive database management software residing on the PC, which is the real engine of the system; and the communications software, which facilitates data exchange between the scanner and the scale.

The job of printing bar codes is carried out onsite at the hospital with a standard Hewlett-Packard LaserJet printer.  Interfaced to the host PC, the printer generates labels using custom software that Walsh also developed.  Code 39 is the symbology of choice.  Printing the paper labels for all the rooms is more or less a one-time proposition, with replacement labels run off as needed thereafter.  Disposable box labels are consumed on an ongoing basis and are usually printed each month  in batched of 1000 or more, depending on the hospital's waste volume.

Once the waste has been collected, boxed, weighed, and recorded, it is ready for disposal.  Many hospitals maintain their own incinerators, where the hazardous waste is destroyed  on premises,  while the non-hazardous can be sent to the landfill.  Conversely, a growing number of hospitals are shipping their medical waste to outside companies for destruction, especially in light of recently tightened air pollution  policies laid down by the EPA.  Should this trend continue, many more of the estimated 5000 hospitals in North America will be utilizing third-party services in the years ahead.

Safety First

Waste Tracker's report function pulls all the collection data together and turns it into meaningful information.  For instance, if a certain department within the hospital routinely puts newspapers and trash into the medical waste bags, this fact, backed up by times and dates, is presented to the department supervisor and to the hospital's health and safety officer.  Or if a department is careless in its disposal of sharps, a report to that effect is generated and passed along to the appropriate people.  In most instances, a word to the wise is all that's needed, and the violations drop off immediately.  In critical situations, such as when leaking blood is found in a waste bag, an audible alarm sounds in the handheld when the infraction is scanned in, and the collection person is instructed to contact the supervisor immediately.

Because the trash is weighed before disposal, it is a simple matter to monitor the various categories of waste volumes at room level.  This yields reliable statistics, which in turn make it possible to spot trends early on and to create budgets with more precision.  Furthermore, when an accreditation agency audits the hospital's waste program, the wealth of data on file provides the auditors with reliable, verifiable information.

One of the most important benefits of the system is that it focuses attention on the need to properly handle bio-hazardous refuse, decreasing the risk of infection for all individuals whose job it is to collect sharps and infectious waste.

Hamilton Health Science Corporation has installed a state-of-the-art waste tracker system that monitors bio-hazardous waste and recyclables in the region's five hospitals and helps them dramatically reduce the volume of waste they generate.  The hospitals anticipate the system will save $1 million in waste disposal costs over the next five years.

The Waste Tracker installation in Hamilton represents a technological advance for its creator, Walsh Integrated Environmental Systems of Montreal.  Although the system has already helped two of Montreal's major hospitals slash their waste disposal costs, this is the first time the systems at several hospitals are linked together at one centralized location.

Canadian technology helps hospitals meet new EPA regulations that go into effect July 31, 1997.

Hospitals that have been sending their medical waste up in smoke for many years will probably be considering some new options after July 31, 1997. That's when some old laws regarding hospital incinerators are finally enforced by the Environmental Protection Agency (EPA). These new regulations were sparked in part by information which traced 70 percent of all the low-level dioxins emitted in the United States back to medical waste incineration. The new enforcement was brought about by a law suit filed by the Sierra Club