Evaluation of quantities of biomedical waste generated in Ontario [Evaluations of quantities of biomedical waste generated in Ontario]

109 Pages·1993·18.2 MB·English

by  Ortech International|Ontario Ministry of Environment and Energy

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EVALUATIONS OF QUANTITIES
1 OF
BIOMEDICAL WASTE GENERATED
IN ONTARIO
u
MARCH 1993
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Ministry of
TD Ontario
Environment
898 B
B56 and Energy
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MOE
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c.2
a a a
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This Ontario Ministry of the Environment work is protected by Crown copyright
(unless otherwise indicated), which is held by the Queen's Printer for Ontario. It
may be reproduced for non-commercial purposes if credit is given and Crown
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It may not be reproduced, in all or in part, for any commercial purpose except
under a licence from the Queen's Printer for Ontario.
For information on reproducing Government of Ontario works, please contact
ServiceOntario Publications at copyrightc'u ontario.ca
ISBN 0-7778-0750-5
EVALUATION OF QUAN TTIES OF BIOMEDICAL WASTE
GENERATED IN ONTARIO
MARCH 1993
Cette publication technique
I
n'est disponible qu'en anglais.
Copyright: Queen's Printer for Ontario, 1993
This publication may be reproduced for non-commercial purposes
with appropriate attribution.
PIBS 2286
EVALUATION OF QUANTITIES OF BIOMEDICAL WASTE
GENERATED IN ONTARIO
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Report prepared by:
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ORTECH International
Mississauga, Ontario
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for
Ontario Ministry of Environment and Energy
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This report was prepared for the Ontario Ministry of the Environment. The views and
ideas expressed in this report are those of the authors and do not necessarily reflect the views
and policies of the Ministry of the Environment, nor does mention of trade names or commercial
products constitute endorsement or recommendation for use.
ORTECH lntemational,on behalf of the Ontario Ministry of the Environment, would Gke to
acknowledge and thank the following individuals and sites for volunteering to participate in this
study, and allowing our biomedical waste auditing team access to their facilities.
Chedoke-McM aster Hospital, Dr. P. Cossin, B.Sc., DDS
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McMaster Division Dr. B. Wilson, B.Sc., DDS
Credit Valley Hospital Dr. R. Bossin, B.A., DDS
Milton District Hospital Dr. R. Sexton, DDS
Kitchener-Waterloo Hospital Commission Dr. D. Hurst, B.Sc., DDS 0
Duff erin Area Hospital Dr. S. Tuck, DDS
Oakville Trafalgar Memorial Hospital Association Dr. K. Henderson, MD, FRCP CC
Shelburne District Hospital Dr. B. Kee, MD
Stevenson Memorial Hospital Dr. M. Keymer, B.Sc., MD, CCFP
St. Peters Hospital Dr. Easton, B.A.,B.Sc.,MD,FRCSC,FRCOG
Queen Street Mental Hospital Institute Victorian Order of Nurses
St. Michael's Hospital Centralia College
Markham-Stouffville Hospital Ontario Veterinary College
Head Office Reference Laboratories Limited Office of the Chief Coroner of Ontario
Med Chem Laboratories Coldwater Animal Hospital
MDS Health Group Limited Bay Cities Animal Hospital
Excel Bestview Medical Laboratories Incorporated S&ercreek Animal Hospital
University of Toronto, Medical Sciences Building Mt. Pleasant Animal Hospital
Connaught Laboratories Limited Kingsdaie Animal Hospital
Ministry of Health-Laboratoratory Services Branch Canadian Red Cross Ontario Div.Toronto Branch
Adria Laboratories of Canada Ltd. Erin Mills Lodge
R. S. Kane Ltd. Ministry of Health Horne Care Program
Trull Funeral Homes Ltd. Glaxo Canada Inc.
Scott Funeral Homes CIBA Geigy Investments Limited
Newbigging Funeral Home Ltd. Syntex Inc.
Turner and Porter Funeral Directors Ltd. Beveridge and Brown Clinic, Cambridge
Shoppers Drug Mart, Guelph, Cambridge, Root Plaza Pharmacy, Guelph
Gail-Cambridge Stewarts Westmount Pharmacy, Guelph
Big V Pharmacies Company Li rnh ed, Fergus, Cambri dge Thrifty's Drug Mart, Erin
Hespeler Pharmacy, Cambridge Mount Forest Pharmacy, Mount Forest
Hy and Zels Incorporated, Cambridge Preston Medical Pharmacy, Cambridge
Coronation Medical Pharmacy, Cambridge IDA Drug Stores, Cambridge
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TABLE OF CONTENTS
Page
EXECUTIVE SUMMARY
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1. INTRODUCTION AND BACKGROUND 4
2. AUDITING PROCEDURE
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2.1 Selecting a Representative Sample 8
2.1.1 Hospitals 9
2.1.2 Doctors' Offices 11
2.1.3 Dentists' Offices 11
2.1.4 Veterinarians' Clinics 12
2.1.5 Funeral Homes 13
2.1.6 Medical Laboratories 14
2.1.7 Other Laboratories 15
2.1.8 Coroners' Offices 16
2.1.9 Other Facilities 17
2.2 Auditing Procedures 19
2.2.1 Pre-Audit Meetings 21
2.2.2 Waste Audit Procedure 22
2.3 Health and Safety Precautions 23
2.3.1 Protective Gear 24
2.3.2 Special Precautions and Modified Waste
L Sorting Procedure 25
2.3.3 Post Audit 31
TABLE OF CONTENTS (Contd.)
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3. METHODS OF DATA AGGREGATION 32
3.1 Hospitals 33 1
3.2 Doctors' Offices 36
3.3 Dentists' Offices 36
3.4 Veterinarians' Clinics 37
3.5 Funeral Homes 37 I
3.6 Medical Laboratories 38
3.7 Other Laboratories 38
3.8 Coroners' Offices 41
3.9 Other Facilities 41
3.9.1 Nursing Homes 41 t
3.9.2 Pharmacies 41
3.9.3 Pharmaceutical Manufacturers 42
3.9.4 In-Home Nursing Care Providers 43
3.9.5 Red Cross Blood Bank Operations 44
4. RESULTS 45 1
TABLE OF CONTENTS (Contd.)
Page
5. DISCUSSION
63
5.1 Choice of Waste Categories 63
5.2 Discussion of Audit Results 65
5.2.1 Factor Affecting the Data 65
5.2.2 Discussion of Tables 5-16 Audit Results for the
11 Categories of Waste 69
5.3 Discussion of Results of the Post Audit Interview 74
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5.3.1 Content and Wording of the Definition 74
5.3.2 Role to be Played by the MOE, MOH, OHA and
Others in Implementation 79
5.4 Discussion of Appropriate Disposal Options for
Biomedical Wastes in Ontario 81
6. CONCLUSIONS AND RECOMMENDATIONS 84
6.1 Conclusions 84
6.2 Recommendations 87
APPENDIX 1: Ministry of Health Regions
APPENDIX 2: Breakdown of Hospital Sections
APPENDIX 3: Post Audit Questionnaire
APPENDIX 4: Ontario Regulation 309
Draft Schedules 5A and 5B
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EXECUTIVE SUMMARY
The Ontario Ministries of the Environment (MOE) and Health (MOH), in
cooperation with the Ontario Hospital Association, are developing a
comprehensive strategy to manage biomedical waste in the province.
A detailed definition of biomedical waste, based on the definition
adopted by the Canadian Council of Ministers of the Environment
(CCME), has been developed in consultation with all stakeholders in
order to clearly define what should be handled as biomedical waste in
Ontario.
The strategy proposes the management of biomedical waste on a
regional basis, defined by the six MOH planning regions. In order to
develop regional plans for biomedical waste management facilities, a
detailed assessment of the quantities of biomedical waste generated in
each region is required.
The Ministry of the Environment contracted ORTECH International to
undertake an audit of biomedical waste generated in the province, the
results of which are presented in this report.
The results of the study are summarized in Table 1. The study estimated
that 14,556 tonnes of waste are currently being disposed as biomedical
by Ontario generators, 39% of which is not biomedical waste and does
not require special handling. Hospitals account for about 67% of the
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biomedical waste currently disposed in the province. For hospitals, the
proportion of non-biomedical waste currently disposed as biomedical
was in the range of 46-68%. Funeral homes and coroners' offices were