MIL-HDBK-1191
includes food preparation waste, packing materials, tray scrapings, paper and
plastic plates and containers, trays and utensils, not economically or
practically processable as RW. Pulped waste shall not be piped to a remote
disposal location, but pulped directly into containers visible to the pulping
machine operator. Central systems for general facility NRMW are not normally
provided, but may be considered for Using Military Department approval if cost
justified.
18.5.6
Incineration. On August 15, 1997, The EPA Administrator final
standards and guidelines, CFR 40 Part 60, to reduce air pollution from
incinerators that are used to burn medical/infectious waste (MWI) by 75 to 98
percent of levels existing at that time. These final standards supply to
"existing MWI's" built before June 20, 1996 and "new MWI's" built after June
20, 1996. Additionally, these final guidelines are for use by States in
developing plans to reduce air pollution from new and existing MWI's and are
only minimum standards. These revised guidelines mean that any new
incinerators will probably be built by large commercial concerns or regional
hospital systems, and not individual healthcare institutions.
18.6
RMW PROCESSING. Selection of a treatment or disposal process for
a particular location requires careful consideration of current installation
practices (as applicable), Federal, State, and Local governmental regulations,
and the relative costs, operational complexities, and legal implications
associated with the available disposal options.
The majority of DOD medical
facilities utilize contractor treatment and disposal of RMW, due to economic
considerations (including maintenance costs) and uncertainties in local laws
or landfill acceptance policies. On-site processing of RMW should be
considered only following careful consideration of local regulations, landfill
policies for the acceptance of treated RMW, the operating and maintenance
costs associated with RMW processing equipment, and the availability and cost
of contractor services.
18.6.1
Landfill Acceptance of RMW. The designer shall verify that the
community landfill(s) will accept RMW, whether treated or in untreated form,
and any requirements for its acceptance. See Appendix 18.1 for additional
information regarding off-site/contractor disposal.
18.6.2
Off-site Disposal/Treatment Considerations. The Environmental
Protection Agency's Medical Waste Tracking Act (MWTA) (reference 18a), while
presently expired, introduced a system imposing extensive responsibilities on
RMW generators (i.e., hospitals) for the ultimate disposal of RMW, whether by
the facility itself or by independent hauling and treatment contractors. It
should be anticipated that the majority of State governments have or will
institute regulations at least as stringent as the MWTA. In addition to the
legal liability implications of waste tracking legislation, the costs and
operational complexities associated with contracted disposal will be
significant, requiring consideration in cost analysis comparisons with on-site
treatment methods. The MWTA was allowed to lapse, although States continue to
use it as a minimum guideline to track medical waste.
18.6.2.1
Pathological Waste Disposal. Where other procedures for disposal
of human or animal body parts are not feasible or cost effective, off-site
pathological waste disposal (incineration or burial) by outside contract with
mortician or veterinarian should be considered.
18.6.3
General On-site Treatment Considerations. On-site treatment of
RMW is desirable to reduce the potential liability associated with transport
of potentially infectious materials and increasingly higher costs for
contracted transport and disposal of untreated RMW. Acceptable treatment
methods are as defined by the MTWA, requiring waste "treatment and
destruction", and renderment to unrecognizability (normally accomplished by
18-7
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