Handling and disposing of medical waste is a more complicated task than most healthcare workers realize. Test your knowledge of safe and cost-effective disposal practices with this quiz.

1 True or false? The management of medical waste is state-regulated.
True. Although various federal agencies, including the Environmental Protection Agency, the Department of Transportation, the Food and Drug Administration, the Occupational Safety and Health Administration, the Nuclear Regulatory Commission and even the U.S. Postal Service, do regulate different aspects of waste management, it's mostly regulated at the state level. For more information about your state's requirements, visit www.epa.gov/epaoswer/w/stateweb.htm.

2 True or false? All regulated medical waste must be red-bagged.
True. Regulated medical waste includes all waste that is generated in direct patient treatment or diagnosis that may contain pathogens (bacteria, viruses, parasites or fungi) in sufficient concentration, quantity and virulence that they could cause disease in a susceptible host. This includes cultures and stocks from labs, blood, sharps and pathological waste. (For more information on what does and doesn't go into red bags, see "Do's and Don'ts of Red Bag Waste" on page 52.)

3 True or false? When sealing bagged medical waste, you can simply tie off the bag.
True. But remember that the bags must stay closed until they get to the disposal site. Therefore, tie the bag in such a manner that it can be held in an inverted position with the tied end at the bottom for five minutes without leaking. Try to minimize entrapped air within the bag to prevent leakage during transportation.

4 True or false? Disposing of red-bagged trash costs significantly more than disposing of regular trash.
True. Waste management companies generally charge by the pound, and some facilities pay six times as much to dispose of red-bagged trash. We pay three cents per pound to dispose of regular trash and 19 cents per pound to dispose of red-bagged trash.

5 True or false? If you wear gloves while handling medical waste, you don't need to wash your hands afterward.
False. With all the emphasis on handwashing these days, this should have been an easy one! We require all staff to wash their hands after handling trash or use an alcohol rub if their hands aren't visibly soiled.

6 True or false? You can dispose of uncontaminated sharps in the regular trash.
False. Even though you might think this would be an obvious answer, the fact is that even trained, experienced employees sometimes dispose of sharps improperly, which helps contribute to the hundreds of thousands of sharps injuries healthcare workers suffer every year.

7 True or false? You can place syringes that don't have needles attached to them in the regular trash.
False. Even if syringes aren't attached to needles, you must dispose of them in sharps containers. The reason for this is twofold: If the syringes break, they create sharp edges (this goes for other unbroken glass or rigid plasticware as well). Also, locked sharps containers ensure that the syringes don't get into the hands of individuals who might try to reuse them.

8 When collecting medical waste, which of the following should be done?
a. wear personal protective equipment
b. create a barrier between yourself and any red-bag waste
c. transport red-bag waste in covered containers
d. never mix red-bag waste with linen or municipal waste
e. all of the above

The answer is e, all of the above. These are some of the basic principles we cover in our environmental staff services training. Managing medical waste is a complex task, and staff must be trained to handle, transport, package and document it properly.

9 True or false? Annual training sessions are generally sufficient for teaching staff how to manage medical waste.
False. Effectively managing any facility's waste stream requires constant vigilance and commitment. At our hospital, we hold yearly comprehensive training sessions to address all of our waste management policies and procedures, but we also hold monthly refresher courses, as well as one-on-one conferences with department heads to nip problems in the bud.

So, how'd you do?
If you got all nine questions correct, way to go. You might want to photocopy this article and test your staff. Finally, let me reiterate that states regulate medical waste disposal. Before you write or update your red-bag policies and procedures, go to www.epa.gov/epaoswer/w/ stateweb.htm to see applicable laws.