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APHA Scientific Session and Event Listing

Patrice Sutton, MPH¹, Julia Quint, PhD², Janice Prudhomme, DO, MPH², Elizabeth Katz, MPH, CIH², Mary Deems, MPH², Jennifer Flattery, MPH², and Robert Harrison, MD, MPH². (1) CDHS Occupational Health Branch, Public Health Institute, 850 Marina Bay Parkway, Building P, 3rd Floor, Richmond, CA 94804, 510-620-5773, psutton1@dhs.ca.gov, (2) Occupational Health Branch, California Department of Health Services, 850 Marina Bay Parkway, Building P, 3rd Floor, Richmond, CA 94804

Regulatory and public recognition that burning medical waste in incinerators produced major sources of dioxins and other hazardous emissions led to significant changes in medical waste disposal practices. CDHS investigated the potential occupational hazards associated with large-scale, off -site steam autoclaves implemented to treat medical waste in lieu of incinerators shut down due to improved environmental regulations. Findings: Workers had a very high rate of injury. The primary occupational hazards documented were related to the design of the work process, not to the steam autoclave technology. Workers' most significant exposures were a predictable consequence of a work process design that involved extensive manual handling of untreated waste. Exposure control measures disproportionately relied on controlling exposure after the hazard was created, rather than on eliminating the hazard from the work process. Feedback mechanisms necessary to identify, evaluate, and prevent occupational hazards were inadequate, fragmented, or absent. Primary prevention involves: (1) generating less medical waste; and (2) incorporating the prevention of work-related hazards into the design of medical waste treatment technologies and associated work processes. Education, feedback, and incentive mechanisms are needed to support the goal of primary prevention. Health care facilities should explicitly integrate measurable worker health and safety criteria into decision-making about the use and selection of off -site medical waste treatment providers; agencies that regulate aspects of the medical waste stream should build partnerships between labor and public health programs and explicitly encourage the development of public health protective waste treatment technologies and work processes.

Learning Objectives: At the end of this presentation participants will

(
• Recognize the interrelationship between environmental justice and occupational health; (2 Identify the need to evaluate the public health impacts of both a technology choice and its associated work process design; (
• Prioritize the elimination of hazards from the work process rather than controlling exposures after a hazard has been created; and (
• List recommendations for primary prevention of occupational health impacts of medical waste treatment and disposal.

Keywords: Environmental Justice, Health Care Workers

Related Web page: www.dhs.ca.gov/ohb/new.htm

Presenting author's disclosure statement:

Any relevant financial relationships? No