7 { No. 91-4 — IBIUBILIOGIRAIPIEUO&'S JUN MOE ID ICIINIE Medical Waste Disposal National Library of Medicine January 1986 through January 1991 629 Citations U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service ¢ National Institutes of Health o% DEPOSITORY JUL 8 1991 '' PUBLIC HEALTH LIBRARY, france \ venen) rievenery OF om ''CBM 91-4 Medical Waste Disposal January 1986 through January 1991 629 Citations Prepared by Jacqueline van de Kamp, M.L.S., Specialized Information Services U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service National Institutes of Health National Library of Medicine Reference Section 8600 Rockville Pike Bethesda, Maryland 20894 ''SEP be pur SERIES NOTE Current Bibliographies in Medicine (CBM) is a continuation in part of the National Library of Medicine’s Literature Search Series, which ceased in 1987 with No. 87-15. In 1989 it also subsumed the Specialized Bibliography Series. Each bibliography in the new series covers a distinct subject area of biomedicine and is intended to fulfill a current awareness function. Citations are usually derived from searching a variety of online databases. NLM databases utilized include MEDLINE”, AVLINE®, BIOETHICSLINE®, CANCERLIT®, CATLINE®, HEALTH, POPLINE™ and TOXLINE®. The only criterion for the inclusion of a particular published work is its relevance to the topic being presented; the format, ownership, or location of the material is not considered. Comments and suggestions on this series may be addressed to: Karen Patrias, Editor Current Bibliographies in Medicine Reference Section National Library of Medicine Bethesda, MD 20894 301/496-6097 Ordering Information: Current Bibliographies in Medicine is sold by the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402. To order the entire CBM series for the calendar year 1991 (20 bibliographies), send $52.00 ($65.00 foreign) to the Superintendent of Documents citing GPO List ID: CBM91. For your convenience an order blank is given inside the back cover. Orders for individual bibliographies in the series ($3.00, $3.75 foreign) should be sent to the Superintendent of Documents citing the title, CBM number, and the GPO List ID given above. Use of funds for printing this periodical has been approved by the Director of the Office of Management and Budget through September 30, 1991. ii ''ALL: vA 2E/ NG Hla Ve fp ; SY [79 / i cf Py The concept of medical waste is multi-faceted. It includes wastes which are infectious as well as those which may give off toxic substances when incinerated. It includes wastes from hospitals, doctors’ and dentists’ offices, veterinary clinics, free-standing surgical and dialysis centers, and households and home health care. Recent incidents of syringes and other medically related material washing up on beaches spurred studies which led to enactment of the Medical Waste Tracking Act of 1988. MEDICAL WASTE DISPOSAL This bibliography contains selected references to English and foreign language publications concerning medical wastes and their disposal. It includes journal articles, books and chapters of books, audiovisuals, editorials, and letters to the editor. Arrangement of the bibliography is by eight subject categories, plus an appendix of journal titles in the field. iii ''SEARCH STRATEGY A variety of online databases are usually searched in preparing bibliographies in the CBM series. To assist you in updating or otherwise manipulating the material in this search, the strategy used for the NLM’s MEDLINE database is given below. Please note that the search strategies presented here differ from individual demand searches in that they are generally broadly formulated and irrelevant citations edited out prior to printing. SS 1= MEDICAL WASTE (MH) SS 2=(TW) WASTE OR WASTES OR TRASH SS 3=2 AND SURGICAL (TW) OR 2 AND MEDICAL (TW) OR 2 AND CLINICAL (TW) OR 2 AND BIOMEDICAL (TW) OR 2 AND NURSING (TW) OR 2 AND ALL CHEMOTHER: (TW) OR 2 AND ALL HOSPITAL# (TW) OR 2 AND ALL PHYSICIAN# (TW) OR 2 AND INFECTIOUS (TW) SS 4= (TW) ALL NEEDLE# OR ALL DRESSING# OR ALL SHARP# OR ALL LINEN# OR BEDDING SS 5=4 AND DISPOSAL (TW) OR 4 AND DISPOSITION (TW) OR 4 AND DISPOSING (TW). OR 4 AND REMOVAL (TW) SS6=1 OR 3 OR 5 GRATEFUL MED® To make online searching easier and more efficient, the Library offers GRATEFUL MED, microcomputer-based software that provides a user-friendly interface to most NLM databases. This software was specifically developed for health professionals and features multiple choice menus and "fill in the blank" screens for easy search preparation. GRATEFUL MED runs on an IBM PC (or IBM- compatible) with DOS 2.0 or a Macintosh, and requires a Hayes (or Hayes-compatible) modem. It may be purchased from the National Technical Information Service in Springfield, Virginia, for $29.95 (plus $3.00 per order for shipping). For your convenience, an order blank has been enclosed at the back of this bibliography. iv ''SAMPLE CITATIONS Citations in this bibliographic series are formatted according to the rules established for Index Medicus”. Sample journal and monograph citations appear below. For journal articl-s written in a foreign language, the English translation of the title is placed in brackets; for monographs, the title is given in the original language. In both cases the language of publication is shown by a three letter abbreviation appearing at the end of the citation. Note also that a colon (:) may appear within an author’s name or article title. The NLM computer system automatically inserts this symbol in the place of a diacritical mark. Journal Article: Authors Article Title jf a Ss LaMoreaux JW, Green N. Risk assessment on managing infectious wastes. Water Environ Technol 1990 Jun;2(6):40-3. a 7 S\ \ Abbreviated Journal Date Volume Issue Pages Title Monograph: Authors Title jt \ \ McLean A, Lehmann R. Managing hazardous wastes and materials. Chicago: Joint Commission on Accreditation of Hospitals; 1986. 64 p. | | 7 / Place of Publisher Date Total No. Publication of Pages '' ''General Analysis Economic Aspects Environmental Aspects Equipment Methods Standards Other Aspects Appendix TABLE OF CONTENTS Vii page 11 15 17 ''''GENERAL Alcantara J. [Biocontaminant medical wastes. The risks for health personnel]. Rev Enferm 1989 Sep; 12(133):21-3. (Spa). Anderson MA. Hazardous waste management in hospitals. In: Majumdar SK, Miller EW, Schmalz RR, editors. Management of hazardous materials and wastes: treatment, minimization and environmental impacts. Easton (PA): Pennsylvania Academy of Science; 1989. p. 161-76. Aston G. Control of clinical waste. Environ Health (Lond) 1989;97(11):296-7. Bendix G, Wenchel HM, Werner HP. Disposable articles as hospital refuse. Zentralbl Hyg Umweltmed 1990;189(4):367. Binder U. [Hospital and environmental analysis]. Schweiz Spital 1986;50(3):23-5. (Ger). Bolton K. Doors open in waste disposal. Health Ind Today 1990 May;53(5):1, 6-7. Brill DR. Disposal of low-level radioactive waste. Invest Radiol 1991;26(1):94-5, Brody MD. AVMA guide for veterinary medical waste management [published erratum appears in J Am Vet Med Assoc 1989 Oct 15;195(8):1130]. J Am Vet Med Assoc 1989 Aug 15;195(4):440-52. Brunner CR, Brown CH. Hospital waste disposal by incineration. Waste streams, technology, and state requirements. JAPCA 1988 Oct;38(10):1297-309. Buckner F. Coping with infectious waste in medical practices. J Med Pract Manage 1990;5(4):278-82. Cariou N. [Waste products in a nursing ward. Elements of observation for the proper regulation of a ward]. Soins 1988 May;(512):37-9. (Fre). Carlisle D. Green care. Ensuring safe practice. Nurs Stand 1989 Jul 8;3(41):25-7. Carpinello MT. Infectious wastes: new options for local policy makers. Public Works 1988;119(6): 82-3. Chapnick SR. Selecting a medical waste disposal service. J Healthc Mater Manage 1990 Feb-Mar; 8(2):32-4, 36-7. Cheremisinoff PN. High hazard pollutants: asbestos, PCBs, dioxins, biomedical wastes. Pollut Eng 1989; 21(2):58-63. Cheremisinoff PN, Shah MK. Hospital waste management. Pollut Eng 1990;22(4):60-6. CIT commercializes new technologies. Environ Bus J 1990 Feb;3(2):5. Cohen R. Impact of the solid waste crisis on medical practices. N J Med 1988 Jun;85(6):509-11. Collins CH. The disposal of infected laboratory waste. J R Soc Health 1989 Jun;109(3):112-4. Comprehensive medical waste plan underway in New York City. J Air Waste Manage Assoc 1990;40(4): 450-1. Crow CT, Stucki H. WTE plant approaches total integration. Solid Waste Power 1989;3(5):48+. De Wever A. [Recommendations of the Public Health Counsel for hospital waste management]. Hop Belge 1990;(202):7-13. (Fre). Disposal of hazardous wastes [videocassette]. Bell FE, Kinnery R, Threatt S, Shaw G. Charleston (SC): Medical University of South Carolina, Health Communications Network; 1987. 1 videocassette: 60 min., sound, color, 3/4 in. (Administrative grand rounds). Disposing of infectious medical waste. J Okla Dent Assoc 1989 Spring;79(4):10-1. {Environmental management in the hospital]. Krankenhaus 1990;82(9):384-92. (Ger). Environmental Protection Agency, Office of Air Quality Planning and Standards. Final report. Proceedings: National Workshops on Hospital Waste Incineration and Hospital Sterilization; 1988 May 10-12; San Francisco; and 1988 May 24-26; Baltimore. Washington: State and Territorial Air Pollution Program Administrators/Association of Local Air Pollution Control Officials; 1989 Jan. Report No.: EPA 450489002. 369 p. Available from: NTIS, Springfield, VA; PB 89182695. EPA sets up two-year pilot program for tracking medical waste [news]. JAPCA 1989 May;39(5): 568-7. Fara GM, Collina D. [Liquid hospital waste]. Ann Ig 1989 Jan-Apr;1(1-2):51-5. (Ita). Finding the Rx for managing medical wastes. Washington: Office of Technology Assessment; 1990 Oct. 91p. Flamm H. [Disposal of hospital waste. I]. Osterr Krankenpflegez 1986 Jun-Jul;39:170-3. (Ger). ''2 Fletcher LL. Needle disposal policies (I). Am J Infect Control 1990;18(3):223. Friedman G. Consistent definition of waste is crucial - study. Healthweek 1989 Aug 14;3(16):6, 35. Gamalero G. [Hospital waste management]. Eco Not Ecol 1989;7(5):40-2. (Ita). Geraci G. [Hospital waste]. Eco Not Ecol 1989;7(9): 38-9. (Ita). Globig KF, Joosten T. [A hospital ecologist]. Krankenh Umsch 1990;59(11):835-46. (Ger). Griffiths G. The safe disposal of clinical waste. JR Soc Health 1989 Aug;109(4):125-7. Hall SK. Infectious waste management, a multi-faceted problem. Pollut Eng 1989;21(8):74-8. Halter P. The emerging medical-waste industry. Med Dev Diag Ind 1990 Mar;12(3):48-9. Hartemann P. [Hospital waste water]. Rev Hosp Fr 1989;53 Spec Iss:48-9. (Fre). Health system waste management review. Adelaide: South Australian Health Commission; 1986. 1 vol. (various pagings). Healthcare hazards: compliance and guidelines. Neenah (WI): J.J. Keller & Associates; 1990. 1 vol. (loose-leaf). Hedrick ER. Infectious waste management--will science prevail? [editorial]. Infect Control Hosp Epidemiol 1988 Nov;9(11):488-90. Hershikowitz A. Without a trace. Technol Rev 1990 Aug-Sep;93(6):35-7, 39 passim. Hershkowitz A. Tracking medical waste. Technol Rev 1990 Aug-Sep;93(6):35. -Hodecek P. [Medical waste management]. Osterr Krankenhaus Z 1990;31(7-8):425-40. (Ger). Hoeltge GA. Managing hazardous waste in the clinical laboratory. Clin Lab Med 1989 Sep;9(3):573-86. Hoffman SL, Cabral NJ. Solving the problems of infectious waste disposal. Solid Waste Power 1989; 3(3):24+. [Hospital waste in Walloon]. Hop Belge 1990;(202): 17-22. (Fre). Hospitals try to get handle on system for waste disposal. Hosp Pharmacist Rep 1990 Feb:36. Huizinga J. [Only five percent of hospital waste is truly hazardous]. Ziekenhuis 1988;18(18):817-9. (Dut). Huser TJ. Emergency decontamination--is your hospital prepared? J Healthc Prot Manage 1990 Spring;6(2):22-6. . Infection control in the office [slide]. Webster L, Halpin T. Columbus (OH): Ohio Medical Education Network; 1989. 27 slides: color. (OMEN; no. 26). Accompanied by: 1 sound cassette; 1 guide. Infectious waste in hospitals and health care facilities [videocassette]. Pierce JO, David KJ. Hollywood (CA): Film Communicators; 1988. 1 videocassette: 10 min., 52 sec., sound, color, 3/4 in. Infectious waste management system. Dent Prod Rep 1989 May;23(5):60. Inoue K. [Memories of medical waste in the past]. Nasu Suteshon 1989 Jun;19(2):132-7. (Jpn). Issues in medical waste management. Background paper. Washington: Office of Technology Assessment; 1988 Oct. 51 p. Jessup DH. Infectious waste: the complete resource guide. Washington: Bureau of National Affairs; 1988. 2 vol. Kasper E, Seipp HM. [Waste disposal in hospital]. Krankenh Umsch 1989;58(7):570-4. (Ger). Kesner BT. Practical aspects of hazardous waste management for hospitals. Hosp Mater Manage 1986;11(11):13-6. Kirshner E. Baxter Healthcare to offer medical waste services. Healthweek 1989 Oct 23;3(21):5. Klee P, Husmann KH, Reis W. [Various kinds of refuse at the hospital--practical recommendations for classification]. Off Gesundheitswes 1986 Dec; 48(12):660-1. (Ger). Knoch J, Wiemann P. [Hospital waste - mostly special waste]. Krankenh Tech 1988;14(12):46-9. (Ger). LaMoreaux JW, Green N. Risk assessment in managing infectious wastes. Water Environ Technol 1990 Jun;2(6):40-3. Landrum VJ , Barton RG. Municipal waste combustion assessment: medical waste combustion practices at municipal waste combustion facilities. Final Rept. Nov 88-Jun 89. Durham (NC): Energy and Environmental Research Corp; 1989 Jul. Report No.: EPA 600889062. 43 p. ''Laskin DM. Getting rid of bugs, drugs, and trash [editorial]. J Oral Maxillofac Surg 1989 May; 47(5):437-8. Laufman H. Environmental concerns in surgery in the 1990s. Todays OR Nurse 1990 Oct;12(10):41-8. Lawrence JM, Sanderson PJ. A method of audit for ward clinical waste. J Hosp Infect 1988 Nov; 12(4):323-6. Liss GM, Crimi C, Jaczek KH, Anderson A, Slattery B, D’Cunha C. Improper office disposal of needles and other sharps an occupational hazard outside of health care institutions. Can J Public Health 1990; 81(6):417-20. Lohfert C. [Examples of rationalization measures for hospitals in the fields of nursing, investigation and treatment and of management, catering and refuse disposal]. Krankenh Umsch 1986;55(6):429-43. (Ger). Longet R. [In the daily life of the hospital--waste, a problem concerning everybody]. Krankenpfl Soins Infirm 1988 Sep;81(9):24-7. (Fre). Maes Ch, Pernet M, Beaufils MP. [Realisation of a policy of refuse evacuation in the hospital group Bichat - Claude-Bernard]. Tech Hosp Med Soc Sanit 1990;45(539-540):33-7. (Fre). Maijer MM. Emptying and disposing of wound drainage...an infection hazard. Todays OR Nurse 1987 Nov;9(11):11-7. Managing hazardous materials and wastes [videocassette]. Keil OR, Grothaus CL, McLean A. Joint Commission on Accreditation of Healthcare Organizations [in association with] Hospital Satellite Network. Chicago: The Commission; 1988. 1 videocassette: 119 min., sound, color, 1/2 in. Marks CH. Burn or not to burn: the hospitals’ modern- day dilemma. Pollut Eng 1988;20(11):97-9. Marrack D. Hospital red bag waste. An assessment and management recommendations. JAPCA 1988 Oct; 38(10):1309-11. Mason CA. The OSHA inspection process: one hospital’s experience. Am J Infect Control 1989; 17(6):353-8. Mayer D. Two communities refuse to be sites of regional med waste incinerators. Healthweek 1990 Jun 25;4(12):4, 40. Mayr HE. [Waste-water]. Osterr Krankenhaus Z 1990; 31(7-8):441-2. (Ger). McLean A, Lehmann R. Managing hazardous wastes and materials. Chicago: Joint Commission on Accreditation of Hospitals; 1986. 64 p. Meaney JG, Cheremisinoff PN. Medical waste strategy. Pollut Eng 1989;21(11):92-106. Medical & infectious waste management. Silver Spring (MD): Hazardous Materials Control Research Institute; 1988. Medical waste: the latest waste management issue. Pollut Eng 1988;20(12):44, 46. Medpak targets medical waste. Battelle Today 1990 Jun;(63):2. Miller RK, Rupnow ME. Medical waste management. Madison (GA): Future Technology Surveys, Inc.; 1991. 50 p. (Survey on technology and markets series; 161). Mittermayer F. [Hospital waste management]. Osterr Krankenhaus Z 1990;31(7-8):421-3. (Ger). Moore JA. The plan for medical wastes. Waste Age 1989 Feb;20(2):34. Morales LA. Managing medical wastes: A bibliography of the periodical literature, 1987-1989. Monticello (IL): Vance Bibliographies; 1990. 7 p. Naber T. Bay disposal’s infectious waste venture. Waste Age 1987 May;18(5):81-112. Naber T. An infectious business. Waste Age 1989 Dec;20(12):70. Naber T. Infectious wastes: the questions remain. Waste Age 1989 May;20(5):89. Naber T. Opportunity knocks in biomedical wastes. Waste Age 1988 Jan;19(1):34. National Research Council, Committee on Hazardous Biological Substances in the Laboratory. Biosafety in the laboratory: prudent practice for the handling and disposal of infectious materials. Washington: National Academy Press; 1989. 222 p. National Technical Information Service. Medical wastes: disposal and treatment. July 1976-April 1990 (A_ bibliography from the Energy Data Base). Springfield (VA): NTIS; 1990 May. 77 p. 128 citations. PB 90-870187. No time to waste [videocassette]. New England Deaconess Hospital. Los Angeles: Media Services for Hospital Satellite Network; 1988. 1 videocassette: 28 min., 30 sec., sound, color, 1/2 in. Accompanied by: 1 guide. ''4 Off-site waste disposal. Dent Prod Rep 1990 Feb;24(2): 80. Patterson P. Keeping a lid on OR waste [editorial]. Todays OR Nurse 1990 Oct;12(10):54. Patterson P. OR nurses are joining efforts to stem medical waste stream. OR Manager 1990 Sep;6(9): 1, 4. Peeters M. [Solution of problems in the formation of a strong hospital hygiene report on the experiences of a hygiene specialist]. Hyg Med 1986;11(10):406-7. (Ger). Penner SS, Chang DP, Goulard R, Lester T. Waste incineration and energy recovery. Energy 1988; 13(12):845-51. Perry PA. GPO’s activity in medical waste management grows. Hosp Mater Manage 1990 Dec; 15(12):1, 12. Peters J. [Comments on recommendations of the GFR ministry of health on refuse collection]. Forum Stadte Hyg 1988;39(6):277-8. (Ger). Pettit CL. Infectious waste: state programs survey. Waste Age 1987 Apr;18(4):115-8. Pownall M. Tipping the balance. Nurs Times 1989 Mar 15-21;85(11):20. Prouveur F. [Treatment of hospital wastes]. Trib Cebedeau 1987;40(529):62-4. (Fre). Questions about infectious wastes. Waste Age 1986 Oct;17(10):112. Rasmussen JM. [Loose syringes are mixed in with the waste]. Sygeplejersken 1988 Jul 13;88(28):13. (Dan). Reinhardt PA, Gordon JG. Infectious and medical waste management. Chelsea (MI): Lewis Publishers; 1990. 350 p. Reinthaler F. [Waste disposal from medical practices and laboratories]. Wien Med Wochenschr 1987 Aug 15;137(14-15):334-5. (Ger). Reinthaler FF, Schmalz H, Mascher F. [Disposal of chemicals in hospital and other medical areas]. Hyg Med 1988;13(6):224-8. (Ger). Rettig PC. ATSDR (Agency for Toxic Substances and Disease Registry): medical waste poses no threat to public. Health Facil Manage 1990 Jun;3(6):60, 62, 64-6. Reybrouck G. [The problems associated with waste management in health care institutions]. Hop Belge 1990;(202):14-6. (Fre). Rosenberg CS. Disposal of medical wastes [letter]. Diabetes Educ 1989 May-Jun; 15(3):203. Sales JW. EPA (Environmental Protection Agency) guide for infectious waste management. Washington: EPA, Office of Solid Waste; 1986. Schaaf D. [Disposal of waste drugs and chemicals in hospitals]. Krankenhaus 1986;78(5):199-203. (Ger). Serene JW. Waste management [letter]. Orthop Rev 1989 Aug;18(8):923. Shulman S. Michigan faces disposal ban. Nature 1990;348(6301):475. Souhradra P. Firms tap growing market for medical- waste disposal. Healthweek 1989 Jan 9;3(1):9. South Dakota Dental Association medical waste management guidelines adopted May 24, 1989. Northwest Dent 1989 Sep-Oct;68(5):39-41. Stewart TR. Perspectives on medical waste: a report of the Nelson A. Rockefeller Institute of Government, State University of New York. Albany: The Institute; 1989. 1 vol. ; Summary of the Agency for Toxic Substances and Disease Registry report to Congress: the public health implications of medical waste. MMWR 1990 Nov 16;39(45):822-4. Survey points to hospital woes. Environ Manage News 1989 Sep 1;4(14):4. Swanson RL. Wastes on New York area beaches. J Environ Syst 1988-89;18(2):183-8. Szczepanski M. Reducing hospital waste [letter]. Nurs Manage 1991 Jan;22(1):12. Take out the trash, but watch out for the waste. Christian Science Monitor 1988 Aug 29;80(192):17. Tillis BP. Infectious waste disposal. An additional responsibility [editorial]. N Y State Dent J 1989 May;55(5):5. Truax H. There’s more than healed bodies coming out of that hospital. NEHW Health Watch 1988 Fall; 9(3):1, 3-5. Turnberg W. An examination and risk evaluation of infectious waste in King County, Washington [letter]. Neonatal Netw 1989 Jun;7(6):81. ''Used needles [letter]. Aust Fam Physician 1990 Feb; 19(2):248-9, Walker RE. State-of-the-art study of hospital‘ waste handling. J Hazard Mater 1990;24(2-3):301-2. Waste management service. Dent Prod Rep 1990 Jan; 24(1):57. Wildbrett G. [Environmentally friendly purchasing and waste disposal in large institutions]. Heim Anstalt 1989;20(3):61-5. (Ger). Yiasemides E. Management of infectious waste calls for strategic hospital planning. Occup Health Saf News Dig 1987;3(4):1-4, 22. ANALYSIS Ault MR. Gamma emitting isotopes of medical origin detected in sanitary waste samples. Radiat Prot Manage 1989;6(1):48-52. Blenkharn JI, Oakland D. Emission of viable bacteria in the exhaust flue gases from a hospital incinerator. J Hosp Infect 1989 Jul;14(1):73-8. Darling C, Brenniman GR, Allen RJ. Air pollution emissions from the incineration of hospital waste. JAPCA 1986 Jul;36(7):829. Drauschke S, Xander L. Tests on refuse from ambulant and stationary dialysis stations with reference to hygienic requirements for disposal. Zentralbl Hyg Umweltmed 1990;189(4):367. EPA begins medical waste tracking program [news]. JAPCA 1989 Aug;39(8):1032-3. Illinois University at the Medical Center, Chicago School of Public Health. Final report. Bacterial emissions from incineration of hospital waste. Chicago: The University; 1988 Jul. Report No.: ILENRREAQ8817. 57 p. Available from: NTIS, Springfield, VA; PB88240494, Jager E, Xander L, Ruden H. [Medical waste. 1. Microbiologic studies of wastes of various specialties at a large and small hospital in comparison to housekeeping waste]. Zentralbl Hyg Umweltmed 1989 Jun;188(3-4):343-64. (Ger). Jager E, Xander L, Ruden H. [Medical wastes. 2. Comparative studies of the microbial contamination of wastes from medical practices of different disciplines and household garbage]. Zentralbl Hyg Umweltmed 1990 May;190(1-2):188-206. (Ger). Kauppinen EI, Pakkanen TA. Mass and trace element size distributions of aerosols emitted by a hospital refuse incinerator. Atmos Environ Part A Gen Top 1990;24(2):423-9, Lindner G, Jenkins AC, McCormack J, Adrian RC. Dioxins and furans in emissions from medical waste incinerators. Chemosphere 1990;20(10-12): 1793-800. Manscher OH, Heidam NZ, Vikelsoe J, Nielsen P, Blinksbjerg P, Madsen H, Pallesen L, Tiernan TO. The Danish incinerator dioxin study. Part 1. Chemosphere 1990;20(10-12):1779-84, Matsushima H. A selected ion monitoring assay for triclosan in medical waste water. Biomed Environ Mass Spectrom 1988 Oct;16(1-12):255-7. ''6 Powell FC. Air pollutant emissions from the incineration of hospital wastes. The Alberta experience. JAPCA 1987 Jul;37(7):836-9. Scott GM, Jones GH. Emission of viable bacteria in the exhaust flue from a waste incinerator [letter]. J Hosp Infect 1990 Aug;16(2):183-4. ECONOMIC ASPECTS Browning-Ferris had loss of $226.3 million in fiscal 2nd period. Wall Street Journal 1990 Apr 24;215(80): C22. Cherskov M. Disposal costs for radioactive waste steadily increase. Hospitals 1986 Dec 20;60(24):80. Copeland DA, Panzica RP. Medical waste: socioeconomic impact. Kao Hsiung I Hsueh Ko Hsueh Tsa Chih 1989 Nov;5(11):593-9. Dagnall S. The use of hospital waste as a fuel. Part 2. J Inst Hosp Eng 1989 Jul;43(6):11-3. Darcey S. New growth predicted for infectious waste industry. Manage World Wastes 1990 Dec;33(12): 39-41. Daschner F, Scherrer M, Just HM. [Hospital refuse: Avoidance, reduction and useful and useless ideas on disposal]. Krankenh Umsch 1989;58(4):262-6. (Ger). Dollar per day solution for medical waste. Hazard Waste Manage 1989 Feb;7(2):11. Fields RA. Containing waste disposal costs. Rev Fed Am Health Syst 1989 May-Jun;22(3):53, 55. Hausner K. Reader questions two June articles [letter]. AORN J 1990 Nov;52(5):942, 944-5. Holthaus D. Incineration cuts waste-disposal costs. Hospitals 1987 Oct 5;61(19):154, 156. Holthaus D. New risk group for environmental pollution. Hospitals 1988 Apr 20;62(8):32. Just HM. [Reduction of hospital waste starts at source. From cost and environmental viewpoint]. Krankenh Tech 1989;15(7):24-8. (Ger). Kensett RG. Waste disposal in the NHS--the alternatives. Health Estate J 1990 Mar;44(2): 11-4, 16, 18-22. Kirshenr E. Volatility marks debate on hospital nuclear waste. Healthweek 1990 Sep 24;4(18):1,30. Litsikas M. Forsyth Memorial cuts disposal costs by 77%. Hosp Mater Manage 1990 Dec;15(12):14-5. Lutz-Dettinger U. [Hospital waste disposal]. Krankenhaus 1988;80(12):576-9. (Ger). Medical waste: a new market niche. Environ Bus J 1990 Jan;3(1):8. ''Rigano JP. How to control infectious-waste disposal costs and liability exposure, too. Health Facil Manage 1990 Jun;3(6):40-1. Rosendahl I. NWDA and BFI form firm to dispose of drug waste. Drug Topics 1991 Jan 21;135(2):66, 68. Ruden H, Jager E. [Economic and hygienic disposal of medical waste]. Krankenhaus 1989;81(9):504-8. (Ger). Schwarzbeck A, Froese P, Bilges H, et al. Disposing of single-use equipment. Lancet 1986;1(8479): 505-6. Sedor PM. Costs soar under EPA’s waste-tracking program. Health Facil Manage 1990 Jun;3(6):24, 26-8, 30. Souhrada L. Reusables revisited as medical waste adds up. Hospitals 1988 Oct 20;62(20):82. Stewart I. Garbage eats nurse or nurses in the throwaway society. Aust Nurses J 1989;18(10): 24-6. Sullivan P. Speakers offer vastly different views on disposable health care products. Can Med Assoc J 1990 Dec 15;143(12):1342, 1345. Tokarski C. Debating the benefits of regulation. Mod Healthe 1990 Aug 20;20(33):35-8. Tokarski C. Hospitals brace for waste-tracking costs. Mod Healthc 1989 Apr 14;19(15):58. Trescher J. [Sterilisation in hospital, cost factors involved]. Gestions Hosp 1988;(273):91-4. (Fre). Vogel G. [Avoidance and reduction of medical waste]. Osterr Krankenhaus Z 1990;31(7-8):447-61. (Ger). Wagner M. Environment, cost concerns spur new interest in reusables. Mod Healthc 1990 May 14; 20(19):46. Waste tracking rule focuses attention on disposal costs. Hosp Mater Manage 1989 May;14(5):1, 6. ENVIRONMENTAL ASPECTS Allen RJ, Brenniman GR, Darling C. Air pollution emissions from the incineration of hospital waste. JAPCA 1986;36(7):829-31. Allen RJ, Brenniman GR, Logue RR, Strand VA. Emission of airborne bacteria from a hospital incinerator. JAPCA 1989 Feb;39(2):164-8. Baugut G. [An operational comparison of hospital environmental activities]. Krankenhaus 1990; 82(12):549-52. (Ger). Brown L. Working for a healthy environment. RNABC News 1990 Mar-Apr;22(2):21-4. Dysari J. Rethinking the earth. Can Nurse 1990 Aug;86(7):16-7. Edhag O. [Are physicians responsible for the environment?] Lakartidningen 1990 Apr 4; 87(14):1138, 1140. (Swe). Griffiths G, Sheppard M, Kelly T. Environmental hazards from a hospital incinerator. J Hosp Infect 1989;14(4):378-9. International toxicity update. Dang Proper Ind Mater Rep 1988;8(6):2-7. Janischowski AJ. [Economy and ecology]. Krankenh Umsch 1990;59(11):852-6. (Ger). Jungwirth H. [Environmental protection in the hospital]. Krankenh Tech 1989;15(6):94-8. (Ger). Katz DM. Pollution concerns hit hospitals. Natl Underwrit Prop Casualty & Employee Benefits Edition 1989 Mar 13;93(11):51, 53. Kensett RG. The control of pollution. J Inst Hosp Eng 1987 Nov;41(10):2-8. Lee MG. The environmental risks associated with the use and disposal of pharmaceuticals in hospitals. In: Richardson ML, editor. Risk assessment of chemicals in the environment. 3rd European Conference; 1988 Jul 11-14; Guilford, England. London: Royal Society of Chemistry; 1988. p. 491- 504. Physicians and the ecologic crisis [letter]. Can Med Assoc J 1989 Dec 153141(12):1224. Salrein G. [Environmental protection and nursing]. Krankenh Umsch 1990;59(11):846-50. (Ger). Scherrer M, Conrad G, Daschner F. [Waste avoidance and environmental protection in relation to medical ''products supply]. Krankenhaus 1990;82(11):475-8. (Ger). Taillens F. [Health institutions and environmental protection. Necessary support]. Krankenpfl Soins Infirm 1989 Sep;82(9):82-4. (Fre). EQUIPMENT Abrams SG, Dyer KE. Needle disposal device: US Patent-4917243. April 17, 1990. Off Gaz U S Pat Trademark Off Pat 1990;1113(3):1574. Anderson RS. Disposal receptacle for used, sharp, medical instruments or other biohazards: US Patent-4890733. January 2, 1990. Off Gaz U S Pat Trademark Off Pat 1990;1110(1):148-9. Annett LW. Hinged container for surgical articles: US Patent-4886165. December 12, 1989. Off Gaz U S Pat Trademark Off Pat 1989;1109(2):660. {Anti-AIDS JETBAC system (news)]. Rev Infirm 1990 Sep;40(14):6. (Fre). Appleby CR. Baltimore to have largest medical-waste burner. Healthweek 1990 Mar 26;4(6):7. Bennett MC. Blood collection needle disposal system: US Patent-4844245. July 4, 1989. Off Gaz U S Pat Trademark Off Pat 1989;1104(1):221. Blake JW 3d, Sloane TE Jr. Disposable hypodermic syringe: US Patent-4986813. January 22, 1991. 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J Hosp Infect 1990 Apr;15(3):287-94. Haber TM. Disposable safety syringe having a retractable needle cannula and cannula lock: US Patent-4908022. March 13, 1990. Off Gaz U S Pat Trademark Off Pat 1990;1112(2):948. Hanifl PH. Closure for a syringe collection and disposal container: US Patent-4657139. April 14, 1987. Off Gaz U S Pat Trademark Off Pat 1987; 1077(2):792. Hanifl PH, Newton JJ Jr, Mosior DJ. Sharps disposal container: US Patent-4779728. October 25, 1988. Off Gaz U S Pat Trademark Off Pat 1988;1095(4): 1759, Harper AC, Wilson JH, Mckee RG, Lasiter DN. Hospital waste disposal system: US Patent-4619409. Oct 28, 1986. Off Gaz U S Pat Trademark Off Pat 1986;1071(4):1557. Haunzwick] A. [The central waste absorption installation]. Osterr Krankenhaus Z 1990;31 Suppl 1:97-100. (Ger). Hilbig R. [An end to stab injuries. A nurse as inventor]. Krankenpflege (Frankfurt) 1990;44(6): 362. (Ger). Hoch L. Blood collection needle disposal system: US Patent-4625877. Dec 2, 1986. Off Gaz U S Pat Trademark Off Pat 1986;1073(1):203-4. Hogan JM. Safety device and method for removal and disposal of medical needles: US Patent-4842586. June 27, 1989. Off Gaz U S Pat Trademark Off Pat 1989;1103(4):2414. Honeycutt TW. Novel infectious waste containment: US Patent-4816307. March 28, 1989. Off Gaz US Pat Trademark Off Pat 1989;1100(4):2383-4. Honeycutt TW. Point-of-use infectious waste disposal system: US Patent-4900500. Feb 13, 1990. Off Gaz U S Pat Trademark Off Pat 1990;1111(2):914. Kaiser finds San-I-Pak an effective waste option. Health Facil Manage 1989 Apr;2(4):58, 61-2. Kelson LP, Kelson RJ. Medical sampling needle removal and disposal device: US Patent-4862573. September 5, 1989. Off Gaz U S Pat Trademark Off Pat 1989;1106(1):32-3. Kelson LP, Kelson RJ, Martin AF. Medical sampling needle removal and disposal device: US Patent-4807344. February 28, 1989. Off Gaz US Pat Trademark Off Pat 1989;1099(4):1783-4. Koffsky RM, Pedersen FS. Waste disposal apparatus: US Patent-4809915. March 7, 1989. Off Gaz U S Pat Trademark Off Pat 1989;1100(1):203. Kurtz SL. Needle disposal device and method for preventing accidental contact with a needle: US Patent-4875896. October 24, 1989. Off Gaz U S Pat Trademark Off Pat 1989;1107(4):1833. ''10 Leishman LS. Apparatus and method for disposing of contaminated needles: US Patent-4848569. July 18, 1989. Off Gaz U S Pat Trademark Off Pat 1989; 1104(3):1730. Loebbert J. Device for hygienic waste collection in hospitals, laboratories and similar establishments: US Patent-4883189. November 28, 1989. Off Gaz U S Pat Trademark Off Pat 1989;1108(4):1730. Maeda T. Destruction apparatus for syringe: US Patent-4786280. November 22, 1988. Off Gaz US Pat Trademark Off Pat 1988;1096(4):1880. Millam D. Update 90: avoiding needle-stick injuries. Nursing 1990 Jan;20(1):61-4. Mueller RL. The syringe disposal device hygienically questionable. Hyg Med 1986;11(9):360-1. (Ger). Nakamura M. Container having injection needle- detaching means: US Patent-4892191. January 9, 1990. Off Gaz U S Pat Trademark Off Pat 1990; 1110(2):648. On-site sterilizer/compactors: one solution to the infectious waste dilemma. J Healthc Mater Manage 1990 Nov-Dec;8(8):86. Padgett LW. Combination sterilization and infectious waste disposal container: US Patent-4644586. February 17, 1987. Off Gaz U S Pat Trademark Off Pat 1987;1075(3):1640. People and environment protected from medical sharps with new disposal system [news]. Crit Care Nurse 1990 Oct;10(9):84. Piggin PR. Development of the Corsair range of waste combustion boilers for hospitals. J Inst Hosp Eng 1989 Nov;43(9):16-7. Quisenberry TM, Wahlenmeier FE. Receptacle for receiving infectious waste material: US Patent-4874103. October 17, 1989. Off Gaz US Pat Trademark Off Pat 1989;1107(3):1211-2. Russo A, Russo AA. Medical waste disposal system: US Patent-4911294, March 27, 1990. Off Gaz US Pat Trademark Off Pat 1990;1112(4):2105. 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Peck J. Sharps: unfair to the dentist. Probe (Lond) 1988 Mar;29(9):290. Power LA, Anderson RW, Cortopassi R, Gera JR, Lewis RM Jr. Update on safe handling of hazardous drugs: the advice of experts. Am J Hosp Pharm 1990 May;47(5):1050-60. Recommendations for prevention of HIV transmission in health-care settings. MMWR 1987 Aug 21;36 Suppl 2:1S-18S. Redstone J. Health and safety: reducing sharps injuries. Nurs Stand 1989 Jul 1;3(40):28. Reed S. The Journal of Infection Control Nursing. Point taken? Nurs Times 1987;83(48):64-71. Ribner BS, Landry MN, Gholson GL, Linden LA. Impact of a rigid, puncture resistant container system upon needlestick injuries. Infect Control 1987 Feb;8(2):63-6. Rich G, Cherry K. The liabilities of hospital waste incineration. Pollut Eng 1986;18(2):48. Scharf L. Safe needle disposal: a timely reminder. RN 1986 Jun;49(6):42. Schmitt-Gleser G. [The GCVS directive for infectious waste]. Krankenh Tech 1989;15(8):40-2. (Ger). Seipp HM. 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Am J Public Health 1990 Oct;80(10):1262-4. U.S. EPA assessment plan for medical waste management. JAPCA 1988;38(10):1312. Uldall A. The disposal of chemical waste from hospital laboratories as background for the handling of waste from H1. Eur J Haematol Suppl 1990; 45(53):64. 19 Update: universal precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus, and other bloodborne pathogens in health-care settings. MMWR 1988 Jun 24;37(24): 377-82, 387-8. Waste consultation venture. Wall Street Journal 1989 Oct 13;214(73):B4c. Weisberg LS. Salutations to a ‘regulated medical waste generator.’ N Engl J Med 1990;323(1):66. Woodhead CM. Sharps disposal [letter]. Br Dent J 1988 Sep 10;165(5):160. Yodaiken RE, Bennett D. Clinical chemical carcinogens and bureaucratic intransigence. Ann N Y Acad Sci 1988;534:762-75. '' ''APPENDIX Healthcare Hazardous Materials Management. HHMM. Plymouth Meeting (PA): ECRI. Vol. 3, No. 10, 1990- . Hospital Hazardous Materials Management. Plymouth Meeting (PA): ECRI. Vol. 1, 1987-Vol. 3, No. 9, Jun 1990. Continued by: Healthcare Hazardous Materials Management. HHMM. Infectious Wastes News. Washington: Richard H. Freeman. Vol. 1, 1986?- . Medical Waste News. Silver Spring (MD): Business Publishers. Vol. 1, 1989?- . ''''®) GRATEFUL MED Software For Macintosh & IBM Please send me copies of GRATEFUL MED for the Macintosh. Order No. PB89- 196083/GBB at $29.95 each. Please sendme____ copies of GRATEFUL MED for IBM and compatibles. Order No. PB86- 158482/GBB at $29.95 each. Total Mac versions Handling $3.00 + Billing Fee* P.O. #: + Total IBM versions + * Add $7.50 Billing Fee if using a Purchase Order. Please attach this form to any purchase order you use. = Total . Enclosed is check / money order payable to NTIS for $ Charge to (check one): American Express Cc] VISA [] MasterCard L_] Card Number Exp. Signature (required to validate order): Please complete the following. 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