"Hot" Medical Waste in CA

[MARKH_at_EHS@CCMAIL.UCSF.EDU]

     Help!
     The state of California has mandated (in a policy guidance memorandum 
     dated 4-22-94), off-site medical waste treatment facilities to monitor 
     medical waste and to set their monitoring devices at three times 
     background. Our vendor has had to return our medical waste to us more 
     than once already and twice the material was found to be Indium-111 
     from diagnostic nuclear medicine procedures. The waste was found to 
     enter the medical waste stream once from surgery and once from an 
     intensive care unit. We currently have procedures for handling known 
     radioactive medical waste generated in the nuclear medicine department 
     and during radionuclide therapies performed on inpatients. Segregating 
     known radioactive medical waste has been effective, but now the levels 
     of detection are set so low that it seems that all of our medical 
     waste must be monitored prior to removal from the facility because 
     there is no surefire way to know who all the patients may be who could 
     leave behind slightly contaminated radioactive waste so that the waste 
     they create can be monitored efficiently. I am preparing a document 
     outlining potential solutions to the problem which will require 
     monitoring of medical waste prior to its leaving the facility. I am 
     interested to hear from this audience if anyone has set up their own 
     procedures for effectively monitoring and removing radioactive medical 
     waste prior to its being removed from their facility. Some of the 
     issues involved are the personnel(which department)who will perform 
     the monitoring, where and when the monitoring will be performed, 
     instrumentation and its maintenance, and the anticipated expenses that 
     will be incurred due to the increased labor and instrumentation 
     required.
     
     Thanks to any of you in advance for your time in responding to this 
     plea for understanding how others in a similar boat may be dealing 
     with this issue at their institutions.
     
     Mark How 
     UCSF