Requirements for the organization of a medical waste management system. Sanpin medical waste russia

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MEDICAL WASTE MANAGEMENT REGULATIONS

Medical waste is materials, substances, products, medicines that have partially or completely lost their original consumer properties when operating in medical institutions. Sanitary and epidemiological requirements for handling medical waste SanPiN 2.1.7.2790-10 "Sanitary and epidemiological requirements for the treatment of medical waste" are defined. Medical waste, depending on the degree of their epidemiological, toxicological and radiation hazard, as well as the impact on the human environment, is divided into 5 hazard classes.

Classification of medical waste

Hazard Class	Characteristics of the morphological composition
Class A (epidemiologically safe)	Waste that does not come into contact with the biological fluids of patients, infectious patients. Stationery, packaging, furniture, inventory - lost consumer properties. Estimates from cleaning the territory, etc. Food waste from centralized catering units and all departments of the organization that carry out medical and / or pharmaceutical activity, except for infectious (including phthisiatric).
Class B (epidemiologically dangerous)	Infected and potentially infectious waste. Materials and tools, objects contaminated with blood and/or other biological fluids. Pathological waste. Organic operational waste. Food waste from infectious diseases departments. Waste from microbiological, clinical diagnostic laboratories, pharmaceutical, immunobiological industries working with microorganisms of 3-4 pathogenicity groups. Biological waste of vivariums. Live vaccines are not suitable for use.
Class B (extremely epidemiologically dangerous)	Patient contact materials infectious diseases, which may lead to emergencies in the field of sanitary and epidemiological welfare of the population and require measures for the sanitary protection of the territory. Waste from laboratories, pharmaceutical and immunobiological industries working with microorganisms of 1-2 pathogenicity groups. Waste of diagnostic and treatment departments of phthisiatric hospitals (dispensaries), contaminated with sputum of patients, waste of microbiological laboratories working with tuberculosis pathogens.
Class G (toxicologically dangerous 1 - 4 class)	Medicinal (including cytostatics), diagnostic, disinfectants that are not to be used. Mercury containing objects, etc.
Class D (radioactive)	All types of waste in which the content of radionuclides exceeds the permissible levels.

medical waste danger sanitary epidemiological

The following factors of potential hazard of medical waste are distinguished: the risk of infection (obvious in contact with infected material); the risk of physical damage (associated with damage to the skin and mucous membranes with sharp objects); the risk of toxic damage (associated with the performance of chemical disinfection of HPE departments, as well as in contact with those removed from HPE toxic waste); the risk of radioactive damage; environmental risk associated with the entry of waste into the environment and their further distribution in the air, water and soil. The head of the healthcare facility approves an instruction that identifies responsible employees and a scheme for handling medical waste in this institution, including the following steps: waste collection within the organization; transfer of waste from departments and temporary storage of waste on the territory of health care facilities; disinfection / neutralization; transportation of waste from a waste generating organization; burial or destruction of medical waste. Persons under the age of 18 are not allowed to work with medical waste. The staff undergoes preliminary and periodic medical examinations. He must also be vaccinated in accordance with the national and regional vaccination schedule and vaccinated against viral hepatitis C. At the time of hiring, and then annually, the staff undergoes a mandatory briefing on the rules for the safe handling of waste. The personnel must work in overalls and removable shoes, in which it is not allowed to go outside the working premises. Personal clothing and workwear should be stored in separate lockers. Washing of overalls is carried out centrally (washing at home is prohibited). Personnel are provided with overalls and personal protective equipment (gowns/overalls, gloves, masks/respirators/protective shields, special footwear, aprons, sleeves, etc.). In the event that an employee receives an injury (prick, cut) while handling medical waste with a violation of the integrity of the skin and / or mucous membranes, it is necessary to take emergency preventive measures. A first aid kit should be at the workplace of the staff medical care with injuries. Responsible person an entry is made in the emergency register and an act on an accident at work is drawn up. Class A waste. Class A waste is collected in reusable containers or disposable bags (any color except for yellow and red). Disposable bags are placed on special trolleys or inside reusable containers. They must be labeled "Waste. Class A. The reusable container after emptying is subject to washing and disinfection. Food waste is allowed to be dumped into the city sewerage system (preliminarily crushed). If it is impossible to dump them, they are taken out and buried in solid waste landfills. household waste(MSW). Food waste can be used in agriculture(except for waste from ward departments of infectious, including dermatovenerological and tuberculosis profiles). Class B waste. Places of class B waste generation are operating rooms, resuscitation, procedural, dressing and other manipulation and diagnostic rooms; infectious, including dermatovenerological departments; medical and pathological laboratories; laboratories working with microorganisms of pathogenicity groups 3, 4, etc. Class B waste is subject to mandatory decontamination (disinfection) / neutralization. The choice of method is determined by the possibilities of the organization and the method of neutralization / destruction of waste adopted in the administrative territory (incineration, removal to landfills, disposal). Disinfection / neutralization of class B waste can be carried out centrally (outside the territory of a medical organization) or decentralized (within the territory of a medical organization) in ways. The physical method of class B waste disinfection (saturated water steam under excess pressure, temperature, radiation, electromagnetic radiation) is used in the presence of special equipment - installations for the disinfection of medical waste. The chemical method of class B waste disinfection is used using special installations or by immersing waste in a labeled container with a disinfectant solution at the place of their formation. Chemical disinfection of class B waste at the place of their generation is used as a mandatory temporary measure in the absence of a medical waste management site in a medical organization or in the absence of centralized system disposal of medical waste in the given administrative territory. Thermal destruction of class B medical waste is organized in a centralized way at incineration plants (both disinfected and non-disinfected). Thermal destruction of class B waste can be carried out in a decentralized way (incinerators or other installations). Class B waste is collected in disposable soft (bags) or hard (non-puncture) packaging (containers) of yellow color or with yellow marking. The choice of packaging depends on the morphological composition of the waste. To collect class B sharps waste, disposable non-puncture, moisture-resistant containers (containers) with a lid should be used. To collect class B organic liquid waste, disposable non-puncture, moisture-resistant containers with a lid (container) should be used to ensure their sealing and exclude the possibility of spontaneous opening. In the case of the use of hardware methods of disinfection in a medical organization at the workplace, it is allowed to collect class B waste in common containers: used syringes in an unassembled form (with a preliminary separation of needles using needle destructors, needle removers), gloves, dressings, etc. Soft packaging (single-use bags) for class B waste collection must be fixed on special rack-carts or containers marked “Waste. Class B "(they are disinfected daily). The yellow bag, after filling no more than 3/4 (at least once every 8 hours), the employee responsible for the collection of waste, ties or closes it using tie tags. Solid (non-piercing) containers are closed with lids when filling (change at least 72 hours) (See manipulation No. 10). In this form, class B waste is transferred to the waste management site of a medical organization or to a temporary storage room. Class B pathoanatomical and organic operational waste (organs, tissues, etc.) are subject to cremation (burning) or burial in cemeteries in special graves in a specially designated area of the cemetery. Class B liquid waste (vomit, urine, feces) may be discharged without prior disinfection into the centralized sewerage system (in the absence of a centralized sewage system, they are disinfected). Class B waste. Class B waste generation sites are units for patients with especially dangerous and quarantine infections; laboratories working with microorganisms of 1, 2 pathogenicity groups; departments for patients with anaerobic infection; phthisiatric and mycological clinics (departments). Class B waste is subject to mandatory decontamination (disinfection) by physical methods. Only food waste and excretions of patients are disinfected by chemical methods, and chemical methods are used in the organization of primary anti-epidemic measures in outbreaks. Export of non-disinfected class B waste outside the territory of the organization is not allowed. Class B waste is collected in disposable soft (bags) or hard (non-puncture) packaging (containers) of red color or with red marking. Note: After hardware disinfection of class B and C waste by physical methods, it is possible to use recycling technologies. It is not allowed to use secondary raw materials obtained from medical waste for the manufacture of children's products, materials and products in contact with drinking water And food products, medical products. After hardware methods of disinfection and change appearance waste (grinding, sintering, pressing, etc.), which excludes the possibility of their reuse, class B and C wastes can be buried in landfills. Waste of class G. Collection of mercury-containing devices, lamps, equipment related to medical waste of class G is carried out in labeled containers with tight-fitting lids of any color (except yellow and red), which are stored in specially designated areas. Collection and temporary storage of wastes of cytostatics and genotoxic drugs without decontamination is prohibited. Medicinal, diagnostic, disinfectants that are not to be used are collected in disposable labeled packaging of any color except yellow and red. The removal of class G waste is carried out by special organizations licensed for this type of activity. Class D waste Collection, storage, disposal of class D waste is carried out in accordance with the requirements of the legislation of the Russian Federation for the handling of radioactive substances and other sources of ionizing radiation, radiation safety standards (NRB). When collecting medical waste, it is prohibited to: manually destroy, cut waste of classes B and C, including used systems for intravenous infusions in order to decontaminate them; manually remove the needle from the syringe after use, put a cap on the needle after use; transfer (reload) unpackaged waste of classes B and C from one container to another; compact waste of classes B and C; carry out any operations with waste without gloves or the necessary personal protective equipment and overalls; use soft disposable packaging to collect sharp medical instruments and other sharp objects; install disposable and reusable containers for collecting waste at a distance of less than one meter from heating devices.

Disinfection - measures aimed at the destruction of pathogens of infectious diseases in external environment in other words, disinfection. Disinfection aims to destroy pathogenic microorganisms. In this it differs from sterilization, in which all types of microorganisms and their spores are destroyed.

The system of collection, storage, transportation and disposal of medical waste in health facilities

In accordance with SanPiN 2.1.7.2790-10, waste is collected in disposable sealed soft or hard packaging, depending on the composition.

Advantages of this system: convenient, easy, safe.

1. The system has a closed cycle from waste generation to its destruction.

2. Containers, packages and other products that provide this system, marked, compatible and marked with the same color as the hazard class of the waste.

4. It is possible to select the sizes of packages, containers, tanks for the actual amount of waste in the health facility.

5. Products that ensure the functioning of the system are registered in the Russian Federation, included in State Register medical products and medical equipment.

The disadvantages depend on the method of disposal.

1st stage. Waste collection.

Soft packing: plastic bags are completed with ties and labels (tags). They are white (class A), yellow (class B), red (class C) and black (class D). They have different sizes: from 300x330 mm to 800x990 mm. They have high strength and tightness. Used to collect and store non-sharp disposable medical waste. They are equipped with special ties for fast and effective sealing of the bag after it is filled to about ¾ of the volume with the possibility of safely collecting up to 15 kg in them. If the rules of use are followed, there is no risk of spreading the infection.

Terms of use plastic bag(Software) for the collection and storage of disposable medical waste

1. Remove the desired package from the box.

2. Straighten and open it around the neck.

3. Insert the bag until it touches the bottom into a suitable container for ease of use.

4. Bend the edges of the bag along the edge of the container to secure the bag.

5. Fill approximately ¾ of the volume with non-sharps waste of the selected hazard class.

6. Fill in the tag for the selected hazard class by answering the questions on the tag.

7. Put the tag on the tie.

8. Gather the edges of the bag and let the air out of it.

9. Twist the mouth of the bag.

10. Seal the bag with a zip tie by wrapping the zip tie around the twisted neck of the bag and inserting its smooth tail into the hole in the zip tie at the other end.

The package is ready for transportation from the place of waste generation to the place of temporary storage of waste on the territory of the medical facility.

Solid Packing: containers - plastic containers for collecting waste not subject to collection in soft containers, including needles and other disposable sharp instruments, organic and microbiological waste of classes B, (yellow) and C (red).

Containers can be used in any structural subdivision of health facilities.

Containers with a capacity of 1 l, 0.5 l, are equipped with a cover No. 1 with holes for contactless removal of the needle from the syringe, a red cover No. 2 with a plug, a base and a sticker - marking. Containers with a capacity of 3 l, 6 l. No. 2 red caps with plug do not have caps. Containers are used during one shift. Containers must be sealed during collection and cannot be opened when transporting waste outside the medical department. They are suitable for collecting SR - syringes (SR - self-destructive).

Capacities - plastic containers are disposable and are used in operating rooms, laboratories, procedural, manipulation and other rooms. When used correctly, the risk of infection with blood-borne diseases is reduced.

Rules for using a container - a container for collecting sharp disposable instruments (EK - 01)

Training

2. Fill in the sticker - marking of the selected hazard class, answering the questions indicated on the tag.

4. Prepare a needle disinfectant solution.

6. Close the base with a large cover No. 1 until it clicks.

7. Place the container close to the injection site so that the potentially dangerous needle is in the air as little as possible.

Container filling

Perform the injection, bring the syringe with the needle to the container.

1. Dip the needle into the disinfectant solution in the container and pull the plunger of the syringe towards you.

2. Pry the cannula of the needle by one of the needle removers (removable device) that is located in the opening of the cover No. 1.

3. Release the solution from the syringe cone back into the container.

Change the disinfectant solution according to guidelines the disinfectant used.

4. Fill the container with needles so that the disinfectant solution completely covers the needles.

5. Close the container with a red cap No. 2 for the duration of exposure.

6. Drain off the solution by slightly opening cap #2.

7. Close the container with lid No. 2 until it clicks.

Rules for using the container - a container for collecting cotton wool, bandages and other wetting consumables

(1st use case)

Used for collecting containers-containers with a capacity of 3 l, 6 l, having only one lid.

1. Disassemble the container, put it in front of you.

3. Stick the label on the base.

4. Prepare the disinfectant solution.

5. Fill the base on? solution.

6. Collect waste until the container is full.

7. Close the container for the exposure time.

8. Make a solution by slightly opening the lid.

9. Close the container with a lid up to the cheek.

The container is ready for transportation from the place of waste generation to the place of temporary storage of waste on the territory of the healthcare facility.

Rules for using a container for collecting organic and microbiological waste

(2nd application)

1. Disassemble the container, put it in front of you.

2. Fill in the label for the selected hazard class by answering the questions on the tag.

3. Stick the label on the base.

4. Fill the base on? waste.

5. Pour or prime with disinfectant solution in accordance with the guidelines for the disinfectant used.

6. Close the container for the exposure time.

7. Make a solution by slightly opening the lid.

8. Close the container with a lid until it clicks.

9. The container is ready for transportation from the place of waste generation to the place of temporary storage of waste on the territory of the medical facility.

Waste storage and transportation

2nd stage

Transportation of waste from collection sites to temporary storage sites on the territory of the department is carried out using a tank with a lightweight wheel support on two driving wheels, with a capacity of 20, 35, and 50 liters.

The tank with a lid is reusable, has a weight of 12 kg.

3rd stage

In order to reduce the labor costs of junior medical personnel, an intermediate option is used: waste collection at waste accumulation sites on the territory of the department in the sanitary room, in which in-vessel containers on three wheels are installed for waste generated during the day in this unit.

Container with airtight lid, capacity 120 l, 240 l, 370 l, moisture-proof, not accessible to animals, made of impact-resistant plastic.

Rules for using a wheeled support with a tank

1. Take the caster with the tank in the sanitary room to the person responsible for waste collection.

2. Make a detour of all places of waste generation.

3. Transfer sealed and labeled soft and solid waste to a bank.

4. Deliver the bank to the sanitary room.

5. Reload from the tank into an in-vessel container for subsequent storage and transportation.

4th stage

Transportation of waste from places of temporary storage on the territory of the department to a place of temporary storage and accumulation outside the territory of the building (specially equipped site) or to the location of the disposal facility.

Transportation is carried out at the end of the working shift directly in in-vessel containers on three wheels (trolley) to the street to the inter-vessel platform or to a specially equipped room where the disposal plant is located by the person responsible for waste collection.

Rules for using an in-hull containeron three wheels (trolley)

1. Take the liner in the sanitary room at the end of the shift to the waste collector.

2. Collect from all places of waste generation.

3. Reload from the tank into an in-hull container for subsequent storage and transportation.

Disposal of waste from healthcare facilities

5th stage

1st way - calling class A waste - by vehicles for municipal solid waste to landfills; class B and C waste - by specialized vehicles to waste processing plants.

2nd way - for disposal, a microwave is used - the UOMO installation - 01 - 150 - "O - CNT", disinfection and removal of waste to solid waste landfills.

3 - option - recycling is carried out in the Newster - 10 installation with the subsequent use of waste as secondary raw materials or standard removal after waste disposal.

The proposed technologies for the disposal of medical waste (including incineration - ashing, steam sterilization, chemical disinfection, pyrolysis, laser, microwave disinfection, etc.) are subject to environmental and hygienic assessment.

In accordance with the requirements of Article 24 of the Law of the Russian Federation "On Sanitary and Epidemiological Welfare" it is not allowed:

* pour waste of classes B and C from one container to another;

* install disposable and reusable containers near electric heaters;

* compact any waste with your hands;

* collect waste without gloves.

Requirements for the collection of medical waste

4.1. Persons under the age of 18 are not allowed to work with medical waste. The staff undergoes preliminary (when hiring) and periodic medical examinations in accordance with the requirements of the law Russian Federation.

4.2. Personnel must be vaccinated in accordance with the national and regional immunization schedule. Personnel not immunized against hepatitis B are not allowed to handle class B and C medical waste.

4.3. Upon hiring and then annually, the staff undergoes mandatory training on the rules of safe waste management.

4.4. The personnel must work in overalls and removable shoes, in which it is not allowed to go outside the working premises. Personal clothing and workwear should be stored in separate lockers.

4.5. Personnel are provided with overalls and personal protective equipment (gowns/overalls, gloves, masks/respirators/protective shields, special footwear, aprons, sleeves, etc.).

Washing of overalls is carried out centrally. Do not wash clothes at home.

4.6. Class A waste is collected in reusable containers or disposable bags. The color of the packages can be any, except for yellow and red. Disposable bags are placed on special trolleys or inside reusable containers. Waste collection containers and trolleys must be marked “Waste. Class A. Filled reusable containers or disposable bags are delivered using small-scale mechanization and reloaded into labeled containers designed to collect waste of this class, installed on a special site (room). The reusable container after emptying is subject to washing and disinfection. The procedure for washing and disinfecting reusable containers is determined in accordance with the waste management scheme in each specific organization. Transportation of class A waste is organized taking into account the sanitary cleaning scheme adopted for the given territory, in accordance with the requirements of sanitary legislation for the maintenance of populated areas and the handling of production and consumption waste.

4.7. For organizations carrying out medical and/or pharmaceutical activities that have a discharge of household wastewater into the city sewer system, the preferred system for the disposal of food raw materials and prepared food waste from catering establishments and canteens classified as class A medical waste is the discharge of food waste into the system urban sewerage by equipping the internal sewerage with food waste grinders (disposers).

If it is not possible to dump food waste into the sewer, food waste is collected separately from other class A waste in reusable containers or disposable bags installed in the premises of catering units, canteens and buffets. Further transportation of food waste is carried out in accordance with the waste management scheme in each specific organization. Food waste intended for removal for disposal at municipal solid waste landfills should be placed for temporary storage in reusable containers in disposable packaging.

Temporary storage of food waste in the absence of specially allocated refrigeration equipment is allowed for no more than 24 hours.

Food waste (except for waste from ward departments of infectious disease, including dermatovenerological and tuberculosis profiles, special sanatoriums for the rehabilitation of those who have recovered from infectious diseases) is allowed to be used in agriculture in accordance with the requirements of the legislation of the Russian Federation.

4.8. Class A waste, except for food waste, can be removed from structural units using a garbage chute or pneumatic transport. It is not allowed to dump objects into the garbage chute that can lead to mechanical blockage (blockage) of the garbage chute shaft. Disposal of waste into the garbage chute must be carried out in a packaged form.

The design, materials and arrangement of garbage chutes and pneumatic transport should ensure the possibility of their cleaning, washing, disinfection and mechanized removal of waste from waste collection chambers. Garbage collection chambers are equipped with containers, water supply and sewer ladder. It is forbidden to dump waste from the garbage chute (pneumatic conveyor) directly onto the floor of the garbage receiving chamber. A supply of containers for the waste collection chamber should be provided for at least one day.

Containers are washed after each emptying, disinfected at least once a week.

Pipeline cleaning, receiving devices, garbage collection chambers is carried out weekly. Preventive disinfection, disinsection is carried out at least once a month, deratization - as needed.

4.9. Class A bulky waste is collected in special bulky waste bins. Surfaces and aggregates of bulky waste that have had contact with infected material or patients are subject to mandatory disinfection before they are placed in a storage bin.

4.10. Class B waste is subject to mandatory decontamination (disinfection)/neutralization. The choice of decontamination / neutralization method is determined by the capabilities of the organization carrying out medical and / or pharmaceutical activities, and is carried out when developing a medical waste management scheme.

If an organization carrying out medical and / or pharmaceutical activities does not have a site for decontamination / neutralization of class B waste or a centralized system for the neutralization of medical waste adopted on the administrative territory, class B waste is disinfected by the personnel of this organization at the places of their formation by chemical / physical methods.

4.11. Class B waste is collected in disposable soft (bags) or hard (non-puncture) packaging (containers) of yellow color or with yellow marking. The choice of packaging depends on the morphological composition of the waste.

To collect class B sharps waste, disposable non-puncture moisture-resistant containers (containers) should be used. The container must have a tight-fitting lid to prevent accidental opening.

To collect class B organic, liquid waste, disposable non-puncture moisture-resistant containers with a lid (container) should be used to ensure their sealing and exclude the possibility of spontaneous opening.

In the case of using hardware methods of disinfection in an organization carrying out medical and / or pharmaceutical activities, it is allowed to collect class B waste at workplaces in common containers (containers, packages) of used syringes in an unassembled form with a preliminary separation of needles (needle removers must be used to separate needles, needle destructors, needle cutters), gloves, dressings and so on.

4.12. Soft packaging (disposable bags) for class B waste collection must be fixed on special carts or containers.

4.13. After filling the bag no more than 3/4, the employee responsible for the collection of waste in this medical unit ties the bag or closes it using tie tags or other devices that prevent Class B waste from spilling out. Solid (non-piercing) containers are closed with lids. Displacement of class B waste outside the unit in open containers is not allowed.

4.14. During the final packaging of class B waste to remove it from the subdivision (organization), disposable containers (bags, tanks) with class B waste are marked with the inscription “Waste. Class B" with the name of the organization, subdivision, date and name of the person responsible for waste collection.

4.15. Disinfection of reusable containers for the collection of class B waste within the organization is carried out daily.

4.16. Class B medical waste from departments in closed disposable containers (bags) is placed in containers and then transferred to a waste management site or a temporary storage room for medical waste, until it is transported by specialized organizations to the place of disinfection / neutralization. Access of unauthorized persons to the temporary storage of medical waste is prohibited.

Containers must be made of materials that are resistant to mechanical stress, high and low temperatures, detergents and disinfectants, closed with lids, the design of which should not allow them to open spontaneously.

4.17. When organizing sites for decontamination/neutralization of medical waste using hardware methods, it is allowed to collect, temporarily store, and transport class B medical waste without preliminary disinfection at the places of generation, provided that necessary requirements epidemiological safety.

At the same time, an organization carrying out medical and / or pharmaceutical activities must be provided with all necessary consumables, including disposable packaging.

4.18. Class B pathological and organic surgical waste (organs, tissues, etc.) are subject to cremation (burning) or burial in cemeteries in special graves in a specially designated area of the cemetery in accordance with the requirements of the legislation of the Russian Federation. Disinfection of such waste is not required.

4.19. It is allowed to move non-disinfected class B medical waste packed in special disposable containers (containers) from remote structural units (health centers, offices, feldsher-obstetric stations) and other places of medical care to a medical organization to ensure their subsequent decontamination / neutralization.

4.20. Work on the treatment of class B medical waste is organized in accordance with the requirements for working with pathogens of 1-2 pathogenicity groups, for the sanitary protection of the territory and the prevention of tuberculosis.

4.21. Class B waste is subject to mandatory decontamination (disinfection) by physical methods (thermal, microwave, radiation, and others). The use of chemical methods of disinfection is allowed only for the disinfection of food waste and excretions of patients, as well as in the organization of primary anti-epidemic measures in outbreaks. The choice of the method of disinfection (disinfection) is carried out when developing a scheme for the collection and disposal of waste. Export of non-disinfected class B waste outside the territory of the organization is not allowed.

4.22. Class B waste is collected in disposable soft (bags) or hard (non-puncture) packaging (containers) of red color or having a red marking. The choice of packaging depends on the morphological composition of the waste. Liquid biological waste, used disposable piercing (cutting) instruments and other medical products are placed in a solid (non-piercing) moisture-resistant sealed packaging (containers).

4.23. Soft packaging (disposable bags) for class B waste collection must be fixed on special racks (trolleys) or containers.

4.24. After filling the bag no more than 3/4, the employee responsible for the collection of waste in this medical unit, in compliance with the requirements biosecurity ties the bag or closes it using tie-tags or other devices that prevent class B waste from spilling out. Solid (non-piercing) containers are closed with lids. Displacement of class B waste outside the unit in open containers is not allowed.

4.25. During the final packaging of class B waste to remove it from the subdivision, disposable containers (bags, tanks) with class B waste are marked with the inscription “Waste. Class B" with the name of the organization, division, date and surname of the person responsible for waste collection.

4.26. Class B medical waste in closed disposable containers is placed in special containers and stored in a room for temporary storage of medical waste.

4.27. Used mercury-containing devices, lamps (fluorescent and others), equipment classified as class D medical waste are collected in labeled containers with tight-fitting lids of any color (except yellow and red), which are stored in specially designated areas.

4.28. Collection, temporary storage of wastes of cytostatics and genotoxic drugs and all types of wastes resulting from the preparation of their solutions (vials, ampoules and others) related to class D medical waste without decontamination is prohibited. Waste is subject to immediate decontamination at the place of generation using special means. It is also necessary to decontaminate the workplace. Work with such waste should be carried out using special personal protective equipment and carried out in a fume hood.

Medicinal, diagnostic, disinfectants that are not to be used are collected in disposable labeled packaging of any color (except for yellow and red).

4.29. Collection and temporary storage of class D waste is carried out in labeled containers (“Waste. Class G”) in accordance with the requirements of regulatory documents, depending on the hazard class of the waste. The export of class G waste for neutralization or disposal is carried out specialized organizations licensed for this type of activity.

4.30. Collection, storage, disposal of class D waste is carried out in accordance with the requirements of the legislation of the Russian Federation for the handling of radioactive substances and other sources of ionizing radiation, radiation safety standards.

4.31. The removal and neutralization of class D waste is carried out by specialized organizations for the management of radioactive waste that have a license for this type of activity.

4.32. Disinfection of reversible (inter) hull containers for collecting waste of classes A, B, car bodies is carried out at unloading points at least once a week by a specialized organization that removes waste.

4.33. When collecting medical waste, it is prohibited:

· manually destroy, cut waste of classes B and C, including used systems for intravenous infusions, in order to decontaminate them;

remove the needle manually from the syringe after using it, put a cap on the needle after injection;

pour (reload) unpackaged waste of classes B and C from one container to another;

tamp waste of classes B and C;

carry out any operations with waste without gloves or the necessary personal protective equipment and overalls;

use soft disposable packaging to collect sharp medical instruments and other sharp objects;

Install disposable and reusable containers for collecting waste at a distance of less than 1 m from heating devices.

4.34. In the event that an employee receives an injury potentially dangerous in terms of infection while handling medical waste (an injection, a cut with a violation of the integrity of the skin and / or mucous membranes), it is necessary to take emergency preventive measures. A first aid kit for injuries should be available at the workplace of the staff.

4.35. The responsible person makes an entry in the emergency register, draws up an accident report at work in the prescribed form indicating the date, time, place, nature of the injury, which describes in detail the situation, the use of personal protective equipment, compliance with safety regulations, indicate the persons who were at the site of injury, as well as the applied method of emergency prevention.

4.36. Notification, registration and investigation of cases of infection of personnel with pathogens of infectious diseases associated with professional activity are carried out in accordance with the established requirements.

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Hazard classes

The management of medical waste is regulated not only sanitary standards but also federal law. Territorial bodies responsible for the sanitary and epidemiological situation in a particular locality are called upon to monitor compliance with these rules.

According to SanPin 2.1.7.2790-10, all medical waste is divided into 5 groups. Assignment of garbage to a certain class is based on the degree of its microbiological hazard , content of radionuclides and toxic substances.

Key points

SanPiN 2172790 10 was approved by the Chief Sanitary Doctor of the Russian Federation on December 9, 2010. This document not only defines the criteria for the danger of medical waste, but also contains. Close attention is paid to the instrumentation, which is used in the collection, transportation, storage, disinfection of potentially dangerous and infected items and materials.

Required inventory

According to the norms, waste is collected in special disposable or reusable containers. It is mandatory to have a label on the container. It is unacceptable to mix the remains of different classes. Garbage belonging to group "A" is collected in single-use bags, which should not be red or yellow. Three-quarters filled packaging is placed in a reusable tank (plastic) that has the appropriate marking.

Class B waste is placed in yellow disposable bags or containers with lids. All containers in which garbage of this group is stored must have high strength, resistance to temperature and chemical effects. The marking must contain the date of packaging, the name of the responsible person, the name of the health facility. Class B waste management differs from the previous group in that this group of hazardous residues is collected in red containers.

"G" - a special group of medical waste, for the collection of which are not used plastic bags. Use tanks or containers with tight-fitting lids. All containers must be signed. Features of the collection and labeling of class "D" waste are established regulations that govern the handling of radiation sources.

It should be noted that even disposable containers in which residues were collected must be disinfected before disposal.

Employee admission

There are a number of requirements for the personnel involved in the collection, storage and transportation of medical waste. These workers are provided with special personal protective equipment and overalls. . So, the following persons are allowed to work:

Personal belongings of the personnel involved in the handling of medical waste are stored in separate cabinets. An injury received by an employee in the course of work is an emergency. The victim is needed help and an act is drawn up, which describes in detail the nature of the damage and the causes of their occurrence. The implemented measures for emergency prevention of infection are indicated. The fact of such a case is recorded in a special journal.

Temporary storage

Medical waste is collected during the shift, while containers for sharps can be filled up to three days. The remains of the "B" class are not stored for more than a day. Waste of groups "B" and "C" is unacceptable to be collected and stored together with other garbage. Sharp objects and equipment are not allowed to be placed in plastic bags.

Waste that belongs to MSW (“A”) is stored on a hard surface site at a distance of at least 25 meters from the main buildings of the healthcare facility. Such an area should have a size equal to the area of each container, plus 1.5 meters on each side.

The unit working with medical residues is assigned a special room, size and specifications which are indicated in the SanPiN for waste in healthcare facilities (no new changes have been made). The principle of forming such a working area is the possibility of dividing it into "dirty" and "clean" zones. Such zoning is necessary for the safe reception, storage and disinfection of medical waste, as well as for the disinfection of containers.

According to SanPiN, class B waste and medical waste, which are classified as extremely hazardous (“C”), are prohibited from being disassembled and cut manually. Situations in which nurses remove or put on caps on used injection needles should be excluded. Medical waste must be sorted immediately and placed in a container that is intended for storage or disposal. Containers should not be filled more than ¾ of their volume. Disposal of medical waste, as a rule, is carried out by special organizations with which medical institutions conclude relevant agreements.

Accounting and control

The head of the healthcare institution is responsible for compliance with the norms for the collection, storage and disposal of medical waste. This official is obliged to issue a local document (order or instruction) that will regulate the treatment of waste in HCF.

Required to keep balance sheets relating to classes "B" and "C", acts on the export and disinfection of residues. It is necessary to conduct an annual check on the quality of hazardous waste disposal, as well as on the presence of toxic substances in the air of specialized premises.

Employees of healthcare facilities that are associated with medical waste must control the availability of disinfectants, packaging and other consumables necessary to ensure uninterrupted operation. Personnel must know where to collect and store leftovers.

Registration N 19871

Requirements have been established for the handling of waste generated in the course of medical and (or) pharmaceutical activities, when performing medical diagnostic and wellness procedures.

Allocate 5 classes of danger. A - epidemiologically without hazardous waste, close in composition to solid household. B - dangerous. B - extremely epidemiologically dangerous. G - toxicologically dangerous. D - radioactive. It is impossible to mix waste of different classes in a common container.

It was determined how the system of collection, temporary storage and transportation of waste should be organized. It should also include their decontamination (neutralization) and subsequent burial or destruction.

Persons under the age of 18 are not allowed to work with waste. The staff undergoes preliminary and periodic medical examinations, safety briefings.

It is fixed how the site for the treatment of wastes of classes B and C is located, equipped and operated. Methods for their disinfection and (or) neutralization have been established.

It is necessary to organize production control. It includes visual, documentary and laboratory-instrumental checks.

Decree of the Chief State Sanitary Doctor of the Russian Federation of December 9, 2010 N 163 "On approval of SanPiN 2.1.7.2790-10" Sanitary and epidemiological requirements for the treatment of medical waste "

Registration N 19871

This Resolution shall enter into force 10 days after the date of its official publication.

Registration N 19871

In accordance with the Federal Law of March 30, 1999 N 52-FZ "On the sanitary and epidemiological well-being of the population" (Collected Legislation of the Russian Federation, 1999, N 14, article 1650; 2002, N 1 (part I), article 2; 2003, N 2, item 167; N 27 (part I), item 2700; 2004, N 35, item 3607; 2005, N 19, item 1752; 2006, N 1, item 10; N 52 (part I), article 5498; 2007, No. 1 (part I), article 21; No. 1 (part I), article 29; No. 27, article 3213; No. 46, article 5554; No. 49, article 6070; 2008, No. 24, article 2801; No. 29 (part I), article 3418; No. 30 (part II), article 3616; No. 44, article 4984; No. 52 ( Part I), Art. 6223; 2009, N 1, Art. 17; 2010, N 40, Art. 4969) and Decree of the Government of the Russian Federation of July 24, 2000 N 554 "On Approval of the Regulations on the State Sanitary and Epidemiological Service of the Russian Federation and Regulations on State Sanitary and Epidemiological Rationing" (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2000, N 31, Art. 3295; 2004, N 8, Art. 663; N 47, Art. 4666; 2005, N 39, Art. 3953) I decide:

Approve the sanitary and epidemiological rules and regulations SanPiN 2.1.7.2790-10 "Sanitary and epidemiological requirements for the management of medical waste" (Appendix).

G.G.Onishchenko

Appendix

Sanitary and epidemiological requirements for the treatment of medical waste

Sanitary and epidemiological rules and regulations SanPiN 2.1.7.2790-10

I. Scope and general provisions

1.1. Sanitary and epidemiological rules and regulations (hereinafter - sanitary rules) are developed in accordance with the legislation of the Russian Federation.
1.2. These sanitary rules establish mandatory sanitary and epidemiological requirements for the handling (collection, temporary storage, disinfection, neutralization, transportation) of waste generated in organizations in the course of medical and / or pharmaceutical activities, the performance of medical diagnostic and health procedures (hereinafter referred to as medical waste ), as well as to the placement, equipment and operation of the site for the treatment of medical waste, the sanitary and anti-epidemic mode of operation when handling medical waste.
1.3. These sanitary rules are intended for citizens, individual entrepreneurs and legal entities whose activities are related to the handling of medical waste.
1.4. Control (supervision) over compliance with these sanitary rules is carried out by bodies exercising the functions of control and supervision in the field of ensuring the sanitary and epidemiological welfare of the population in accordance with the legislation of the Russian Federation.

II. Classification of medical waste

2.1. Medical waste depending on the degree of their epidemiological, toxicological and radiation hazard, as well as negative impact on the habitat are divided into five hazard classes (Table 1):
Class A - epidemiologically safe waste, close in composition to municipal solid waste (hereinafter referred to as MSW).
Class B - epidemiologically hazardous waste.
Class B - extremely epidemiologically hazardous waste.
Class D - toxicologically hazardous waste of 1 - 4 hazard classes.
Class D - radioactive waste.

2.2. After hardware methods of disinfection using physical methods and changing the appearance of waste, excluding the possibility of their reuse, waste of classes B and C can be accumulated, temporarily stored, transported, destroyed and disposed of together with waste of class A. Packaging of decontaminated medical waste of classes B and C must have a label indicating that the waste has been decontaminated.

III. Requirements for the organization of a medical waste management system

3.1. The system of collection, temporary storage and transportation of medical waste should include the following steps:
- waste collection within organizations engaged in medical and/or pharmaceutical activities;
- transfer of waste from subdivisions and temporary storage of waste on the territory of the organization that generates waste;
- disinfection/neutralization;
- transportation of waste from the territory of the organization generating waste;
- burial or destruction of medical waste.
3.2. The head of an organization carrying out medical and / or pharmaceutical activities approves an instruction that identifies responsible employees and the procedure for handling medical waste in this organization.
3.3. Mixing waste of different classes in a common container is unacceptable.
3.4. The processes of moving waste from places of generation to places of temporary storage and / or disinfection, unloading and loading of reusable containers must be mechanized (trolleys, elevators, lifts, trucks, and so on).
3.5. It is not allowed to involve persons who have not undergone preliminary briefing on the safe handling of medical waste to work on the treatment of medical waste.
3.6. Collection, temporary storage and disposal of waste should be carried out in accordance with the scheme for the management of medical waste adopted in this organization carrying out medical and / or pharmaceutical activities.
This scheme is developed in accordance with the requirements of these sanitary rules and approved by the head of the organization.
3.7. The medical waste management scheme specifies:
- qualitative and quantitative composition of generated medical waste;
- standards for the formation of medical waste, developed and adopted in the region;
- the need for consumables and containers for collecting medical waste, based on the obligation to change bags once per shift (at least once every 8 hours), disposable containers for sharps - at least 72 hours, in operating rooms - after each operation;
- the procedure for collecting medical waste;
- the procedure and places for temporary storage (accumulation) of medical waste, the frequency of their removal;
- applied methods of disinfection/neutralization and disposal of medical waste;
- the procedure for personnel actions in case of violation of the integrity of the package (scattering, spilling medical waste);
- organization of hygienic training of personnel in the rules of epidemiological safety when handling medical waste.
3.8. Transportation of waste from the territory of organizations engaged in medical and / or pharmaceutical activities is carried out by transport of specialized organizations to the place of subsequent neutralization, placement of medical waste, taking into account the unified centralized system of sanitary cleaning of this administrative territory.

IV. Requirements for the collection of medical waste

4.1. Persons under the age of 18 are not allowed to work with medical waste. The personnel undergoes preliminary (when hiring) and periodic medical examinations in accordance with the requirements of the legislation of the Russian Federation.
4.2. Personnel must be vaccinated in accordance with the national and regional immunization schedule. Personnel not immunized against hepatitis B are not allowed to handle class B and C medical waste.
4.3. Upon hiring and then annually, the staff undergoes mandatory training on the rules of safe waste management.
4.4. The personnel must work in overalls and removable shoes, in which it is not allowed to go outside the working premises. Personal clothing and workwear should be stored in separate lockers.
4.5. Personnel are provided with overalls and personal protective equipment (gowns/overalls, gloves, masks/respirators/protective shields, special footwear, aprons, sleeves, etc.).
Washing of overalls is carried out centrally. Do not wash clothes at home.
4.6. Class A waste is collected in reusable containers or disposable bags. The color of the packages can be any, except for yellow and red. Disposable bags are placed on special trolleys or inside reusable containers. Waste collection containers and trolleys must be marked "Waste. Class A". Filled reusable containers or disposable bags are delivered using small-scale mechanization and reloaded into labeled containers designed to collect waste of this class, installed on a special site (room). The reusable container after emptying is subject to washing and disinfection. The procedure for washing and disinfecting reusable containers is determined in accordance with the waste management scheme in each specific organization. Transportation of class A waste is organized taking into account the sanitary cleaning scheme adopted for the given territory, in accordance with the requirements of sanitary legislation for the maintenance of populated areas and the handling of production and consumption waste.
4.7. For organizations carrying out medical and/or pharmaceutical activities that have a discharge of household wastewater into the city sewer system, the preferred system for the disposal of food raw materials and prepared food waste from catering establishments and canteens classified as class A medical waste is the discharge of food waste into the system urban sewerage by equipping the internal sewerage with food waste grinders (disposers).
If it is impossible to dump food waste into the sewerage, food waste is collected separately from other class A waste in reusable containers or disposable bags installed in the premises of catering units, canteens and buffets. Further transportation of food waste is carried out in accordance with the waste management scheme in each specific organization. Food waste intended for removal for disposal at municipal solid waste landfills should be placed for temporary storage in reusable containers in disposable packaging.
Temporary storage of food waste in the absence of specially allocated refrigeration equipment is allowed for no more than 24 hours.
Food waste (except for waste from ward departments of infectious disease, including dermatovenerological and tuberculosis profiles, special sanatoriums for the rehabilitation of those who have recovered from infectious diseases) is allowed to be used in agriculture in accordance with the requirements of the legislation of the Russian Federation.
4.8. Class A waste, except for food waste, can be removed from structural units using a garbage chute or pneumatic transport. It is not allowed to dump objects into the garbage chute that can lead to mechanical blockage (blockage) of the garbage chute shaft. Disposal of waste into the garbage chute must be carried out in a packaged form.
The design, materials and arrangement of garbage chutes and pneumatic transport should ensure the possibility of their cleaning, washing, disinfection and mechanized removal of waste from waste collection chambers. Garbage collection chambers are equipped with containers, water supply and sewer ladder. It is forbidden to dump waste from the garbage chute (pneumatic conveyor) directly onto the floor of the garbage receiving chamber. A supply of containers for the waste collection chamber should be provided for at least one day.
Containers are washed after each emptying, disinfected at least once a week.
Cleaning of pipeline shafts, receiving devices, waste collection chambers is carried out weekly. Preventive disinfection, disinsection is carried out at least once a month, deratization - as needed.
4.9. Class A bulky waste is collected in special bulky waste bins. Surfaces and aggregates of bulky waste that have had contact with infected material or patients are subject to mandatory disinfection before they are placed in a storage bin.
4.10. Class B waste is subject to mandatory decontamination (disinfection)/neutralization. The choice of decontamination / neutralization method is determined by the capabilities of the organization carrying out medical and / or pharmaceutical activities, and is carried out when developing a medical waste management scheme.
If an organization carrying out medical and / or pharmaceutical activities does not have a site for decontamination / neutralization of class B waste or a centralized system for the neutralization of medical waste adopted in the administrative territory, class B waste is disinfected by the personnel of this organization at the places of their generation by chemical / physical methods.
4.11. Class B waste is collected in disposable soft (bags) or hard (non-puncture) packaging (containers) of yellow color or with yellow marking. The choice of packaging depends on the morphological composition of the waste.
To collect class B sharps waste, disposable non-puncture moisture-resistant containers (containers) should be used. The container must have a tight-fitting lid to prevent accidental opening.
To collect class B organic, liquid waste, disposable non-puncture moisture-resistant containers with a lid (container) should be used to ensure their sealing and exclude the possibility of spontaneous opening.
In the case of using hardware methods of disinfection in an organization carrying out medical and / or pharmaceutical activities, it is allowed to collect class B waste at workplaces in common containers (containers, packages) of used syringes in an unassembled form with a preliminary separation of needles (needle removers must be used to separate needles, needle destructors, needle cutters), gloves, dressings and so on.
4.12. Soft packaging (disposable bags) for class B waste collection must be fixed on special carts or containers.
4.13. After filling the bag no more than 3/4, the employee responsible for waste collection in this medical unit ties the bag or closes it using tie tags or other devices that prevent class B waste from spilling out. Solid (non-piercing) containers are closed with lids. Displacement of class B waste outside the unit in open containers is not allowed.
4.14. During the final packaging of class B waste to remove it from the subdivision (organization), disposable containers (bags, tanks) with class B waste are marked with the inscription "Waste. Class B" with the name of the organization, subdivision, date and surname of the person responsible for waste collection.
4.15. Disinfection of reusable containers for the collection of class B waste within the organization is carried out daily.
4.16. Class B medical waste from departments in closed disposable containers (bags) is placed in containers and then transferred to the waste management site or temporary storage of medical waste until it is transported by specialized organizations to the place of decontamination / neutralization. Access of unauthorized persons to the temporary storage of medical waste is prohibited.
Containers must be made of materials that are resistant to mechanical stress, high and low temperatures, detergents and disinfectants, closed with lids, the design of which should not allow them to open spontaneously.
4.17. When organizing sites for decontamination / neutralization of medical waste using hardware methods, it is allowed to collect, temporarily store, and transport class B medical waste without preliminary disinfection at the places of generation, provided that the necessary epidemiological safety requirements are met.
At the same time, an organization carrying out medical and / or pharmaceutical activities must be provided with all necessary consumables, including disposable packaging.
4.18. Class B pathological and organic surgical waste (organs, tissues, etc.) are subject to cremation (burning) or burial in cemeteries in special graves in a specially designated area of the cemetery in accordance with the requirements of the legislation of the Russian Federation. Disinfection of such waste is not required.
4.19. It is allowed to move non-disinfected class B medical waste packed in special disposable containers (containers) from remote structural units (health centers, offices, feldsher-obstetric stations) and other places of medical care to a medical organization to ensure their subsequent decontamination / neutralization.
4.20. Work on the treatment of class B medical waste is organized in accordance with the requirements for working with pathogens of 1-2 pathogenicity groups, for the sanitary protection of the territory and the prevention of tuberculosis.
4.21. Class B waste is subject to mandatory decontamination (disinfection) by physical methods (thermal, microwave, radiation, and others). The use of chemical methods of disinfection is allowed only for the disinfection of food waste and excretions of patients, as well as in the organization of primary anti-epidemic measures in outbreaks. The choice of the method of disinfection (disinfection) is carried out when developing a scheme for the collection and disposal of waste. Export of non-disinfected class B waste outside the territory of the organization is not allowed.
4.22. Class B waste is collected in disposable soft (bags) or hard (non-puncture) packaging (containers) of red color or having a red marking. The choice of packaging depends on the morphological composition of the waste. Liquid biological waste, used disposable stabbing (cutting) instruments and other medical products are placed in solid (non-piercing) moisture-resistant sealed packaging (containers).
4.23. Soft packaging (disposable bags) for class B waste collection must be fixed on special racks (trolleys) or containers.
4.24. After filling the bag no more than 3/4, the employee responsible for waste collection in this medical unit, in compliance with biological safety requirements, ties the bag or closes it using tie tags or other devices that prevent Class B waste from spilling out. Solid (non-piercing) containers closed with lids. Displacement of class B waste outside the unit in open containers is not allowed.
4.25. During the final packaging of class B waste to remove it from the unit, disposable containers (bags, tanks) with class B waste are marked with the inscription "Waste. Class B" with the name of the organization, unit, date and name of the person responsible for collecting the waste.
4.26. Class B medical waste in closed disposable containers is placed in special containers and stored in a room for temporary storage of medical waste.
4.27. Used mercury-containing devices, lamps (fluorescent and others), equipment classified as class D medical waste are collected in labeled containers with tight-fitting lids of any color (except yellow and red), which are stored in specially designated areas.
4.28. Collection, temporary storage of wastes of cytostatics and genotoxic drugs and all types of wastes resulting from the preparation of their solutions (vials, ampoules and others) related to class D medical waste without decontamination is prohibited. Waste is subject to immediate decontamination at the place of generation using special means. It is also necessary to decontaminate the workplace. Work with such waste should be carried out using special personal protective equipment and carried out in a fume hood.
Medicinal, diagnostic, disinfectants that are not to be used are collected in disposable labeled packaging of any color (except for yellow and red).
4.29. Collection and temporary storage of class G waste is carried out in labeled containers ("Waste. Class G") in accordance with the requirements of regulatory documents, depending on the hazard class of the waste. The removal of class G waste for neutralization or disposal is carried out by specialized organizations licensed for this type of activity.
4.30. Collection, storage, disposal of class D waste is carried out in accordance with the requirements of the legislation of the Russian Federation for the handling of radioactive substances and other sources of ionizing radiation, radiation safety standards.
4.31. The removal and neutralization of class D waste is carried out by specialized organizations for the management of radioactive waste that have a license for this type of activity.
4.32. Disinfection of reversible (inter) hull containers for collecting waste of classes A, B, car bodies is carried out at unloading points at least once a week by a specialized organization that removes waste.
4.33. When collecting medical waste, it is prohibited:
- manually destroy, cut waste of classes B and C, including used systems for intravenous infusion, in order to decontaminate them;
- manually remove the needle from the syringe after using it, put a cap on the needle after injection;
- transfer (reload) unpackaged waste of classes B and C from one container to another;
- compact waste of classes B and C;
- carry out any operations with waste without gloves or the necessary personal protective equipment and overalls;
- use soft disposable packaging to collect sharp medical instruments and other sharp objects;
- install disposable and reusable containers for collecting waste at a distance of less than 1 m from heating devices.
4.34. In the event that an employee receives an injury potentially dangerous in terms of infection while handling medical waste (an injection, a cut with a violation of the integrity of the skin and / or mucous membranes), it is necessary to take emergency preventive measures. A first aid kit for injuries should be available at the workplace of the staff.
4.35. The responsible person makes an entry in the emergency register, draws up an accident report at work in the prescribed form indicating the date, time, place, nature of the injury, which describes in detail the situation, the use of personal protective equipment, compliance with safety regulations, indicate the persons who were at the site of injury, as well as the applied method of emergency prevention.
4.36. Notification, registration and investigation of cases of infection of personnel with pathogens of infectious diseases associated with professional activities are carried out in accordance with established requirements.

V. Methods and methods of disinfection and / or neutralization of medical waste of classes B and C

5.1. The choice of methods for safe decontamination and/or neutralization of class B waste depends on the capacity and profile of the medical organization, the availability of waste decontamination / disposal facilities, the method of waste decontamination / destruction adopted in the administrative territory (incineration, removal to landfills, disposal).
5.2. Class B waste disinfection/neutralization can be carried out in a centralized or decentralized way.
With a decentralized method, a waste management site is located within the territory of an organization carrying out medical and / or pharmaceutical activities.
With the centralized method, the site for the treatment of medical waste is located outside the territory of the organization carrying out medical and / or pharmaceutical activities, while the transportation of waste is organized.
5.3. Class B waste is disinfected only in a decentralized way, storage and transportation of non-disinfected class B waste is not allowed.
5.4. The physical method of disinfection of class B and C wastes, including exposure to saturated water vapor under excessive pressure, temperature, radiation, electromagnetic radiation, is used in the presence of special equipment - installations for the disinfection of medical waste.
5.5. The chemical method of disinfection of class B and C wastes, including exposure to solutions of disinfectants with bactericidal (including tuberculocidal), virucidal, fungicidal (sporicidal - as needed) action in the appropriate modes, is used using special installations or by immersing waste in labeled containers with disinfectant solution in the places of their formation.
5.6. Chemical disinfection of class B waste at the place of their generation is used as a mandatory temporary measure in the absence of a medical waste management site in organizations engaged in medical and / or pharmaceutical activities, or in the absence of a centralized medical waste disposal system in a given administrative territory.
5.7. Class B liquid waste (vomit, urine, feces) and similar biological fluids of tuberculosis patients may be drained without prior disinfection into the centralized sewerage system. In the absence of a centralized sewage system, the disinfection of this category of waste is carried out by chemical or physical methods.
5.8. For any method of disinfection of class B and C medical waste, disinfectants and equipment registered in the Russian Federation are used in accordance with the instructions for their use.
5.9. Thermal destruction of medical waste of classes B and C can be carried out in a decentralized way (incinerators or other thermal treatment plants intended for use for this purpose). Thermal destruction of decontaminated medical waste of classes B and C can be carried out in a centralized way (incineration plant). Thermal destruction of non-disinfected class B waste can be carried out in a centralized way, including as a separate section of an incineration plant.
5.10. With a decentralized method of neutralizing medical waste of classes B and C, special installations are located on the territory of an organization carrying out medical and / or pharmaceutical activities in accordance with the requirements of the sanitary legislation of the Russian Federation.
5.11. The use of recycling technologies, including waste sorting, is possible only after preliminary hardware disinfection of class B and C waste by physical methods. It is not allowed to use secondary raw materials obtained from medical waste for the manufacture of children's products, materials and products that come into contact with drinking water and food, medical products.
5.12. Disposal of decontaminated wastes of class B and C at the landfill is allowed only if their presentation has changed (grinding, sintering, pressing, and so on) and it is impossible to reuse them.
5.13. Disinfection and destruction of vaccines is carried out in accordance with the requirements of the sanitary legislation of the Russian Federation to ensure the safety of immunization.

VI. Requirements for the conditions of temporary storage (accumulation) of medical waste

6.1. Waste collection in places of their formation is carried out during the working shift. When using disposable containers for sharp instruments, they can be filled within 3 days.
6.2. Storage (accumulation) for more than 24 hours of food waste, non-disinfected class B waste is carried out in refrigerators or freezers.
6.3. Disposable bags used to collect waste of classes B and C must ensure the possibility of safely collecting no more than 10 kg of waste in them.
6.4. Accumulation and temporary storage of non-disinfected waste of classes B and C is carried out separately from waste of other classes in special rooms that exclude access by unauthorized persons. In small medical organizations (health centers, offices, feldsher-midwife stations, and so on), temporary storage and accumulation of class B and C waste in containers located in utility rooms is allowed (refrigeration equipment is used for storage for more than 24 hours). The use of refrigeration equipment intended for the accumulation of waste for other purposes is not allowed.
6.5. Class A waste containers are stored at a special site. The container site should be located on the territory of the economic zone at least 25 m from the medical buildings and the catering unit, and have a hard surface. The size of the container platform should exceed the base area of the containers by 1.5 meters in all directions. The site must be fenced off.

VII. Requirements for the organization of transportation of medical waste

7.1. Transportation of class A waste is organized taking into account the sanitary cleaning scheme adopted for the given territory, in accordance with the requirements of sanitary legislation for the maintenance of populated areas and the handling of production and consumption waste.
7.2. When transporting class A waste, the use of transport used for the transport of municipal solid waste is allowed.
7.3. Reusable containers for transportation of class A waste must be washed and disinfected at least once a week, for class B waste - after each emptying.
7.4. The organization carrying out the transportation of waste must have a site for washing, disinfecting and disinsection of containers and vehicles.
7.5. For transportation of non-disinfected class B waste, specialized vehicles are used; their use for other purposes is not allowed.
7.6. Transportation, neutralization and burial of class G waste is carried out in accordance with hygiene requirements imposed on the procedure for the accumulation, transportation, neutralization and disposal of toxic industrial waste.
7.7. Transportation of class D waste is carried out in accordance with the requirements of the legislation of the Russian Federation for the handling of radioactive substances.
7.8. Sanitary and epidemiological requirements for vehicles intended for the transportation of non-disinfected class B waste:
- the driver's cab must be separated from the car body;
- the car body must be made of materials that are resistant to detergents and disinfectants, mechanical stress, have a smooth inner surface and be marked "Medical Waste" on the outside;
- with a duration of more than 4 hours of transportation of waste stored in freezers, cooled transport is provided;
- the body must be provided with devices for fixing containers, their loading and unloading;
- vehicle should be provided with a set of means for emergency disinfection in case of spillage, spillage of medical waste (bags, gloves, water, disinfectants, rags, etc.);
- vehicles engaged in the transportation of waste must be washed and disinfected at least once a week. Disinfection is carried out by irrigation from a hydraulic console, sprayers or by wiping with disinfectant solutions using rags and brushes. In this case, it is necessary to observe the precautions provided for in the instructions / guidelines for the use of a particular disinfectant (protective clothing, respirators, goggles, rubber gloves);
- the vehicle is equipped with means of mobile communication.
7.9. Personnel involved in the transportation of medical waste must undergo preliminary (when hiring) and periodic medical examinations, and are also subject to preventive immunization in accordance with the requirements of the legislation of the Russian Federation. Persons under the age of 18 and not immunized against hepatitis B are not allowed to work on the treatment of class B and C medical waste.
7.10. Personnel involved in the transportation of medical waste are provided with overalls and personal protective equipment (gloves, masks / respirators / protective shields, special shoes, aprons).

VIII. Accounting and control over the movement of medical waste

8.1. Accounting and control of the movement of wastes of classes A, G, D is carried out in accordance with the requirements of the legislation of the Russian Federation.
8.2. The following documents are used to account for medical waste of classes B and C:
- technological register of waste of classes B and C in the structural unit; the log indicates the number of packaging units for each type of waste;
- technological journal of accounting for medical waste of the organization. The journal indicates the number of exported packaging units and / or the weight of the waste, as well as information about their export, indicating the organization that carries out the export;
- documents confirming the removal and disposal of waste, issued by specialized organizations engaged in the transportation and disposal of waste;
- technological log of the waste management site, which is the main accounting and reporting document of this site.

IX. Production control

9.1. Legal entities And individual entrepreneurs, carrying out activities in the field of waste management, organize and exercise production control over compliance with the requirements of the legislation of the Russian Federation in the field of waste management.
9.2. Production control over the collection, temporary storage, disposal of medical waste includes:
9.2.1. Visual and documentary check (at least once a month):
- the amount of consumables (stock of packages, containers, etc.), small-scale mechanization, disinfectants;
- provision of personnel with personal protective equipment, organization of centralized washing of overalls and its regular change;
- the sanitary condition and disinfection regime of temporary storage facilities and/or areas for the treatment of medical waste, garbage chutes, container sites;
- observance of the modes of disinfection/neutralization;
- regularity of waste disposal.
9.2.2. Laboratory and instrumental check:
- microbiological control of the effectiveness of decontamination / neutralization of waste at installations according to approved methods (at least once a year);
- control of microclimate parameters (at least once a year);
- air control of the working area in the areas of decontamination / disposal of waste for the content of volatile toxic substances (carried out in accordance with the technological regulations of the equipment).

X. Requirements for the organization of a site for the treatment of medical waste of classes B and C

10.1. The site for waste management of classes B and C is a structural subdivision of an organization carrying out medical and / or pharmaceutical activities, or an independent specialized organization (hereinafter referred to as the site). The site is located in specially equipped premises of a medical organization or on an independent territory and collects, accumulates, hardware decontamination / neutralization, disposal of class B and C waste. Placement of a site as part of medical units is not allowed (except for rooms for disinfection in laboratories that work with pathogens 1 - 4 pathogenicity groups). Composition and minimum areas the premises of the site are presented in Appendix 1 to these sanitary rules.

10.2. General requirements to the site.
The site can be located both in a separate building in an economic zone with access roads, and as part of a building, including in basements with autonomous exhaust ventilation (with the exception of installations for waste disposal by incineration, pyrolysis). The distance from residential and public buildings to a site equipped with a waste disposal plant by incineration, pyrolysis is determined in accordance with the requirements of the law.
The site must be provided with sewerage, water supply, electricity, heating and independent ventilation. Space-planning and design solutions for the premises of the site must ensure flow technological process and the possibility of observing the principle of separation into "clean" and "dirty" zones.
On the territory of the site, reception, processing (neutralization or disinfection), temporary storage (accumulation) of waste, washing and disinfection of racks, carts, containers and other equipment used to move waste are carried out.

10.3. Requirements for premises.
The premises of the site provide for a conditional division into zones:
- "dirty", which includes a room for the reception and temporary storage of incoming medical waste, a waste treatment room equipped with facilities for decontamination / neutralization of class B and C waste, a washing and disinfection room. With small volumes, temporary storage of incoming waste and their disinfection in one room is possible. When storing waste of classes B and C for more than 24 hours, refrigeration equipment is provided.
- "clean", which includes storage facilities for decontaminated / decontaminated waste, washed and decontaminated waste transfer facilities (possible joint temporary storage in the same room), consumables warehouse, staff room, bathroom, shower room.
The height of the premises is taken in accordance with the dimensions of the installed equipment, but not less than 2.6 m.
10.4. The surface of walls, floors and ceilings must be smooth, resistant to moisture, detergents and disinfectants. The floors are covered with moisture-resistant material, non-slip and resistant to mechanical stress.
The outer and inner surface of furniture and equipment must be smooth, made of materials that are resistant to moisture, detergents and disinfectants.

10.5. lighting requirements.
Combined or artificial lighting is provided in all rooms in accordance with hygienic requirements for natural, artificial and combined lighting of residential and public buildings. In industrial premises, the level of artificial illumination should be at least 200 lux.
Luminaires must have closed diffusers. Luminaires should be cleaned at least 2 times a year.

10.6. Requirements for the organization of air exchange.
The air exchange of the premises of the site must ensure the maintenance of acceptable microclimate parameters, compliance with hygienic standards for the content of pollutants in the air of the working area and comply with the requirements presented in Appendix 2 to these sanitary rules.
The ventilation device must prevent overflow air masses from "dirty" zones (premises) to "clean" ones.
In the premises of the site, autonomous supply and exhaust ventilation with mechanical stimulation is provided. The air exchange scheme is determined by the technological task. The rate of air exchange through the exhaust and the need to install local exhausts is determined by calculation, depending on the type, quantity and power of the process equipment.
Exhaust ventilation with mechanical stimulation without an organized inflow device is provided from the premises of the "dirty" zone.

10.7. Requirements for the microclimate of the premises.
The air temperature in production rooms should be within 18 - 25 ° C, relative humidity no more than 75%.

10.8. Requirements for water supply and sewerage.
Main industrial premises(for the reception and temporary storage of waste, decontamination, washing and disinfection of inventory and equipment) must be equipped with a watering tap, floor drains (pallets). In the room for disinfection / disposal of waste, a sink for washing hands is provided.

10.9. site equipment requirements.
The arrangement of equipment should be carried out taking into account the provision of free access to all equipment. The distance from the walls to the equipment should be at least 0.6 m, and from the side of the service area - at least 1.0 m. Minimum dimensions passages must be at least 0.6 m.
The premises for the reception and temporary storage of waste are equipped with scales.
Premises for temporary storage and decontamination / disposal of waste are equipped with bactericidal irradiators or other air disinfection devices.

10.10. Hygienic requirements for the maintenance of premises, equipment and inventory.
All premises, equipment, inventory must be kept clean. Current cleaning is carried out in a wet way, at least once a day with the use of detergents and disinfectants. General cleaning is carried out at least once a month. Walls, furniture, technological equipment, floor. Wipe the equipment with a rag moistened with a disinfectant solution, remove visible dirt from the walls, then wash the floor.
Cleaning equipment, separate for the "clean" and "dirty" areas, must be clearly marked with the types of cleaning work, used strictly for their intended purpose and stored separately in pantries or lockers of the main production facilities.

FEDERAL SERVICE FOR SUPERVISION IN THE FIELD OF CONSUMER RIGHTS PROTECTION AND HUMAN WELL-BEING
CHIEF STATE SANITARY PHYSICIAN OF THE RUSSIAN FEDERATION
RESOLUTION
dated December 9, 2010 N 163

ON APPROVAL SANPIN 2.1.7.2790-10 "SANITARY AND EPIDEMIOLOGICAL REQUIREMENTS FOR THE MANAGEMENT OF MEDICAL WASTE"

G.G. ONISCHENKO

SANITARY AND EPIDEMIOLOGICAL REQUIREMENTS
TO THE MANAGEMENT OF MEDICAL WASTE

Sanitary and epidemiological rules and regulations SanPiN 2.1.7.2790-10

I. Scope and general provisions

1.1. Sanitary and epidemiological rules and regulations (hereinafter - sanitary rules) are developed in accordance with the legislation of the Russian Federation.

1.2. These sanitary rules establish mandatory sanitary and epidemiological requirements for the handling (collection, temporary storage, disinfection, neutralization, transportation) of waste generated in organizations in the course of medical and / or pharmaceutical activities, the performance of medical diagnostic and health procedures (hereinafter referred to as medical waste ), as well as to the placement, equipment and operation of the site for the treatment of medical waste, the sanitary and anti-epidemic mode of operation when handling medical waste.

1.3. These sanitary rules are intended for citizens, individual entrepreneurs and legal entities whose activities are related to the handling of medical waste.

1.4. Control (supervision) over compliance with these sanitary rules is carried out by bodies exercising the functions of control and supervision in the field of ensuring the sanitary and epidemiological welfare of the population in accordance with the legislation of the Russian Federation.

II. Classification of medical waste

2.1. Medical waste, depending on the degree of their epidemiological, toxicological and radiation hazard, as well as the negative impact on the environment, is divided into five hazard classes (Table 1):
Class A - epidemiologically safe waste, close in composition to municipal solid waste (hereinafter referred to as MSW).
Class B - epidemiologically hazardous waste.
Class B - extremely epidemiologically hazardous waste.
Class D - toxicologically hazardous waste of 1 - 4 hazard classes.
Class D - radioactive waste.

3.2. The head of an organization carrying out medical and / or pharmaceutical activities approves an instruction that identifies responsible employees and the procedure for handling medical waste in this organization.

3.3. Mixing waste of different classes in a common container is unacceptable.

3.4. The processes of moving waste from places of generation to places of temporary storage and / or disinfection, unloading and loading of reusable containers must be mechanized (trolleys, elevators, lifts, trucks, and so on).

3.5. It is not allowed to involve persons who have not undergone preliminary briefing on the safe handling of medical waste to work on the treatment of medical waste.

3.6. Collection, temporary storage and disposal of waste should be carried out in accordance with the scheme for the management of medical waste adopted in this organization carrying out medical and / or pharmaceutical activities.

This scheme is developed in accordance with the requirements of these sanitary rules and approved by the head of the organization.

3.7. The medical waste management scheme specifies:
- qualitative and quantitative composition of generated medical waste;
- standards for the formation of medical waste, developed and adopted in the region;
- the need for consumables and containers for collecting medical waste, based on the obligation to change bags once per shift (at least once every 8 hours), - at least 72 hours, in operating rooms - after each operation;
- the procedure for collecting medical waste;
- the procedure and places for temporary storage (accumulation) of medical waste, the frequency of their removal;
- applied methods of disinfection/neutralization and disposal of medical waste;
- the procedure for personnel actions in case of violation of the integrity of the package (scattering, spilling medical waste);
- organization of hygienic training of personnel in the rules of epidemiological safety when handling medical waste.

3.8. Transportation of waste from the territory of organizations engaged in medical and / or pharmaceutical activities is carried out by transport of specialized organizations to the place of subsequent neutralization, placement of medical waste, taking into account the unified centralized system of sanitary cleaning of this administrative territory.

IV. Requirements for the collection of medical waste

4.3. Upon hiring and then annually, the staff undergoes mandatory training on the rules of safe waste management.

4.4. The personnel must work in overalls and removable shoes, in which it is not allowed to go outside the working premises. Personal clothing and workwear should be stored in separate lockers.

4.5. Personnel are provided with overalls and personal protective equipment (gowns/overalls, gloves, masks/respirators/protective shields, special footwear, aprons, sleeves, etc.).

Washing of overalls is carried out centrally. Do not wash clothes at home.

4.6. Class A waste is collected in reusable containers or disposable bags. The color of the packages can be any, except for yellow and red. Disposable bags are placed on special trolleys or inside reusable containers. Waste collection containers and trolleys must be marked "Waste. Class A". Filled reusable containers or disposable bags are delivered using small-scale mechanization and reloaded into labeled containers designed to collect waste of this class, installed on a special site (room). The reusable container after emptying is subject to washing and disinfection. The procedure for washing and disinfecting reusable containers is determined in accordance with the waste management scheme in each specific organization. Transportation of class A waste is organized taking into account the sanitary cleaning scheme adopted for the given territory, in accordance with the requirements of sanitary legislation for the maintenance of populated areas and the handling of production and consumption waste.

If it is impossible to dump food waste into the sewerage, food waste is collected separately from other class A waste in reusable containers or disposable bags installed in the premises of catering units, canteens and buffets. Further transportation of food waste is carried out in accordance with the waste management scheme in each specific organization. Food waste intended for removal for disposal at municipal solid waste landfills should be placed for temporary storage in reusable containers in disposable packaging.

Temporary storage of food waste in the absence of specially allocated refrigeration equipment is allowed for no more than 24 hours.

Containers are washed after each emptying, disinfected at least once a week.

Cleaning of pipeline shafts, receiving devices, waste collection chambers is carried out weekly. Preventive disinfection, disinsection is carried out at least once a month, deratization - as needed.

If an organization carrying out medical and / or pharmaceutical activities does not have a site for decontamination / neutralization of class B waste or a centralized system for the neutralization of medical waste adopted in the administrative territory, class B waste is disinfected by the personnel of this organization at the places of their generation by chemical / physical methods.

To collect class B sharps waste, disposable non-puncture moisture-resistant containers (containers) should be used. The container must have a tight-fitting lid to prevent accidental opening.

4.12. Soft packaging (disposable bags) for class B waste collection must be fixed on special carts or containers.

4.13. After filling the bag no more than 3/4, the employee responsible for waste collection in this medical unit ties the bag or closes it using tie tags or other devices that prevent class B waste from spilling out. Solid (non-piercing) containers are closed with lids. Displacement of class B waste outside the unit in open containers is not allowed.

4.14. During the final packaging of class B waste to remove it from the subdivision (organization), disposable containers (bags, tanks) with class B waste are marked with the inscription "Waste. Class B" with the name of the organization, subdivision, date and surname of the person responsible for waste collection.

4.15. Disinfection of reusable containers for the collection of class B waste within the organization is carried out daily.

4.16. Class B medical waste from departments in closed disposable containers (bags) is placed in containers and then transferred to the waste management site or temporary storage of medical waste until it is transported by specialized organizations to the place of decontamination / neutralization. Access of unauthorized persons to the temporary storage of medical waste is prohibited.

4.17. When organizing sites for decontamination / neutralization of medical waste using hardware methods, it is allowed to collect, temporarily store, and transport class B medical waste without preliminary disinfection at the places of generation, provided that the necessary epidemiological safety requirements are met.

At the same time, an organization carrying out medical and / or pharmaceutical activities must be provided with all necessary consumables, including disposable packaging.

4.22. Class B waste is collected in disposable soft (bags) or hard (non-puncture) packaging (containers) of red color or having a red marking. The choice of packaging depends on the morphological composition of the waste. Liquid biological waste, used disposable stabbing (cutting) instruments and other medical products are placed in solid (non-piercing) moisture-resistant sealed packaging (containers).

4.23. Soft packaging (disposable bags) for class B waste collection must be fixed on special racks (trolleys) or containers.

4.24. After filling the bag no more than 3/4, the employee responsible for waste collection in this medical unit, in compliance with biological safety requirements, ties the bag or closes it using tie tags or other devices that prevent Class B waste from spilling out. Solid (non-piercing) containers closed with lids. Displacement of class B waste outside the unit in open containers is not allowed.

4.25. During the final packaging of class B waste to remove it from the unit, disposable containers (bags, tanks) with class B waste are marked with the inscription "Waste. Class B" with the name of the organization, unit, date and name of the person responsible for collecting the waste.

4.26. Class B medical waste in closed disposable containers is placed in special containers and stored in a room for temporary storage of medical waste.

Medicinal, diagnostic, disinfectants that are not to be used are collected in disposable labeled packaging of any color (except for yellow and red).

4.29. Collection and temporary storage of class G waste is carried out in labeled containers ("Waste. Class G") in accordance with the requirements of regulatory documents, depending on the hazard class of the waste. The removal of class G waste for neutralization or disposal is carried out by specialized organizations licensed for this type of activity.

4.31. The removal and neutralization of class D waste is carried out by specialized organizations for the management of radioactive waste that have a license for this type of activity.

4.33. When collecting medical waste, it is prohibited:

Manually destroy, cut waste of classes B and C, including used systems for intravenous infusion, in order to decontaminate them;
- manually remove the needle from the syringe after using it, put a cap on the needle after injection;
- transfer (reload) unpackaged waste of classes B and C from one container to another;
- compact waste of classes B and C;
- carry out any operations with waste without gloves or the necessary personal protective equipment and overalls;
- use soft disposable packaging to collect sharp medical instruments and other sharp objects;
- install disposable and reusable containers for collecting waste at a distance of less than 1 m from heating devices.

4.36. Notification, registration and investigation of cases of infection of personnel with pathogens of infectious diseases associated with professional activities are carried out in accordance with established requirements.

V. Methods and methods of disinfection and / or neutralization of medical waste of classes B and C

5.2. Class B waste disinfection/neutralization can be carried out in a centralized or decentralized way.

With a decentralized method, a waste management site is located within the territory of an organization carrying out medical and / or pharmaceutical activities.

With the centralized method, the site for the treatment of medical waste is located outside the territory of the organization carrying out medical and / or pharmaceutical activities, while the transportation of waste is organized.

5.3. Class B waste is disinfected only in a decentralized way, storage and transportation of non-disinfected class B waste is not allowed.

5.4. The physical method of disinfection of class B and C wastes, including exposure to saturated water vapor under excessive pressure, temperature, radiation, electromagnetic radiation, is used in the presence of special equipment - installations for the disinfection of medical waste.

5.5. The chemical method of disinfection of class B and C wastes, including exposure to solutions of disinfectants with bactericidal (including tuberculocidal), virucidal, fungicidal (sporicidal - as needed) action in the appropriate modes, is used using special installations or by immersing waste in labeled containers with disinfectant solution in the places of their formation.

5.6. Chemical disinfection of class B waste at the place of their generation is used as a mandatory temporary measure in the absence of a medical waste management site in organizations engaged in medical and / or pharmaceutical activities, or in the absence of a centralized medical waste disposal system in a given administrative territory.

5.7. Class B liquid waste (vomit, urine, feces) and similar biological fluids of tuberculosis patients may be drained without prior disinfection into the centralized sewerage system. In the absence of a centralized sewage system, the disinfection of this category of waste is carried out by chemical or physical methods.

5.8. For any method of disinfection of class B and C medical waste, disinfectants and equipment registered in the Russian Federation are used in accordance with the instructions for their use.

5.9. Thermal destruction of medical waste of classes B and C can be carried out in a decentralized way (incinerators or other thermal treatment plants intended for use for this purpose). Thermal destruction of decontaminated medical waste of classes B and C can be carried out in a centralized way (incineration plant). Thermal destruction of non-disinfected class B waste can be carried out in a centralized way, including as a separate section of an incineration plant.

5.10. With a decentralized method of neutralizing medical waste of classes B and C, special installations are located on the territory of an organization carrying out medical and / or pharmaceutical activities in accordance with the requirements of the sanitary legislation of the Russian Federation.

5.11. The use of recycling technologies, including waste sorting, is possible only after preliminary hardware disinfection of class B and C waste by physical methods. It is not allowed to use secondary raw materials obtained from medical waste for the manufacture of children's products, materials and products that come into contact with drinking water and food, medical products.

5.12. Disposal of decontaminated wastes of class B and C at the landfill is allowed only if their presentation has changed (grinding, sintering, pressing, and so on) and it is impossible to reuse them.

5.13. Disinfection and destruction of vaccines is carried out in accordance with the requirements of the sanitary legislation of the Russian Federation to ensure the safety of immunization.

VI. Requirements for the conditions of temporary storage (accumulation) of medical waste

6.1. Waste collection in places of their formation is carried out during the working shift. When using disposable containers for sharp instruments, they can be filled within 3 days.

6.2. Storage (accumulation) for more than 24 hours of food waste, non-disinfected class B waste is carried out in refrigerators or freezers.

6.3. Disposable bags used to collect waste of classes B and C must ensure the possibility of safely collecting no more than 10 kg of waste in them.

6.4. Accumulation and temporary storage of non-disinfected waste of classes B and C is carried out separately from waste of other classes in special rooms that exclude access by unauthorized persons. In small medical organizations (health centers, offices, feldsher-midwife stations, and so on), temporary storage and accumulation of class B and C waste in containers located in utility rooms is allowed (refrigeration equipment is used for storage for more than 24 hours). The use of refrigeration equipment intended for the accumulation of waste for other purposes is not allowed.

6.5. Class A waste containers are stored at a special site. The container site should be located on the territory of the economic zone at least 25 m from the medical buildings and the catering unit, and have a hard surface. The size of the container platform should exceed the base area of the containers by 1.5 meters in all directions. The site must be fenced off.

VII. Requirements for the organization of transportation of medical waste

7.2. When transporting class A waste, the use of transport used for the transport of municipal solid waste is allowed.

7.3. Reusable containers for transportation of class A waste must be washed and disinfected at least once a week, for class B waste - after each emptying.

7.4. The organization carrying out the transportation of waste must have a site for washing, disinfecting and disinsection of containers and vehicles.

7.5. For transportation of non-disinfected class B waste, specialized vehicles are used; their use for other purposes is not allowed.

7.6. Transportation, neutralization and disposal of class G waste is carried out in accordance with the hygienic requirements for the procedure for the accumulation, transportation, neutralization and disposal of toxic industrial waste.

7.7. Transportation of class D waste is carried out in accordance with the requirements of the legislation of the Russian Federation for the handling of radioactive substances.

7.8. Sanitary and epidemiological requirements for vehicles intended for the transportation of non-disinfected class B waste:
- the driver's cab must be separated from the car body;
- the car body must be made of materials that are resistant to detergents and disinfectants, mechanical stress, have a smooth inner surface and be marked "Medical Waste" on the outside;
- with a duration of more than 4 hours of transportation of waste stored in freezers, cooled transport is provided;
- the body must be provided with devices for fixing containers, their loading and unloading;
- the vehicle must be provided with a set of means for emergency disinfection in case of spillage, spillage of medical waste (bags, gloves, water, disinfectants, rags, etc.);
- vehicles engaged in the transportation of waste must be washed and disinfected at least once a week. Disinfection is carried out by irrigation from a hydraulic console, sprayers or by wiping with disinfectant solutions using rags and brushes. In this case, it is necessary to observe the precautions provided for in the instructions / guidelines for the use of a particular disinfectant (protective clothing, respirators, goggles, rubber gloves);
- the vehicle is equipped with means of mobile communication.

7.9. Personnel involved in the transportation of medical waste must undergo preliminary (when hiring) and periodic medical examinations, and are also subject to preventive immunization in accordance with the requirements of the legislation of the Russian Federation. Persons under the age of 18 and not immunized against hepatitis B are not allowed to work on the treatment of class B and C medical waste.

7.10. Personnel involved in the transportation of medical waste are provided with overalls and personal protective equipment (gloves, masks / respirators / protective shields, special shoes, aprons).

VIII. Accounting and control over the movement of medical waste

8.1. Accounting and control of the movement of wastes of classes A, G, D is carried out in accordance with the requirements of the legislation of the Russian Federation.

8.2. The following documents are used to account for medical waste of classes B and C:

Technological register of waste of classes B and C in the structural unit; the log indicates the number of packaging units for each type of waste;
- technological journal of accounting for medical waste of the organization. The journal indicates the number of exported packaging units and / or the weight of the waste, as well as information about their export, indicating the organization that carries out the export;
- documents confirming the removal and disposal of waste, issued by specialized organizations engaged in the transportation and disposal of waste;
- technological log of the waste management site, which is the main accounting and reporting document of this site.

IX. Production control

9.1. Legal entities and individual entrepreneurs operating in the field of waste management organize and exercise production control over compliance with the requirements of the legislation of the Russian Federation in the field of waste management.

9.2. Production control over the collection, temporary storage, disposal of medical waste includes:

9.2.1. Visual and documentary check (at least once a month):
- the amount of consumables (stock of packages, containers, etc.), small-scale mechanization, disinfectants;
- provision of personnel with personal protective equipment, organization of centralized washing of overalls and its regular change;
- the sanitary condition and disinfection regime of temporary storage facilities and/or areas for the treatment of medical waste, garbage chutes, container sites;
- observance of the modes of disinfection/neutralization;
- regularity of waste disposal.

9.2.2. Laboratory and instrumental check:

Microbiological control of the effectiveness of decontamination / neutralization of waste at installations according to approved methods (at least once a year);
- control of microclimate parameters (at least once a year);
- air control of the working area in the areas of decontamination / disposal of waste for the content of volatile toxic substances (carried out in accordance with the technological regulations of the equipment).

X. Requirements for the organization of a site for the treatment of medical waste of classes B and C

10.1. The site for the treatment of waste of classes B and C is a structural subdivision of the organization