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03/23/20P,15, 16-,33 461751 MED STAFF f* MED 01 ch - Elope rtman Capertrnant of Health Sarv16pA SANDRA SHEWRY Director State of California—Health and Human Services Agency Department of Health Services February 7, 2005 TO:�W` DEPT; H F= FAX CO: FROM; FAX:_,. G DATE: To: All Medical Waste Generators and Offsite Treatment Facilities Subject: Steam Sterilization of Suction Canisters kRNOLD SCHWARZENEGGER Governor The Department of Health Services (Department) has recently been involved in an evaluation of the efficacy of the treatment of suction canister waste by steam sterilization. The results of that evaluation suggest that in certain circumstances, suction canister waste may not be adequately treated by steam sterilization. Per the Medical Waste Management Act, Chapter 8, Section 118215 (a)(2)(D) treatment of waste must be demonstrated using a biological indicator. The law states that the indicator must be placed in the center of the waste load. Due to the density of filled waste canisters, the center of the load should be considered they"center of a filled canister surrounded by waste if such containers are routinely part of waste loads. The Department views the results from this initial evaluation as preliminary and further investigation, including testing, is necessary to allow for any definitive conclusions regarding steam sterilization treatment of this waste stream. Treatment systems that include a grinding component that destroys the suction canister and exposes a greater waste surface area for treatment appear to adequately sterilize the waste even if solidified. Sterilization also appears to be complete when.un-solidified wasts is in a .suction canister made of a material that does not withstand the temperature conditions under which an autoclave is typically operated. Based on the preliminary testing performed on surrogate suction canister waste, it appears that the addition of soiidifiers to the liquid waste present in the suction canister prevents or inhibits the resulting solidified waste from reaching optimum temperatures that ensure adequate sterilization. Therefore it is inappropriate for solidified suction canisters to be treated by steam sterilization. The options for this waste stream would include treatment by incineration, extreme heat treatment systems such as pyrolysis and plasma arc technologies or systems than include grinding of the waste as part of the treatment technology. Due to waste management controls in place, the Department believes that, even in those cases where the treatment of the contents of the suction canisters may be incomplete, the risk to the general public is minimal. However, facilities,mlust revio w their waste treatment and quality control pro dUres, including the proper use of spore eocal waste anagemen rogram,S974 3, Sac—_ n o, CA, 95IJ9 (916) 449-5671 Internet Address: ht wvww.d s.ca. ov edicalwaste