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Name Game

By Dan Scungio, MT(ASCP), SLS

Margie was new to the Histology department, and she was told to dispose of last year’s slides. She was told at this hospital it was too expensive to treat them as sharps, and that they were to be put into cardboard boxes and placed into regular trash.

Zane knew that urine was not considered a regulated medical waste in his state. He emptied the urine specimens into the sink and threw the empty cups into the regular trash. 

While there have been a couple of “Trash Talk” columns written in the past, this one is a little bit different, and deals with Protected Health Information or HIPAA concerns. When Margie threw away the slides, where will that patient information show up? Who might find it? Was it safe? Zane did not take care of the patient identification information on the empty urine cups, and he tossed them into regular trash. That information will end up in a regular landfill for anyone to find.

So how do we know how to handle this waste from the lab in order to be safe and to protect patients’ privacy?

The first step is to do some research. Find out how your waste is handled and treated. You can most likely presume that regular trash will end up untreated and in a landfill. Anything with patient information you dispose of there would be considered unprotected. Contact your regulated medical waste contractor to see how biohazard waste and sharps containers are handled.

At our facilities, our biohazard bags are treated with a high-steam process before being sent to a biohazard landfill. The steam process renders all information illegible. Sharps containers are incinerated, and all patient information is destroyed in the process. Knowing that, at larger facilities, we dispose of empty urine cups into sharps containers to protect patient information. We could black the information out or place a blank label over the cup label (which we do at smaller sites), but that may not be possible in a reference laboratory given the volumes.

Remember there are costs and the environment to consider as well. It can cost eight to ten times more to dispose of biohazard or sharps waste than it does to get rid of regular trash. The cost is usually calculated by weight. If you’re disposing of full urine cups into sharps containers, you may want to consider emptying the urine first (if it’s allowed in your area). If your lab staff just throws everything away into biohazard trash, you are paying more than necessary and you are adding unnecessary waste to the biohazard landfills. If you have extra patient labels or requisitions, it may be a better option to use a shredder service instead of throwing away paper as regulated medical waste to protect patient information.

The bottom line for Protected Health Information may not be money. It has to do with safety, practicality, and treatment of waste as well. Know what your facility and local regulations are, and find out how your trash is handled. That way you can be sure your lab will not inadvertently violate a HIPAA regulation, and you can be sure your staff will remain safe as well.