Registration N 19871

In accordance with the Federal Law of March 30, 1999 N 52-FZ “On the sanitary and epidemiological welfare of the population” (Collected Legislation of the Russian Federation, 1999, N 14, Art. 1650; 2002, N 1 (Part I), Art. 2; 2003, No. 2, Article 167; No. 27 (Part I), Article 2700; 2004, No. 35, Article 3607; 2005, No. 19, Article 1752; 2006, No. 1, Article 10; No. 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; N 49, Article 6070; 2008, N 24, Article 2801; N 29 (Part I), Article 3418; N 30 (Part II), Article 3616; N 44, Article 4984; N 52 ( Part I), Article 6223; 2009, No. 1, Article 17; 2010, No. 40, Article 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 regulation" (Collected Legislation of the Russian Federation, 2000, N 31, Art. 3295; 2004, N 8, Art. 663; N 47, Art. 4666; 2005, N 39, Art. 3953) I decree:

Approve sanitary and epidemiological rules and regulations SanPiN 2.1.7.2790-10 “Sanitary and epidemiological requirements for handling medical waste" (application).

G.G.Onishchenko

Application

Sanitary and epidemiological requirements for 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 referred to as sanitary rules) have been 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, decontamination, rendering harmless, transportation) of waste generated in organizations during the implementation of medical and/or pharmaceutical activities, performance of therapeutic, diagnostic and health procedures (hereinafter referred to as medical waste ), as well as to the placement, equipment and operation of the site for handling medical waste, the sanitary and anti-epidemic regime of work when handling medical waste.
1.3. These sanitary rules are intended for citizens, individual entrepreneurs and legal entities whose activities are related to the management of medical waste.
1.4. Control (supervision) over compliance with these sanitary rules is carried out by bodies exercising control and supervision functions in the field of ensuring the sanitary and epidemiological well-being 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 its epidemiological, toxicological and radiation hazard, as well as negative impact The habitat is divided into five hazard classes (Table 1):
Class A - epidemiologically without hazardous waste, close in composition to solids household waste(hereinafter - MSW).
Class B - epidemiologically hazardous waste.
Class B - extremely epidemiologically hazardous waste.
Class G - toxicologically hazardous waste of hazard classes 1 - 4.
Class D - radioactive waste.

2.2. After hardware disinfection methods using physical methods and changes appearance waste, excluding the possibility of their reuse, waste of classes B and C can be accumulated, temporarily stored, transported, destroyed and buried together with waste of class A. The packaging of disinfected medical waste of classes B and C must be marked indicating that the waste has been disinfected.

III. Requirements for organizing a medical waste management system

3.1. The system for collection, temporary storage and transportation of medical waste should include the following stages:
- waste collection within organizations engaged in medical and/or pharmaceutical activities;
- movement of waste from departments and temporary storage of waste on the territory of the organization generating the waste;
- disinfection/neutralization;
- transportation of waste from the territory of the organization generating the waste;
- burial or destruction of medical waste.
3.2. The head of an organization carrying out medical and/or pharmaceutical activities approves instructions that define 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 (carts, elevators, lifts, trucks, etc.).
3.5. It is not allowed to involve persons who have not undergone preliminary training in handling medical waste. safe handling with medical waste.
3.6. Collection, temporary storage and removal of waste should be carried out in accordance with the medical waste management scheme adopted by the given 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 generation of medical waste developed and adopted in the region;
- the need for consumables and containers for collecting medical waste, based on the requirement to change bags once a shift (at least once every 8 hours), disposable containers for sharp instruments - at least 72 hours, in operating rooms - after each operation;
- 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;
- procedure for personnel actions in case of violation of the integrity of the packaging (scattering, spilling of medical waste);
- organization of hygienic training of personnel in epidemiological safety rules when handling medical waste.
3.8. Transportation of waste from the territory of organizations carrying out medical and/or pharmaceutical activities is carried out by transport of specialized organizations to the place of subsequent neutralization, disposal of medical waste, taking into account a single centralized system sanitary cleaning of this administrative territory.

IV. Requirements for the collection of medical waste

4.1. Persons under 18 years of age are not allowed to work with medical waste. Personnel undergo preliminary (upon 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 schedule of preventive vaccinations. Personnel who are not immunized against hepatitis B are not allowed to work with medical waste of classes B and C.
4.3. Upon hiring and then annually, personnel undergo mandatory training on the rules of safe waste management.
4.4. Personnel must work in special clothing and replaceable shoes, in which they are not allowed to leave the work premises. Personal clothing and workwear must be stored in separate closets.
4.5. The staff is provided with sets of workwear and personal protective equipment (robes/overalls, gloves, masks/respirators/protective shields, special shoes, aprons, oversleeves, etc.).
Workwear washing is carried out centrally. It is prohibited to wash workwear at home.
4.6. Class A waste is collected in reusable containers or disposable bags. The packages can be any color, with the exception of yellow and red. Disposable bags are placed on special carts or inside reusable containers. Waste collection containers and carts must be marked “Waste. Class A." Filled reusable containers or disposable bags are delivered using small-scale mechanization and reloaded into marked containers intended for collecting waste of this class, installed on a special site (room). Reusable containers must be washed and disinfected after emptying. 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 treatment scheme adopted for the given territory, in accordance with the requirements of sanitary legislation for the maintenance of populated areas and the management of production and consumption waste.
4.7. For organizations engaged in medical and/or pharmaceutical activities, producing household goods Wastewater into the citywide sewerage system, the preferred system for the disposal of food raw materials and prepared food waste from catering units and buffets, classified as Class A medical waste, is discharge food waste into the city sewerage system by equipping the internal sewerage system with food waste grinders (disposers).
If it is impossible to discharge food waste into the sewer system, food waste is collected separately from other class A waste in reusable containers or disposable bags installed in catering units, canteens and pantries. 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 solid waste landfills must be placed for temporary storage in reusable containers in disposable packaging.
Temporary storage of food waste in the absence of specially designated refrigeration equipment is allowed for no more than 24 hours.
Food waste (except for waste from ward departments of infectious diseases, including skin and venereal diseases and tuberculosis, special sanatoriums for the improvement of those who have recovered from infectious diseases) may 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 throw objects into the garbage chute that could lead to mechanical blocking (clogging) of the garbage chute. Waste must be disposed of in a garbage chute in packaged form.
The design, materials and arrangement of waste chutes and pneumatic transport must ensure the possibility of cleaning, washing, disinfecting and mechanized removal of waste from waste collection chambers. Garbage collection chambers are equipped with containers, water supply and sewer drain. It is prohibited to dump waste from the garbage chute (pneumatic transport) directly onto the floor of the garbage collection chamber. A supply of containers for the waste collection chamber must be provided for at least one day.
Containers are washed after each emptying and disinfected at least once a week.
Cleaning of pipeline trunks, receiving devices, and waste collection chambers is carried out weekly. Preventive disinfection, disinsection is carried out at least once a month, deratization - as necessary.
4.9. Bulky waste of class A is collected in special bins for bulky waste. 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 disinfection (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 disinfection/neutralization of class B waste or a centralized system for neutralizing medical waste adopted in the administrative territory, class B waste is disinfected by the personnel of this organization at the places of its generation using chemical/physical methods.
4.11. Class B waste is collected in disposable soft (bags) or hard (puncture-resistant) packaging (containers) yellow color or having a yellow marking. The choice of packaging depends on the morphological composition of the waste.
To collect Class B sharps waste, disposable, puncture-resistant, moisture-resistant containers (containers) must be used. The container must have a tight-fitting lid to prevent accidental opening.
To collect organic, liquid waste of class B, disposable, puncture-proof, moisture-resistant containers with a lid (containers) must be used to ensure their sealing and eliminate the possibility of spontaneous opening.
In the case of using hardware disinfection methods in an organization carrying out medical and/or pharmaceutical activities, at workplaces, it is allowed to collect waste of class B in common containers (containers, bags) of used syringes in unassembled form with preliminary separation of needles (to separate needles, it is necessary to use needle removers, needle destructors, needle cutters), gloves, dressings, and so on.
4.12. Soft packaging (disposable bags) for collecting Class B waste must be secured to special trolley racks or containers.
4.13. After filling the bag no more than 3/4, the employee responsible for waste collection in a given medical unit ties the bag or closes it using tie tags or other devices that prevent the spillage of Class B waste. Hard (pierce-resistant) containers are closed with lids. Moving Class B waste outside the unit in open containers is not permitted.
4.14. During the final packaging of class B waste for removal from the unit (organization), disposable containers (bags, tanks) with class B waste are marked with the inscription “Waste. Class B" with the name of the organization, department, date and surname of the person responsible for waste collection.
4.15. Disinfection of reusable containers for collecting 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 transported in them to a waste management site or a room for temporary storage of medical waste before subsequent transportation by specialized organizations to the place of decontamination/neutralization. Access by unauthorized persons to temporary storage areas for medical waste is prohibited.
Containers must be made of materials resistant to mechanical stress, high and low temperatures, detergents and disinfectants, be closed with lids, the design of which should not allow them to open spontaneously.
4.17. When organizing sites for disinfection/neutralization of medical waste using hardware methods, it is permitted to collect, temporarily store, and transport Class B medical waste without prior 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. Pathological and organic operational waste of class B (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 medical waste of class B, packaged in special disposable containers (containers), from remote structural units (health centers, offices, first aid stations) and other places of care medical care to a medical organization to ensure their subsequent decontamination/neutralization.
4.20. Work on handling medical waste of class B is organized in accordance with the requirements for working with pathogens of pathogenicity groups 1 - 2, for sanitary protection of the territory and for the prevention of tuberculosis.
4.21. Class B waste is subject to mandatory disinfection (disinfection) by physical methods (thermal, microwave, radiation and others). The use of chemical disinfection methods is allowed only for the disinfection of food waste and patient secretions, as well as when organizing primary anti-epidemic measures in outbreaks. The choice of disinfection (disinfection) method is carried out when developing a waste collection and disposal scheme. Removal of non-disinfected Class B waste outside the territory of the organization is not permitted.
4.22. Class B waste is collected in disposable soft (bags) or hard (puncture-resistant) packaging (containers) that are red or have red markings. 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 solid (puncture-proof) moisture-resistant sealed packaging (containers).
4.23. Soft packaging (disposable bags) for collecting Class B waste must be secured to special racks (trolleys) or containers.
4.24. Once the bag is no more than 3/4 full, the employee responsible for waste collection at the given medical unit, in compliance with biological safety requirements, ties the bag or closes it using tie tags or other devices that prevent spillage of Class B waste. Hard (puncture-resistant) containers are closed with lids. Moving Class B waste outside the unit in open containers is not permitted.
4.25. During the final packaging of class B waste for removal 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, department, date and name 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 medical waste of class G are collected in labeled containers with tight-fitting lids of any color (except yellow and red), which are stored in specially designated rooms.
4.28. The collection and temporary storage of waste cytostatics and genotoxic drugs and all types of waste generated as a result of the preparation of their solutions (bottles, ampoules, etc.), classified as medical waste of class G, without decontamination is prohibited. Waste is subject to immediate decontamination at the point of generation using special means. It is also necessary to decontaminate the workplace. Work with such waste must be carried out using special personal protective equipment and carried out in a fume hood.
Medicinal, diagnostic, and disinfectants that are not to be used are collected in disposable labeled packaging of any color (except yellow and red).
4.29. Collection and temporary storage of Class G waste is carried out in marked containers (“Waste. Class G”) in accordance with the requirements regulatory documents depending on the hazard class of the waste. Removal of class G waste for neutralization or disposal is carried out by specialized organizations licensed to this type activities.
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 handling radioactive substances and other sources of ionizing radiation, radiation safety standards.
4.31. Removal and disposal of class D waste is carried out by specialized organizations for handling radioactive waste who have a license for this type of activity.
4.32. Disinfection of reusable (inter-hull) containers for collecting waste of classes A, B, and car bodies is carried out at unloading points at least once a week by a specialized waste removal organization.
4.33. When collecting medical waste it is prohibited:
- manually destroy and cut waste of classes B and C, including used systems for intravenous infusions, in order to disinfect them;
- manually remove the needle from the syringe after using it, put the cap on the needle after injection;
- pour (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 necessary funds personal protection and protective clothing;
- use soft disposable packaging to collect sharp medical instruments and other sharp objects;
- install disposable and reusable waste collection containers at a distance of less than 1 m from heating devices.
4.34. If an employee receives an injury while handling medical waste that is potentially dangerous in terms of infection (injection, cut with damage to the integrity of the skin and/or mucous membranes), it is necessary to take emergency preventive measures. At the personnel workplace there should be a first aid kit for injuries.
4.35. Responsible person an entry is made in the emergency log book, an industrial accident report is drawn up in the established 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, and indicates the persons who were at the scene injuries, as well as the emergency prevention method used.
4.36. Notification, recording and investigation of cases of personnel infection with pathogens infectious diseases related to professional activity, are carried out in accordance with established requirements.

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

5.1. The choice of methods for safe disinfection and/or disposal of class B waste depends on the power and profile medical organization, the presence of waste disinfection/disposal facilities, the method of waste neutralization/destruction accepted in the administrative territory (incineration, removal to landfills, recycling).
5.2. Disinfection/neutralization of class B waste can be carried out in centralized or decentralized ways.
In the decentralized method, the waste management site is located within the territory of the organization carrying out medical and/or pharmaceutical activities.
With the centralized method, the medical waste management site is located outside the territory of the organization carrying out medical and/or pharmaceutical activities, and waste transportation is organized.
5.3. Class B waste is disinfected only in a decentralized manner; storage and transportation of non-disinfected Class B waste is not allowed.
5.4. The physical method of disinfection of waste of classes B and C, including exposure to 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.
5.5. A chemical method for disinfecting waste of classes B and C, including exposure to solutions of disinfectants that have bactericidal (including tuberculocidal), virucidal, fungicidal (sporicidal - as necessary) effects in appropriate modes, is used using special installations or by immersing waste in marked containers with disinfectant solution in places of their formation.
5.6. Chemical disinfection of class B waste at the site of its generation is used as a mandatory temporary measure in the absence of a medical waste management site in organizations carrying out medical and/or pharmaceutical activities, or in the absence of a centralized system for the neutralization of medical waste in a given administrative territory.
5.7. Liquid waste of class B (vomit, urine, feces) and similar biological fluids of tuberculosis patients may be discharged without prior disinfection into the centralized sewerage system. In the absence of a centralized sewerage system, disinfection of this category of waste is carried out using chemical or physical methods.
5.8. For any method of disinfection of medical waste of classes B and C, 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 neutralization installations intended for use for these purposes). Thermal destruction of disinfected medical waste of classes B and C can be carried out in a centralized way ( incinerator). Thermal destruction of non-disinfected Class B waste can be carried out in a centralized manner, including as a separate section of a waste 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 using 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 products, medical products.
5.12. Disposal of neutralized waste of class B and C at a landfill is allowed only if its presentation has changed (crushing, sintering, pressing, etc.) and it is impossible to reuse it.
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 conditions of temporary storage (accumulation) of medical waste

6.1. Waste collection at the places of its generation is carried out within work shift. When using disposable containers for sharp instruments, they can be filled within 3 days.
6.2. Storage (accumulation) of food waste and non-disinfected class B waste for more than 24 hours is carried out in refrigeration or freezer compartments.
6.3. Disposable bags used for collecting waste of classes B and C must allow the safe collection of no more than 10 kg of waste.
6.4. The accumulation and temporary storage of non-disinfected waste of classes B and C is carried out separately from waste of other classes in special premises that exclude access to unauthorized persons. In small medical organizations (health centers, offices, first aid stations, etc.), temporary storage and accumulation of waste of classes B and C is allowed in containers located in utility rooms (for storage of more than 24 hours, refrigeration equipment is used). The use of refrigeration equipment intended for waste accumulation for other purposes is not permitted.
6.5. Containers with class A waste are stored in a special area. The container site must be located on the territory of the economic zone at least 25 m from the medical buildings and catering unit, and have a hard surface. The size of the container site must exceed the base area of ​​the containers by 1.5 meters in all directions. The site must be fenced.

VII. Requirements for organizing the transportation of medical waste

7.1. Transportation of class A waste is organized taking into account the sanitary treatment scheme adopted for the given territory, in accordance with the requirements of sanitary legislation for the maintenance of populated areas and the management of production and consumption waste.
7.2. When transporting Class A waste, the use of vehicles used for transporting solid household waste is permitted.
7.3. Reusable containers for transporting class A waste must be washed and disinfected at least once a week, for class B waste - after each emptying.
7.4. The organization transporting waste must have an area for washing, disinfecting and disinfesting containers and vehicles.
7.5. To transport non-disinfected Class B waste, specialized vehicles, their use for other purposes is not permitted.
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 transportation of non-disinfected waste of class B:
- the driver’s cabin must be separated from the car body;
- the car body must be made of materials that are resistant to treatment with detergents and disinfectants, mechanical stress, have a smooth inner surface and be marked “Medical waste” on the outside;
- if the transportation of waste stored in freezers lasts more than 4 hours, refrigerated transport is provided;
- the body must be equipped with devices for securing containers, loading and unloading them;
- the vehicle must be provided with a set of means for emergency disinfection in the event of spillage of medical waste (bags, gloves, water, disinfectants, rags, etc.);
- vehicles used for transporting waste must be washed and disinfected at least once a week. Disinfection is carried out by irrigation from a hydraulic remote control, 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 specific disinfectant (protective clothing, respirators, safety glasses, rubber gloves);
- the vehicle is equipped with mobile communications.
7.9. Personnel involved in the transportation of medical waste must undergo preliminary (upon 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 18 years of age and not immunized against hepatitis B are not allowed to handle medical waste of classes B and C.
7.10. Personnel involved in the transportation of medical waste are provided with sets of 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 waste of classes A, D, D is carried out in accordance with the requirements of the legislation of the Russian Federation.
8.2. To record medical waste of classes B and C, the following documents are used:
- technological log of waste of classes B and C in the structural unit; the log indicates the number of packaging units of each type of waste;
- technological log of medical waste of the organization. The log indicates the number of packaging units being exported and/or the weight of the waste, as well as information about their removal, indicating the organization carrying out the removal;
- documents confirming the removal and disposal of waste, issued by specialized organizations involved in 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 carry out 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, and disposal of medical waste includes:
9.2.1. Visual and documentary inspection (at least once a month):
- quantities of consumables (stock of bags, containers, etc.), small mechanization equipment, disinfectants;
- provision of personnel with personal protective equipment, organization of centralized washing of workwear and its regular change;
- sanitary condition and disinfection regime of temporary storage premises and/or areas for handling medical waste, garbage chutes, container sites;
- compliance with disinfection/neutralization regimes;
- regularity of waste removal.
9.2.2. Laboratory and instrumental testing:
- microbiological control of the efficiency of waste disinfection/neutralization at installations according to approved methods (at least once a year);
- control of microclimate parameters (at least once a year);
- air control working area at waste decontamination/neutralization areas for volatile content toxic substances(carried out in accordance with technological regulations equipment).

X. Requirements for organizing a site for the management of medical waste of classes B and C

10.1. The waste management site for classes B and C is structural unit 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 carries out the collection, accumulation, hardware disinfection/neutralization, disposal of waste of classes B and C. The location of the site as part of medical units is not allowed (except for premises for disinfection in laboratories that work with pathogens 1 - 4 pathogenicity groups). The composition and minimum area of ​​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 either in a separate building in an economic zone with access roads, or as part of a building, including in basements with autonomous exhaust ventilation (with the exception of installations for waste disposal by incineration and pyrolysis). Distance from residential and public buildings to a site equipped with an installation for waste destruction by incineration, pyrolysis is determined in accordance with legal requirements.
The site must be provided with sewerage, water supply, electricity, heating and autonomous ventilation. Space planning and Constructive decisions premises of the site must ensure the flow of the technological process and the ability to comply with the principle of separation into “clean” and “dirty” zones.
Reception, processing (neutralization or disinfection), temporary storage (accumulation) of waste, washing and disinfection of trolley racks, containers and other equipment used to move waste are carried out on the site.

10.3. Requirements for site premises.
The premises of the site provide for a conditional division into zones:
- “dirty”, which includes a room for receiving and temporary storage of incoming medical waste, a waste treatment room equipped with installations for the disinfection/neutralization of waste of classes B and C, a washing and disinfection room. For small volumes, it is possible to temporarily store incoming waste and disinfect it in one room. When storing waste of classes B and C for more than 24 hours, refrigeration equipment is provided.
- “clean”, which includes storage rooms for disinfected/neutralized waste, washed and disinfected means of transporting waste (joint temporary storage in one room is possible), a warehouse for consumables, a staff room, a bathroom, and a shower.
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 external and internal surfaces of furniture and equipment must be smooth, made of materials that are resistant to moisture, detergents and disinfectants.

10.5. Lighting requirements.
All premises are provided with combined or artificial lighting 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.
Lamps must have closed diffusers. Cleaning of lamps should be done at least 2 times a year.

10.6. Requirements for organizing air exchange.
The air exchange of the site premises 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 meet the requirements presented in Appendix 2 to these sanitary rules.
The ventilation device must prevent the flow of air masses from “dirty” areas (rooms) to “clean” ones.
Autonomous supply and exhaust ventilation with mechanical drive is provided in the premises of the site. The air exchange scheme is determined by the technological task. The frequency of air exchange in the hood and the need to install local suction are determined by calculation depending on the type, quantity and power of the technological equipment.
Exhaust ventilation with mechanical drive without an organized inflow device is provided from the premises of the “dirty” zone.

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

10.8. Requirements for water supply and sewerage.
The main production premises (for receiving and temporary storage of waste, decontamination, washing and disinfection of inventory and equipment) must be equipped with a watering tap and floor drains (pallets). A sink for hand washing is provided in the waste decontamination/disposal room.

10.9. Requirements for site equipment.
The arrangement of equipment should be carried out taking into account ensuring free access to all equipment. The distance from the walls to the equipment must 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.
Waste reception and temporary storage premises are equipped with scales.
Premises for temporary storage and disinfection/disposal of waste are equipped with bactericidal irradiators or other air disinfection devices.

10.10. Hygienic requirements to the maintenance of premises, equipment and inventory.
All premises, equipment, inventory must be kept clean. Routine cleaning is carried out using a wet method, at least once a day, using detergents and disinfectants. General cleaning is carried out at least once a month. Walls, furniture, technological equipment, floor. Use a rag soaked in a disinfectant solution to wipe the equipment, remove visible dirt from the walls, and then wash the floor.
Cleaning equipment, separate for the “clean” and “dirty” areas, must be clearly marked indicating the types of cleaning work, used strictly for their intended purpose and stored separately in storerooms or lockers of the main production premises.

Registration N 19871

Application

Sanitary and epidemiological rules and regulations
SanPiN 2.1.7.2790-10
"Sanitary and epidemiological requirements for the management of medical waste"
(approved by Resolution of the Chief State Sanitary Doctor of the Russian Federation dated December 9, 2010 N 163)

I. Scope and general provisions

1.1. Sanitary and epidemiological rules and regulations (hereinafter referred to as sanitary rules) have been 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, decontamination, rendering harmless, transportation) of waste generated in organizations during the implementation of medical and/or pharmaceutical activities, performance of therapeutic, diagnostic and health procedures (hereinafter referred to as medical waste ), as well as to the placement, equipment and operation of the site for handling medical waste, the sanitary and anti-epidemic regime of work when handling medical waste.

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

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

II. Classification of medical waste

class A - epidemiologically safe waste, similar in composition to municipal solid waste (hereinafter referred to as MSW);

class B - epidemiologically hazardous waste;

class B - extremely epidemiologically hazardous waste;

class G - toxicologically hazardous waste of hazard classes 1-4;

class D - radioactive waste.

Table 1

Hazard Class	Characteristics of morphological composition
(epidemiologically safe waste, composition close to solid waste)	Waste that does not come into contact with biological fluids of patients or infectious patients. Stationery, packaging, furniture, inventory, lost consumer properties. Estimates for cleaning the area and so on. Food waste from central catering units, as well as from all departments of an organization carrying out medical and/or pharmaceutical activities, except for infectious diseases, including phthisiatrics
(epidemiologically hazardous waste)	Infectious and potentially infectious waste. Materials and instruments, objects contaminated with blood and/or other biological fluids. Pathological and anatomical waste. Organic surgical waste (organs, tissues, etc.). 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 vivariums. Live vaccines not suitable for use
(extremely epidemiologically hazardous waste)	Materials that came into contact with patients infectious diseases, which can lead to emergency situations in the field of sanitary and epidemiological well-being of the population and require measures for sanitary protection of the territory. Waste from laboratories, pharmaceutical and immunobiological industries working with microorganisms of pathogenicity groups 1-2. Waste from treatment and diagnostic departments of phthisiatric hospitals (dispensaries), contaminated with the sputum of patients, waste from microbiological laboratories working with tuberculosis pathogens
(toxicologically hazardous waste of hazard classes 1-4)	Medicinal (including cytostatics), diagnostic, disinfectants that should not be used. Waste from the operation of equipment, transport, lighting systems and others
(radioactive waste)	All types of waste in any state of aggregation, in which the content of radionuclides exceeds the permissible levels established by radiation safety standards

______________________________

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

4.4. Personnel must work in special clothing and replaceable shoes, in which they are not allowed to leave the work premises. Personal clothing and workwear must be stored in separate closets.

4.5. The staff is provided with sets of workwear and personal protective equipment (robes/overalls, gloves, masks/respirators/protective shields, special shoes, aprons, oversleeves, etc.).

Workwear washing is carried out centrally. It is prohibited to wash workwear at home.

4.6. Waste is collected in reusable containers or disposable bags. The packages can be any color, with the exception of yellow and red. Disposable bags are placed on special carts or inside reusable containers. Waste collection containers and carts must be marked "Waste. Class A". Filled reusable containers or disposable bags are delivered using small-scale mechanization and reloaded into marked containers intended for collecting waste of this class, installed on a special site (room). Reusable containers must be washed and disinfected after emptying. 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 treatment scheme adopted for the given territory, in accordance with the requirements of sanitary legislation for the maintenance of populated areas and the management of production and consumption waste.

4.7. For organizations engaged in medical and/or pharmaceutical activities that discharge household wastewater into the city-wide sewerage system, the preferred system for removing food raw materials and prepared food waste from catering units and buffets classified as medical waste is the discharge of food waste into the city sewerage system by equipping the internal sewage system with food waste grinders (disposers).

If it is impossible to discharge food waste into the sewer system, food waste is collected separately from other waste in reusable containers or disposable bags installed in catering units, canteens and pantries. 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 solid waste landfills must be placed for temporary storage in reusable containers in disposable packaging.

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

Food waste (except for waste from ward departments of infectious diseases, including skin and venereal diseases and tuberculosis, special sanatoriums for the improvement of those who have recovered from infectious diseases) may be used in agriculture in accordance with the requirements of the legislation of the Russian Federation.

4.8. Waste, except food, can be removed from structural units using a garbage chute or pneumatic transport. It is not allowed to throw objects into the garbage chute that could lead to mechanical blocking (clogging) of the garbage chute. Waste must be disposed of in a garbage chute in packaged form.

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

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

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

4.9. Bulky waste is collected in special bulk 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. Waste is subject to mandatory disinfection (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 waste decontamination/neutralization site 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 its generation using chemical/physical methods.

4.11. Waste is collected in disposable soft (bags) or hard (puncture-resistant) packaging (containers) that are yellow or have yellow markings. The choice of packaging depends on the morphological composition of the waste.

Disposable, puncture-resistant, moisture-resistant containers should be used to collect sharps waste. The container must have a tight-fitting lid to prevent accidental opening.

To collect organic and liquid waste, disposable, puncture-proof, moisture-resistant containers with a lid (containers) should be used to ensure their sealing and prevent spontaneous opening.

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

4.12. Soft packaging (disposable bags) for waste collection must be secured to special trolley stands 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 to prevent waste from spilling out. Solid (impenetrable) containers are closed with lids. Moving Class B waste outside the unit in open containers is not permitted.

4.14. During the final packaging of waste for removal from the department (organization), disposable containers (bags, tanks) with waste of class B are marked with the inscription “Waste. Class B” with the name of the organization, department, date and name of the person responsible for collecting waste.

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

4.16. Medical waste from departments in closed disposable containers (bags) is placed in containers and then transported in them to a waste management site or a room for temporary storage of medical waste before subsequent transportation by specialized organizations to the place of decontamination/neutralization. Access by unauthorized persons to temporary storage areas for medical waste is prohibited.

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

4.17. When organizing sites for disinfection/neutralization of medical waste using hardware methods, the collection, temporary storage, and transportation of medical waste without prior disinfection at the places of generation is permitted, 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. Pathological, anatomical 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 medical waste packaged in special disposable containers (containers) from remote structural units (health centers, offices, first aid stations) and other places of medical care to a medical organization to ensure their subsequent disinfection/neutralization.

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

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

4.22. Waste is collected in disposable soft (bags) or hard (puncture-proof) packaging (containers) that are red or have red markings. 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 solid (puncture-proof) moisture-resistant sealed packaging (containers).

4.23. Soft packaging (disposable bags) for waste collection must be secured to special racks (carts) 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 waste from spilling out. Solid (impenetrable) containers are closed with lids. Moving Class B waste outside the unit in open containers is not permitted.

4.25. During the final packaging of waste for removal from the department, disposable containers (bags, tanks) with waste of class B are marked with the inscription “Waste. Class B” with the name of the organization, department, date and name of the person responsible for collecting waste.

4.26. 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 related to medical waste are collected in labeled containers with tight-fitting lids of any color (except yellow and red), which are stored in specially designated rooms.

4.28. Collection, temporary storage of waste cytostatics and genotoxic drugs and all types of waste generated as a result of the preparation of their solutions (bottles, ampoules, etc.), classified as medical waste, without decontamination are prohibited. Waste must be immediately decontaminated at the point of generation using special means. It is also necessary to decontaminate the workplace. Work with such waste must be carried out using special personal protective equipment and carried out in a fume hood.

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

4.29. Collection and temporary storage of waste is carried out in marked containers (“Waste. Class G”) in accordance with the requirements of regulatory documents, depending on the hazard class of the waste. 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, and disposal of waste are 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, and radiation safety standards.

4.31. Removal and neutralization of 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 reusable (inter-hull) containers for collecting waste, 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 and cut waste, including used intravenous infusion systems, in order to disinfect them;

Manually remove the needle from the syringe after use, put the cap on the needle after injection;

Pour (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 clothing;

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

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

4.34. If an employee receives an injury while handling medical waste that is potentially dangerous in terms of infection (an injection, a cut that breaks the integrity of the skin and/or mucous membranes), it is necessary to take emergency preventive measures. At the personnel workplace there should be a first aid kit for injuries.

4.35. The responsible person makes an entry in the emergency log, draws up an industrial accident report in the established 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, and indicates the persons who were present. at the site of injury, as well as the emergency prevention method used.

4.36. Notification, recording and investigation of cases of personnel infection with infectious disease agents associated with professional activities are carried out in accordance with established requirements.

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

5.1. The choice of methods for safe disinfection and/or disposal of waste depends on the capacity and profile of the medical organization, the availability of waste disinfection/neutralization facilities, and the method of waste neutralization/destruction adopted in the administrative territory (incineration, removal to landfills, disposal).

5.2. Disinfection/disposal of waste can be carried out in centralized or decentralized ways.

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

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

5.3. Waste is disinfected only in a decentralized manner; storage and transportation of non-disinfected Class B waste is not allowed.

5.4. The physical method of waste disinfection, including exposure to 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.

5.5. A chemical method of waste disinfection, including exposure to solutions of disinfectants that have bactericidal (including tuberculocidal), virucidal, fungicidal (sporicidal - as necessary) effects in appropriate modes, is used using special installations or by immersing waste in marked containers with a disinfectant solution in places of their formation.

5.6. Chemical disinfection of waste at the site of its 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 system for the neutralization of medical waste in a given administrative territory.

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

5.8. For any method of disinfection of 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 can be carried out in a decentralized manner (incinerators or other thermal treatment plants intended for use for these purposes). Thermal destruction of disinfected 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 manner, including as a separate section of a waste incineration plant.

5.10. With a decentralized method of neutralizing medical waste, 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 waste and 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, and medical products.

5.12. Disposal of neutralized waste at a landfill is allowed only if its presentation has changed (crushing, sintering, pressing, etc.) and it is impossible to reuse it.

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 conditions of temporary storage (accumulation) of medical waste

6.1. Waste collection at the places of its generation is carried out during the work shift. When using disposable containers for sharp instruments, they can be filled within 3 days.

6.2. Storage (accumulation) of food waste and non-disinfected class B waste for more than 24 hours is carried out in refrigeration or freezer compartments.

6.3. Disposable bags used for waste collection must allow the safe collection of no more than 10 kg of waste.

6.4. The accumulation and temporary storage of non-disinfected waste is carried out separately from waste of other classes in special premises that exclude access to unauthorized persons. In small medical organizations (health centers, offices, first aid stations, etc.), temporary storage and accumulation of waste of classes B and C 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 waste accumulation for other purposes is not permitted.

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

VII. Requirements for organizing the transportation of medical waste

7.1. Transportation of waste is organized taking into account the sanitary treatment scheme adopted for the given territory, in accordance with the requirements of sanitary legislation for the maintenance of populated areas and the management of production and consumption waste.

7.2. When transporting waste, it is permitted to use vehicles used for transporting solid household waste.

7.3. Reusable containers for transporting waste must be washed and disinfected at least once a week, for waste - after each emptying.

7.4. The organization transporting waste must have an area for washing, disinfecting and disinfesting containers and vehicles.

7.5. Specialized vehicles are used to transport non-disinfected waste; their use for other purposes is not permitted.

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

Federal Service for Supervision of Rights Protection
consumers and human well-being

2.1.7. SOIL, CLEANING PLACES,
PRODUCTION AND CONSUMPTION WASTE,
SOIL SANITARY PROTECTION

Sanitary and epidemiological requirements
to medical waste management

SanPiN 2.1.7.2790-10

MOSCOW
2011

1. Developed by the Federal Service for Supervision of Consumer Rights Protection and Human Welfare (O.I. Aksenova, A.V. Bormashov, A.L. Mishina); Research Institute of Human Ecology and Hygiene environment them. A.N. Sysina RAMS (N.V. Rusakov, I.A. Kryatov, G.I. Korotkova, A.Yu. Orlov, V.A. Mironova, D.E. Kadyrov, N.Yu. Starodubova, O.V. Ushakova , L.V. Kitaeva, V.N. Frolov); OJSC "Academy" utilities them. K.D. Pamfilova" (N.F. Abramov, V.N. Abramov); Federal State Institution “Research Institute of Disinfectology” of Rospotrebnadzor (L.G. Panteleeva, I.M. Abramova, L.S. Fedorova); GOU VPO MMA im. THEM. Sechenov (V.G. Akimkin); GOU DPO SPbMAPO Roszdrav (A.P. Shcherbo, O.V. Mironenko); FGUZ Federal Center hygiene and epidemiology (T.D. Kuzkina, O.P. Chernyavskaya, E.F. Opochinsky); Office of Rospotrebnadzor in Moscow (N.N. Filatov, S.G. Fokin, E.P. Igonina, L.S. Mamontova, N.A. Radchenko); Federal State Institution “TsGiE in Moscow” (A.V. Ivanenko, I.A. Khrapunova, O.A. Gruzdeva, O.P. Bezsmertnaya); Perm State Technical University (Ya.I. Vaisman, V.N. Korotaev); State Institution "Kaluga Regional Bureau" forensic medical examination(S.I. Lantsov); State Educational Institution of Higher Professional Education SPb State Medical Academy named after. I.I. Mechnikova (E.N. Kolosovskaya, G.B. Eremin, V.A. Nikonov); All-Russian public organization small and medium-sized enterprises “Support of Russia” (N.V. Ushakova).

2. Recommended for approval by the Commission on State Sanitary and Epidemiological Standards under Federal service on supervision in the field of consumer rights protection and human well-being (protocol dated October 14, 2010 No. 2).

3. Approved by the resolution of the Chief State Sanitary Doctor of the Russian Federation G.G. Onishchenko dated December 9, 2010 No. 163.

4. Registered with the Ministry of Justice of the Russian Federation on February 17, 2011, registration number 19871.

“State sanitary and epidemiological rules and regulations (hereinafter referred to as sanitary rules) - regulatory legal acts, establishing sanitary and epidemiological requirements (including criteria for the safety and (or) harmlessness of environmental factors for humans, hygienic and other standards), non-compliance with which creates a threat to human life or health, as well as the threat of the emergence and spread of diseases” (Article 1 ).

“Compliance with sanitary rules is mandatory for citizens, individual entrepreneurs and legal entities” (Article 39).

“For violation of sanitary legislation, disciplinary, administrative and criminal liability is established in accordance with the legislation of the Russian Federation” (Article 55).

RUSSIAN FEDERATION

RESOLUTION

12/9/2010 Moscow No. 163

On approval of SanPiN 2.1.7.2790-10

"Sanitary and epidemiological

application requirements

with medical waste"

52-FZ “On the sanitary and epidemiological welfare of the population” (Collected Legislation of the Russian Federation, 1999, No. 14, Art. 1650; 2002, No. 1 (Part 1), Art. 2; 2003, No. 2, Art. 167; No. 27 (Part 1), Article 2700; 2004, No. 35, Article 3607; 2005, No. 19, Article 1752; 2006, No. 1, Article 10; No. 52 (Part 1), Article 5498; 2007, No. 1 (Part 1), Article 21; No. 1 (Part 1), Article 29; No. 27, Article 3213; No. 46, Article 5554; No. 49, Article 6070; 2008, No. 24, Article 2801; No. 29 (Part 1), Article 3418; No. 30 (Part 2), Article 3616; No. 44, Article 4984; No. 52 (Part 1), Article 6223; 2009 , No. 1, Article 17; 2010, No. 40, Article 4969) and the Decree of the Government of the Russian Federation dated July 24, 2000 No. “On approval of the Regulations on the State Sanitary and Epidemiological Service of the Russian Federation and the Regulations on State Sanitary and Epidemiological Standardization” (Meeting Legislation of the Russian Federation, 2000, No. 31, Article 3295; 2004, No. 8, Article 663; No. 47, Article 4666; 2005, No. 39, Article 3953)

I DECIDE:

Approve 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

CHIEF STATE SANITARY DOCTOR

RUSSIAN FEDERATION

RESOLUTION

4.03.2011 Moscow No. 18

“Rules for collection, storage and disposal of waste

medical and preventive institutions"

In accordance with the Federal Law of March 30, 1999 No. 52-FZ “On the sanitary and epidemiological welfare of the population” (Collected Legislation of the Russian Federation, 1999, No. 14, Art. 1650; 2002, No. 1 (Part 1), Art. 2; 2003, No. 2, Article 167; No. 27 (Part 1), Article 2700; 2004, No. 35, Article 3607; 2005, No. 19, Article 1752; 2006, No. 1, Article 10; No. 52 (Part 1), Article 5498; 2007, No. 1 (Part 1), Article 21; No. 1 (Part 1), Article 29; No. 27, Article 3213; No. 46, Article 5554; No. 49, Article 6070; 2008, No. 24, Article 2801; No. 29 (Part 1), Article 3418; No. 30 (Part 2), Article 3616; No. 44, Article 4984; No. 52 ( Part 1), Article 6223; 2009, No. 1, Article 17; 2010, No. 40, Article 4969; 2011, No. 1, Article 6) and Decree of the Government of the Russian Federation dated July 24, 2000 No. “On approval of the Regulations on the state sanitary and epidemiological service of the Russian Federation and the Regulations on state sanitary and epidemiological regulation" (Collected Legislation of the Russian Federation, 2000, No. 31, Art. 3295; 2004, No. 8, Art. 663; No. 47, Art. 4666; 2005, No. 39, Art. 3953)

I DECIDE:

Since the introduction of sanitary and epidemiological rules and regulations SanPiN 2.1.7.2790-10 “Sanitary and epidemiological requirements for the management of medical waste”, approved by the Decree of the Chief State Sanitary Doctor of December 9, 2010 No. 163 and registered by the Ministry of Justice of Russia on February 17, 2011, registration number 19871 , consider the sanitary rules and norms SanPiN 2.1.7.728-99 “Rules for the collection, storage and disposal of waste from medical institutions”, approved by the Decree of the Chief State Sanitary Doctor No. 2 of January 22, 1999, as no longer in force, as amended by the Decree of the Chief State Sanitary Doctor dated March 16, 2009 No. 15 “On approval of SanPiN 2.1.7.2527-09 “Changes 1 to sanitary rules and regulations SanPiN 2.1.7.728-99 “Rules for the collection, storage and disposal of waste from medical institutions.”

Application

2.1.7. SOIL, CLEANING PLACES, PRODUCTION AND CONSUMPTION WASTE, SOIL SANITARY PROTECTION

Sanitary and epidemiological requirements for the management of medical waste

Sanitary and epidemiological rules and regulations

Class A- epidemiologically safe waste, similar in composition to municipal solid waste (hereinafter referred to as MSW).

Class B- epidemiologically hazardous waste.

Class IN- extremely epidemiologically hazardous waste.

Class G- toxicologically hazardous waste of hazard classes 1 - 4.

Class D- radioactive waste.

Table 1

	Characteristics of morphological composition
Class A (epidemiologically safe waste, composition close to solid waste)	Waste that does not come into contact with biological fluids of patients or infectious patients. Stationery, packaging, furniture, equipment that have lost their consumer properties. Estimates for cleaning the area, etc. Food waste from central catering units, as well as from all departments of an organization carrying out medical and/or pharmaceutical activities, except for infectious diseases, incl. phthisiatric
Class B (epidemiologically hazardous waste)	Infectious and potentially infectious waste. Materials and instruments, objects contaminated with blood and/or other biological fluids. Pathological and anatomical waste. Organic surgical waste (organs, tissues, etc.). Food waste from infectious diseases departments. Waste from microbiological, clinical diagnostic laboratories, pharmaceutical, immunobiological industries working with microorganisms of the 3rd - 4th pathogenicity groups. Biological waste from vivariums. Live vaccines not suitable for use
Class B (extremely epidemiologically hazardous waste)	Materials that have been in contact with patients with infectious diseases, which can lead to emergencies in the field of sanitary and epidemiological well-being of the population and require measures for sanitary protection of the territory. Waste from laboratories, pharmaceutical and immunobiological industries working with microorganisms of pathogenicity groups 1 - 2. Waste from treatment and diagnostic departments of phthisiatric hospitals (dispensaries), contaminated with the sputum of patients, waste from microbiological laboratories working with tuberculosis pathogens
Class G (toxicologically hazardous waste 1 - 4 hazard classes*)	Medicinal (including cytostatics), diagnostic, disinfectants that should not be used. Waste from the operation of equipment, transport, lighting systems and others
Class D Radioactive waste	All types of waste, in any state of aggregation, in which the content of radionuclides exceeds the permissible levels established by radiation safety standards
Name of premises Minimum area, m2 Reception and temporary storage (accumulation) of non-disinfected waste depending on the dimensions of the equipment, but not less than 12 Temporary storage of processed waste (premises are provided if there are no conditions for storage on site) depending on the power of the site, but not less than 6 Consumables warehouse Sanitary facilities (dressing room, shower, toilet, storage of cleaning equipment) Notes: * For newly constructed and reconstructed buildings. ** When the volume of processed waste is up to 200 liters per day, the presence of minimum set premises consisting of two zones in accordance with clause 10.3.1.		Workroom for waste disinfection		based on the removal of heat and moisture excess*	according to the calculation of heat and moisture excess*	not allowed
	Temporary storage of treated waste				not allowed
	Washing and disinfection of containers, racks, trolleys				not allowed
	Temporary storage room for containers, racks, trolleys
	Consumables warehouse
	Sanitary facilities (wardrobe shower, bathroom, storage of cleaning equipment)		influx from the corridor	75 m3/h at 1 d.s.
	Staff room with workplace

Note:

*Depending on technology and type of equipment.

Appendix 3
(informative)

Name of structural unit_______________________

Appendix 4
(informative)

Name of company______________________________________

Appendix 6
(informative)

Production and consumption waste- remains of raw materials, materials, semi-finished products, other items or products that were formed in the process of production or consumption, as well as goods (products) that have lost their consumer properties.

Waste disposal- waste treatment using technologies leading to the loss of all dangerous properties waste in order to prevent it harmful effects on human health and the environment.

Disinfection (disinfection) of waste- disinfection of waste, which consists in the destruction (killing) of pathogenic and conditionally pathogenic microorganisms contained in waste in order to eliminate its epidemiological danger. Disinfection of waste is carried out by appropriate physical and/or chemical methods waste processing (including the hardware method - in specialized installations).

Waste collection- acceptance or receipt of waste from individuals and legal entities for the purpose of further use, neutralization, transportation, and disposal of such waste.

Waste accumulation- temporary storage of waste in places (sites) equipped in accordance with the requirements of legislation in the field of environmental protection and legislation in the field of ensuring the sanitary and epidemiological well-being of the population, for the purpose of their further use, neutralization, disposal, transportation.

Waste disposal- storage and disposal of waste.

Waste storage- maintenance of waste in waste disposal facilities for the purpose of their subsequent burials, disposal or use.

Waste disposal- isolation of waste that is not subject to further use in special storage facilities in order to prevent the entry harmful substances into the natural environment.

Transportation of waste- movement of waste using vehicles outside borders land plot owned legal entity or individual entrepreneur or provided to them under other rights.

Recycling- use of production and consumption waste as secondary resources after appropriate processing. Used waste includes waste that is used in the national economy as raw materials or additives to raw materials for the production of products, as well as as fuel, feed and fertilizers.

Waste use- use of waste for the production of goods (products), performance of work, provision of services or for energy production.

Type of waste- a collection of waste that have common characteristics in accordance with the waste classification system.

Medical waste treatment plants- specialized installations for incineration and disinfection and/or disposal of waste, their processing, permitted for use in the Russian Federation in accordance with the established procedure.

Individual protection means- technical means, materials, including clothing, used to prevent or reduce exposure of workers to harmful or dangerous production factors, as well as to protect against pollution.

Bibliographic data

1. Federal Law of March 30, 1999 No. 52-FZ “On the sanitary and epidemiological welfare of the population.”

2. SanPiN 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations engaged in medical activities.”

3. SanPiN 2.2.1/2.1.1.1278-03 “Hygienic requirements for natural, artificial and combined lighting of public and residential buildings.” “Hygienic requirements for the placement and disposal of production and consumption waste.” “Sanitary and epidemiological requirements for the conditions of transportation, storage and dispensing to citizens of medical immunobiological preparations used for immunoprophylaxis by pharmacies and healthcare institutions” (with amendments and additions).

12. SP 3.3.2.1248-03 “Conditions for transportation and storage of medical immunobiological preparations” (with amendments and additions).

13. SP 3.3.2342-08 “Ensuring the safety of immunization.”

14. SanPiN 2.2.1/2.1.1.1200-03 “Sanitary protection zones and sanitary classification of enterprises, structures and other objects” (updated edition).

15. SanPiN 2.1.1279-03 “Hygienic requirements for the placement, arrangement and maintenance of cemeteries, buildings and structures for funeral purposes.”

16. SP 1.3.1285-03 “Safety of working with microorganisms of I - II pathogenicity (hazard) groups.”

Of the total amount of waste medical make up about 2-3%, but this is one of the most hazardous wastes. Therefore, the issue of their disposal is taken very seriously. Medical waste has its own structure and classification, according to which medical waste is recorded, collected, stored and disposed of.

Waste composition

1. Plastic. This category includes medical devices such as syringes, droppers and other disposable devices. They do not pose any danger in themselves, but they may contain drug residues that can cause great harm.
2. Paper. The safest waste material, since it mainly consists of packaging. But paper cannot be treated with disdain either: you never know what was packed in them.
3. Food service waste. As a rule, these are all unused products.
4. Glass. This category includes various types of ampoules, test tubes, medical equipment.
5. Biological material.
6. Chemical substances. These are the drugs themselves and the components of medical devices.

All components of medical waste are great danger for the population. That is why they are disinfected or completely destroyed before disposal. After all, some elements could come into direct contact with patients with dangerous viral and infectious diseases, and therefore pose a danger to healthy people.

In addition, medical waste can be divided into other groups:

Biological waste. These are various tissues and organs that are formed during medical and veterinary practice. This may be post-operative waste or resulting from the death of livestock. This type of waste is also found in hairdressing salons, fitness centers and other similar organizations. The most effective and reliable with medical point The main way is to use special combustion furnaces.

Medical waste. This waste occurs in healthcare settings, such as blood donation centers, pharmacies, nursing homes, and pharmaceutical manufacturing.

Waste from medical and preventive departments. Waste from pharmacies, pharmaceutical factories, as well as medical and preventive departments. Such waste may be drugs or equipment that have already been used, are expired, or are otherwise unusable.

Hazard classes of medical waste

In addition to its constituent units, medical waste is classified according to SanPiN 2.1.7.2790-10 according to the degree of hazard, since each group requires its own methods of handling and disposal. Therefore, in all medical institutions there are several containers for each group of waste, colored according to the classifier.

• Class A waste. This is the least hazardous category of waste. Uninfected paper, furniture, damaged equipment, food waste(this should not include waste from dermatovenerological and infectious diseases departments), construction garbage and all other non-toxic objects are all components of Class A waste. They are indicated in white. Like any other waste, it can be disposed of in solid waste landfills.
• Class B waste. Hazardous waste. As a rule, this is waste from infectious diseases departments, instruments that have been in contact with patients, contaminated with hazardous liquids, waste from microbiological laboratories not exceeding 3-4 levels of pathogenicity, as well as waste from pathology and surgical departments. Designated yellow. Waste in this category is placed in medical waste bags and sorted into a separate yellow container and must undergo a disinfection process before disposal, as it can cause harm.

Medical waste disposal bags are designed for classes (A, B, C and D), are available in different colors, and have two layers. Outer layer – polyethylene low pressure, providing excellent strength of the bag, the inner layer is elastic, thanks to polyethylene high pressure. 100% - the tightness of the bags is ensured by a tie - a tie, which is a mandatory element of the bags.

• Class B waste. Extremely hazardous waste. This is equipment that has been in direct contact with patients with severe viral diseases, waste of 1-2 pathogenicity groups. This also includes waste from mycological and physiatry departments, as well as waste that has been in contact with patients with anaerobic infections. Indicated in red. To ensure that waste of this class does not harm anyone, it is disinfected in special installations - recycling units, often this equipment is located within medical institution. Their transportation in any other form is strictly prohibited.
• Class G waste. Various expired drugs, chemicals and cytostatics, mercury. In terms of danger, this waste is close to industrial waste, it is very toxic and poses a great threat. Indicated in black. The removal and disposal of waste of this category in accordance with the rules for handling medical waste is carried out exclusively by specialists.
• Class D waste – . Disposal of class D waste is similar to class G.

According to the rules for handling medical waste, a mandatory document must be drawn up for waste - a passport; without it, any actions with hazardous waste are prohibited by law. The director of the enterprise is responsible for drawing up the passport.

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Federal Service for Supervision of Rights Protection
consumers and human well-being

2.1.7. SOIL, CLEANING PLACES,
PRODUCTION AND CONSUMPTION WASTE,
SOIL SANITARY PROTECTION

Sanitary and epidemiological requirements
to medical waste management

SanPiN 2.1.7.2790-10

MOSCOW
2011

1. Developed by the Federal Service for Supervision of Consumer Rights Protection and Human Welfare (O.I. Aksenova, A.V. Bormashov, A.L. Mishina); Research Institute of Human Ecology and Environmental Hygiene named after. A.N. Sysina RAMS (N.V. Rusakov, I.A. Kryatov, G.I. Korotkova, A.Yu. Orlov, V.A. Mironova, D.E. Kadyrov, N.Yu. Starodubova, O.V. Ushakova , L.V. Kitaeva, V.N. Frolov); OJSC Academy of Public Utilities named after. K.D. Pamfilova" (N.F. Abramov, V.N. Abramov); Federal State Institution “Research Institute of Disinfectology” of Rospotrebnadzor (L.G. Panteleeva, I.M. Abramova, L.S. Fedorova); GOU VPO MMA im. THEM. Sechenov (V.G. Akimkin); GOU DPO SPbMAPO Roszdrav (A.P. Shcherbo, O.V. Mironenko); Federal State Health Institution Federal Center for Hygiene and Epidemiology (T.D. Kuzkina, O.P. Chernyavskaya, E.F. Opochinsky); Office of Rospotrebnadzor in Moscow (N.N. Filatov, S.G. Fokin, E.P. Igonina, L.S. Mamontova, N.A. Radchenko); Federal State Institution “TsGiE in Moscow” (A.V. Ivanenko, I.A. Khrapunova, O.A. Gruzdeva, O.P. Bezsmertnaya); Perm State Technical University (Ya.I. Vaisman, V.N. Korotaev); State Healthcare Institution “Kaluga Regional Bureau of Forensic Medicine (S.I. Lantsov); State Educational Institution of Higher Professional Education SPb State Medical Academy named after. I.I. Mechnikova (E.N. Kolosovskaya, G.B. Eremin, V.A. Nikonov); All-Russian public organization of small and medium-sized businesses “Support of Russia” (N.V. Ushakova).

2. Recommended for approval by the Commission on State Sanitary and Epidemiological Standards under the Federal Service for Surveillance in the Sphere of Consumer Rights Protection and Human Welfare (Minutes dated October 14, 2010 No. 2).

3. Approved by the resolution of the Chief State Sanitary Doctor of the Russian Federation G.G. Onishchenko dated December 9, 2010 No. 163.

4. Registered with the Ministry of Justice of the Russian Federation on February 17, 2011, registration number 19871.

“State sanitary and epidemiological rules and regulations (hereinafter referred to as sanitary rules) - regulatory legal acts establishing sanitary and epidemiological requirements (including criteria for the safety and (or) harmlessness of environmental factors for humans, hygienic and other standards), non-compliance with which creates threat to human life or health, as well as the threat of the occurrence and spread of diseases” (Article 1).

“Compliance with sanitary rules is mandatory for citizens, individual entrepreneurs and legal entities” (Article 39).

“For violation of sanitary legislation, disciplinary, administrative and criminal liability is established in accordance with the legislation of the Russian Federation” (Article 55).

RUSSIAN FEDERATION

RESOLUTION

12/9/2010 Moscow No. 163

On approval of SanPiN 2.1.7.2790-10

"Sanitary and epidemiological

application requirements

with medical waste"

52-FZ “On the sanitary and epidemiological welfare of the population” (Collected Legislation of the Russian Federation, 1999, No. 14, Art. 1650; 2002, No. 1 (Part 1), Art. 2; 2003, No. 2, Art. 167; No. 27 (Part 1), Article 2700; 2004, No. 35, Article 3607; 2005, No. 19, Article 1752; 2006, No. 1, Article 10; No. 52 (Part 1), Article 5498; 2007, No. 1 (Part 1), Article 21; No. 1 (Part 1), Article 29; No. 27, Article 3213; No. 46, Article 5554; No. 49, Article 6070; 2008, No. 24, Article 2801; No. 29 (Part 1), Article 3418; No. 30 (Part 2), Article 3616; No. 44, Article 4984; No. 52 (Part 1), Article 6223; 2009 , No. 1, Article 17; 2010, No. 40, Article 4969) and the Decree of the Government of the Russian Federation dated July 24, 2000 No. “On approval of the Regulations on the State Sanitary and Epidemiological Service of the Russian Federation and the Regulations on State Sanitary and Epidemiological Standardization” (Meeting Legislation of the Russian Federation, 2000, No. 31, Article 3295; 2004, No. 8, Article 663; No. 47, Article 4666; 2005, No. 39, Article 3953)

I DECIDE:

Approve 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

CHIEF STATE SANITARY DOCTOR

RUSSIAN FEDERATION

RESOLUTION

4.03.2011 Moscow No. 18

“Rules for collection, storage and disposal of waste

medical and preventive institutions"

In accordance with the Federal Law of March 30, 1999 No. 52-FZ “On the sanitary and epidemiological welfare of the population” (Collected Legislation of the Russian Federation, 1999, No. 14, Art. 1650; 2002, No. 1 (Part 1), Art. 2; 2003, No. 2, Article 167; No. 27 (Part 1), Article 2700; 2004, No. 35, Article 3607; 2005, No. 19, Article 1752; 2006, No. 1, Article 10; No. 52 (Part 1), Article 5498; 2007, No. 1 (Part 1), Article 21; No. 1 (Part 1), Article 29; No. 27, Article 3213; No. 46, Article 5554; No. 49, Article 6070; 2008, No. 24, Article 2801; No. 29 (Part 1), Article 3418; No. 30 (Part 2), Article 3616; No. 44, Article 4984; No. 52 ( Part 1), Article 6223; 2009, No. 1, Article 17; 2010, No. 40, Article 4969; 2011, No. 1, Article 6) and Decree of the Government of the Russian Federation dated July 24, 2000 No. “On approval of the Regulations on the state sanitary and epidemiological service of the Russian Federation and the Regulations on state sanitary and epidemiological regulation" (Collected Legislation of the Russian Federation, 2000, No. 31, Art. 3295; 2004, No. 8, Art. 663; No. 47, Art. 4666; 2005, No. 39, Art. 3953)

I DECIDE:

Since the introduction of sanitary and epidemiological rules and regulations SanPiN 2.1.7.2790-10 “Sanitary and epidemiological requirements for the management of medical waste”, approved by the Decree of the Chief State Sanitary Doctor of December 9, 2010 No. 163 and registered by the Ministry of Justice of Russia on February 17, 2011, registration number 19871 , consider the sanitary rules and norms SanPiN 2.1.7.728-99 “Rules for the collection, storage and disposal of waste from medical institutions”, approved by the Decree of the Chief State Sanitary Doctor No. 2 of January 22, 1999, as no longer in force, as amended by the Decree of the Chief State Sanitary Doctor dated March 16, 2009 No. 15 “On approval of SanPiN 2.1.7.2527-09 “Changes 1 to sanitary rules and regulations SanPiN 2.1.7.728-99 “Rules for the collection, storage and disposal of waste from medical institutions.”

G.G. Onishchenko

I. Scope and general provisions. 4 II. Classification of medical waste. 4 III. Requirements for organizing a medical waste management system. 5 IV. Requirements for the collection of medical waste. 6 V. Methods and methods of disinfection and/or neutralization of medical waste of classes B and C.. 11 VI. Requirements for conditions of temporary storage (accumulation) of medical waste. 12 VII. Requirements for organizing the transportation of medical waste. 12 VIII. Accounting and control over the movement of medical waste. 13 IX. Production control. 14 X. Requirements for organizing a site for the management of medical waste of classes B and C.. 14 Appendix 1. Composition and minimum area of ​​premises in the waste management area of ​​classes B and C.. 16 Appendix 2. Design temperatures, air exchange rates in the premises of the medical waste management area of ​​classes B and C.. 16 Appendix 3. Technological log of class B and C waste in a structural unit. 17 Appendix 4. Technological log of waste of classes B and C of the organization. 17 Appendix 5. Technological log of the waste treatment site of classes B and C.. 17 Appendix 6. Terms and definitions. 18 Bibliographic data. 19

Application

2.1.7. SOIL, CLEANING PLACES, PRODUCTION AND CONSUMPTION WASTE, SOIL SANITARY PROTECTION

Sanitary and epidemiological requirements for 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 referred to as sanitary rules) have been 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, decontamination, rendering harmless, transportation) of waste generated in organizations during the implementation of medical and/or pharmaceutical activities, performance of therapeutic, diagnostic and health procedures (hereinafter referred to as medical waste ), as well as to the placement, equipment and operation of the site for handling medical waste, the sanitary and anti-epidemic regime of work when handling medical waste.

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

1.4. Control (supervision) over compliance with these sanitary rules is carried out by bodies exercising control and supervision functions in the field of ensuring the sanitary and epidemiological well-being 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 its epidemiological, toxicological and radiation hazard, as well as negative impact on the environment, is divided into five hazard classes (Table 1):

Class A- epidemiologically safe waste, similar in composition to municipal solid waste (hereinafter referred to as MSW).

Class B- epidemiologically hazardous waste.

Class IN- extremely epidemiologically hazardous waste.

Class G- toxicologically hazardous waste of hazard classes 1 - 4.

Class D- radioactive waste.

Table 1

Hazard Class	Characteristics of morphological composition
Class A (epidemiologically safe waste, composition close to solid waste)	Waste that does not come into contact with biological fluids of patients or infectious patients. Stationery, packaging, furniture, equipment that have lost their consumer properties. Estimates for cleaning the area, etc. Food waste from central catering units, as well as from all departments of an organization carrying out medical and/or pharmaceutical activities, except for infectious diseases, incl. phthisiatric
Class B (epidemiologically hazardous waste)	Infectious and potentially infectious waste. Materials and instruments, objects contaminated with blood and/or other biological fluids. Pathological and anatomical waste. Organic surgical waste (organs, tissues, etc.). Food waste from infectious diseases departments. Waste from microbiological, clinical diagnostic laboratories, pharmaceutical, immunobiological industries working with microorganisms of the 3rd - 4th pathogenicity groups. Biological waste from vivariums. Live vaccines not suitable for use
Class B (extremely epidemiologically hazardous waste)	Materials that have been in contact with patients with infectious diseases, which can lead to emergencies in the field of sanitary and epidemiological well-being of the population and require measures for sanitary protection of the territory. Waste from laboratories, pharmaceutical and immunobiological industries working with microorganisms of pathogenicity groups 1 - 2. Waste from treatment and diagnostic departments of phthisiatric hospitals (dispensaries), contaminated with the sputum of patients, waste from microbiological laboratories working with tuberculosis pathogens
Class G (toxicologically hazardous waste 1 - 4 classes * hazard)	Medicinal (including cytostatics), diagnostic, disinfectants that should not be used. Waste from the operation of equipment, transport, lighting systems and others
Class D Radioactive waste	All types of waste, in any state of aggregation, in which the content of radionuclides exceeds the permissible levels established by radiation safety standards
* in accordance with SP 2.1.7.1386-03 “Sanitary rules for determining the hazard class toxic waste production and consumption" (registered by the Ministry of Justice of Russia on June 19, 2003, registration number 4755, with amendments registered by the Ministry of Justice of Russia on February 12, 2010, registration number 16389).

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 buried together with waste of class A. Packaging of disinfected medical waste of classes B and C must be marked indicating that the waste has been disinfected.

III. Requirements for organizing a medical waste management system

3.1. The system for collection, temporary storage and transportation of medical waste should include the following stages:

Waste collection within organizations engaged in medical and/or pharmaceutical activities;

Transfer of waste from departments and temporary storage of waste on the territory of the organization generating the waste;

Disinfection/neutralization;

Transportation of waste from the territory of the organization generating the waste;

Disposal or destruction of medical waste.

3.2. The head of an organization carrying out medical and/or pharmaceutical activities approves instructions that define 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 (carts, elevators, lifts, trucks, etc.).

3.5. It is not permitted to involve persons who have not undergone preliminary training in the safe handling of medical waste for work on the management of medical waste.

3.6. Collection, temporary storage and removal of waste should be carried out in accordance with the medical waste management scheme adopted by the given 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;

Medical waste generation standards developed and adopted in the region;

The need for consumables and containers for collecting medical waste based on the requirement to change bags once a shift (at least once every 8 hours), disposable containers for sharp instruments - at least 72 hours, in operating rooms - after each operation;

Procedure for collecting medical waste;

The procedure and places for temporary storage (accumulation) of medical waste, the frequency of their removal;

Methods used for disinfection/neutralization and disposal of medical waste;

Procedure for personnel actions in case of violation of the integrity of the packaging (scattering, spilling of medical waste);

Organization of hygienic training of personnel in epidemiological safety rules when handling medical waste.

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

IV. Requirements for the collection of medical waste

4.1. Persons under 18 years of age are not allowed to work with medical waste. Personnel undergo preliminary (upon 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 schedule of preventive vaccinations. Personnel who are not immunized against hepatitis B are not allowed to work with medical waste of classes B and C.

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

4.4. Personnel must work in special clothing and replaceable shoes, in which they are not allowed to leave the work premises. Personal clothing and workwear must be stored in separate closets.

4.5. The staff is provided with sets of workwear and personal protective equipment (robes/overalls, gloves, masks/respirators/protective shields, special shoes, aprons, oversleeves, etc.).

Workwear washing is carried out centrally. It is prohibited to wash workwear at home.

4.6. Class A waste is collected in reusable containers or disposable bags. The packages can be any color, with the exception of yellow and red. Disposable bags are placed on special carts or inside reusable containers. Waste collection containers and carts must be marked “Waste. Class A." Filled reusable containers or disposable bags are delivered using small-scale mechanization and reloaded into marked containers intended for collecting waste of this class, installed on a special site (room). Reusable containers must be washed and disinfected after emptying. 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 treatment scheme adopted for the given territory, in accordance with the requirements of sanitary legislation for the maintenance of populated areas and the management of production and consumption waste.

4.7. For organizations engaged in medical and/or pharmaceutical activities that discharge household wastewater into the city-wide sewerage system, the preferred system for removing food raw materials and prepared food waste from catering units and buffets, classified as Class A medical waste, is the discharge of food waste into the system city ​​sewerage by equipping the internal sewerage system with food waste grinders (disposers).

If it is impossible to discharge food waste into the sewer system, food waste is collected separately from other class A waste in reusable containers or disposable bags installed in catering units, canteens and pantries. 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 solid waste landfills must be placed for temporary storage in reusable containers in disposable packaging.

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

Food waste (except for waste from ward departments of infectious diseases, including skin and venereal diseases and tuberculosis, special sanatoriums for the improvement of those who have recovered from infectious diseases) may 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 throw objects into the garbage chute that could lead to mechanical blocking (clogging) of the garbage chute. Waste must be disposed of in a garbage chute in packaged form.

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

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

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

4.9. Bulky waste of class A is collected in special bins for bulky waste. 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 disinfection (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 disinfection/neutralization of Class B waste or a centralized system for neutralizing medical waste adopted in the administrative territory, Class B waste is disinfected by the personnel of this organization at the places of its generation using chemical/physical methods.

4.11. Class B waste is collected in disposable soft (bags) or hard (puncture-proof) packaging (containers) that are yellow or have yellow markings. The choice of packaging depends on the morphological composition of the waste.

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

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

In the case of using hardware disinfection methods in an organization carrying out medical and/or pharmaceutical activities, at workplaces it is allowed to collect class B waste in general containers (containers, bags): used syringes in unassembled form with preliminary separation of needles (to separate needles it is necessary to use needle removers , needle destructors, needle cutters), gloves, dressings, etc.

4.12. Soft packaging (disposable bags) for collecting Class B waste must be secured to special trolley racks or containers.

4.13. After filling the bag no more than 3/4, the employee responsible for waste collection in a given medical unit ties the bag or closes it using tie tags or other devices that prevent the spillage of Class B waste. Hard (pierce-resistant) containers are closed with lids. Moving Class B waste outside the unit in open containers is not permitted.

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

4.15. Disinfection of reusable containers for collecting 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 transported in them to a waste management site or to a room for temporary storage of medical waste before subsequent transportation by specialized organizations to the place of decontamination/neutralization. Access by unauthorized persons to temporary storage areas for medical waste is prohibited.

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

4.17. When organizing sites for disinfection/neutralization of medical waste using hardware methods, the collection, temporary storage, and transportation of medical waste of class B without prior disinfection at the places of generation is permitted, 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, incl. disposable packaging containers.

4.18. Pathological-anatomical and organic operational waste of class B (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 medical waste of class B, packaged in special disposable containers, from remote structural units (health centers, offices, first aid stations) and other places of medical care to a medical organization to ensure their subsequent disinfection/neutralization.

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

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

4.22. Class B waste is collected in disposable soft (bags) or hard (puncture-resistant) packaging (containers) that are red or have red markings. 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 solid (puncture-proof) moisture-resistant sealed packaging (containers).

4.23. Soft packaging (disposable bags) for collecting Class B waste must be secured to special racks (trolleys) or containers.

4.24. Once the bag is no more than 3/4 full, the employee responsible for waste collection at the given medical unit, in compliance with biological safety requirements, ties the bag or closes it using tie tags or other devices that prevent spillage of Class B waste. Hard (puncture-resistant) containers are closed with lids. Moving Class B waste outside the unit in open containers is not permitted.

4.25. During the final packaging of class B waste for removal 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, department, date and name 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, etc.), equipment classified as medical waste of class G are collected in labeled containers with tight-fitting lids of any color (except yellow and red), which are stored in specially designated rooms.

4.28. The collection and temporary storage of waste cytostatics and genotoxic drugs and all types of waste generated as a result of the preparation of their solutions (bottles, ampoules, etc.), classified as medical waste of class G, without decontamination is prohibited. Waste must be immediately decontaminated at the point of generation using special means. It is also necessary to decontaminate the workplace. Work with such waste must be carried out using special personal protective equipment and carried out in a fume hood.

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

4.29. Collection and temporary storage of Class G waste is carried out in marked containers (“Waste. Class G”) in accordance with the requirements of regulatory documents, depending on the hazard class of the waste. 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, and 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, and radiation safety standards.

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

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

4.33. When collecting medical waste it is prohibited:

Manually destroy and cut waste of classes B and C, incl. used intravenous infusion systems for the purpose of their disinfection;

Manually remove the needle from the syringe after use, put the cap on the needle after injection;

Pour (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 clothing;

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

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

4.34. If an employee receives an injury while handling medical waste that is potentially dangerous in terms of infection (an injection, a cut that breaks the integrity of the skin and/or mucous membranes), it is necessary to take emergency preventive measures. At the personnel workplace there should be a first aid kit for injuries.

4.35. The responsible person makes an entry in the emergency log, draws up an industrial accident report in the established 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, and indicates the persons who were present. at the site of injury, as well as the emergency prevention method used.

4.36. Notification, recording and investigation of cases of personnel infection with infectious disease agents associated with professional activities are carried out in accordance with established requirements.

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

5.1. The choice of methods for safe disinfection and/or neutralization of Class B waste depends on the capacity and profile of the medical organization, the availability of waste disinfection/neutralization facilities, and the method of waste neutralization/destruction adopted in the administrative territory (incineration, removal to landfills, disposal).

5.2. Disinfection/neutralization of class B waste can be carried out in centralized or decentralized ways.

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

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

5.3. Class B waste is disinfected only in a decentralized manner; storage and transportation of non-disinfected Class B waste is not allowed.

5.4. The physical method of disinfection of waste of classes B and C, including exposure to 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.

5.5. A chemical method for disinfecting waste of classes B and C, including exposure to solutions of disinfectants that have bactericidal (including tuberculocidal), virucidal, fungicidal (sporicidal - as necessary) effects in appropriate modes, is used using special installations or by immersing waste in marked containers with disinfectant solution in places of their formation.

5.6. Chemical disinfection of class B waste at the site of its generation is used as a mandatory temporary measure in the absence of a medical waste management site in organizations carrying out medical and/or pharmaceutical activities, or in the absence of a centralized system for the neutralization of medical waste in a given administrative territory.

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

5.8. For any method of disinfection of medical waste of classes B and C, 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 neutralization installations intended for use for these purposes). Thermal destruction of disinfected 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, incl. in a separate section of the 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. Application of recycling technologies, incl. with 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, and medical products.

5.12. Disposal of neutralized waste of class B and C at a landfill is permitted only if its presentation has changed (crushing, sintering, pressing, etc.) and it is impossible to reuse it.

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 conditions of temporary storage (accumulation) of medical waste

6.1. Waste collection at the places of its generation is carried out during the work shift. When using disposable containers for sharp instruments, they can be filled within 3 days.

6.2. Storage (accumulation) of food waste and non-disinfected class B waste for more than 24 hours is carried out in refrigeration or freezer compartments.

6.3. Disposable bags used for collecting waste of classes B and C must allow the safe collection of no more than 10 kg of waste.

6.4. The accumulation and temporary storage of non-disinfected waste of classes B and C is carried out separately from waste of other classes in special premises that exclude access to unauthorized persons. In small medical organizations (health centers, offices, medical and obstetric centers, etc.), temporary storage and accumulation of waste of classes B and C 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 waste accumulation for other purposes is not permitted.

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

VII. Requirements for organizing the transportation of medical waste

7.1. Transportation of class A waste is organized taking into account the sanitary treatment scheme adopted for the given territory, in accordance with the requirements of sanitary legislation for the maintenance of populated areas and the management of production and consumption waste.

7.2. When transporting Class A waste, the use of vehicles used for transporting solid household waste is permitted.

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

7.4. The organization transporting waste must have an area for washing, disinfecting and disinfesting containers and vehicles.

7.5. Specialized vehicles are used to transport non-disinfected Class B waste; their use for other purposes is not permitted.

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 transportation of non-disinfected waste of class B:

The driver's cabin must be separated from the car body;

The car body must be made of materials that are resistant to treatment with detergents and disinfectants, mechanical stress, have a smooth inner surface and be marked “Medical waste” on the outside;

If the duration of transportation of waste stored in freezers is more than 4 hours, refrigerated transport is provided;

The body must be equipped with devices for securing containers, loading and unloading them;

The vehicle must be provided with a set of means for emergency disinfection in the event of spillage of medical waste (bags, gloves, water, disinfectants, rags, etc.);

Transport transporting waste must be washed and disinfected at least once a week. Disinfection is carried out by irrigation from a hydraulic remote control, 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 specific disinfectant (protective clothing, respirators, safety glasses, rubber gloves);

The vehicle is equipped with mobile communications.

7.9. Personnel involved in the transportation of medical waste must undergo preliminary (upon 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 18 years of age and not immunized against hepatitis B are not allowed to handle medical waste of classes B and C.

7.10. Personnel involved in the transportation of medical waste are provided with sets of 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 waste of classes A, D, D is carried out in accordance with the requirements of the legislation of the Russian Federation.

8.2. To record medical waste of classes B and C, the following documents are used:

Technological log of waste of classes B and C in a structural unit - the log indicates the number of packaging units of each type of waste;

Technological log of medical waste of the organization. The log indicates the number of packaging units being exported and/or the weight of the waste, as well as information about their removal, indicating the organization carrying out the removal;

Documents confirming the removal and disposal of waste, issued by specialized organizations involved in transportation and disposal of waste;

Technological log of the waste management site, which is the main accounting and reporting document for this site.

IX. Production control

9.1. Legal entities and individual entrepreneurs operating in the field of waste management organize and carry out 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, and disposal of medical waste includes:

9.2.1) visual and documentary check (at least once a month):

Quantities of consumables (stock of bags, containers, etc.), small mechanization equipment, disinfectants;

Providing personnel with personal protective equipment, organizing centralized washing of work clothes and regular changes;

The sanitary condition and disinfection regime of temporary storage premises and/or medical waste management areas, garbage chutes, container sites;

Compliance with disinfection/neutralization regimes;

Regularity of waste removal;

9.2.2) laboratory and instrumental testing:

Microbiological monitoring of the effectiveness of waste disinfection/neutralization at installations according to approved methods (at least once a year);

Monitoring microclimate parameters (at least once a year);

Monitoring of the air in the working area at waste decontamination/neutralization areas for the content of volatile toxic substances (carried out in accordance with the technological regulations of the equipment).

X. Requirements for organizing a site for the management of medical waste of classes B and C

10.1. The waste management site 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 carries out the collection, accumulation, hardware disinfection/neutralization, disposal of waste of classes B and C. The location of the site as part of medical units is not allowed (except for premises for disinfection in laboratories that work with pathogens 1 - 4 pathogenicity groups). The composition and minimum area of ​​the premises of the site are presented in Appendix. 1 to these sanitary rules.

10.2. General requirements for the site.

The site can be located either in a separate building in a utility zone with access roads, or as part of a building, incl. in basements with autonomous exhaust ventilation (except for installations for waste disposal by incineration and pyrolysis). The distance from residential and public buildings to a site equipped with an installation for waste destruction by incineration and pyrolysis is determined in accordance with legal requirements.

The site must be provided with sewerage, water supply, electricity, heating and autonomous ventilation. Space-planning and design solutions for the premises of the site must ensure the flow of the technological process and the ability to comply with the principle of separation into “clean” and “dirty” zones.

Reception, processing (neutralization or disinfection), temporary storage (accumulation) of waste, washing and disinfection of trolley racks, containers and other equipment used to move waste are carried out on the site.

10.3. Requirements for site 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 installations for the disinfection/neutralization of waste of classes B and C, a washing and disinfection room. For small volumes, it is possible to temporarily store incoming waste and disinfect it in one room. When storing waste of classes B and C for more than 24 hours, refrigeration equipment is provided.

“clean”, which includes storage rooms for disinfected/neutralized waste, washed and disinfected means of transporting waste (joint temporary storage in one room is possible), a warehouse for consumables, a staff room, a bathroom, and a shower.

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 external and internal surfaces of furniture and equipment must be smooth, made of materials that are resistant to moisture, detergents and disinfectants.

10.5. Lighting requirements.

All premises are provided with combined or artificial lighting 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.

Lamps must have closed diffusers. Cleaning of lamps should be done at least 2 times a year.

10.6. Requirements for organizing 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 meet the requirements presented in the appendix. 2 to these sanitary rules.

The ventilation device must prevent the flow of air masses from “dirty” areas (rooms) to “clean” ones.

Autonomous supply and exhaust ventilation with mechanical drive is provided in the premises of the site. The air exchange scheme is determined by the technological task. The frequency of air exchange in the hood and the need to install local suction are determined by calculation depending on the type, quantity and power of the technological equipment.

Exhaust ventilation with mechanical drive without an organized inflow device is provided from the premises of the “dirty” zone.

10.7. Requirements for indoor microclimate.

The air temperature in production premises should be within 18 - 25 ° C, relative humidity no higher than 75%.

10.8. Requirements for water supply and sewerage.

The main production premises (for receiving and temporary storage of waste, decontamination, washing and disinfection of inventory and equipment) must be equipped with a watering tap and floor drains (pallets). A sink for hand washing is provided in the waste decontamination/disposal room.

10.9. Requirements for site equipment.

The arrangement of equipment should be carried out taking into account ensuring free access to all equipment. The distance from the walls to the equipment must be at least 0.6 m, and from the side of the service area - at least 1.0 m. The minimum dimensions of passages must be at least 0.6 m.

Waste reception and temporary storage premises are equipped with scales.

Temporary storage and waste decontamination/neutralization premises 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. Routine cleaning is carried out using a wet method, at least once a day, using detergents and disinfectants. General cleaning is carried out at least once a month. Walls, furniture, technological equipment, and floors are subject to treatment. Use a rag soaked in a disinfectant solution to wipe the equipment, remove visible dirt from the walls, and then wash the floor.

Cleaning equipment, separate for the “clean” and “dirty” areas, must be clearly marked indicating the types of cleaning work, used strictly for their intended purpose and stored separately in storerooms or lockers of the main production premises.

Annex 1

Composition and minimum area of ​​premises in the waste management area of ​​classes B and C *

	Name of premises	Minimum area, m 2
		depending on the dimensions of the equipment, but not less than 12
	Temporary storage of processed waste (premises are provided if there are no conditions for storage on site)	depending on the power of the site, but not less than 6
	Consumables warehouse
	Sanitary facilities (dressing room, shower, toilet, storage of cleaning equipment)

Notes:

* For newly constructed and reconstructed buildings.

** When the volume of processed waste is up to 200 liters per day, the presence of a minimum set of premises consisting of two zones is allowed in accordance with clause 10.3.1.

Appendix 2

Design temperatures, air exchange rates in the premises of the medical waste management area of ​​classes B and C

	Name of premises	Internal temperature, °C	Air exchange rate		Exhaust ratio with natural air exchange
	Reception and temporary storage (accumulation) of non-disinfected waste
	Workroom for waste disinfection		based on the removal of excess heat and moisture *	according to the calculation of heat and moisture excess *	not allowed
	Temporary storage of treated waste				not allowed
	Washing and disinfection of containers, racks, trolleys				not allowed
	Temporary storage room for containers, racks, trolleys
	Consumables warehouse
	Sanitary facilities (wardrobe shower, bathroom, storage of cleaning equipment)		influx from the corridor	75 m 3 / h at 1 d.s.
	Staff room with workplace

Note:

*Depending on technology and type of equipment.

Appendix 3
(informative)

Technological log of class B and C waste in a structural unit

Name of structural unit_______________________

Appendix 4
(informative)

Technological log of waste of classes B and C of the organization

Name of company______________________________________

Appendix 5
(informative)

Technological log of the waste treatment area of ​​classes B and C

Name of company ___________________________________

Appendix 6
(informative)

Terms and Definitions

Production and consumption waste- remains of raw materials, materials, semi-finished products, other items or products that were formed in the process of production or consumption, as well as goods (products) that have lost their consumer properties.

Waste disposal- processing of waste using technologies leading to the loss of all hazardous properties of waste in order to prevent their harmful effects on human health and the environment.

Disinfection (disinfection) of waste- disinfection of waste, which consists of the destruction (killing) of pathogenic and conditionally pathogenic microorganisms contained in waste in order to eliminate their epidemiological danger. Disinfection of waste is carried out by appropriate physical and/or chemical methods of waste treatment (including the hardware method - in specialized installations).

Waste collection- acceptance or receipt of waste from individuals and legal entities for the purpose of further use, neutralization, transportation, and disposal of such waste.

Waste accumulation- temporary storage of waste in places (sites) equipped in accordance with the requirements of legislation in the field of environmental protection and legislation in the field of ensuring the sanitary and epidemiological well-being of the population, for the purpose of their further use, neutralization, disposal, transportation.

Waste disposal- storage and disposal of waste.

Waste storage- maintenance of waste in waste disposal facilities for the purpose of their subsequent burials, disposal or use.

Waste disposal- isolation of waste that is not subject to further use in special storage facilities in order to prevent the release of harmful substances into the environment.

Transportation of waste- movement of waste using vehicles outside the boundaries of a land plot owned by a legal entity or individual entrepreneur or provided to them on other rights.

Recycling- use of production and consumption waste as secondary resources after appropriate processing. Used waste includes waste that is used in the national economy as raw materials or additives to raw materials for the production of products, as well as as fuel, feed and fertilizers.

Waste use- use of waste for the production of goods (products), performance of work, provision of services or for energy production.

Type of waste- a collection of waste that have common characteristics in accordance with the waste classification system.

Medical waste treatment plants- specialized installations for incineration and disinfection and/or disposal of waste, their processing, permitted for use in the Russian Federation in accordance with the established procedure.

Individual protection means- technical means, materials, including clothing, used to prevent or reduce exposure of workers to harmful or dangerous production factors, as well as to protect against pollution.

Bibliographic data

1. Federal Law of March 30, 1999 No. 52-FZ “On the sanitary and epidemiological welfare of the population.”

2. SanPiN 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations engaged in medical activities.”

3. SanPiN 2.2.1/2.1.1.1278-03 “Hygienic requirements for natural, artificial and combined lighting of public and residential buildings.” “Hygienic requirements for the placement and disposal of production and consumption waste.” “Sanitary and epidemiological requirements for the conditions of transportation, storage and dispensing to citizens of medical immunobiological preparations used for immunoprophylaxis by pharmacies and healthcare institutions” (with amendments and additions).

12. SP 3.3.2.1248-03 “Conditions for transportation and storage of medical immunobiological preparations” (with amendments and additions).

13. SP 3.3.2342-08 “Ensuring the safety of immunization.”

14. SanPiN 2.2.1/2.1.1.1200-03 “Sanitary protection zones and sanitary classification of enterprises, structures and other objects” (updated edition).

15. SanPiN 2.1.1279-03 “Hygienic requirements for the placement, arrangement and maintenance of cemeteries, buildings and structures for funeral purposes.”

16. SP 1.3.1285-03 “Safety of working with microorganisms of I - II pathogenicity (hazard) groups.”