Aesthetic and emotional considerations (originating during the early years of the HIV epidemic) have, however, figured into the development of treatment and disposal policies, particularly for pathology and anatomy wastes and sharps. 1400, 1401 This statement excludes, however, sharps injuries sustained during or immediately after the delivery of patient care before the sharp is “discarded.” Therefore, identifying wastes for which handling and disposal precautions are indicated is largely a matter of judgment about the relative risk of disease transmission, because no reasonable standards on which to base these determinations have been developed. 1397, 1398 Moreover, no epidemiologic evidence suggests that traditional waste-disposal practices of health-care facilities (whereby clinical and microbiological wastes were decontaminated on site before leaving the facility) have caused disease in either the health-care setting or the general community. 1399–1402 Although hospital wastes had a greater number of different bacterial species compared with residential waste, wastes from residences were more heavily contaminated. Several studies have compared the microbial load and the diversity of microorganisms in residential wastes and wastes obtained from a variety of health-care settings. No epidemiologic evidence suggests that most of the solid- or liquid wastes from hospitals, other healthcare facilities, or clinical/research laboratories is any more infective than residential waste.
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