63 
DR. CAPE: Dr. Gelfand has a couple of remarks. 
DR. FREDRICKSON: All right, he may substitute for you. His brevity is 
already on the record. 
DR. GELFAND: Two short points. The revised Guidelines do not require 
an autoclave within a P3 facility. They suggest that one could be there, 
and that there be an autoclave within the facility or within the building. 
In light of the fact that there are several large pressure-cooker-type 
autoclaves that are relatively inexpensive, we feel that it should be manda- 
tory to require an autoclave of this type within a P3 in order to assure 
sterilization of all liquid waste prior to removal. 
Second, with regard to a P4 facility there are certain types of double- 
door autoclaves which can be arranged such that once you put material into 
the autoclave it would be impossible to open the door from the other side 
without it having gone through a sterilization cycle. That is not required 
in the Guidelines; we feel it should be. 
DR. FREDRICKSON: Dr. Barkley, would you address Dr. Gelfand's first 
comment about the autoclave in the P3? We have talked about this before. 
DR. BARKLEY: I think the point is that we certainly would recommend 
and encourage an autoclave being installed within a P3 laboratory. We also 
recognize, however, that one can safely package waste and transport it to a 
site within the same building for effective sterilization. So the fact that 
that can be done safely needs to be considered in the development of Guide- 
lines . 
Now, autoclaves are terribly expensive things, and I would caution peo- 
ple about the statement that you made about the pressure cooker. The pres- 
sure cooker is a pressure cooker, and it can sterilize. It is used very 
effectively to sterilize instruments, but it should not be used to sterilize 
contaminated biological waste, because a pressure cooker has a relief valve, 
and that relief valve serves as an aerosol generator of the contaminant that 
you have within the pressure cooker. So the pressure cooker is not a substi- 
tute for an autoclave for handling contaminated waste. The fact that auto- 
claves may take you 12 to 18 months to get installed, one needs to recognize 
that there are other procedures that can allow-one to handle contaminated 
waste safely in P3 facilities. 
DR. FREDRICKSON: You had better get back to Cetus and get rid of that 
pressure cooker. 
(Laughter. ) 
DR. GELFAND: It is not a small-type pressure cooker. It is a big 
tank specifically designed for autoclaving, but I will describe it later. 
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