 North
Dakota
Medical
Waste
Background Information
Definition of Regulated Infectious Waste
Managing Regulated Infectious
Waste
OSHA Regulations
Statutes, Regulations and Guidelines
Contacts
More Information
Background Information
Medical waste differs from hazardous waste. Hazardous waste is regulated by the US EPA (and related state rules) under the Resource Conservation and Recovery Act. Medical waste is not covered federal environmental laws or US EPA regulations (with the exception of a medical waste that also meets the definition of hazardous waste). Rather, medical waste is mostly controlled by state law and associated regulations. In addition to state environmental agency laws/rules, aspects of medical waste management are also controlled by the Occupational Safety & Health Administration (federal and/or state) and Department of Transportation (federal and state).
Each of our 50 states have developed rules and implemented regulations for medical waste. The state rules vary to some extent, including terminology. Depending on which state you live in, you may hear the terms regulated medical waste, biohazardous waste or infectious medical waste. In most cases, these terms all refer to the same thing: that portion of the medical waste stream that may be contaminated by blood, body fluids or other potentially infectious materials, thus posing a significant risk of transmitting infection.
Most states have regulations covering packaging, storage, and transportation of medical waste. Some states require health care facilities to register and/or obtain a permit. State rules may also cover the development of contingency plans, on-site treatment, training, waste tracking, recordkeeping, and reporting.
In most states, the environmental protection agency is primarily responsible for developing and enforcing regulations for medical waste management and disposal. Although in some states, the department of health may play an important role or even serve as the primary regulatory agency. Where both agencies are involved, typically the department of health is responsible for on-site management and the environmental agency is responsible for transportation and disposal.
OSHA, whether it is the U.S. Department of Labor Occupational Safety & Health Administration or an OSHA state program (24 states operate their own program), regulates several aspects of medical waste, including management of sharps, requirements for containers that hold or store medical waste, labeling of medical waste bags/containers, and employee training. These standards are designed to protect healthcare workers from the risk of exposure to bloodborne pathogens. However, they also help to systematically manage wastes, which benefit the public and environment.
Regulated medical waste is defined by the US Department of Transportation as a hazardous material. DOT rules mostly apply to transporters rather than healthcare facilities; although, knowledge of these rules is important because of the liability associated with shipping waste off-site.
Definition of Regulated Infectious
Waste
Regulated infectious
waste is considered a solid waste and is defined as follows:
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Cultures and stocks
of infectious agents and associated biologicals, including cultures
from medical and pathological laboratories; cultures and stocks of
infectious agents from research and industrial laboratories; wastes
from the production of biologicals; discarded live and attenuated
vaccines; and culture dishes and devices used to transfer, inoculate,
and mix cultures.
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Pathological waste.
Human pathological waste, including tissues, organs, and body parts
and body fluids that are removed during surgery or autopsy, or other
medical procedures, and specimens of body fluids and their containers.
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Human blood and blood
products. Liquid waste human blood; products of blood; items saturated
or dripping with human blood; or items that were saturated or dripping
with human blood that are now caked with dried human blood (including
serum, plasma, and other blood components, and their containers).
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Sharps that have been
used in animal or human patient care or treatment or in medical,
research, or industrial laboratories, including hypodermic needles,
syringes (with or without the attached needle), pasteur pipettes,
scalpel blades, blood vials, needles with attached tubing, and culture
dishes (regardless of presence of infectious agents). Also included
are other types of broken or unbroken glassware that were in contact
with infectious agents, such as used slides and cover slips.
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Animal waste. Contaminated
animal carcasses, body parts, and bedding of animals that were known
to have been exposed to infectious agents during research (including
research in veterinary hospitals), production of biological, or testing
of pharmaceuticals.
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Isolation waste. Biological
waste and discarded materials contaminated with blood, excretion,
exudates, or secretions from humans who are isolated to protect others
from highly communicable diseases, or isolated animals known to be
infected with highly communicable diseases.
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Unused sharps. Unused,
discarded sharps, hypodermic needles, suture needles, and scalpel
blades.
Ash from incineration
and residues from disinfection processes are not infectious waste once
the incineration or the disinfection has been completed.
Managing Regulated Infectious
Waste
Every person who collects,
stores, transports, treats, or disposes of regulated infectious waste
shall comply with the following standards of performance.
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At the point of origin,
regulated infectious waste must be separated from other wastes and
placed in distinctive containers which do not leak and which are
impervious, puncture resistant, and tear resistant and which contain
obvious markings (for example, red or orange plastic bags or the
biohazard label). Bags and containers holding regulated infectious
waste must be tied, closed, or sealed securely to prevent leakage.
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At the point of origin,
sharps must be separated from other regulated infectious waste, disinfected
onsite, rendered non-sharp onsite, and then disposed; or, placed
in rigid and puncture-resistant biohazard containers and handled
as required.
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The handling and storage
of regulated infectious waste, before treatment, must be conducted
in a manner that minimizes exposure to employees of the waste generator,
the waste transporter, and the public.
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Recycled containers
or devices such as carts used for the handling of wastes must be
disinfected after each use.
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All regulated infectious
waste must be incinerated or disinfected and sharps that are not
incinerated must be rendered non-sharp before disposal. Incineration
and disinfection equipment and facilities shall meet all applicable
requirements.
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Blood and blood products
can be discarded without incineration or disinfection through municipal
sewage disposal systems that meet applicable requirements.
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The disposal of nonviable
human fetuses shall meet all applicable requirements.
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An infectious waste
that is not regulated may be disposed at a permitted municipal waste
landfill.
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Household waste containing
regulated infectious waste in amounts normally found in household
waste may be disposed of at a permitted municipal waste landfill.
General Requirements
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Any person who owns
or operates any premises, business establishment, or industry is
responsible for infectious waste management activities, such as storage,
transportation, resource recovery, or disposal, of infectious waste
generated or managed at that person's premises, business establishment,
or industry.
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No infectious waste
may be delivered to a facility that is not in compliance or abandoned
upon any street, alley, highway, public place, or private premises.
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Infectious waste must
be stored, collected, and transported in a manner that provides for
public safety, prevents uncontrolled introduction into the environment,
and minimizes harborage for insects, rats, or other vermin.
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Except in unincorporated
areas of this state, household waste must be removed from the premises
or containers at regular intervals not to exceed seven days and transported
to a solid waste management unit or facility.
Collection
and Transportation Vehicles
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Vehicles
used for the commercial collection and transportation of any residue,
sludge, agricultural, inert, industrial waste, or special waste must
be loaded and moved in such a manner that the contents will not fall,
leak, or spill there from. Where spillage does occur, the collector
or transporter shall immediately return spilled waste to the vehicle
or container and, if necessary, clean and decontaminate the area.
-
Vehicles used for
the commercial collection and transportation of regulated infectious
waste, household waste, or municipal waste incinerator ash must be
fully leak proof and fully enclosed or covered to prevent scattering
of material. Regulated infectious waste may not be subject to mechanical
stress or compaction during loading, unloading, and transit. Any
spilled material must be immediately returned to the transport vehicle
or container and, if necessary, the area must be cleaned and decontaminated.
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The cargo-carrying
body of a vehicle used for commercial collection or transportation
of solid waste must be maintained in good repair and in sanitary
condition.
Permits
Every person who treats
or transports solid waste or operates a solid waste management unit
or facility is required to have a valid permit issued by the department,
unless the activity is an emergency, exemption, or exception.
Permit Exemptions
A solid waste management
permit is not required for the following activities or facilities:
-
Onsite incinerators
used by hospitals, clinics, laboratories, or other similar facilities
solely for incineration of commercial waste or infectious waste generated
onsite;
-
Transport solely their
own waste to a solid waste management unit or facility; or
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Transport waste entirely
within a regulated facility or entirely on their property.
Treatment and
Resource Recovery Facilities
The owner or operator
of a facility that conducts treatment or resource recovery other than
processing shall comply with the following standards:
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All liquids must be
collected and treated to meet water protection provisions.
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Surface water must
be diverted away from all open storage areas.
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Solid waste must be
confined to storage containers and areas specifically designed to
store waste. Waste handling and storage systems must provide sufficient
excess capacity to prevent nuisances, environmental impacts, or health
hazards in the event of mechanical failure or unusual waste flows.
-
Resource recovery
systems or facilities must be operated on first-in, first-out basis.
Stored solid waste containing garbage may not be allowed to remain
unprocessed for more than forty-eight hours unless adequate provisions
are made to control flies, rodents, odors, or other environmental
hazards or nuisances.
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All solid waste, recovered
materials, or residues must be controlled and stored in a manner
that does not constitute a fire or safety hazard or a sanitary nuisance.
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All residues from
resource recovery systems or facilities must be handled and disposed
of according to applicable regulations.
-
All incinerators used
for solid waste must be constructed and operated in compliance with
applicable regulations.
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