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
Medical Waste
Nevada has adopted
the US Dept. Of Transportation definition for regulated medical
waste found in (49
CFR Part 173). Regulated medical waste means a waste
or reusable material known to contain or suspected of containing
an infectious substance in Risk Group 2 or 3 and generated in the
diagnosis, treatment, or immunization of human beings or animals;
research on the diagnosis, treatment or immunization of human beings
or animals; or the production or testing of biological products. Where, Risk
group means a ranking of a micro-organism's ability to cause
injury through disease. A risk group is defined by criteria
developed by the World Health Organization (WHO) based on the severity
of the disease caused by the organism, the mode and relative ease
of transmission, the degree of risk to both an individual and a
community, and the reversibility of the disease through the availability
of known and effective preventative agents and treatment.
Managing
Medical Waste
Nevada Division
of Environmental Protection states that if medical waste has been
treated by incineration, autoclaving or an alternative method approved
by the solid waste management authority, it can be managed as ordinary
solid waste with no special requirements. Special requirements
apply to the storage, collection, labeling, transporting and disposal
of regulated medical waste. Nevada regulations allow the direct
disposal by landfilling of untreated medical waste.
There are services
throughout the state for the collection and disposal of medical
waste generated in healthcare and veterinary facilities. Services
for home-generated medical waste sharps are not prevalent, however.
According to
the Nevada Division of Environmental Protection, there are two
basic ways of managing medical waste that can protect workers and
the public from disease transmission: 1) treatment to render the
waste non-infectious, or 2) segregation to prevent exposure. Nevada
regulations do not require treatment of medical waste. Disposal
in a permitted landfill according to approved practices is acceptable. However,
until the waste had been either treated or disposed, it must be
stored and collected according to the requirements of Nevada Administrative
Code (NAC) 444.662. The US Occupational Safety and Health Administration
(OSHA) has adopted regulations to limit workers’ occupational exposure
to blood and other body fluids which may pose a risk of infection
by bloodborne pathogens. These rules are discussed below.
Storage, Collection
and Disposal Regulations
The Nevada Administrative
Code (NAC) contains the following regulations concerning the storage,
collection, and disposal of medical waste:
