Definition of Regulated Medical Waste
Managing Infectious Medical Wastes
Statutes, Regulations and Guidelines
of Regulated Medical Waste
Medical waste is waste from a generator or
a health care related facility which, if improperly treated, handled,
or disposed of may serve to transmit an infectious disease and
which includes the following:
Pathological waste. All
human unfixed tissues, organs and anatomical parts, other than
intact skin, which emanate from surgeries, obstetrical procedures,
dental procedures, autopsies and laboratories. Such waste shall
be exclusive of bulk formaldehyde and other preservative agents.
Liquid or semi-liquid
blood such as human blood, human blood components and/or
products made from human blood (e.g., serum, plasma) and other
potentially infectious materials, to include regulated human
body fluids such as semen, vaginal secretions, cerebrospinal
fluid, pleural fluid, pericardial fluid, synovial fluid, peritoneal
fluid, amniotic fluid, saliva in dental procedures, any body
fluid that is visibly contaminated with blood and all body
fluids where it is difficult or impossible to differentiate
between body fluids, not to include urine or feces, which cannot
be discharged into the collection system of a publicly owned
treatment works (POTW) within the generating facility.
Contaminated items to
include dressings, bandages, packings, gauze, sponges, wipes,
personal protective equipment, cotton rolls and balls, etc.,
which cannot be laundered or disinfected and from which blood,
blood components, or regulated body fluids drip freely, or that
would release blood or regulated body fluids in a liquid or semi-liquid
state if compressed or are caked with dried blood or regulated
body fluids and all capable of releasing these materials during
single-use gloves such as surgical or examination gloves
shall not be washed or decontaminated for reuse and are to
be handled as a contaminated item.
- Protective coverings such as plastic wrap
and aluminum foil used to cover equipment and environmental surfaces
when removed following their contamination are considered a contaminated
- All patient care items from hospital isolation
rooms and end-stage renal dialysis units, or from patients with
communicable diseases, which cannot be laundered and which are
contaminated with regulated body fluids or blood or potential
infectious material, must be considered a contaminated item.
Microbiological waste which
includes, but is not limited to, cells and tissue cultures, culture
medium or other solutions and stocks of infectious agents, organ
cultures, culture dishes, devices used to transfer, inoculate
and mix cultures, paper and cloth which has come in contact with
specimens or cultures and discarded live vaccines
Contaminated sharps which
includes, but is not limited to, any contaminated object that
can penetrate the skin, e.g., hypodermic needles, intravenous
tubing with needles attached, syringes with attached needles,
razor blades used in surgery, scalpel blades, Pasteur pipettes,
capillary tubes, broken glass from laboratories, and dental wires.
(Potential breakable container(s) of blood, regulated body fluid,
microbiological waste, or infectious material must be treated
as contaminated sharps when disposed of.
Infectious Medical Waste
Identification of Medical Waste
A person who generates a medical waste shall determine
if that waste is a medical waste. Any wastes that contain medical
waste mixed with general solid waste shall be managed as medical
waste if the solid waste has been contaminated by pathological waste,
blood or body fluids, contaminated items and/or microbiological waste.
Any medical wastes which meet the definition of "hazardous waste",
or which are mixed with hazardous wastes shall be managed as hazardous
Segregation of Medical Waste
- Medical waste must be segregated from other regular
waste at the point of its generation in the producing facility.
- Segregation of medical waste must be made
into containers in compliance with the OSHA Bloodborne Pathogen Standard.
Containers meeting this standard must be closable and constructed
to contain all contents and prevent leakage of fluids during handling,
storage, transport, or shipment.
A non-sharps container of medical waste shall
be closed at all times except when actively receiving medical waste.
A sharps container with openings large enough to allow entry of
any human hand shall be subject to any additional physical and/or
administration controls necessary to prevent access by the public
during normal conditions of use.
Packaging and Labeling of Medical Waste
Medical waste, except for sharps capable of cutting
or puncturing, shall be contained for reprocessing at the site of
generation in collection containers impervious to moisture, which
are leak resistant and have a sufficient strength to preclude ripping,
tearing or bursting under normal conditions of usage.
- Full containers shall be securely closed (fastened,
taped or tied) to prevent leakage or loss of solid or liquid wastes.
- Contaminated sharps shall be packaged for
reprocessing at the site of generation in containers that are leak
resistant on the bottom and sides, rigid, closable, and puncture
resistant. Sharps containers shall be assembled and utilized at all
times as intended by the manufacturer. Sharps that have been treated
and are still capable of cutting or puncturing must also meet this
packaging requirement unless they have been rendered unrecognizable
and are no longer capable of cutting or puncturing.
- Warning labels shall be affixed to all bags
and containers used for medical waste or affixed as close as feasible
to the container by string, wire, adhesive, or other method that
prevents their loss or unintentional removal. Labels must be water
resistant and legible, colored fluorescent orange or orange-red (or
predominantly so), with lettering or symbols in a contrasting color,
and include the universal biohazard legend.
- When medical waste leaves the facility where
it was generated, the name and address of the generator must clearly
be marked on the outside of the container. If the waste has been
treated using an approved method, then it must also be labeled on
the container with the words "TREATED" and "BIOHAZARDOUS
WASTE" or "INFECTIOUS SUBSTANCE" or "MEDICAL
WASTE" or the universal biohazard legend.
- Medical waste that has been treated by an
approved method and determined by the Department as rendered unrecognizable,
is not required to have special packaging or labeling when transported
or disposed. The handling and disposal of incinerator ash is regulated
by the ADEQ.
- Treated medical waste cannot be disposed
of if it is in a red or orange-red bag or container and it must be
further overpacked in a different color container and then labeled.
- If medical waste requires labeling, packaging
or management under federal regulations, then the generator shall
comply with the labeling and other applicable requirements specified
in those regulations.
- Mechanical compaction of medical waste shall
not be conducted prior to treatment and/or disposal, unless the mechanical
compaction and treatment are part of a single, self-contained process
that does not place employees or the public at risk of exposure to
untreated medical waste.
Storage of Medical Waste
Medical waste packaged in disposable containers
and shall be placed in disposable or reusable pails, cartons, drums,
dumpsters or portable bins. Disposable and reusable systems shall
be kept clean and rigid, be designed to prevent leakage of fluids,
remain impervious to moisture, and be of sufficient strength to prevent
tearing or bursting under normal conditions of use and handling and
be kept sealed or closed to prevent leakage. The containers may be
of any color and shall be conspicuously labeled
- Storage of medical waste shall be in a manner
and location which affords protection from unauthorized entry, animals,
adverse weather conditions such as rain, snow, ice, sleet, hail and
wind, does not provide a breeding place or a food source for insects
and rodents and minimizes exposure of employees and the public. When
waste is not being actively placed in storage, the area must be secured.
The location of the medical waste in storage
shall be conspicuously marked with signs which shall include the
universal biohazard legend.
- Storage time within the generating facility
shall not exceed thirty (30) days once the container has been filled
and closed. Storage of medical waste for longer than thirty (30)
days must be approved by the Department. Filled containers of medical
waste must be held at room temperature or below in a secure location
with limited access (unauthorized entry) as specified. If the generating
facility is unable to control odor from its stored waste, the Department
may require more frequent removal and further limit the storage time.
Transport of Medical Waste
The generator of medical waste may transport such
waste to an off-site permitted treatment or disposal facility in
a fully enclosed container designed to prevent leakage of fluids
as outlined, without having to obtain a transportation permit. Generator's
that transport their medical waste shall keep a log of all medical
Commercial medical waste transporters must comply
with additional requirements for transporting medical waste.
Treatment of Medical Waste
Treatment of medical waste shall be by one of the
- Incineration. Burning of medical waste
in conformance with the standards prescribed by the ADEQ or the U.S.
EPA. A permit must be obtained from the ADEQ before an incinerator
can be installed or operated. Inspection of incinerators shall be
conducted by the ADEQ.
Sterilization Technology: Sterilization
is the complete elimination of microbial viability. Procedures
utilized must be performed properly and according to the manufacturer's
operating instructions, provided the results changes the biological
character or composition of the medical waste completely and reliably
inactivating bacillus stearothermophilus spores or other appropriate
organisms at a 4 Log 10 reduction (99.99%) or greater and meet
or exceed the parameters listed below.
- Disinfection: A potential less lethal
process compared to sterilization that eliminates or inactivates
many or all pathogenic microorganisms including viruses, fungi, and
bacteria (but not necessarily all their endospores) on inanimate
Discharge into the collection system of a
publicly owned treatment works (POTW): Grinding and/or flushing
of waste into a POTW within the generating facility, except as
prohibited by the Department, the ADEQ or the superintendent/manager
of the POTW.
- Encapsulation: Complete encapsulation
of medical waste in a solid matrix which will significantly reduce
the possibility of exposure.
Other available technology
(alternate technology):Technology other than listed above
shall be evaluated and approved by the Department.
Disposal of Untreated Medical Waste
Disposal shall be by one of the following methods:
- Discharged from the health care related facility
into a POTW.
- Interment: The disposition of pathological
waste by burial or cremation according to standards and practices
of the mortuary industry.
- Other available technology: If approved by
*Not all methods of treatment and disposal are
approved for all categories of medical waste. Check the regulations
for the specific type of waste and approved disposal method.
Medical waste which may no longer serve to transmit
an infectious disease and is not recognizable, may be disposed of
in the regular solid waste stream and/or in a permitted landfill
without any labeling requirements.
Untreated medical waste cannot be disposed of in
Disposal of Treated Medical Waste
Treated medical waste may be disposed of in a permitted
sanitary landfill. Solid waste landfills cannot accept liquid wastes.
Treated medical waste, where applicable, must be packaged and labeled.
the generator of medical waste has treated the waste by an approved
method and it is packaged and labeled, then the waste may be included
in the facility's normal, solid waste stream.
health care related facility with an ADEQ permitted incinerator or
use of an approved technology may accept medical waste for treatment/disposal
from physicians and surgeons on staff of the health care facility
without obtaining an commercial incinerator or non-incinerator technology
permit or operating license. Satellite facilities including additional
hospitals, affiliated off-site services and physician offices or
other affiliated services owned and managed by the primary generator/treater
may accept and treat such medical waste without a non-incineration
technology permit or operating license unless the facility is engaged
in medical waste disposal for profit.
Requirements for Transporters of Commercial
No person in Arkansas may transport commercial
medical waste for a generator, other than the generator themselves,
without first obtaining a Commercial Medical Waste Transportation