Colorado
Infectious
Medical Waste
Background Information
Definition of Infectious Medical Waste
Management of Infectious Medical Waste
OSHA Regulations
Statutes, Regulations and Guidelines
Contacts
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 Infectious Waste
In Colorado, infectious waste is defined
as any waste capable of producing an infectious disease in a susceptible
person. Generally recognized infectious wastes include, but are not
limited to: isolation wastes from persons having a disease requiring
Biosafety Level IV containment; cultures and stocks of infectious agents
and biologicals; human blood, blood products and other body fluids;
human pathological or anatomical waste consisting of tissues and body
parts; contaminated sharps; and contaminated research animals and bedding.
Managing
Regulated Medical Waste
Management Plan. Healthcare facilities
that generate infectious waste must develop and implement an on-site
infectious waste management plan appropriate for their particular facility.
This plan must be available to the hauler of the waste, to the disposal
facility, and to the licensing or regulatory agency. The plan must
include the designation of infectious waste, provisions for the handling
of that waste, staff training, contingency planning for spills or loss
of containment, the designation of a person responsible for implementation
of the plan, and provisions for appropriate on and off-site treatment
or final disposal.
Packaging and Labeling. Receptacles
containing infectious waste must be clearly labeled with the biohazard
symbol or with the words “Infectious Waste” in letters at least one
inch high. Untreated waste must be stored, packaged, contained, and
transported in a manner that prevents the release of the waste material
and in a manner to prevent nuisance conditions. Contaminated sharps
(needles, syringes, lancets) must be placed in a puncture resistant
container and be properly designated as untreated infectious waste
or made noninfectious by an appropriate treatment method. Untreated
containers of sharps cannot be compacted.
Storage. There are no storage
time limits for generators of infectious waste. The waste need only
be stored in a manner to prevent release of the waste and to prevent
nuisance conditions.
Off-Site Disposal in a Landfill. Properly
labeled and packaged infectious waste may be disposed of in a permitted
solid waste disposal facility without treatment. Landfills must be
approved by their local governing authority and the state health department
to accept this type of waste. If untreated infectious waste is disposed
of in a solid waste disposal facility, these procedures must be documented
in the generator’s waste handling plan and must be acceptable to the
waste hauler and disposal site. Recognizable human anatomical remains
cannot be disposed of at a solid waste landfill. These must be either
incinerated or interred.
Other Treatment/Disposal Options. Healthcare
facilities may treat their infectious waste themselves to render it
noninfectious or contract with a medical waste disposal company. Infectious
waste that has been appropriately treated to render it non-infectious
is no longer considered infectious for handling and disposal purposes. Treated
waste can be disposed of with other noninfectious and nonhazardous
solid wastes after the generator either identifies it as appropriately
treated waste or provides the hauler and disposal facility with a written
statement that its general waste includes appropriately treated infectious
waste. Appropriate treatment is any method that renders the waste
noninfectious, and must include the following: documentation that the
method is effective; a written standard operating procedure for implementation
of the method; and regular monitoring to test the effectiveness of
the treatment. Widely used treatment methods include incineration,
autoclaving, decontamination, and sterilization.
The Colorado Department of Public Health
and Environment does not approve or recommend specific treatment methods,
but leaves it up to the generator to determine what is an appropriate
and effective treatment method for their wastes.
OSHA
Regulations
In addition to the state medical waste
environmental regulations there are some Occupational Safety and Health
Administration (OSHA) rules that apply to medical/infectious waste. Colorado
is one of 26 states covered entirely by the federal OSHA program. This
program is operated by the Occupational Safety and Health Administration. OSHA
rules (Occupational Exposure to Bloodborne Pathogens Standards) impact
various aspects of medical/infectious waste, including management of
sharps, requirements for containers that hold or store medical/infectious
waste, labeling of medical/infectious waste bags/containers, and employee
training.
Statutes,
Regulations and Guidelines
Statements of Basis and Purpose and Specific Statutory Authority for 6 CCR 1007-2 Solid Waste Regulations.
Contacts
Colorado Department of Public
Health and the Environment--Hazardous Material and Waste Management
Division
More Information
Information for health care facilities concerning medical waste. |
