Regulated Medical Waste

Kansas

Medical Services Waste

Background Information
Managing Medical Services 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 Medical Services Waste

Medical services wastes are those solid waste materials which are potentially capable of causing disease or injury and which are generated in connection with human or animal care through inpatient and outpatient services. Medical services waste shall not include any solid waste that has been classified as a hazardous waste, or that is radioactive treatment material.

Managing Medical Services Waste

Segregation

All medical services waste shall be segregated from other solid wastes at the point of origin.

Storage

All medical services waste shall be stored in a manner and in a container that will

prevent the transmission of disease or the causing of injury. Hypodermic needles and syringes, scalpel blades, suture needles, or other sharp objects shall be stored only in a rigid, puncture-resistant container that has been closed to prevent the escape of any material, including liquids or aerosols. All reusable containers used to store infectious waste shall be cleaned and disinfected before each use.

Containment/Labeling

The medical services waste must be placed in containers that are closable, constructed to contain all contents and prevent leakage of fluids, and closed prior to removal. The containers must be labeled or color-coded in accordance with the federal Bloodborne Pathogens requirements. The labels must have the BIOHAZARD legend. Red bags or red containers may be substituted for labels.

Collection

Medical services wastes shall be collected at least daily from the point of origin for transport to a storage or disposal area or a processing facility. Personnel shall take precautions to prevent accidental contact with the waste during transfer.

Transportation

All medical services wastes transported off-site shall be transported in a manner that will prevent the spread of disease or the causing of injury to persons.

The waste transporter or disposal firm shall be notified of the types of waste.

Containers of medical services waste transported off-site shall be labeled or color-coded in accordance with the federal Bloodborne Pathogens requirements.

Processing

In all processing of medical services waste, dispersal of aerosols and liquids

shall be prevented through the use of proper coverings, seals, and ventilation. Personnel shall be protected against contact with the waste through the use of protective clothing and equipment. Medical services waste that has been processed may be combined with other solid waste. Where feasible, all medical services wastes shall be processed before transportation off-site by using either of the following methods:

Sterilizing infectious wastes by autoclaving or chemical treatment, to destroy the disease/transmission potential; or
Grinding, melting, or pulverizing sharp objects to destroy their injury producing potential.

Disposal

If the potential to cause disease or injury is removed, then the waste can be mixed with general solid waste and transported to a Municipal Solid Waste Landfill (MSWLF). If the medical waste is not processed:

The facility may obtain a Special Waste Disposal Authorization and transport the medical waste separately to a MSWLF; or
The facility may contract with a medical waste company for transportation and disposal of the medical waste to a MSWLF (with SWDA) or to a permitted medical waste processing facility.

Medical services waste shall be disposed of in a manner that minimizes the risk to health, safety, or the environment. The following shall be considered acceptable disposal methods:

Discharge of liquids to a sanitary sewer that is connected to a secondary sewage treatment plant;
Incineration of combustible solids, followed by disposal of the ash in a sanitary landfill;
Disposal in a properly permitted hazardous waste disposal facility; or
Disposal in an approved sanitary landfill

OSHA Regulations: HERC OSHA State Page

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. Kansas 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.