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.

Environmental Regulations

Kentucky does not have specific environmental regulations applicable to medical/infectious wastes generated at healthcare facilities except for air quality regulations pertaining to medical waste incineration.  The Division for Air Quality requires that all medical waste incinerators obtain a special permit prior to conducting medical waste incineration.

HealthCare Regulations

Kentucky hospital regulations cover certain aspects of medical waste, as follows:

• “A sharp waste container shall be incinerated on or off site, or shall be rendered nonhazardous.” (Hospital Operations and Services Regulation 902 KAR 20:016 Section 3(10) (g) 3).
• “The containers of sharp wastes shall either be incinerated on or off site, or be rendered nonhazardous by a technology of equal or superior efficacy, which is approved by both the Cabinet for Human Resources and the Natural Resources and Environmental Protection Cabinet.” Nursing Facility Operations and Services Regulation 902 KAR 20:300 Section 6 (7) (b) 4 c.

OSHA Regulations

There are some Occupational Safety and Health Administration (OSHA) rules that apply to medical/infectious waste.  Kentucky is one of 21 states operating an approved occupational safety and health program.  This program is operated by the Occupational Safety and Health Administration of the Department of Employment.  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. 

More Information

In this section, you will find links to points of contacts at the Kentucky agencies responsible for regulating solid waste from healthcare facilities.

Contacts

KY Division of Waste Management Solid Waste Branch

For questions about Health and Family Services regulations, contact the cabinet’s Office of Inspector General (502-564-2800).

Occupational safety and health standards require procedures to protect healthcare and medical workers.  Inquiries about these regulations should be made to the Kentucky Department of Labor at 502-564-3070.

The Division for Air Quality requires that all medical waste incinerators obtain a special permit prior to conducting medical waste incineration. The Division for Air Quality can be reached at 502-573-3382.

Statutes, Regulations and Guidelines

KRS Chapter 224, Environmental Protection of the Kentucky Revised Statutes contains the core set of environmental protection statutes for Kentucky.  Subchapter 43 covers solid waste.

Additional Resources

A summary of medical waste rules in Kentucky

Kentucky Medical Waste Guidance