New
Mexico
Regulated Medical Waste
Background Information
Definition
of Infectious Waste
Managing Infectious 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 Infectious Waste
Infectious waste is considered a “special
waste," that has unique handling, transportation, or disposal
requirements to assure protection of the environment and the public
health, welfare and safety. Infectious waste means a limited class
of substances that carry a probable risk of transmitting disease
to humans, including but not limited to:
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Microbiological laboratory
wastes, including cultures and stocks of infectious agents from
clinical research and industrial laboratories, and disposable
culture dishes and devices used to transfer, inoculate and mix
cultures;
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Pathological wastes, including
human or animal tissues, organs and body parts, removed during
surgery, autopsy or biopsy;
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Disposable equipment,
instruments, utensils, and other disposable materials which require
special precautions because of contamination by highly contagious
diseases;
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Human blood and blood
products, including waste blood, blood serum, and plasma;
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Used sharps, including
used hypodermic needles, syringes, scalpel blades, Pasteur pipettes
and broken glass; and
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Contaminated animal carcasses,
body parts and bedding, especially those intentionally exposed
to pathogens in research, in the production of biologicals or
the "in vivo" testing of pharmaceuticals;
Managing
Infectious Waste
Infectious Waste Restrictions
Infectious waste shall be disposed of only at solid waste facilities
authorized for disposal of special waste.
If infectious waste is to be incinerated,
it shall only be incinerated in an infectious waste incinerator
authorized under applicable Air Quality regulations and permitted
under the regulations.
A manifest shall accompany each load of asbestos,
infectious waste, petroleum contaminated soils, ash or other special
wastes as specified by the Department originating or to be disposed
in New Mexico.
These restrictions apply without regard to
the quantity of infectious waste produced, to any producer of infectious
waste including, but not limited to, any:
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General acute care hospitals;
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Skilled nursing facility
or convalescent hospitals;
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Intermediate care facilities;
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In-patient care facilities
for the developmentally disabled;
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Health maintenance organizations;
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Acute psychiatric hospitals;
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To all infectious waste
storage, treatment, and disposal facilities.
All material that has been rendered non-infectious
may be handled as non-infectious waste, provided:
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It is not an otherwise
regulated, hazardous, special, or radioactive waste and is not
subject to applicable requirements;
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The operator of the disposal
facility applies daily cover as required prior to any compaction
of the sharps; and:
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Any person that treats
infectious waste shall certify in writing the waste has been
rendered noninfectious by sterilization, incineration or another
method approved by the Secretary. Certification shall be provided
to the transporter or disposal facility and kept in the facility
operating record. A certification that the waste has been rendered
noninfectious shall be provided to the generator, transporter,
and disposal facility. The generator and disposal facility shall
maintain copies of certifications and the records made available
to the Department upon request.
Storage and Containment Requirements
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Containment shall be in
a manner and location that affords protection from animal intrusion,
does not provide a breeding place or a food source for insects
and rodents, and minimizes exposure to the public.
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Infectious waste shall
be segregated by separate containment from other waste at the
point of origin.
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Except for sharps, shall
be contained in plastic bags inside rigid containers. The bags
shall be securely tied to prevent leakage or expulsion of solid
or liquid wastes during storage, handling or transport.
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Sharps shall be contained
for storage, transportation, treatment, and disposal in leak-proof,
rigid, puncture-resistant containers that are manufactured for
the purpose of sharps containment and are taped closed or tightly
lidded to preclude loss of contents.
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All bags used for containment
purposes shall be red or orange and clearly identified as specified
by federal regulations. Rigid containers shall be labeled "biomedical
waste", or otherwise conspicuously labeled as holding infectious
waste, or placed in disposable bags used for other infectious
waste. Disposable rigid containers shall meet or exceed the
standards for a classified strength of at least 200-pound mullen
test.
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If other waste is placed
in the same container as regulated infectious waste, then the
generator shall package, label and mark the container and its
entire contents as infectious waste.
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Rigid infectious waste
containers may be reused for infectious or non-infectious waste
if they are thoroughly washed and decontaminated each time they
are emptied and the surfaces of the containers have been completely
protected from contamination by disposable, unpunctured or undamaged
liners, bags, or other devices that are removed with the infectious
waste, and the surface of the containers have not been damaged
or punctured.
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Storage and containment
areas shall protect infectious waste from the elements, be ventilated
to the outdoors, be only accessible to authorized persons, and
be marked with prominent warning signs on, or adjacent to, the
exterior doors or gates. The warning signs shall be easily read
during daylight from a distance of 25 feet.
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Generators of medical
waste, shall place an absorbent material inside the liner of
the rigid container equal to one cup of absorbent material per
each six cubic feet of box area if the rigid container is to
hold any containers which had held free liquids; if the rigid
container is to hold containers which do hold free liquids, then
enough absorbent material shall be placed inside the liner of
the rigid container sufficient to absorb 15% of the total volume
of free liquids inside the rigid container.
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Compactors, grinders or
similar devices shall not be used to reduce the volume of infectious
waste before the waste has been rendered non-infectious unless
prior approval has been obtained from the Department.
Operational Requirements
All applicable infectious waste treatment,
storage and disposal facilities shall comply with the following
operational requirements:
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Every person who generates,
transports, stores, treats, or disposes of infectious waste shall
prepare and maintain on file a management plan for the waste
that identifies the type of waste the person generates or handles,
the segregation, packaging, labeling, collection, storage, and
transportation procedures to be implemented, the treatment or
disposal methods that will be used, the transporter and disposal
facility that will be used, and the person responsible for the
management of the infectious waste.
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All infectious waste management
facilities may only accept infectious waste that is accompanied
by a manifest that contains the information required by the regulations.
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Report to the Secretary
any delivery of unauthorized waste, contamination of any person,
or other emergencies immediately upon recognition.
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Human fetal remains shall
be disposed by incineration or interment, which are considered
to be human fetal remains when measured to be 500 grams or greater
as defined by the State Medical Examiner.
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Infectious waste consisting
of recognizable human anatomical remains shall be disposed by
incineration or interment, unless such remains have been contaminated
with a regulated hazardous chemical or radioactive substance. Such
contaminated remains shall be disposed of at a permitted hazardous
or radioactive waste facility.
Treatment and Disposal of Infectious Waste
Treatment and disposal of infectious waste
shall be by one of the following methods:
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Incineration in a controlled
air multi-chambered incinerator which provides complete combustion
of the waste to carbonized or mineralized ash:
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Sterilization by heating
in a steam sterilizer so as to render the waste non-infectious:
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Discharge to a sewage
treatment system that provides secondary treatment of waste and
only if the waste is liquid or semi-solid and if approved by
the operator of the sewage treatment system; or
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Other methods approved
by the Secretary
Transporting Infectious Waste
All infectious waste haulers shall comply
with the following transportation requirements:
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Infectious waste shall
not be transported in the same vehicle with other waste unless
the infectious waste is contained in a separate, fully enclosed
leak-proof container within the vehicle compartment or unless
all of the waste has been treated as infectious waste;
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Persons manually loading
or unloading containers of infectious waste onto or from transport
vehicles shall be provided by their employer with, and required
to wear, protective gloves, shoes and eye wear, and clean coveralls.
Face shields and respirators may be required as deemed necessary
by the Secretary;
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Surfaces of transport
vehicles that have contacted spilled or leaked infectious waste
shall be decontaminated by procedures approved by the Secretary;
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Vehicles transporting
infectious waste shall be identified on each side of the vehicle
with the name or trademark of the hauler and a biohazard symbol;
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Each truck, trailer, semi
trailer, or container used for shipping infectious waste shall
be so designed and constructed, and its contents limited so that
under conditions normally incident to transportation, there shall
be no releases of infectious waste to the environment;
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Any truck, trailer, semi
trailer, or container used for shipping infectious waste shall
be free from leaks, and all discharge openings shall be securely
closed during transportation;
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No person shall transport
infectious waste into the state for treatment, storage, or disposal
unless the waste is packaged, contained, labeled and transported
in the manner required;
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All generator storage
containers shall be labeled with the generator's name, the city,
and date of collection; and
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Storage of infectious
waste by commercial haulers shall be limited to seven days prior
to disposal or treatment unless refrigerated at or below 45 degrees
Fahrenheit.
Transporters of ash shall not accept or transport
ash unless it has been treated, or is securely covered to prevent
release of fugitive dust; cover vehicles to prevent fugitive dust
loss during transport; and line or seal vehicles in a manner to
prevent any leakage of liquids or fugitive dust during transport.
OSHA
Regulations
New Mexico is one of 21 states operating an approved
occupational safety and health program. This program is operated
by the New Mexico Occupational Health and Safety Bureau. The New
Mexico Occupational Health and Safety Bureau (NMOHSB) is a state
regulatory agency that is part of the New Mexico Environment Department.
It has the responsibility of enforcing Occupational Health and Safety
Regulations within New Mexico. New Mexico has adopted the Federal
OSHA Regulations and has promulgated some State specific regulations,
including construction standards (11 NMAC 5.3).
Statutes,
Regulations and Guidelines
New Mexico Solid
Waste Management Requirements (current)
Contacts
New Mexico Solid Waste Bureau
More
Information
None located.
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