Regulated Medical Waste

Oregon

Infectious 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 solid waste and includes:

Biological wastes, which includes blood and blood products, excretions, exudates, secretions, suctionings and other body fluids that cannot be directly discarded into a municipal sewer system, and waste materials saturated with blood or body fluids, but does not include diapers soiled with urine or feces.
Cultures and stocks, which includes etiologic agents and associated biologicals, including specimen cultures and dishes and devices used to transfer, inoculate and mix cultures, wastes from production of biologicals, and serums and discarded live and attenuated vaccines. “Cultures” does not include throat and urine cultures.
Pathological waste, which includes biopsy materials and all human tissues, anatomical parts that emanate from surgery, obstetrical procedures, autopsy and laboratory procedures and animal carcasses exposed to pathogens in research and the bedding and other waste from such animals. “Pathological waste” does not include teeth or formaldehyde or other preservative agents.
Sharps, which includes needles, IV tubing with needles attached, scalpel blades, lancets, glass tubes that could be broken during handling and syringes that have been removed from their original sterile containers.

Medical waste is a solid waste generated as a result of patient diagnosis, treatment, or immunization of human beings or animal. Medical waste, other than infectious waste or hazardous wastes, may be disposed of without special treatment in permitted municipal solid waste landfills, if such disposal is not prohibited in the permit.

Managing Infectious Waste

Restrictions on Discarding, Storing or Transporting Infectious Waste

No person who generates infectious waste shall discard or store the waste, except as provided in the regulations.
No person shall transport infectious waste other than infectious waste that is an incidental part of other solid waste, except as provided in the regulations.

Segregation, Containment, Storage, Packaging and Labeling

Infectious waste shall be segregated from other wastes by separate containment at the point of generation. Enclosures used for storage of infectious waste shall be secured to prevent access by unauthorized persons and shall be marked with prominent warning signs.
Infectious waste, except for sharps, shall be contained in disposable red plastic bags or containers made of other materials impervious to moisture and strong enough to prevent ripping, tearing or bursting under normal conditions of use. The bags or containers shall be closed to prevent leakage or expulsion of solid or liquid wastes during storage, collection or transportation.
Sharps shall be contained for storage, collection, transportation and disposal in leak proof, rigid, puncture-resistant red containers that are taped closed or tightly lidded to prevent loss of the contents. Sharps may be stored in such containers for more than seven days.
All bags, boxes or other containers for infectious waste and rigid containers of discarded sharps shall be clearly identified as containing infectious waste.
Infectious waste shall be stored at temperatures and only for times established by rules of the Department of Human Services.
Infectious waste shall not be compacted before treatment and shall not be placed for collection, storage or transportation in a portable or mobile trash compactor.
Infectious waste contained in disposable bags shall be placed for collection, storage, handling or transportation in a disposable or reusable pail, carton, box, drum, dumpster, portable bin or similar container. The container shall have a tight fitting cover and be kept clean and in good repair. The container may be of any color and shall be conspicuously labeled with the international biohazard symbol and the words “Biomedical Waste” on the sides so as to be readily visible from any lateral direction when the container is upright.
Each time a reusable container for infectious waste is emptied, the container shall be thoroughly washed and decontaminated unless the surfaces of the container have been protected from contamination by a disposable red liner, bag or other device removed with the waste.
Trash chutes shall not be used to transfer infectious waste between locations where it is contained or stored.

Exemption: Generators that produce 50 pounds or less of infectious waste in any calendar month are exempt from the requirements pertaining to containers holding disposable red bags.

Treatment and Disposal of Infectious Waste

Pathological wastes shall be treated by incineration in an incinerator that provides complete combustion of waste to carbonized or mineralized ash. The ash shall be disposed of as provided in the regulations. However, if the Department of Environmental Quality determines that incineration is not reasonably available within a waste shed, pathological wastes may be disposed of in the same manner provided for cultures and stocks.

Cultures and stocks shall be incinerated as described in the regulations or sterilized by other means prescribed by Department of Human Services rule. Sterilized waste may be disposed of in a permitted land disposal site if it is not otherwise classified as hazardous waste.

Liquid or soluble semisolid biological wastes may be discharged into a sewage treatment system that provides secondary treatment of waste.

Sharps and biological wastes may be incinerated, or sterilized by other permitted means. Sharps may be disposed of in a permitted land disposal site only if the sharps are in containers as required by the regulations and are placed in a segregated area of the landfill.

Other methods of treatment and disposal may be approved by rule of the Environmental Quality Commission.

Infectious Waste Storage Times and Temperature

Infectious waste shall be segregated from other wastes by separate containment at the point of generation.
Enclosures used for storage of infectious waste shall be secured to prevent access by unauthorized persons and marked with prominent warning signs.
Pathological waste, biological waste and cultures/stocks shall be treated or disposed within seven days of generation, unless it is refrigerated (between 33 and 48 degrees Fahrenheit) or frozen (less than 32 degrees Fahrenheit). Refrigerated or frozen infectious waste may be stored 30 days prior to treatment or disposal.
Prior to being treated, sharps contained in a leak proof, rigid, puncture resistant container which is taped closed or tightly lidded to prevent loss of the contents may be stored indefinitely.
Generators that produce 50 pounds or less of infectious waste in any calendar month shall be exempt from the requirements pertaining to storage times and temperatures.

Transporting Infectious Waste—Certification and Recordkeeping

Each person who transports infectious waste for consideration, other than waste that is an incidental part of other solid waste, shall:

Provide written certification to a person who discards more than 50 pounds per month of infectious waste that such waste will be disposed of in compliance with the regulations; and
Maintain records showing the point of origin and date and place of final disposal of infectious waste collected from generators. A copy of these records shall be given to the generator or the Department of Environmental Quality upon request.

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. Oregon is one of 21 states operating an approved occupational safety and health program. This program is operated by the Oregon Occupational Safety and Health Division. 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. These requirements can be found in the HERC section entitled OSHA Standards for Regulated Waste.