South
Dakota
Infectious
Medical Waste
Background Information Waste Categories
Definition of
Regulated 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.
Waste Categories
South Dakota classifies wastes generated by health
care facilities into four main categories:
Hazardous wastes. This refers to a class of
wastes specifically defined in a federal law (the Resource conservation
and Recovery Act, or RCRA). These wastes contain certain toxic chemicals
or have certain characteristics that cause them to be a significant risk
to the environment and/or human health. Some certain chemotherapy waste
is hazardous waste.
Medical waste. Medical waste means any solid
waste which is generated in the diagnosis, treatment, or immunization
of human beings or animals, in research, or in the production or testing
of biologicals. It does not include any hazardous waste, radioactive
waste, or household waste.
Regulated medical waste (RMW). These are a
special subcategory of medical wastes that present significant health
risks such as the potential for infectious disease transmission, and
special rules apply to them.
Municipal solid waste. These wastes present
fewer environmental or health risks than medical wastes. Municipal solid
waste can be disposed of into dumpsters.
It is important that you categorize your facility's
waste accurately.
- Hazardous waste disposed of as regulated medical
waste or municipal solid waste, or regulated medical waste disposed
of as municipal solid waste are violations of the law and can result
in substantial penalties.
- Conversely, most medical waste may be handled as
general solid waste and does not require special handling or treatment.
- Correctly identifying and segregating your IW can
reduce the cost of disposal. Infectious medical waste makes up
only a small portion of the total medical waste stream. Some
facilities, such as long-term care facilities, generate medical waste,
but little or no infectious medical waste. Use the guidance and
references below to accurately categorize your wastes. For additional
help, see Contacts below.
- Infectious waste that is treated to specific standards
can be disposed of as municipal solid waste, provided that no local
rules prohibit it.
Definition of Regulated Medical
Waste
Regulated medical waste is solid waste generated in
the diagnosis, treatment, or immunization of human beings or animals,
in research pertaining to diseases of humans or animals, in research
pertaining to diseases of humans or animals, or in the production or
testing of biologicals, as listed below:
- Cultures and stocks of infectious agents and associated
biologicals.
- Pathological waste.
- Human blood and blood products.
- Sharps.
- Animal waste that are known to be contaminated with human pathogens.
- Isolation Waste such as biological and discarded
materials contaminated wit blood, excretion, exudates, or secretions
from humans who are isolated to protect others from certain highly
communicable diseases.
Managing
Regulated Medical Waste
Regulated medical waste must either be disposed of
by incineration in accordance or treated by steam sterilization, chemical
disinfectant, or an equally effective treatment method. Treated regulated
medical waste may be disposed of as a solid waste.
Healthcare facilities sending their regulated medical
waste off-site for disposal must meet comply with regulations covering
packaging, labeling, and storage. These are discussed below.
Container requirements. Containers of regulated
medical waste for transport off-site must meet the following requirements:
- Containers must be rigid, leak-resistant, impervious
to moisture, resistant to tearing or bursting under normal conditions
of use and handling, and sealed to prevent leakage during transport.
- Treated and untreated sharps and sharps with residual
fluids must be placed in packaging that is rigid, leak-resistant, and
puncture-resistant.
- Quantities of fluids greater than 20 cubic centimeters
must be placed in packaging that is break-resistant and tightly lidded
or stoppered.
- Oversized regulated medical waste need not be placed
into containers, but any special handling instructions must be attached
to the waste. Generators may use one or more containers to meet these
requirements.
If a healthcare facility plans to reuse containers,
they must comply with the following rules:
- All nonrigid packaging and inner liners must be
managed as regulated medical waste and may not be reused.
- Any container used for the storage or transport,
or both, of regulated medical waste and designated for reuse once emptied
must be decontaminated if the container shows signs of visible contamination.
- If any container used for the storage or transport,
or both, of regulated medical waste is for any reason not capable of
being rendered free of any visible signs of contamination, the container
must be managed as regulated medical waste and labeled, marked, and
treated or disposed of.
Storage Requirements. Storage of regulated
medical waste before treatment or disposal on-site or transport off-site
must comply with the following storage requirements:
- Must be stored in a manner and location that maintains
the integrity of the packaging and provides protection from the elements.
- Must be maintained in a non-putrescent state, using
refrigeration when necessary.
- Must be stored in a manner that affords protection
from animals and does not provide a breeding place or a food source
for insects and rodents.
- All on-site storage of regulated medical waste must
be in a designated area away from traffic flow patterns and must be
accessible only to authorized personnel.
- Outdoor storage areas containing regulated medial
waste must be locked to prevent unauthorized access.
- Containment of regulated medical waste must be effected
in such a manner that no discharge or release of any waste occurs.
Labeling Requirements. Before transporting
regulated medical waste or offering it for transport off-site, each package
of untreated medical wastes must have a water-resistant label affixed
to or printed on the outside of the container. The label must include
the words “Medical Waste” or “Infectious Waste” or display the universal
biohazard symbol. Plastic bags used as inner packaging need not display
a label.
Healthcare facilities must mark each package of regulated
medical waste according to the following marking requirements before
the waste is transported off-site:
- The outermost surface of each package prepared for
shipment must be marked with a water-resistant identification tag of
sufficient dimension to include the generator’s name and address, the
transporter’s name and address, the date of shipment and the identification
of contents as medical waste.
- If the generator has used inner containers, including
sharps and fluid containers, each inner container must b e marked with
indelible ink or imprinted with water-resistant tags. The marking
must contain the generator’s name and address.
- If the generator has used inner containers, including
sharps and fluid containers each inner container must be marked with
indelible ink or imprinted with water-resistant tags. The marking
must contain the generator’s name and address.
Incinerator and Other Treatment Regulations
Health care facilities may operate a medical waste
incinerator on-site for the disposal of regulated medical waste. There
are various rules that apply to these facilities, which are found in
Article 74:35:11 See Statutes, Regulations and Guidelines below. Incinerators
must be permitted before use.
For treatment methods other than incineration, any
process designed to treat or actually treating greater than 200 pounds
of regulated medical waste for each treatment cycle may not be constructed
or operated unless all appropriate local, state, and federal permits
and approvals have been obtained.
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. South Dakota 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
Rule 74:35
Medical Waste
Contacts
South
Dakota Department of Environment and Natural Resources
More Information
Managing Medical Waste in South Dakota
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