 Tennessee
Special/Medical
Waste
Background Information
Definition of Regulated Medical
Waste
Managing Regulated Medical 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 Regulated Medical
Waste
In Tennessee, medical waste is considered a Special
Waste, which is a solid waste that is either difficult or dangerous
to manage and may include. Medical waste means the following solid
wastes:
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Wastes generated by hospitalized patients who
are isolated to protect others from communicable diseases.
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Cultures and stocks of infectious agents, including
specimen cultures from medical and pathological laboratories, cultures
and stocks of infectious agents from research and industrial laboratories,
wastes from the production of biologicals, discarded live and attenuated
vaccines, and culture dishes and devices used to transfer, inoculate,
and mix cultures.
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Waste human blood and blood products such as serum,
plasma, and other blood components.
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Pathological wastes (i.e., tissues, organs, body
parts, and body fluids) that are removed during surgery and autopsy.
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All discarded sharps (e.g., hypodermic needles,
syringes, pasteur pipettes, broken glass, scalpel blades) used in
patient care or which have come into contact with infectious agents
during use in medical, research, or industrial laboratories.
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Contaminated carcasses, body parts, and bedding
of animals that were intentionally exposed to pathogens in research,
in the production of biologicals, or in the in vivo testing of pharmaceuticals.
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The following wastes from patients known to be
infected with blood-borne disease: Contaminated wastes from surgery
and autopsy (e.g., soiled dressings, sponges, drapes, lavage tubes,
drainage sets, underpads, surgical gloves).
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Wastes from medical, pathological, pharmaceutical,
or other research, commercial, or industrial laboratories that were
in contact with infectious agents (e.g., specimen containers, slides
and cover slips, disposable gloves, lab coats, aprons).
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Wastes that were in contact with the blood of
patients undergoing hemodialysis, including contaminated disposal
equipment and supplies such as tubing, filters, disposable sheets,
towels, gloves, aprons, and lab coats.
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Discarded equipment and parts that were used in
patient care, medical and industrial laboratories, research, and
in the production and testing of certain pharmaceuticals and that
may be contaminated with infectious agents.
Managing Regulated Medical
Waste
Waste Evaluation Application
If you generate and want to process or dispose of
medical waste, you must make application to the Commissioner for a
waste evaluation. Also, if you generate and wish to process or dispose
of medical wastes, which are not subject to applicable regulations,
you must also make application to the Commissioner for waste evaluation,
unless the Commissioner determines it is not necessary. The application
must be on a form provided by the Department and completed according
to specified instructions.
Off-Site Processing or Disposal of Medical Waste
If you generate and have medical waste processed
or disposed of at an off-site facility, you must annually recertify
the accuracy of the information, certifying that there has been no
change in the waste stream or the process generating the waste since
the original special waste approval was granted; and submit all recertifications
as required.
The approval will specify the management conditions
deemed necessary to prevent or minimize potential adverse impacts to
public health, and the environment in order to promote safe and efficient
facility operation. Failure to meet the required management conditions
is unlawful disposal.
You may be required to keep records on the receipt
and management of certain special wastes. Copies of special waste approvals
shall be kept by the operator, which the facility has accepted into
the landfill and all recertifications submitted by generators of such
waste.
Special Waste Approval
Persons who wish to dispose of special (medical)
waste in a permitted landfill or have the special waste processed in
a permitted processing facility require a special waste approval from
the Tennessee Division of Solid Waste Management (SWM). Persons applying
for a special waste approval must:
- Locate a landfill or processing
facility that will accept the special (medical) waste and obtain
approval from the Division of SWM prior to disposal or processing
of the special waste.
- Submit a completed Waste
Evaluation Fee Worksheet application and the proper fee.
- Submit a completed Special
Waste Data Collection Form with required attachments.
Effect of a Special Waste Approval
A special waste approval does not grant any right
of disposal of the medical waste at the designated facility. The operator
may refuse to accept any special waste even if it has been approved
by the Commissioner to be disposed of at his facility.
Special Waste Variances and Waivers
After public notice and an opportunity for public
comment, any standard, or requirement in these rules may be waived
by the Commissioner if the operator can demonstrate, to the satisfaction
of the Commissioner, that the standard is inapplicable, inappropriate,
or unnecessary to his facility, or that it is equaled in effect by
alternative standards or requirements.
Medical Waste Management Requirements
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Sharps must be securely packaged in puncture-proof
containers prior to landfilling.
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Cultures and stocks of infectious agents and associated
biologicals must not be landfilled unless and until they have been
treated (e.g., autoclaved, incinerated) to render them non-infectious.
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Human blood and blood products and other body
fluids may not be landfilled. This restriction applies to bulk liquids
or wastes containing substantive amounts of free liquids, but does
not apply to simply blood-contaminated materials such as emptied
blood bags, bandages, or “dirty” linens.
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Recognizable human organs and body parts may not
be landfilled.
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Dead animals may not be disposed of in a Class
II, Class III or Class IV disposal facility except as may be specifically
approved in writing by the Commissioner; or be disposed of in Class
I disposal facilities only if managed as follows:
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Dead animals must be covered upon receipt with
a minimum of two feet of cover and placed in an area which will
receive additional waste and cover within 48 hours; or covered
with three feet of compacted cover soil if placed in an area
which will not receive additional waste and cover within 48 hours.
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Dead animals must not be disposed of in an
area of a landfill which will not accommodate a minimum of five
feet of depth from the finished landfill surface elevation when
final cover has been put in place.
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Dead animals must be distributed for disposal
over the landfill area in such a manner as to minimize the occurrences
of future sinks and depressions in the final landfill cover caused
by carcass decay.
Veterinary Facilities Disposal of Dead Animals
and Waste
Veterinary facilities shall dispose of dead animals,
biological waste, and medical waste (including sharps) in a prompt,
sanitary, and aesthetic manner.
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The disposal of dead animals, biological waste,
and medical waste (including sharps) shall comply with all federal,
state, county and municipal laws, ordinances, and regulations.
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With the exception of large animals, all dead
animals on the premises shall be refrigerated.
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Dead animals not claimed within forty-eight (48)
hours by the owner or agent shall be disposed at the discretion of
the veterinarian.
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