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 Biomedical Waste

"Biomedical waste" means, and is limited to, the following types of waste:

Managing Biomedical Waste

In Washington, local governments primarily regulate medical waste. As a general rule, biomedical waste generators must segregate the waste and treat it before disposal. If the generator treats the waste onsite, they most likely have to obtain a permit from the health department.

The state's definition of biomedical waste is the sole definition for biomedical waste within the state, and shall preempt biomedical waste definitions established by a local health department or local government.

Managing Infectious Waste

Manage infectious wastes in accordance with local health department requirements. Contact a reliable vendor that picks up and disposes infectious or biohazardous wastes. Follow the vendor's protocols on management and packaging. Follow established safety procedures when working with infectious wastes.

Managing Non-Infectious Waste

Non-infectious solid waste can be disposed of in the garbage.

Managing Mixed Infectious/Hazardous Waste

Some infectious wastes are also hazardous wastes. For example, a syringe that contained flu vaccine with thimerosol (the RCRA-regulated component) as a preservative and was partially injected into a patient is considered both infectious and hazardous. Another example of mixed infectious and hazardous waste is a partially administered IV bag that still contains a P-listed or U-listed chemotherapy drug.

Wherever possible, segregate these wastes. In the flu vaccine example, remove the sharp from the syringe and place it in the sharps container. Then place the barrel of the syringe with the remaining vaccine in the hazardous-waste container. In the IV example, separate the infectious component (the sharp and T-interlock) from the non-infectious component (the tubing and reservoir). Place the sharp and T-interlock in the sharps container and the non-infectious, hazardous-waste tubing and reservoir into the hazardous-waste container. At all times, keep safety foremost in your mind and use adequate personal-protective equipment.

If you have mixed infectious / hazardous waste that meets the definitions of Washington state's conditional exclusion, contact your vendor or solid-waste incinerator to find out if this waste is accepted and how to prepare it for the facility. If an in-state incineration facility meeting the state's specifications is unable to accept conditionally excluded wastes because it is infectious, it may be necessary to find a RCRA-permitted incinerator that is capable of managing infectious wastes.

Washington recommends the following practices for managing infectious, hazardous wastes:

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.  Washington is one of 21 states operating an approved occupational safety and health program. This program is operated by the Department of Labor and Industries. 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.

Statutes, Regulations and Guidelines

Contacts

More Information

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