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Mississippi

Infectious
Medical Waste

Background Information
Definition of Infectious Medical Waste
Managing Infectious Medical Wastes
OSHA Regulations
Contacts
Statutes, Regulations and Guidelines
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 Medical Waste

Infectious Medical Waste includes solid or liquid wastes, which may contain pathogens with sufficient virulence and quantity such that exposure to the waste by a susceptible host has been proven to result in an infectious disease. The following wastes are considered to be infectious medical waste:

  • Wastes resulting from the care of patients and animals who have Class I and /or Class II diseases that are transmitted by blood and body fluid.
  • Cultures and stocks of agents; including specimen cultures collected from medical and pathological labs, cultures and stocks of infectious agents from research and industrial labs, wastes from the production of biologicals, discarded live and attenuated vaccines, culture dishes and devices used to transfer, inoculate, and mix cultures.
  • Blood and blood products such as serum, plasma, and other blood components.
  • Pathological wastes, such as tissues, organs, body parts, and body fluids that are removed during surgery and autopsy.
  • Contaminated carcasses, body parts, and bedding of animals that were exposed to pathogens in medical research.
  • All discarded sharps which have come into contact with infectious agents.
  • Other wastes determined infectious by the generator or so classified by the Mississippi Department of Health.

Managing Infectious Medical Wastes

The Mississippi Department of Environmental Quality has not, at this time, developed comprehensive regulations regarding the transportation and management of infectious medical waste. However, the proper transportation, management and disposal of infectious medical waste in Mississippi are regulated under the general provisions of the Mississippi Solid Waste Law and the Mississippi Nonhazardous Waste Management Regulations.

The Mississippi State Department of Health regulates the on-site storage and management of medical waste through the Adopted Standards for the Regulation of Medical Waste in Health Care Facilities Licensed by the Mississippi State Department of Health. For information on the regulation of commercial management of medical wastes, contact the Solid Waste Management Branch at the Department of Environmental Quality.

The off-site management and disposal of infectious medical waste is regulated by the Department of Environmental Quality under the provisions of the Mississippi Non-hazardous Solid Waste Management Regulations and the Mississippi Solid Waste Law. Disposal of such waste at a landfill or other solid waste facility is addressed through specific conditions in that facilitys solid waste management permit. These permit conditions generally prohibit municipal solid waste disposal facilities from accepting infectious medical waste that has not been rendered non-infectious. State regulations also require that, prior to the establishment of any commercial facility in the State specifically for the storage, transfer, treatment or processing of infectious medical wastes, the owner or operator of the facility must obtain environmental operating permits form the Department for a solid waste management facility.

Treatment and Disposal of Infectious Medical Waste

Treatment or disposal of infectious medical waste shall be by one of the following methods:

  • By incineration in an approved incinerator which provides combustion of the waste to carbonized or mineralized ash.
  • By sterilization by heating in a steam sterilizer, so as to render the waste non-infectious. Infectious medical waste so rendered non-infectious shall be disposable as medical waste.
  • Use of heat sensitive tape or other device for each container that is processed to indicate the attainment of adequate sterilization conditions.
  • Use of the biological indicator Bacillus stearothermophilus placed at the center of a load processed under standard operating conditions at least monthly to confirm the attainment of adequate sterilization conditions.
  • By discharge to the approved sewerage system if the waste is liquid or semi-liquid, except as prohibited by the State Department of Health.
  • Recognizable human anatomical remains shall be disposed of by incineration or internment, unless burial at an approved landfill is specifically authorized by the Mississippi State Department of Health.
  • Chemical sterilization shall use only those chemical sterilants recognized by the U.S. Environmental Protection Agency, Office of Pesticides and Toxic Substances. Ethylene oxide, glutaraldehyde, and hydrogen peroxide are examples of sterilants that, used in accordance with manufacturer recommendation, will render infectious waste non-infectious. Testing with Bacillus subtilis spores or other equivalent organisms shall be conducted quarterly to ensure the sterilization effectiveness of gas or steam treatment.

Treatment and disposal of medical waste that is not infectious shall be by one of the following methods:

  • By incineration in an approved incinerator which provides combustion of the waste to carbonized or mineralized ash.
  • By sanitary landfill, in an approved landfill which shall mean a disposal facility or part of a facility where medical waste is placed in or on land, and which is not a treatment facility.

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. Mississippi 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. These requirements can be found in the HERC section entitled OSHA Standards for Regulated Waste.

Contacts

Mississippi Department of Environmental Quality

For additional specific information on the Standards for the Regulation of Medical Waste in Health Care Facilities Licensed by the Mississippi State Department of Health, contact the Health Facilities Licensure and Certification Division of that agency at (601) 576-7300. For information on the regulation of commercial management of medical wastes, contact the Solid Waste Management branch at the Department of Environmental Quality at (601) 961-5171.

Statutes, Regulations and Guidelines

None located.

More Information

In this section, you will find links to points of contacts at the Mississippi agencies responsible for regulation healthcare facility waste, links to the text of the regulation, and additional resources that you might find of interest on this topic.

Adopted Standards for the Regulation of Medical Waste in health care facilities licensed by the Mississippi State Department of Health.

Medical Waste Fact Sheet.

Commercial Medical Waste Facilities in Mississippi