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New Mexico

Regulated Medical 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 “special waste," that has unique handling, transportation, or disposal requirements to assure protection of the environment and the public health, welfare and safety. Infectious waste means a limited class of substances that carry a probable risk of transmitting disease to humans, including but not limited to:

  • Microbiological laboratory wastes, including cultures and stocks of infectious agents from clinical research and industrial laboratories, and disposable culture dishes and devices used to transfer, inoculate and mix cultures;
  • Pathological wastes, including human or animal tissues, organs and body parts, removed during surgery, autopsy or biopsy;
  • Disposable equipment, instruments, utensils, and other disposable materials which require special precautions because of contamination by highly contagious diseases;
  • Human blood and blood products, including waste blood, blood serum, and plasma;
  • Used sharps, including used hypodermic needles, syringes, scalpel blades, Pasteur pipettes and broken glass; and
  • Contaminated animal carcasses, body parts and bedding, especially those intentionally exposed to pathogens in research, in the production of biologicals or the "in vivo" testing of pharmaceuticals;

Managing Infectious Waste

Infectious Waste Restrictions
 
Infectious waste shall be disposed of only at solid waste facilities authorized for disposal of special waste. 

If infectious waste is to be incinerated, it shall only be incinerated in an infectious waste incinerator authorized under applicable Air Quality regulations and permitted under the regulations.

A manifest shall accompany each load of asbestos, infectious waste, petroleum contaminated soils, ash or other special wastes as specified by the Department originating or to be disposed in New Mexico.

These restrictions apply without regard to the quantity of infectious waste produced, to any producer of infectious waste including, but not limited to, any:

  • General acute care hospitals;
  • Skilled nursing facility or convalescent hospitals;
  • Intermediate care facilities;
  • In-patient care facilities for the developmentally disabled;
  • Dialysis clinics;
  • Free clinics;
  • Community clinics;
  • Employee clinics;
  • Health maintenance organizations;
  • Home health agencies;
  • Surgical clinics;
  • Urgent care clinics;
  • Acute psychiatric hospitals;
  • Blood/plasma centers;
  • Laboratories;
  • Medical buildings;
  • Physicians offices;
  • Veterinarians;
  • Dental offices;
  • Acupuncturists;
  • Funeral homes; and
  • Eye clinics; and
  • To all infectious waste storage, treatment, and disposal facilities.

All material that has been rendered non-infectious may be handled as non-infectious waste, provided:

  • It is not an otherwise regulated, hazardous, special, or radioactive waste and is not subject to applicable requirements;
  • The operator of the disposal facility applies daily cover as required prior to any compaction of the sharps; and:
  • Any person that treats infectious waste shall certify in writing the waste has been rendered noninfectious by sterilization, incineration or another method approved by the Secretary.  Certification shall be provided to the transporter or disposal facility and kept in the facility operating record.  A certification that the waste has been rendered noninfectious shall be provided to the generator, transporter, and disposal facility.  The generator and disposal facility shall maintain copies of certifications and the records made available to the Department upon request.

Storage and Containment Requirements

  • Containment shall be in a manner and location that affords protection from animal intrusion, does not provide a breeding place or a food source for insects and rodents, and minimizes exposure to the public.
  • Infectious waste shall be segregated by separate containment from other waste at the point of origin.
  • Except for sharps, shall be contained in plastic bags inside rigid containers.  The bags shall be securely tied to prevent leakage or expulsion of solid or liquid wastes during storage, handling or transport.
  • Sharps shall be contained for storage, transportation, treatment, and disposal in leak-proof, rigid, puncture-resistant containers that are manufactured for the purpose of sharps containment and are taped closed or tightly lidded to preclude loss of contents.
  • All bags used for containment purposes shall be red or orange and clearly identified as specified by federal regulations.  Rigid containers shall be labeled "biomedical waste", or otherwise conspicuously labeled as holding infectious waste, or placed in disposable bags used for other infectious waste.  Disposable rigid containers shall meet or exceed the standards for a classified strength of at least 200-pound mullen test.
  • If other waste is placed in the same container as regulated infectious waste, then the generator shall package, label and mark the container and its entire contents as infectious waste.
  • Rigid infectious waste containers may be reused for infectious or non-infectious waste if they are thoroughly washed and decontaminated each time they are emptied and the surfaces of the containers have been completely protected from contamination by disposable, unpunctured or undamaged liners, bags, or other devices that are removed with the infectious waste, and the surface of the containers have not been damaged or punctured.
  • Storage and containment areas shall protect infectious waste from the elements, be ventilated to the outdoors, be only accessible to authorized persons, and be marked with prominent warning signs on, or adjacent to, the exterior doors or gates.  The warning signs shall be easily read during daylight from a distance of 25 feet.
  • Generators of medical waste, shall place an absorbent material inside the liner of the rigid container equal to one cup of absorbent material per each six cubic feet of box area if the rigid container is to hold any containers which had held free liquids; if the rigid container is to hold containers which do hold free liquids, then enough absorbent material shall be placed inside the liner of the rigid container sufficient to absorb 15% of the total volume of free liquids inside the rigid container.
  • Compactors, grinders or similar devices shall not be used to reduce the volume of infectious waste before the waste has been rendered non-infectious unless prior approval has been obtained from the Department.

Operational Requirements

All applicable infectious waste treatment, storage and disposal facilities shall comply with the following operational requirements:

  • Every person who generates, transports, stores, treats, or disposes of infectious waste shall prepare and maintain on file a management plan for the waste that identifies the type of waste the person generates or handles, the segregation, packaging, labeling, collection, storage, and transportation procedures to be implemented, the treatment or disposal methods that will be used, the transporter and disposal facility that will be used, and the person responsible for the management of the infectious waste.
  • All infectious waste management facilities may only accept infectious waste that is accompanied by a manifest that contains the information required by the regulations.
  • Report to the Secretary any delivery of unauthorized waste, contamination of any person, or other emergencies immediately upon recognition.
  • Human fetal remains shall be disposed by incineration or interment, which are considered to be human fetal remains when measured to be 500 grams or greater as defined by the State Medical Examiner.
  • Infectious waste consisting of recognizable human anatomical remains shall be disposed by incineration or interment, unless such remains have been contaminated with a regulated hazardous chemical or radioactive substance.  Such contaminated remains shall be disposed of at a permitted hazardous or radioactive waste facility.

Treatment and Disposal of Infectious Waste

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

  • Incineration in a controlled air multi-chambered incinerator which provides complete combustion of the waste to carbonized or mineralized ash:
  • Sterilization by heating in a steam sterilizer so as to render the waste non-infectious:
  • Discharge to a sewage treatment system that provides secondary treatment of waste and only if the waste is liquid or semi-solid and if approved by the operator of the sewage treatment system; or
  • Other methods approved by the Secretary

Transporting Infectious Waste

All infectious waste haulers shall comply with the following transportation requirements:

  • Infectious waste shall not be transported in the same vehicle with other waste unless the infectious waste is contained in a separate, fully enclosed leak-proof container within the vehicle compartment or unless all of the waste has been treated as infectious waste;
  • Persons manually loading or unloading containers of infectious waste onto or from transport vehicles shall be provided by their employer with, and required to wear, protective gloves, shoes and eye wear, and clean coveralls. Face shields and respirators may be required as deemed necessary by the Secretary;
  • Surfaces of transport vehicles that have contacted spilled or leaked infectious waste shall be decontaminated by procedures approved by the Secretary;
  • Vehicles transporting infectious waste shall be identified on each side of the vehicle with the name or trademark of the hauler and a biohazard symbol;
  • Each truck, trailer, semi trailer, or container used for shipping infectious waste shall be so designed and constructed, and its contents limited so that under conditions normally incident to transportation, there shall be no releases of infectious waste to the environment;
  • Any truck, trailer, semi trailer, or container used for shipping infectious waste shall be free from leaks, and all discharge openings shall be securely closed during transportation;
  • No person shall transport infectious waste into the state for treatment, storage, or disposal unless the waste is packaged, contained, labeled and transported in the manner required;
  • All generator storage containers shall be labeled with the generator's name, the city, and date of collection; and
  • Storage of infectious waste by commercial haulers shall be limited to seven days prior to disposal or treatment unless refrigerated at or below 45 degrees Fahrenheit.

Transporters of ash shall not accept or transport ash unless it has been treated, or is securely covered to prevent release of fugitive dust; cover vehicles to prevent fugitive dust loss during transport; and line or seal vehicles in a manner to prevent any leakage of liquids or fugitive dust during transport.

OSHA Regulations HERC OSHA State Page

New Mexico is one of 21 states operating an approved occupational safety and health program. This program is operated by the New Mexico Occupational Health and Safety Bureau. The New Mexico Occupational Health and Safety Bureau (NMOHSB) is a state regulatory agency that is part of the New Mexico Environment Department. It has the responsibility of enforcing Occupational Health and Safety Regulations within New Mexico. New Mexico has adopted the Federal OSHA Regulations and has promulgated some State specific regulations, including construction standards (11 NMAC 5.3).

Statutes, Regulations and Guidelines

New Mexico Solid Waste Management Requirements (current)

Contacts

New Mexico Solid Waste Bureau

More Information

Infectious Waste Information