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InstituteHazardous WasteToxic/Hazardous Substance ReleasesWaste GeneratorsCERCLA, SARA, EPCRA SARA CompliancePesticidesCommunity Right to KnowPesticidesWater ProgramsRisk Management ProgramOil Spill PreventionSafety Data Sheet ReportingRisk Management ProgramPesticide ManagementWater ProgramsStormwaterAir PermittingTank SystemsTier II Inventory ReportingSpecialized IndustriesUnderground Storage TanksRelease NotificationsWater PermittingEmergency Release PlanningMedical WasteIndustrial WastewaterFederal Insecticide, Fungicide and Rodenticide ActEthylene OxideWaste PermittingOil SpillsAir Programs

Environmental requirements for healthcare

['CERCLA, SARA, EPCRA', 'Toxic and Hazardous Substances - OSHA', 'Water Programs', 'Toxic Substances Control Act - EPA', 'Risk Management Program', 'Waste', 'Specialized Industries', 'Oil Spill Prevention', 'Tank Systems', 'Pesticides', 'Air Programs']
Environmental requirements for healthcare
  • The healthcare industry is affected by multiple environmental statutes.
  • Environmental requirements in healthcare settings may cover wastewater discharges, drinking water, waste, emergency planning and community right-to-know, air emissions, toxic substance control, and pesticides.

The healthcare industry is affected by multiple federal environmental statutes. In addition, the industry is subject to numerous environmental laws and regulations from state, tribal, and local governments. Let’s take a high-level look. The table is not comprehensive, and there may be other environmental issues.

Environmental issueOverview
Water dischargesWastewater sources include sinks, drains, showers, toilets, and tubs; photographic development drains from radiology (x-rays), other imaging, and dentistry; and stormwater. The healthcare industry is subject to various provisions of the Clean Water Act (CWA), including:
  • Wastewater discharges — Hospitals that are indirect dischargers are subject to regulations by the local sewer authority. Most municipalities have established local prohibitions that apply specifically to medical waste discharges. Hospitals that are direct dischargers of process and sewer wastes must obtain a permit (from EPA or the state) for any point source discharge of pollutants to waters of the U.S.
  • Stormwater permits — Municipal separate storm sewer systems (MS4s), such as those from hospitals and construction activities, are subject to stormwater permitting requirements.
  • Oil pollution prevention requirements — Hospitals that have a total aboveground oil storage capacity exceeding 1,320 gallons or a completely underground storage capacity exceeding 42,000 gallons are subject to spill prevention, control, and countermeasure (SPCC) plan requirements.
Drinking waterSafe Drinking Water Act (SDWA) regulations protect human health from contaminants in drinking water. A hospital, for example, would be considered a public water system if it regularly serves at least 25 of the same persons six months per year from its own water source. The hospital would be required to comply with SDWA monitoring and reporting requirements. Healthcare facilities that have their own drinking water treatment could generate hazardous or radioactive waste.
WasteUnder federal hazardous waste laws, most healthcare facilities are hazardous waste generators. EPA regulates facilities that generate, transport, treat, store, or dispose of hazardous waste. Important waste requirements for healthcare facilities include:
Emergency planning and community right-to-knowEmergency planning and community right-to-know laws establish reporting obligations (such as emergency planning notification, emergency release notification, annual Tier II reporting, safety data sheet reporting, and annual toxics release inventory (TRI) reporting) for facilities that store or manage specified chemicals, including many chemicals commonly found at healthcare facilities.
Air emissionsAir emissions may come from air conditioning and refrigeration, boilers, medical waste incinerators (if onsite), asbestos, paint booths, ethylene oxide sterilization units, emergency generators, anesthesia, laboratory chemicals, and laboratory fume hoods. Under the Clean Air Act (CAA), states develop plans to identify sources of air pollution and to determine what reductions are required to meet federal air quality standards. Healthcare facilities that qualify as a major source are required to have a Title V permit, and may be required to submit information about emissions, control devices, and the general process at the facility in the permit application.
The CAA also sets forth a list of regulated substances and thresholds, requirements for owners or operators of stationary sources concerning the prevention of accidental releases, and accidental release prevention programs. These requirements are codified in the Risk Management regulations at 40 CFR 68.
Toxic substances controlHealthcare facilities may be subject to the Toxic Substances Control Act (TSCA) through, for example:
PesticidesIn healthcare settings, EPA regulates disinfectants that are used on environmental surfaces (housekeeping and clinical contact surfaces). Disinfectants intended for use on clinical contact surfaces (e.g., light handles, radiographic-ray heads, or drawer knobs) or housekeeping surfaces (e.g., floors, walls, or sinks) are regulated under the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA).
Similarly, pesticides, including insecticides, herbicides, fungicides, rodenticides, and antimicrobials, used on the healthcare facility grounds are subject to FIFRA.

For further guidance, visit:

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FOUNDATIONAL LEARNING
InstituteSpecialized IndustriesSafety & HealthConstruction SafetyGeneral Industry SafetyAgriculture SafetyMaritime SafetySpecialized IndustriesEnglishMine SafetyAnalysisFocus AreaCompliance and Exceptions (Level 2)USA

Contractor safety

InstituteSpecialized IndustriesSafety & HealthConstruction SafetyGeneral Industry SafetyAgriculture SafetyMaritime SafetySpecialized IndustriesUSAEnglishMine SafetyAnalysisFocus AreaIn Depth (Level 3)

Contractor responsibilities

InstituteSpecialized IndustriesSafety & HealthConstruction SafetyGeneral Industry SafetyAgriculture SafetyMaritime SafetySpecialized IndustriesFocus AreaEnglishMine SafetyAnalysisIn Depth Sub Topics (Level 4)USA

Before contract work

InstituteSpecialized IndustriesSafety & HealthIn Depth Sub Topics (Level 4)Construction SafetyGeneral Industry SafetyAgriculture SafetyMaritime SafetySpecialized IndustriesEnglishMine SafetyAnalysisFocus AreaUSA

During contract work

InstituteSpecialized IndustriesSafety & HealthConstruction SafetyGeneral Industry SafetyAgriculture SafetyMaritime SafetySpecialized IndustriesUSAEnglishMine SafetyAnalysisFocus AreaIn Depth (Level 3)

Training

InstituteSpecialized IndustriesSafety & HealthConstruction SafetyGeneral Industry SafetyAgriculture SafetyMaritime SafetySpecialized IndustriesUSAEnglishMine SafetyAnalysisFocus AreaIn Depth (Level 3)

Policies and reporting

InstituteSpecialized IndustriesConcrete/Masonry ConstructionSafety & HealthDemolitionGeneral Industry SafetySpecialized IndustriesEnglishAnalysisFocus AreaCompliance and Exceptions (Level 2)USA

Concrete/Masonry construction

InstituteRepetitive MotionErgonomicsFatigueIn Depth (Level 3)EnglishHealthcareErgonomicsSpecialized IndustriesSafety & HealthGeneral Industry SafetyLifting and Back SafetySpecialized IndustriesCarpal Tunnel SyndromeAnalysisFocus AreaUSA

Healthcare worker injuries and illnesses

InstituteLaboratory SafetyFormaldehydeDiseases and illnessesFatiguePosture and MovementIndoor Air QualityPandemic FluErgonomicsRepetitive MotionIn Depth (Level 3)HealthcareMachine GuardingSpecialized IndustriesHeat and Cold ExposureHAZWOPER Emergency ResponseInfectious DiseasesSafety & HealthInfectious DiseasesCOVID-19Toxic and Hazardous Substances - OSHAElectrical SafetyLifting and Back SafetyEthylene OxideCarpal Tunnel SyndromeHazardous Materials Safety - OSHARespiratory ProtectionHeat and Cold ExposureFire Protection and PreventionMachine GuardingToxic and Hazardous Substances - OSHAOxygen

Hazards to healthcare workers

InstituteAerial LiftsRepetitive MotionErgonomicsDiseases and illnessesPandemic FluSafety and Health Programs and TrainingHazard CommunicationSpecialized IndustriesInfectious DiseasesForklifts and Powered TrucksElectrical Safety Construction StandardsInjury and Illness Recordkeeping FormsInfectious DiseasesEmergency Planning (OSHA)COVID-19First Aid and MedicalExit RoutesEmergency ExitsEthylene OxideRespiratory ProtectionFire ExtinguishersFire Protection and PreventionFirst Aid and MedicalCranes, Lifts, and ScaffoldingSafety and Health Programs and TrainingPersonal Protective EquipmentElectrical SafetyLockout/TagoutFall ProtectionForklifts and Powered TrucksWalking Working Surfaces

OSHA requirements apply to healthcare

InstituteDiseases and illnessesPandemic FluEmergency AlarmsUSAInjury and Illness RecordkeepingEnglishHealthcareSpecialized IndustriesEmergency Planning - OSHAInfectious DiseasesSafety & HealthWeather and Natural DisastersInjury and Illness RecordkeepingInfectious DiseasesCOVID-19Exit RoutesEmergency Planning (OSHA)Emergency ExitsInjury and Illness Recordkeeping FormsGeneral Industry SafetyOSHA RecordkeepingSpecialized IndustriesAnalysisFocus AreaIn Depth (Level 3)

OSHA requirements relate to accreditation standards

InstituteSafety and Health Programs and TrainingSafety and Health Programs and TrainingUSASanitationEnglishHealthcareEmergency Planning - OSHASpecialized IndustriesSafety & HealthEmergency Planning (OSHA)General Industry SafetySanitationSpecialized IndustriesAnalysisFocus AreaIn Depth (Level 3)

OSHA safety and health program recommendations

InstituteFormaldehydeErgonomicsDiseases and illnessesPandemic FluIn Depth (Level 3)HealthcareSpecialized IndustriesHAZWOPER Emergency ResponseInfectious DiseasesSafety & HealthInfectious DiseasesToxic and Hazardous Substances - OSHALifting and Back SafetyMedical WasteEthylene OxideHazardous Materials Safety - OSHARespiratory ProtectionToxic and Hazardous Substances - OSHAPersonal Protective EquipmentBloodborne Pathogens Prevention and ControlBloodborne PathogensCompressed GasesHAZWOPERRadiationEnglishErgonomicsWorkplace ViolenceWorkplace ViolenceGeneral Industry SafetyWasteHand Protection

OSHA guidance for healthcare

InstituteDiseases and illnessesIndoor Air QualityIndustrial HygieneIn Depth (Level 3)Fire Protection and PreventionHazmatRadiationEnglishHealthcareAir ContaminantsSpecialized IndustriesInfectious DiseasesSafety & HealthVentilationInfectious DiseasesGeneral Industry SafetyFood SafetySpecialized IndustriesHazmat License/Permit/RegistrationFire Protection and PreventionAnalysisFocus AreaToxic and Hazardous Substances - OSHAUSA

Other requirements for healthcare

InstituteHazardous WasteToxic/Hazardous Substance ReleasesWaste GeneratorsCERCLA, SARA, EPCRA SARA CompliancePesticidesCommunity Right to KnowPesticidesWater ProgramsRisk Management ProgramOil Spill PreventionSafety Data Sheet ReportingRisk Management ProgramPesticide ManagementWater ProgramsStormwaterAir PermittingTank SystemsTier II Inventory ReportingSpecialized IndustriesUnderground Storage TanksRelease NotificationsWater PermittingEmergency Release PlanningMedical WasteIndustrial WastewaterFederal Insecticide, Fungicide and Rodenticide ActEthylene OxideWaste PermittingOil SpillsAir Programs

Environmental requirements for healthcare

Environmental requirements for healthcare

InstituteHazardous WasteToxic/Hazardous Substance ReleasesWaste GeneratorsCERCLA, SARA, EPCRA SARA CompliancePesticidesCommunity Right to KnowPesticidesWater ProgramsRisk Management ProgramOil Spill PreventionSafety Data Sheet ReportingRisk Management ProgramPesticide ManagementWater ProgramsStormwaterAir PermittingTank SystemsTier II Inventory ReportingSpecialized IndustriesUnderground Storage TanksRelease NotificationsWater PermittingEmergency Release PlanningMedical WasteIndustrial WastewaterFederal Insecticide, Fungicide and Rodenticide ActEthylene OxideWaste PermittingOil SpillsAir Programs
['CERCLA, SARA, EPCRA', 'Toxic and Hazardous Substances - OSHA', 'Water Programs', 'Toxic Substances Control Act - EPA', 'Risk Management Program', 'Waste', 'Specialized Industries', 'Oil Spill Prevention', 'Tank Systems', 'Pesticides', 'Air Programs']
Environmental requirements for healthcare
  • The healthcare industry is affected by multiple environmental statutes.
  • Environmental requirements in healthcare settings may cover wastewater discharges, drinking water, waste, emergency planning and community right-to-know, air emissions, toxic substance control, and pesticides.

The healthcare industry is affected by multiple federal environmental statutes. In addition, the industry is subject to numerous environmental laws and regulations from state, tribal, and local governments. Let’s take a high-level look. The table is not comprehensive, and there may be other environmental issues.

Environmental issueOverview
Water dischargesWastewater sources include sinks, drains, showers, toilets, and tubs; photographic development drains from radiology (x-rays), other imaging, and dentistry; and stormwater. The healthcare industry is subject to various provisions of the Clean Water Act (CWA), including:
  • Wastewater discharges — Hospitals that are indirect dischargers are subject to regulations by the local sewer authority. Most municipalities have established local prohibitions that apply specifically to medical waste discharges. Hospitals that are direct dischargers of process and sewer wastes must obtain a permit (from EPA or the state) for any point source discharge of pollutants to waters of the U.S.
  • Stormwater permits — Municipal separate storm sewer systems (MS4s), such as those from hospitals and construction activities, are subject to stormwater permitting requirements.
  • Oil pollution prevention requirements — Hospitals that have a total aboveground oil storage capacity exceeding 1,320 gallons or a completely underground storage capacity exceeding 42,000 gallons are subject to spill prevention, control, and countermeasure (SPCC) plan requirements.
Drinking waterSafe Drinking Water Act (SDWA) regulations protect human health from contaminants in drinking water. A hospital, for example, would be considered a public water system if it regularly serves at least 25 of the same persons six months per year from its own water source. The hospital would be required to comply with SDWA monitoring and reporting requirements. Healthcare facilities that have their own drinking water treatment could generate hazardous or radioactive waste.
WasteUnder federal hazardous waste laws, most healthcare facilities are hazardous waste generators. EPA regulates facilities that generate, transport, treat, store, or dispose of hazardous waste. Important waste requirements for healthcare facilities include:
Emergency planning and community right-to-knowEmergency planning and community right-to-know laws establish reporting obligations (such as emergency planning notification, emergency release notification, annual Tier II reporting, safety data sheet reporting, and annual toxics release inventory (TRI) reporting) for facilities that store or manage specified chemicals, including many chemicals commonly found at healthcare facilities.
Air emissionsAir emissions may come from air conditioning and refrigeration, boilers, medical waste incinerators (if onsite), asbestos, paint booths, ethylene oxide sterilization units, emergency generators, anesthesia, laboratory chemicals, and laboratory fume hoods. Under the Clean Air Act (CAA), states develop plans to identify sources of air pollution and to determine what reductions are required to meet federal air quality standards. Healthcare facilities that qualify as a major source are required to have a Title V permit, and may be required to submit information about emissions, control devices, and the general process at the facility in the permit application.
The CAA also sets forth a list of regulated substances and thresholds, requirements for owners or operators of stationary sources concerning the prevention of accidental releases, and accidental release prevention programs. These requirements are codified in the Risk Management regulations at 40 CFR 68.
Toxic substances controlHealthcare facilities may be subject to the Toxic Substances Control Act (TSCA) through, for example:
PesticidesIn healthcare settings, EPA regulates disinfectants that are used on environmental surfaces (housekeeping and clinical contact surfaces). Disinfectants intended for use on clinical contact surfaces (e.g., light handles, radiographic-ray heads, or drawer knobs) or housekeeping surfaces (e.g., floors, walls, or sinks) are regulated under the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA).
Similarly, pesticides, including insecticides, herbicides, fungicides, rodenticides, and antimicrobials, used on the healthcare facility grounds are subject to FIFRA.

For further guidance, visit:

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