Medical waste is generated at health care facilities such as hospitals, physicians’ offices, dental offices, blood banks, veterinary clinics and hospitals, medical research facilities, and laboratories.
The Occupational Safety and Health Administration’s (OSHA) Bloodborne Pathogens Standard (BBP) applies to all occupational exposures to blood or other potentially infectious materials in General Industry. Waste generated in the workplace that falls under the BBP Standard may also be regulated medical waste.
Other federal regulations that may apply include the EPA requirement for facilities to identify their waste streams, DOT hazardous materials transportation requirements, and infectious disease controls from the Centers for Disease Control and Prevention (CDC).
Scope
Medical waste is regulated primarily at the state level. It may be called regulated medical waste, medical waste, biomedical waste, biological waste, or infectious waste. States may regulate medical waste as a solid waste, special waste, hazardous waste, or a combination of all three.
Regulatory citations
- 40 CFR 261 — Identification and Listing of Hazardous Waste
- 40 CFR 262 — Standards Applicable to Generators of Hazardous Waste
- 29 CFR 1910.1030 — Bloodborne Pathogens
- 49 CFR Subchapter C — Hazardous Materials Regulations
Key definitions
- Bloodborne pathogens: Pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV).
- Contaminated: The presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface.
- Infectious waste (EPA): A waste that contains pathogens with sufficient virulence and quantity so that exposure to the waste by a susceptible host could result in an infectious disease.”
- Infectious waste (Generator): A health care facility that produces infectious waste.
- Infectious waste (Transportation): The shipment or conveyance of medical waste by air, rail, highway, or water.
- Infectious waste (Transporter): A person engaged in off-site transportation of medical waste.
- Medical waste: A subset of wastes generated at health care facilities, such as hospitals, physicians’ offices, dental practices, blood banks, and veterinary hospitals/clinics, as well as medical research facilities and laboratories. Generally, medical waste is healthcare waste that may be contaminated by blood, body fluids or other potentially infectious materials and is often referred to as regulated medical waste.
- Medical Waste Tracking Act: The expired federal medical waste tracking program run by EPA from 1988 to 1991.
- Occupational exposure (OSHA): Reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or OPIM that may result from the performance of an employee’s duties.
- Regulated waste (OSHA): Liquid or semi-liquid blood or other potentially infectious materials, contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed; items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or other potentially infectious materials.
- Regulated medical waste: Waste generated specifically by the heath care industry, including infectious and hazardous medical wastes.
- Sharps: Needles, syringes, scalpel blades, pipettes, specimen slides, cover slips, glass petri dishes, and broken glass potentially contaminated with infectious material.
- Universal precautions: An approach to infection control. According to the concept of Universal Precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other bloodborne pathogens.
Summary of requirements
Healthcare facilities.
- Understand the state medical waste regulations that apply to your waste.
- Properly identify and manage all the types of wastes you generate.
- Separate, or segregate, infectious waste from other waste types.
- Manage infectious waste that is also a hazardous waste (certain chemotherapy drugs, disinfectants, sterilants, etc.) as hazardous waste.
- Treat or disinfect infectious waste (or send the waste to a facility that will treat or disinfect it) before disposing of it.
- Ensure sharps are placed in appropriate sharps containers (puncture resistant, closable).
- Ensure proper packing for transportation.
- Use a licensed infectious waste transporter (if required by the state).
- Provide personal protective clothing and equipment (gloves, masks, aprons, etc.) to workers who manage infectious waste.
Non-healthcare facilities.
- Understand if OSHA’s Bloodborne Pathogens (BBP) Standard applies to you. The BBP applies to General Industry employers that have employees with occupational exposures to BBP.
- Take universal precautions. Treat all human blood and human body fluids as if known to be infectious.
- Follow all the requirements of the BBP Standard at 29 CFR 1910.1030.
- Best practices include double-bagging contaminated wastes (used gloves, face masks, wipes, and other disposable items) and placing this bag into a rigid trash container with a lid or a dumpster.
- Affix warning labels to containers of regulated waste; containers of contaminated reusable sharps; refrigerators and freezers containing blood or other potentially infectious materials; other containers used to store, transport, or ship blood or OPIM; contaminated equipment that is being shipped or services; and bags or containers of contaminated laundry. Facilities may use red bags or red containers instead of labels.
- Ensure proper packaging for transportation.
Transporters.
- States may require transports to obtain infectious waste, or special waste permits.
- Ensure medical waste is properly packaged and labeled to the specifications listed in the DOT’s Hazardous Materials Regulations.
- It is recommended to ship untreated medical waste in refrigerated box trucks.
