The Do’s and Don’ts of Medical Waste Packaging

Medical Waste Packaging

Just when you thought that your waste was packaged properly, you learn that your state has laws that differ from federal regulations. Did you know that states have the authority to add additional rules to many federal regulations? It’s important to follow local, state, and federal requirements when packaging and labeling your waste. Here are a few simple steps that you can follow to lessen the potential environmental, safety, and financial risks associated with improper packaging of your medical waste.

As a “Generator,” you are accountable for the proper classification and packaging of your wastes and subject to fines and penalties for any default. So what are the best options for learning proper packaging for medical waste in your state?

First, you must identify which wastes are classified as regulated medical waste. Each state has a specific definition, very similar to that included in OSHA’s Bloodborne Pathogens Standard. According to OSHA, regulated medical waste includes:

  • Sharps
  • Liquid or semi-liquid blood or other potentially infectious materials (OPIM1)
  • Contaminated items that would release blood or OPIM in a liquid or semi-liquid state if compressed
  • Items that are caked with dried blood or OPIM and are capable of releasing these materials during handling
  • Pathological and microbiological wastes containing blood or other potentially infectious materials.

Next, you must properly package your waste for transport according to Federal Department of Transportation (DOT) and any specific state or local regulations. For example, some states require identification on the box if waste must be incinerated. Others may require generator identification on red bags and sharps containers. Others have time limits for storage of your waste. Feel free to discuss these requirements with your service provider or check your specific state requirements at

After setting up your transport box, line it with the red-bag liner. This will reduce the chance of any liquid seepage onto the box. Absorbent materials, such as kitty litter, should be placed in the bottom of the red-bag liner if any amount of liquids may be in the bag. If you have large volumes of liquid waste, let Sharps Compliance know so they can set you up with the proper system for this type of waste. Next, place tied red bags and securely-closed sharps containers into the transport box (loose sharps are not allowed).

As a reminder, please note that the following items should not be placed in the medical waste transport box:

  • Regular trash
  • Items contaminated with urine, feces, and other non-OPIM body fluids

The items below MUST NOT be placed into the medical waste transport box. Contact Sharps Compliance for the proper systems for these materials.

  • Hazardous and chemical waste
  • Loose sharps
  • Compressed gas cylinders
  • Radiographic and amalgam waste
  • Medication
  • Free liquids

Once the transport box is full or otherwise ready to be sealed2, the red-bag liner must be closed by gathering and twisting the neck into a single knot or by using a twist tie. Next, tape the box flaps closed, making sure that the red bag is not visible. Keep in mind that if the box is damaged or not packaged correctly, the service provider will not accept the box.

Apply the supplied barcode label to the exterior of the box on indicated location and have the appropriate person sign the tracking form. The person who signs the tracking form should be knowledgeable about what is contained in the box. Keep your copy for the state-required length of time. All Sharps Compliance customers can access their proof of destruction and run needed reports at

Click here to download our Medical Waste Packaging poster.


[1] OPIM (Other Potentially Infectious Materials): Cerebrospinal, synovial, pleural, peridcardial, peritoneal, amniotic fluids; semen and vaginal secretions; saliva in dental procedures; unfixed human tissues or organs and any body fluid visibly contaminated with blood; and all body fluids in situations where it is difficult or impossible to differentiate between body fluids.

[2] States differ regarding storage times for different waste streams. Check with your state environmental department. Access your state regulations at, or contact Sharps for your specific state storage times.

Jan Harris

Author: Jan Harris

Jan Harris holds a masters degree in Occupational Health and Safety Management and is an authorized OSHA outreach trainer. She has worked as a consultant focusing on OSHA and medical waste compliance since 1990, and for Sharps Compliance since 1999.