Healthcare-Related Wastes Explained

Last updated on February 8, 2018

Regulated medical waste, sharps waste, isolation waste, hazardous waste, and universal waste…what’s the difference, and how should they be segregated for proper disposal? This blog will discuss the differences between these healthcare-related wastes and how to safely dispose of them while saving money and reducing your chance of regulatory violations.

Regulated medical waste becomes regulated when it contains enough blood or other potentially infectious materials (OPIM*) to be a risk for spreading bloodborne pathogens when disposed. As healthcare professionals, we know that items contaminated with any amount of blood or OPIM require protection, such as engineering controls and personal protective equipment.

To be considered regulated medical waste, according to OSHA (Occupational Safety and Health Administration) and state regulations, that item must be contaminated with enough blood or OPIM to require containment in a red bag and disposal by a medical waste management company. OSHA regulates how medical waste is handled and contained within your facility in order to protect employees. Each state’s environmental department regulates what medical wastes can be disposed into that state’s landfills.

In general, state definitions of medical waste are very similar to OSHA, which defines medical waste as:

  • Liquid or semi-liquid blood or OPIM
    • Blood in vacutainer and capillary tubes; blood bags and tubing
    • Fluids in suction canisters
  • Contaminated items that would release blood or OPIM in a liquid or semi-liquid state if compressed
    • Blood-soaked gauze or dressings
  • Items that are caked with dried blood or OPIM and are capable of releasing these materials during handling
    • Blood-soaked gauze that has dried and the blood could flake off
    • Bloody gloves or other items that have not absorbed the blood
  • Sharps
    • Needles, syringes with needles attached, scalpels, dental carpules with blood in them
    • Some states define sharps as syringes with or without needles as medical waste
  • Pathological and microbiological wastes

Sharps waste refers to any blood or OPIM-contaminated sharp devices, like needles, scalpel blades, dental carpules, and lancets. Some states consider syringes with or without needles as sharps waste. Most states also require even needles that have not been used be managed as sharps waste as well.

Isolation wastes that must be managed as a regulated waste are wastes from patients infected with highly communicable diseases such as Ebola, Marburg, and other diseases listed on CDC Table 27. According to the CDC, they include biological waste and discarded materials contaminated with blood, excretion, exudates, or secretion from humans or animals who are isolated to protect others from highly communicable diseases.

Unless patients are infected with one of these highly communicable diseases, their wastes are managed as other regulated medical waste. For example, if a patient is isolated for C. diff, MRSA, or VRE (not highly communicable infectious diseases according to CDC Table 27), all contact precautions are practiced according to CDC Isolation Precautions. However, the wastes are managed as any other medical waste.

Hazardous Waste is waste that is dangerous or potentially harmful to our health or the environment and is defined by the EPA. Hazardous wastes can be liquids, solids, gases, or sludge. They can be discarded commercial products, like cleaning fluids, pesticides, or even certain pharmaceuticals.

Pharmaceutical waste can include pharmaceuticals that are not only classified as hazardous waste but also as controlled drug waste, or non-controlled/non-hazardous. Each type of pharmaceutical waste is handled differently.

The EPA created the Universal Waste Rule for certain wastes that are generated in a wide variety of settings including homes and businesses and are able to have their hazardous components removed for the purpose of recycling. The Universal Waste Rule encourages proper disposal and limits the burdens of storage, handling, treatment, and recordkeeping associated with other types of hazardous waste, such as batteries, pesticides, mercury-containing devices, fluorescent bulbs, and certain dental wastes such as dental x-ray fixer, lead foils, and amalgam. All businesses, small and large, should have a hazardous waste plan, including the recycling of universal wastes.


*Other Potentially Infectious Materials (OPIM) means (1) The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids; (2) Any unfixed human tissue or organ from a human.

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.

published in Medical Waste