Medical Waste Regulations

Last updated on January 27, 2021

Medical waste is regulated by many government agencies. This can make staying in compliance complicated and time-consuming. Since states, counties, and even cities can differ in their requirements, waste generators must be aware of all the different regulations. In this blog, we will discuss a number of differences between state medical waste regulations.

So, why exactly is medical waste regulated? Medical waste is regulated when it either has the potential to or is capable of transmitting infectious diseases to humans.  Waste items become regulated medical waste (RMW) when they are soaked with blood or other potentially infectious materials (OPIM*).

A clinician must handle items with ANY amount of contamination with precautions such as gloves. However, if there is not enough contamination of blood or OPIM on an item for it to be defined as RMW, it may be disposed of as trash. In general, state definitions are very similar to OSHA’s definition which is contained in the Bloodborne Pathogens Standard.

Regulated medical waste consists of the following:

  • Liquid or semi-liquid blood or OPIM
  • Contaminated items that would release blood or OPIM in a liquid or semi-liquid state if compressed (squeezed)
  • Items that are caked with dried blood or OPIM and are capable of releasing during handling
  • Sharps
  • Pathological and microbiological waste

Check with your state for variations in this definition.

While OSHA defines and regulates the containment and safe handling of RMW by employees, it’s the individual states, Department of Transportation (DOT), United States Postal Service (USPS), and the Environmental Protection Agency (EPA) that regulate the transport and disposal of RMW.

Keeping track of your state’s regulations for containment, transport, and disposal of RMW can be confusing. States even call medical waste by different names, such as infectious waste, biohazardous waste, biomedical waste, etc. Although state medical waste regulations have many similarities, there are differences. For example, states can differ on generator requirements for registration, storage, medical waste management plans, and manifesting.

It is important that you review your state’s regulations. Sharps customers have access to the Sharps Regulatory Hub, which provides an interactive map with links to each state’s regulatory information.

One of the most important requirements in some states is the need to register as a medical waste generator. Listed below are the states, counties, and cities requiring RMW generators to register.

Alabama New York – New York City
California Ohio
Delaware Pennsylvania – Philadelphia
District of Columbia Rhode Island
Florida South Carolina
Maine Washington
Michigan West Virginia
New Jersey

It is also important to know if your state regulates how long you can store your medical waste prior to sending it for disposal. Some states have no limits, some limit how long non-sharps RMW can be stored but not sharps, and some states limit both sharps and non-sharps.

States or counties may also require generators to create and maintain a facility-specific medical waste management plan. Plans, if required, must be updated when changes are made, such as the location of sharps containers, changes to the disposal company, or changes to the types of waste generated.

Facilities must also maintain their manifest tracking forms for specific lengths of time in many states. Whether using a pickup service whose driver hands you a tracking form to sign or a mailback with the tracking form attached, you must sign it before transferring the waste for disposal. If your state requires, you also must document that your waste has been received and treated by the disposal facility.

To see how long your state allows you to store medical waste or if you need to prepare a medical waste management plan or other specific requirements, check your state regulations or contact Sharps’ team of regulatory experts. With decades of experience in the medical waste environment, we work each day to keep your employees, patients, and business safe and compliant.

*OPIM (Other Potentially Infectious Materials): Cerebrospinal, synovial, pleural, pericardial, peritoneal, amniotic fluids; semen and vaginal secretions; saliva generated in a dental procedure due to the potential for blood; unfixed human tissues or organs; and all body fluids visibly contaminated with blood.

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