Transporting Regulated Medical Wastes for Disposal

Last updated on February 8, 2018

Did you know that there are different methods of transporting regulated medical wastes for disposal: mail-back programs and pick-up services? For some customers, mail-back is the more practical and economical option; where for others, pick-up service makes more sense. There are several factors that go into determining which option is the best. The most common include:

  • Regulatory considerations
  • Types and volumes of regulated wastes
  • Pick-up service contracts
  • Cost of transport

Regulatory Considerations

Both state and federal regulations can be among the largest determining factors in the decision of whether to use mail-back systems or pick-up service for the transport and disposal of regulated wastes for your facility. Regulations define the following:

  • Type of wastes that can be transported via mail
  • What category of generator may utilize mail-back systems
  • How wastes must be packaged and labeled
  • mount of time waste can be stored prior to disposal


The United States Postal Service (USPS) regulates what can and cannot be sent through the mail as well as how it must be packaged for mailing. For example, if your medical waste falls into one of the types of regulated medical waste (RMW) that is not allowed by USPS, e.g., body parts, liquid wastes, or Category A infectious wastes; or, if your RMW is not packaged, marked, labeled, and documented per USPS regulations, it cannot be sent via the mail. Therefore, if you decide to utilize a mail-back system for transport and disposal of your RMW, you will need to be sure you comply with all USPS as well as state regulations.


The Department of Transportation (DOT) regulates the transporting regulated medical wastes via highways, waterways, and air travel. Therefore, if you decide to use a pick-up service for transport and disposal of your waste, you must follow DOT, as well as state regulations for waste classification and packaging for transport. DOT also requires specific training for all those employees involved in packaging regulated wastes for transport as well as those responsible for filling out the required shipping papers.

Individual States

Even though USPS and DOT are federal regulatory agencies that reach across state lines, state-specific regulations, such as the following, can also govern the transport of regulated wastes:

  • A state may limit what is transported via USPS.
  • Some states may limit the amount of regulated waste shipped through the mail, limiting mail-back use to small quantity generators.
  • States may require specific labeling on sharps containers or transport boxes.
  • States may limit the time a generator can store regulated wastes prior to transport. Generators may find using a monthly pick-up option helps them stay in compliance with these storage time limits.

Type and Volume of Waste Generated

Another factor used to determine the use of mail-back versus pick-up is the type and volume of waste generated. If your facility generates a large volume of RMW or a waste type that cannot be mailed, e.g., body parts, then your option would be a pick-up service. However, if you generate smaller volumes of RMW, pharmaceuticals, or universal wastes, for example, then a mail-back system may be your best choice. Lastly, no regulations require you to utilize a single transport option for all waste streams. So, when you consider the type and amount of waste generated and the associated cost of transportation and disposal, you will likely reach a decision to implement a blended program of both pick-up service and mail-back systems.

Pick-Up Service Contracts

Exclusive contracts between a pick-up service and your county or state can be a determining factor. This is not very common, but if your county or state has such a contract, you can still utilize a mail-back service, which may reduce cost and provide a much more convenient option for your facility.

Cost of Transport

The cost associated with the transport of your regulated wastes is a crucial factor in the mail-back versus pick-up decision. The three aspects most commonly related to cost of transportation are the amount of waste generated, location of and accessibility to your facility or facilities, and often, it simply comes down to your transport preference.

Amount of Waste Generated

Mail-back transport is typically the most cost-effective option for small quantity generators. However, at some point, which is different for every generator, you may start to produce more waste which tips the scale to pick-up being more cost-effective.

Location of Facility

The location of and accessibility to your facility is another aspect in determining the cost of transportation. If your facility is remote, then a pick-up service may either not be available to you, or not be cost-effective. A mail-back system in this case is always available.

Transport Preference

Some facilities prefer one type of transport over another regardless of the associated cost. Working with a company that has experience with and can provide both mail-back and pick-up makes this preference a reality.


As you can see, there are many determining factors to consider when deciding between a mail-back disposal system and a pick-up service for transporting regulated medical wastes. Sharps Compliance offers our customers both options, as well as a blended service option.

Sharps also provides DOT training and additional state and federal resources to help our customers stay in compliance whether they are using mail-back or pick-up. We can help you navigate all the determining factors to arrive at the most cost-effective disposal options for your facility.

Wanda Voigt holds a BA in Nursing from Texas Woman’s University and a BBA in Business Management from Texas A&M University. In Fall 2021, Wanda will begin her Master Jurisprudence in Health Law and Policy at Texas A&M University. Wanda has over 20 years of clinical practice in both hospital and private practice practicing in various specialties.

As the Director of Regulatory Compliance, Wanda assists Sharps’ customers in evaluating current federal and state-specific medical and pharmaceutical waste regulations, implementing compliant regulated medical and pharmaceutical waste management programs and processes, and developing training programs for both internal and external customers.

published in Medical Waste