Medical Waste

Off-Site Transportation of COVID-19 Waste

Off-Site Transportation of COVID-19 Waste

The COVID-19 public health emergency within the U.S. has created an unprecedented challenge for EHS professionals. One challenge: what to do with the waste generated during the testing for the coronavirus and the treatment of those with COVID-19? An earlier article (FAQ: Are wastes associated with COVID-19 a hazardous waste?) explained the status of this waste under Federal regulations of the USEPA and state regulations – primarily for its on-site management.

This article will address the regulatory requirements of the U.S. Environmental Protection Agency (USEPA), state environmental regulatory agencies, and the Pipeline and Hazardous Materials Safety Administration within the U.S. Department of Transportation (USDOT/PHMSA) for the off-site transportation of waste contaminated – or potentially contaminated – with SARS-CoV-2 (the virus that causes COVID-19). (more…)

FAQ: Are wastes associated with COVID-19 a hazardous waste?

FAQ: Are wastes associated with COVID-19 a hazardous waste?

No.  Wastes such as used medical equipment or personal protective equipment contaminated with the coronavirus are not regulated as a hazardous waste under USEPA regulations.

Regulations codified under the Resource Conservation and Recovery Act (RCRA) identify solid waste as a any discarded material not excluded by regulation.  The used medical equipment, personal protective equipment (PPE), or COVID-19 test kits generated in connection with the diagnosis, treatment, or immunization of persons infected – or suspected of being infected – with SARS-CoV-2 (the virus that causes COVID-19) will be a solid waste.

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To meet the criteria of a hazardous waste, a solid waste must be one – or both – of the following according to USEPA regulations:

  • Identified on one of the lists of hazardous waste at 40 CFR 261, subpart D; i.e., a listed hazardous waste.
  • Display one of the characteristics of a hazardous waste identified at 261, subpart C; i.e., a characteristic hazardous waste.
Lists of hazardous waste:UN3291 Regulated Medical Waste
  • F001-F039 – Hazardous waste from non-specific sources.
  • K001-K181 – Hazardous waste from specific sources.
  • U001-U411 – Discarded commercial chemical products, off-specification species, container residues, and spill residues thereof (toxic).
  • P001-P205 – Discarded commercial chemical products, off-specification species, container residues, and spill residues thereof (acutely toxic).
Characteristics of hazardous waste:
  • D001 – Characteristic of Ignitability.  Liquid, solid, or gas that can self-ignite and burn vigorously or is capable of ignition at a temperature below a regulatory threshold.  It also includes oxidizers.
  • D002 – Characteristic of Corrosivity.  Liquid of low (acid) or high (alkaline) pH or liquid capable of corroding steel.
  • D003 – Characteristic of Reactivity.  Includes: waste that is unstable and readily undergoes violent change without detonation; waste that reacts violently with water; waste that emits toxic levels of cyanide or sulfide gas, waste that is capable of detonation.
  • D004-D043 – Characteristic of Toxicity. Waste that contains an identified toxin that is leachable from the waste and is above a regulatory threshold.

Contact me with any questions you may have about the generation, identification, management, and disposal of hazardous waste

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USEPA regulations do not define wastes as hazardous due to their infectious nature, including those contaminated by the novel coronavirus which causes COVID-19.  It is up to the generator of the waste to complete the hazardous waste determinationHowever, I can, with some confidence, write that it is unlikely a solid waste contaminated with SARS-CoV-2 will either be a listed hazardous waste or display a characteristic of a hazardous waste.

Non-hazardous solid waste – including waste contaminated with SARS-CoV-2 – is subject to state regulatory programs.  This includes states that lack RCRA authorization, e.g., Iowa, Alaska, and Puerto Rico.  State regulations for the management of medical waste vary between the states.  For example, not all states refer to this waste as medical waste, but I will for this article.  This website is a great place to start to determine the regulations of your state for the management of medical waste.
BioHazard red bag

The Centers for Disease Control and Prevention (CDC) has helpful guidance for medical waste generated by healthcare facilities:

Medical waste (trash) coming from healthcare facilities treating COVID-2019 patients is no different than waste coming from facilities without COVID-19 patients. CDC’s guidance states that management of laundry, food service utensils, and medical waste should be performed in accordance with routine procedures. There is no evidence to suggest that facility waste needs any additional disinfection.

More guidance about environmental infection control is available in section 7 of CDC’s Interim Infection Prevention and Control Recommendations for Patients with Confirmed COVID-19 or Persons Under Investigation for COVID-19 in Healthcare Settings.

If you are a healthcare provider, medical facility, hospital, community-based testing site, or some other commercial or government facility generating a waste potentially contaminated with the SARS-CoV-2 virus, you should do the following regarding that waste:

  1. Conduct a documented hazardous waste determination.
  2. If a hazardous waste (unlikely), manage it according to USEPA and state regulations as a hazardous waste.  Be sure to inform the transporter and designated facility it may be contaminated with the coronavirus.
  3. If not a hazardous waste, research your state regulations to determine your cradle-to-grave responsibility for its on-site and off-site management as a medical waste.
  4. Follow CDC and OSHA guidelines to ensure worker protection.
  5. Comply with USDOT/PHMSA regulations for its off-site transportation as a Division 6.2 Infectious Substance.
  6. Keep records of all activities.
  7. Be safe.

Daniels Training Services, Inc.

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https://www.danielstraining.com/

USEPA and most states do not regulate the wastes generated by a homeowner.  Even California does not currently regulate home-generated medical waste, with the exception of sharps (i.e., needles).  Therefore, household waste that has come in contact with someone who has COVID-19 should be managed with prudence but is not subject to regulation.  This fact sheet from the Illinois EPA contains information helpful to any homeowner for management of this waste and related items.

USEPA Regulations for the Management of Medical Waste

USEPA Regulations for the Management of Medical Waste:

It was the summer between my freshman and sophomore years of college at the University of Wisconsin – Stevens Point when news broke in July of 1988 about needles and other medical waste washing up on public beaches on the eastern seaboard.  The national media performed admirably as a source of un-sensationalized and thoughtful information about this public health calamity (Note: irony).  By 1991 it became clear that the panic was overblown, as it was later reported that “At the end of the summer, the medical-type waste found on Long Island’s beaches would have barely filled a picnic basket.”Sharps Container

That didn’t stop the U.S. Congress from enacting the Medical Waste Tracking Act (MWTA) of 1988 to amend the Solid Waste Disposal Act (SWDA).  The U.S. Environmental Protection Agency (USEPA) regulations for the act went into effect on June 24, 1989 and expired on June 21, 1991.  In that time they were effective in four states only: New York, New Jersey, Connecticut, Rhode Island, and Puerto Rico.  There were several purposes for this two year program:

  • Gather information related to medical waste management.
  • Focus attention on the medical waste issue.
  • Examine various treatment technologies for medical waste.
  • Provide a model for states and other federal agencies to develop their own medical waste programs.

USEPA concluded from the MWTA that the disease-causing potential of medical waste decreases naturally from its point of generation as it moves toward its final destination.  USEPA has not renewed the MWTA and has left regulation to the individual states or to other federal agencies.

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State Regulations for the Management of Medical Waste:

Most states have since further developed their own programs resulting in each state program differing significantly from each other.  One key difference between state regulations and the Federal MWTA is their application to industrial and commercial facilities and not just to medical facilities and hospitals.  Therefore, any medical waste generated at an industrial or commercial facility – even if generated by employees and not part of the business – cannot go to landfill, but must meet strict state requirements for on-site handling and off-site disposal.

Another difference is how the waste is named.  While identified as “Medical Waste” by the Federal act and regulations, it may go by several different names under state regulations:

Check with your state to determine your responsibility for management of Medical Waste

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Other Federal Agencies Management of Medical Waste:

The Pipeline and Hazardous Materials Safety Administration within the U.S. Department of Transportation (USDOT/PHMSA) regulates the transportation of medical waste as a Division 6.2 Infectious Substance.  The definition of an infectious substance at 49 CFR 173.134(a)(6) reads:

Sharps means any object contaminated with a pathogen or that may become contaminated with a pathogen through handling or during transportation and also capable of cutting or penetrating skin or a packaging material. Sharps includes needles, syringes, scalpels, broken glass, culture slides, culture dishes, broken capillary tubes, broken rigid plastic, and exposed ends of dental wires.”

Regardless of Federal and state regulations, USDOT/PHMSA Hazardous Materials Regulations (HMR) will apply to the off-site transportation of a medical waste as a Division 6.2 Infectious Substance.

The Occupational Safety and Health Administration’s (OSHA) Bloodborne Pathogen Standard can be found at 29 CFR 1910.1030.  While aimed primarily at healthcare workers and others who deal with blood and body fluids on a regular basis, it also covers maintenance, custodial, laundry, and waste handlers that may be called upon to clean up body fluids after an accident.  OSHA website.

The Centers for Disease Control and Prevention (CDC) has guidance for persons working with infectious pathogens.  CDC website.

State regulations, whether for Medical Waste, Hazardous Waste, Universal Waste, Non-Hazardous Waste, or Used Oil present an additional level of regulations for any industrial, commercial, or government facility.  Please contact me with any questions you may have about the management of waste under Federal or State regulations.

Daniels Training Services, Inc.

815.821.1550

Info@DanielsTraining.com

https://www.danielstraining.com/