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. By 1991 it became clear that the panic was overblown, as it was laterreported that “At the end of the summer, the medical-type waste found on Long Island’s beaches would have barely filled a picnic basket.”
That didn’t stop the US Congress from enacting the Medical Waste Tracking Act (MWTA) of 1988 to amend the Solid Waste Disposal Act. The US EPA regulations for the act went into effect on 6.24.89 and expired on 6.21.91. 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.
US EPA 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. US EPA has not renewed the MWTA and has left regulation to the individual states or to other federal agencies.
In an interesting postscript, Congressman Frank Pallone of New Jersey has introduced a bill (H.R. 2546) known as the Medical Waste Mangement Act of 2011. Its purpose is to create US EPA regulations for the management and tracking of medical waste. As proposed, the bill includes “sharps” in the definition of medical waste. It will pay for facilities to keep a close eye on this legislation.
Many states have created their own regulations for the on-site handling and disposal of medical waste, sometimes referred to as Potentially Infectious Medical Waste (PIMW) or Bio Medical Waste. One key difference between state regulations and the MWTA is their application to industrial/commercial facilities and not just to medical facilities and hospitals. Any medical waste generated at your facility cannot go to landfill, but must meet strict state requirements for on-site handling and off-site disposal.
The US Department of Transportation (DOT) regulates the transportation of medical waste as an infectious substance (Division 6.2). 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.”
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.
At my EPA Hazardous Waste and DOT HazMat Employee training events I ask attendees if they manage medical waste on-site in compliance with their applicable state regulations. All too frequently the answer I receive is, “We don’t generate any medical waste.” Then I ask them if any of their employees are self-injecting diabetics. After a pause, my follow-up question is, “What is being done with their needles, which as sharps, are regulated as a medical waste? This usually prompts a discussion about how best to handle such waste.
I recommend the following:
- Ensure that any medical waste generated on site is handled in compliance with applicable state regulations.
- Contract with a licensed medical waste hauler to remove accumulated medical waste on a regular basis.
- Inform applicable staff of their responsibilities in the event clean-up from a trauma is required. Thisnewsletter from Lab Safety Supply can help.
- Follow the Food and Drug Administration guidelines for safe handling and disposal of sharps at home and in the workplace.
Medical waste is just one of the many types of routine waste generation I address at my EPA Hazardous Waste and DOT HazMat Employee training events. I also discuss handling and disposal of: asbestos, PCB lighting ballast, aerosol cans & propane cylinders, e-waste, and cathode ray tubes.