Connecticut
Biomedical
Waste
Waste Categories
In Connecticut, biomedical waste (BMW)
is regulated as a solid/special waste. BMW is not regulated
as hazardous waste unless it exhibits a hazardous characteristic
or is mixed with a listed hazardous waste
Definition
of Biomedical Waste (BMW)
BMW
is any infectious, pathological, and chemotherapy waste
generated during the administration of medical care or
the performance of medical research involving humans or
animals. BMW includes:
- Infectious
waste (including sharps).
- Disposable
non-decontaminated reusable containers.
Managing
Biomedical Medical Waste (BMW)
A
generator of BMW is any person who owns or operates a
facility that produces BMW in any quantity. This includes,
but is
not limited to, the following: hospitals, skilled nursing
facilities, laboratories, physicians’ offices, veterinarians,
dental offices, and funeral homes. Where more than one
generator of BMW is located in the same building, each
individual business entity is considered a separate generator.
Generators
must prepare a written management plan for each facility
that generates BMW. The BMW plan must set forth policies
and procedures for segregating the waste and to ensure
the below conditions are met:
- BMW
that is mixed with hazardous waste or radioactive material
will be managed as hazardous waste or radioactive material.
- Any
solid waste this is mixed with BMW will be managed as
BMW.
Follow these prescribed
practices for managing BMW:
- Segregate
sharps, body fluids and other BMW.
- Implement
a written BMW Management Plan.
- Package
in appropriate containers.
- Label
containers with water-resistant labels.
- Mark
primary and secondary containers with water-resistant identification
tags.
Identification and Segregation
Generators
must segregate BMW from other solid waste before placing
the BMW into primary containers. BMW must be segregated
into the following groupings:
- Bodily fluids in a quantity
greater than 20 cubic centimeters
Packaging Requirements
Before
transporting BMW, generators are required to package the
BMW as follows:
- Place BMW in containers that
are rigid, leak-resistant, impervious to moisture, sufficiently
strong to prevent tearing or bursting under normal conditions,
and sealed to prevent leakage.
- Place sharps in containers that
are puncture-resistant.
- Body fluids in quantities greater
than 20 cm3 must be placed in containers that
are break-resistant and tightly lidded or stoppered.
- Employees packaging BMW must
wear personal protective equipment.
- The
outside of each container must be marked with a
water-resistant label displaying
the universal biohazard symbol or the words “medical
waste” or “infectious waste.”
Storage Requirements
BMW
must be stored in such a way that it avoids mixing with
other materials, and access to it must be limited to personnel
authorized by the generator, transporter, or solid waste
facility operator to handle it. Outdoor storage areas,
such as dumpsters, sheds, or trailers, must be locked.
Furthermore, the areas used for storage must be constructed
of finished materials that are impermeable and capable
of being easily maintained in a sanitary condition.
The
waste itself should be stored in a manner and location
that protects
it from water, precipitation, wind, animals, and
does not provide a breeding place or food source for insects
or
rodents. To maintain a non-putrescent state, BMW
may
be refrigerated during storage. Finally, a sign displaying
the universal biohazard symbol and/or the words “BIOHAZARD” must
be posted wherever BMW is stored.
Labeling and Marking
Biomedical Waste (BMW) for Off-Site Transport
Before
transporting BMW, the generator must:
- Place
the waste in a red bag to render it universally recognizable
as biomedical.
- Package
it in rigid, leak-resistant containers that are resistant
to moisture.
- Use
a container that is strong enough to avert tearing or bursting
under normal circumstances and seal it to prevent leakage.
- Make
sure each container displays the universal
biohazard symbol or the words “BIOHAZARD” in large,
easy-to-read lettering.
- Never
reuse a container that housed BMW for any purpose unless
its surfaces were protected from contamination through
the use of a liner or bag that was removed with the waste,
or it has been thoroughly washed and disinfected, with
all visible traces of prior contamination removed.
Disposal of Biomedical
Waste (BMW)
BMW which
has been treated in accordance with BMW regulations and
which has been rendered unrecognizable may be disposed
of as municipal solid waste. Solid waste facilities shall
not accept BMW which is not packaged, labeled and marked
as required by regulations, or which is not accompanied
by a tracking form that complies with all applicable law.
The methods of disposal are as follows:
- Chemotherapy
waste by incineration.
- Pathological
waste (i.e. human tissue, organs, body
parts) by incineration
or internment.
- Infectious
waste (i.e. body fluids or items dripping
with body fluids, discarded sharps, biological waste
generated from research) either
by incineration, discharge to a sanitary sewer, or treatment
by steam sterilization or other approved alternative treatment
technology (ATT). The waste may be discharged to a sewer
given it is liquid or semi-liquid in form, and that secondary
treatment is provided at a private or public treatment
works. In all cases, once the waste has been treated in
accordance with the provisions of the regulations, the
end result must be rendered unrecognizable as biomedical
waste. It may then be disposed of as municipal solid waste.
Note: this category includes ALL infectious waste EXCEPT
that which falls under the categories of “chemotherapy” and “pathological.”
- Needles
which are specifically used to administer antineoplastic
agents shall be handled in accordance with this section
or under regulations adopted for the handling of chemotherapy
waste; and
- Syringes
designed to deliver drugs into the human body in a manner
other than injection shall be exempted from the disposal
requirements of this section.
On-Site
Treatment or Disposal of Biomedical Waste (BMW)
If BMW is treated or disposed of at the site where it was generated,
the generator shall develop written procedures for each
treatment or disposal method in use at such site which
methods shall be consistent with the provisions of this
section and shall ensure compliance with such procedures.
Such procedures shall be incorporated into the BMW management plan
required by law and shall (1) assure the effectiveness
of any treatment method in use and reflect acceptable standards
of practice, (2) provide for and conduct an ongoing program
of staff training on the implementation of such procedures
and the requirements of this section, and (3) provide for
a quality assurance program to assure compliance with the
biomedical management plan prepared as required by law.
Incinerating
Biomedical Waste (BMW)
Biomedical
waste incinerator residue shall be managed as a special waste
in accordance with the regulations. A steam sterilizer used
to decontaminate biomedical waste shall be operated in accordance
with the following requirements:
- In a gravity flow sterilizer, biomedical waste shall
be subjected to a temperature of not less than two hundred
fifty degrees Fahrenheit at fifteen pounds per square
inch of gauge pressure for no less than sixty minutes.
- In a vacuum type sterilizer, biomedical waste shall be
subjected to a temperature of not less than two hundred
seventy degrees Fahrenheit at twenty-seven pounds per
square inch gauge pressure for no less than forty-five
minutes.
- Notwithstanding subdivisions (1) and (2) of this subsection,
a different combination of operational time, temperature
and pressure may be utilized for steam sterilization
of biomedical waste if such combination is first described
in writing to the commissioner and approved in writing
by the commissioner. The commissioner shall not grant
approval unless such combination is proven on the basis
of thorough tests, including tests of its capacity to
kill bacillus stearothermophilus and to completely and
reliably kill all microorganisms in waste at design capacity.
- Biomedical waste shall be steam sterilized in its primary
container. The primary container shall be placed in the
sterilization chamber so that sufficient space is provided
between the chamber walls and the container to allow
the steam to penetrate the container. The primary container
shall then be unsealed to allow the steam to penetrate
the contents of the container.
- Unless the steam sterilizer is equipped to continuously
monitor and record temperatures during the entire length
of each sterilization cycle, the operator of such sterilizer
shall affix to the primary container temperature-sensitive
tape which indicates when the desired temperature is
reached. Biomedical waste shall not be considered decontaminated
unless the temperature-sensitive tape indicates that
a temperature of at least two hundred fifty degrees Fahrenheit
was reached during the sterilization process. A steam
sterilizer which is used for the first time after July
1, 1994, shall automatically and continuously monitor
and record temperatures throughout the entire length
of each steam sterilization cycle.
- At least once during every forty hours of operation,
tests shall be conducted to evaluate the effectiveness
of the sterilization process, including tests of the
capacity of such process to kill bacillus stearothermophilus.
A log shall be maintained recording the dates and results
of such test.
- At least once during every forty hours of operation,
a sterilization unit shall be evaluated to determine
whether it is operating properly with respect to temperature
and pressure. A log shall be maintained recording the
dates and results of such evaluations and the dates of
calibration.
- For each sterilization unit a log shall be maintained
recording, for each use, the date, time, operator, type
and approximate amount of biomedical waste treated, the
sterilization pressure reading and the poststerilization
reading on the temperature-sensitive tape.
Sharps shall be physically altered so as to render
them unrecognizable in accordance with the regulations.
No
person shall:
- Deliver biomedical waste or cause biomedical waste to be delivered
to any incinerator, whether located inside or outside of
this state, unless such incinerator complies with all applicable
law; or
- Operate an incinerator in which biomedical waste is burned unless
such incinerator complies with all applicable law.
Licensed Transporters
Generators must use transporters permitted by DEP. Connecticut
requires separate permits for transporting
hazardous and biomedical waste. Under Connecticut law,
ANY
person who
transports BMW, regardless of the quantity,
needs a permit issued by the Commissioner. To receive the
most current
list of licensed BMW transporters, contact
the
Waste Engineering and Enforcement Division’s
Solid Waste Section at 860-424-3366.
One
exception to this permit requirement is if
you are a BMW Small Quantity
Generator (SQG) and you generate or transport
less than 50 lbs in
a month or in any single shipment. SQG’s may self-transport
without a permit, ship certain BMW using the US Postal
Service and are exempt from certain tracking and record
keeping requirements. SQG’s may ship to a
solid waste facility or another facility
owned by
the generator.
Generators
may ship from the original generation point
to a central collection point if:
- The
waste is segregated, packaged, labeled and marked.
- Written
authorization is provided for employees.
- The
waste is transported by employer/employees.
- Shipping
logs are maintained at each site.
Note: Although
qualified SQG’s can self-transport certain
BMW, it is recommended that you use a permitted
BMW
transporter to ship BMW, to
ensure that the waste is being transported
in accordance with applicable law.
Each generator
of biomedical waste shall submit to the Commissioner of
Environmental Protection, in writing, the name of the person
said generator has contracted with to dispose of its biomedical
waste, the amount of such waste and the site of disposal.
Tracking Forms, Reporting
and Recordkeeping
Generators
must use the DEP-provided form to track BMW from cradle
to grave. The generator must prepare one copy for its facility,
one copy for the transporter, and two copies for the solid
waste facility where the BMW is being transported.
If applicable, maintain
the following records on-site for three years:
- Signed
Medical Waste Tracking forms.
- Original
US Postal Service receipts and return mail receipts.
- Operating
logs and annual reports.
OSHA Regulations
HERC OSHA State Page
In
addition to the state medical waste environmental
regulations there are some
Occupational Safety and Health Administration
(OSHA) rules that apply to medical/infectious waste. Connecticut
is one of 24 states operating an approved occupational
safety and health program. However, the
Connecticut program only covers the workplace
safety and health of
public sector employees only.
Private sector employees
in Connecticut are covered by <a
Federal OSHA. OSHA state and federal rules (Occupational
Exposure to Bloodborne Pathogens Standards)
impact various aspects
of medical/infectious waste, including management
of sharps, requirements for containers that
hold or store medical/infectious
waste, labeling of medical/infectious waste
bags/containers, and employee training. These
requirements can be found in the HERC section
entitled OSHA Standards
for Regulated Waste
Statutes, Regulations and Guidelines
Connecticut BMW Definitions
Connecticut BMW Disposal Requirements
Connecticut BMW Disposal by Generators
Connecticut Solid Waste Management
Requirements
Source performance
standards (NSPS) for hospital/medical/infectious
waste incinerators (HMIWI)
Emission guidelines for existing HMIWIs: 40 CFR 60.30e to
60.39e
Contacts
CT-DEP, Bureau of Waste Management
More Information
CT BMW Requirements (22a-209-15) and Common Industry Practices
CT Permit Application for the Disposal of Special Wastes
CT-DEP Waste Transportation Guidance Document
CT-DEP Special Wastes or Asbestos Disposal Authorization
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