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Nebraska

Infectious Medical Waste

Waste Categories

Nebraska classifies wastes generated by health care facilities into four main categories:

Hazardous wastes. This refers to a class of wastes specifically defined in a federal law (the Resource conservation and Recovery Act, or RCRA). These wastes contain certain toxic chemicals or have certain characteristics that cause them to be a significant risk to the environment and/or human health. Some certain chemotherapy waste is hazardous waste. In Nebraska, hazardous waste regulations are enforced by the Nebraska Department of Environmental Quality (NDEQ).

Medical waste. Medical waste means any solid waste which is generated in the diagnosis, treatment, or immunization of human beings or animals, in research, or in the production or testing of biologicals. It does not include any hazardous waste, radioactive waste, or household waste.

Infectious Medical Waste (IMW). These are a special subcategory of medical wastes that present significant health risks such as the potential for infectious disease transmission, and special rules apply to them.

Municipal solid waste. These wastes present fewer environmental or health risks than medical wastes. Municipal solid waste can be disposed of into dumpsters.

It is important that you categorize your facility’s waste accurately.

  • Hazardous waste disposed of as infectious medical waste or municipal solid waste, or infectious medical waste disposed of as municipal solid waste are violations of the law and can result in substantial penalties.
  • Conversely, most medical waste may be handled as general solid waste and does not require special handling or treatment.
  • Correctly identifying and segregating your IMW can reduce the cost of disposal. Infectious medical waste makes up only a small portion of the total medical waste stream. Some facilities, such as long-term care facilities, generate medical waste, but little or no infectious medical waste. Use the guidance and references below to accurately categorize your wastes. For additional help, see Contacts below.
  • Infectious medical waste that is treated to specific standards can be disposed of as municipal solid waste, provided that no local rules prohibit it.

Definition of Infectious Medical Waste

Infectious medical waste means a solid waste capable of causing an infectious disease. For a waste to be deemed infectious, consideration is given to the elements required in order for infections to occur, such as the presence of a pathogen or causative organism, of significant virulence in an adequate dose, which is able to gain a portal of entry in a susceptible host. Infectious waste includes, but is not limited to the following:

  • Blood, blood products and body fluids.
  • Infectious sharps waste.
  • Laboratory waste including all cultures and stocks of infectious agents, as specimen cultures from medical and pathological laboratories, wastes from the production of medical and pathological laboratories, wastes from the production of biologicals, discarded live and attenuated vaccines, and culture dishes and devices used to transfer, inoculate and mix cultures.
  • Contaminated animal waste.
  • Waste identified by infectious waste generators which includes those wastes determined by the infectious waste generator or the infectious waste generator’s infectious control staff to be treated as infectious waste because of the risk of disease.

Managing Infectious Waste

The management of medical waste, which is not infectious, is not specifically addressed in Nebraska Title 132 Integrated Solid Waste Management Regulations. Most medical or veterinary wastes may be disposed at a permitted municipal solid waste disposal area as long as they have not been contaminated with something that is considered infectious. These wastes may include dressings, laboratory wastes, animal bedding, waste or carcasses. The landfill or hauler of medical or veterinary wastes may have additional restrictions or disposal requirements specific to the disposal facility.

Infectious medical waste is specifically restricted by the Nebraska Department of Environmental Quality. It is the responsibility of the generator of the waste to determine if it is infectious and to handle it properly. According to Title 132, Chapter 13, “infectious wastes must not be disposed of at any solid waste disposal area unless such wastes are first rendered non-infectious by incineration, autoclaving, or other treatment method”. This provision does not apply to infectious waste from households. Prior written approval from the Nebraska Department of Environmental Quality for disposal at a municipal solid waste landfill is not required for infectious wastes that have been rendered non-infectious.

Household medical waste is any waste that is generated as a result of health care activities in the home. In may include bandages, hypodermic needles and lancets. Medical waste generated in the home is a health concern when it is infectious waste. This infectious waste should be treated so the waste is no longer infectious or properly packaged so that the risk of exposing others to possible infection is reduced. Properly treated or packaged household medical waste can be added to your general household waste or transported to a permitted municipal solid waste landfill.

Packaging of Infectious Medical Waste

NDEQ recommends the following guidelines for packaging and transporting infectious wastes generated in the home:

  • Placement of the waste in a rigid or semi-rigid, puncture resistant and leak-proof container;
  • Marking the container prominently with the universal Bio-hazard symbol;
  • Labeling “Infectious Waste” or “Bio-hazard Waste”;
  • Sealing the container; and
  • Insuring that the outside of the container is free from contamination.

OSHA Regulations

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. Nebraska is one of 26 states covered entirely by the federal OSHA program. This program is operated by the Occupational Safety and Health Administration. OSHA 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

Nebraska Title 132 Integrated Solid Waste Management Regulations

Contacts

For more information, contact NDEQ via MoreInfo@NDEQ.State.NE.US or phone: 402-471-2186.

NDEQ Field Offices. The Field Office Section consists of 15 employees who conduct compliance inspections, complaint investigations, environmental sampling, project management, and local compliance assistance for the NDEQ’s Air Quality, Waste Management and Water Quality Divisions.

More Information

In this section, you will find links to points of contacts at the Nebraska agencies responsible for regulating healthcare facility waste, links to the text of the regulations, and additional resources that you might find of interest on this topic.

Medical Waste Disposal Fact Sheet.
H2E HERC