Ohio
Infectious Waste
Waste Categories
Ohio 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.
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 waste (IW). 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 waste or municipal solid waste, or infectious 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 IW 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 waste. See the guidance and references below to accurately categorize your wastes.
- Infectious 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 Waste
“Infectious wastes” includes all of the following substances or categories of substances:
- Cultures and stocks of infectious agents and associated biologicals.
- Laboratory wastes that were, or are likely to have been, in contact with infectious agents.
- Pathological wastes, including human and animal tissues, organs, and body parts, and body fluids and excreta that are contaminated with or are likely to be contaminated with infectious agents.
- Waste materials from the rooms of humans, or the enclosures of animals, that have been isolated because of diagnosed communicable disease that are likely to transmit infectious agents.
- Human and animal blood specimens and blood products that are being disposed of.
- Contaminated carcasses, body parts, and bedding of animals that were intentionally exposed to infectious agents.
- Sharp wastes used in the treatment, diagnosis, or inoculation of human beings or animals
- Any other waste materials generated in the diagnosis, treatment, or immunization of human beings or animals, in research or in the production of testing of biologicals.
- Any other waste materials the generator designates as infectious waste.
Regulation of Infectious Wastes
The Ohio EPA’s Infectious Waste Program (IW/Compost Unit) regulates the generation, treatment, packaging, storage, transportation, and disposal of infectious waste in the state. The detailed requirements can be found in Ohio Revised Code Chapter (ORC) 3734. Ohio Administrative Code Chapters 3745-27 and 3745-37. Depending upon the amount of infectious waste generated in a calendar month a person is considered to be a small generator (less than 50 lbs per month) or a large generator (50 lbs or more a calendar month). A large generator must submit a registration application to the Ohio EPA.
Managing Regulated Medical Waste
Healthcare facilities are divided into two categories, depending on the quantity of infectious waste that they generate:
- small quantity generators (less than 50 pounds per month of infectious waste), and
- large quantity generators (50 or more pounds of infectious waste in any one month).
When calculating the quantity of infectious waste generated, do not consider the weight of blood, blood products, other body fluids, or embalming fluids that are legally discharged to a sewer system.
Rules for these two categories are provided below.
Large Quantity Generators
Generator Registration. A healthcare facility or other generator of infectious waste who generates 50 pounds or more of infectious waste during any one month must register with the Ohio EPA. Once a facility is registered, they are given a registration certificate and they must follow certain rules covering management and disposal of infectious waste.
For details concerning the registration process, see Requirements for Infectious Waste Registration Certificate, below.
Procedures.
Large quantity generators must implement the following procedures:
- Place all “sharps” in a suitable container (rigid, puncture-resistant, leak resistant, and closed tightly to prevent loss of contents).
- Either treat all specimen cultures and cultures of viable infectious agents on the premises where they are generated to render them noninfectious or ensure that the wastes are treated to render them noninfectious at a treatment facility.
- Quantify the waste generation rate and keep records recorded in pounds on a calendar month basis. This rule can be met by keeping a monthly generation rate log, keeping treatment shipping papers that document the weight of all the infectious waste that is generated and sent for treatment documented in pounds for a calendar month; or a combination of a monthly generation rate log and treatment shipping papers.
- Not grind any sharp infectious wastes, not compact any such wastes until after the wastes have been treated.
- Dispose of the infectious wastes at a solid waste disposal facility holding an appropriate license.
- Employ only transporters who are registered to transport untreated infectious wastes.
- Provide information to transporters and treatment facilities regarding the generator’s system for distinguishing between waste packages that contain treated and untreated wastes.
- Ensure that all infectious wastes, whether treated or untreated, that are transported offsite are accompanied by a shipping paper (see Infectious Waste Shipping Paper System, below).
- Develop a spill containment and clean-up procedure.
- Ensure that clean-up materials / kits are available in those areas designated in the spill containment and clean-up procedures and that they are effectively utilized, as needed.
- Generators of infectious wastes may discharge untreated liquid or semi-liquid infectious wastes consisting of blood, blood products, body fluids, and excreta into a sewer system provided it is not otherwise regulated by the local authority.
- A generator of infectious wastes may transport off-site infectious wastes that have been treated to render them noninfectious in the same manner as noninfectious wastes are transported.
- A hospital may accept for treatment or storage prior to transportation to a treatment facility the following wastes:
- Properly packaged sharp infectious wastes and all unused discarded hypodermic needles, syringes, and scalpel blades that are generated by a small quantity generator.
- Infectious wastes generated by an individual for purposes of his/her own care or treatment.
- Infectious wastes generated in providing care to a patient by an emergency medical services organization.
Small Quantity Generators
Although small quantity generators are exempt from some of the regulations that pertain to large quantity generators, such as use of the shipping paper system, they still must meet certain basic rules:
- Identify and separate infectious from non-infectious waste at the point of generation for the purposes of determining the generator status (small vs. large) the facility.
- Quantify the waste generation rate and keep records recorded in pounds on a calendar month basis. This rule can be met by keeping a monthly generation rate log, keeping treatment shipping papers that document the weight of all the infectious waste that is generated and sent for treatment documented in pounds for a calendar month; or a combination of a monthly generation rate log and treatment shipping papers.
- Determine by monthly records if fifty pounds or more of infectious waste is generated. If the monthly quantity reaches 50 pounds in any month, the facility must register and obtain a certificate.
- Place all “sharps” in a suitable container (rigid, puncture-resistant, leak resistant, and closed tightly to prevent loss of contents).
- Either treat all specimen cultures and cultures of viable infectious agents on the premises where they are generated to render them noninfectious or ensure that the wastes are treated to render them noninfectious at a treatment facility.
- A small quantity generator who complies with the above sharps rules may transport and dispose of infectious wastes in the same manner as solid wastes.
Packaging and Labeling Infections Waste
The following rules apply to packaging of infectious waste:
- Bags must be red in color or conspicuously labeled with the international biohazard symbol.
- Each bag must be constructed of material of sufficient single thickness to preclude ripping, tearing, or bursting under normal conditions.
- Bags must be of sufficient film strength, strength of seals, and leakage resistance.
- Bags must be impervious to moisture;
- Filled bags must be securely tied or sealed to prevent leakage or expulsion of wastes from them during storage, handling, or transport.
- Bags containing infectious wastes that are being transported off-site must be placed inside a second sealed plastic bag or one single bag within a fully enclosed, rigid, sturdy container.
- Containers for infectious waste must be at a minimum labeled with the international biohazard symbol on two opposite sides.
- Reusable containers must be thoroughly cleaned with a detergent and disinfected after each use.
- Sharps containers must be rigid, puncture-resistant, leak resistant, and closed tightly to prevent loss of contents. Sharps containers must be only those containers specifically designed and manufactured for the management and/or disposal of sharps.
Storage Requirements
The following rules apply to the storage of infectious waste:
- Infectious waste must be stored in a manner which maintains the integrity of the packaging.
- Infectious waste must be kept in a nonputrescent state.
- Clearly mark all storage areas.
- Infectious waste must be stored in a manner such that the IW does not become a food source or breeding place for insects or animals.
- Outside storage areas must be locked.
- May not store IW for more than 35 days.
- “In-use” sharps containers are not considered storage.
On-Site Treatment of Infectious Waste
Large generators that treat infectious waste on-site must abide with certain rules. Treatment methods approved in the state of Ohio include:
Alternative treatment technologies must be approved by the Ohio EPA.
For details on infectious waste treatment, see Standards for Treatment of Infectious Wastes, below.
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. Ohio
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
OAC Chapter 3745-27: Solid & Infectious Waste Regulations
Standards for Generators of Infectious Waste
Requirements for Infectious Waste Registration Certificate
“Infectious Waste Shipping Paper System”: http://www.epa.state.oh.us/dsiwm/document/currentrule/3745-27-33_current.pdf”
Standards for Packaging Infections Wastes
Standards for Treatment of Infectious Wastes
Contacts
The
Division of Solid & Infectious Waste Management (DSIWM)
Central Office is comprised of several technical units.
These units provide technical expertise regarding various
different regulatory programs to DSIWM District Office
field staff, the regulated community, and the general public. Contact
the Infectious Waste and Composting Unit
An
infectious waste specialist in the Ohio EPA central office
who can be reached by telephone at 614-644-2621 or write
to:
Ohio EPA – DSIWM
Infectious Waste Specialist
P.O. Box 1049
Columbus, OH 43216-1049
More
Information
Amended
Infectious Waste Generator Registration Certificate
Application Form 079
Annual Survey
of Solid And Infectious Waste Programs 018
Facility Lists and
Other General Documents
Infectious
Waste Host Fee Submittal Form 086
Infectious
Waste Regulation Summary 107
Infectious
Waste Transporter Registration Certificate App. Form
082
Infectious
Waste Transporter Registration Certificate Decal Return
Form 080
Infectious
Waste Treatment Facility-Autoclaving 634
Inspection
Checklist-Infectious Waste – Steris Ecocycle 10™
576
Inspection
Checklist-Infectious Waste Transporter 055
Inspection Checklist-Infectious Waste-Autoclave Facility 053
Inspection
Checklist-Infectious Waste-Incinerator Facility 054
Inspection
Checklist-Infectious Waste-Large Generator 052
Inspection
Checklist-Infectious Waste-Small Generator 051
OSHA Blood
borne Pathogen Standard vs. OEPA Infectious Waste Regulations
073
Summary
of Infectious Waste Generator Rules
To
subscribe to the Ohio EPA Listserv for Infectious Waste
rules, send an e-mail to majordomo@lists.epa.state.oh.us and
place the following in the message body: “subscribe iwrules”.
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