Utah
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
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 Regulated Medical Waste
An
infectious waste is defined by statute as a “solid waste
that contains or may reasonably be expected to contain
pathogens of sufficient virulence and quantity that exposure
to the waste by a susceptible host could result in an
infectious disease.” This waste includes such materials
as used sharps, body fluids or materials mixed with body
fluids, bandages, or other materials that have come in
contact with body fluids.
The
state of Utah uses the term “Infectious Waste” which is
waste that is capable of producing an infectious disease. This
definition requires a consideration of the factors necessary
for introduction of disease, which includes doses, host
susceptibility, presence of a pathogen, virulence of a
pathogen, and the most commonly absent factor, a portal
of entry. Therefore, for waste to be infectious, it must
contain pathogens with sufficient virulence and quantity
so that exposure to the waste by a susceptible host could
result in an infectious disease. Because there are no
tests that allow infectious waste to be objectively identified,
the waste is considered to be infectious when it is suspected
to contain or has the potential to contain pathogens in
sufficient numbers to cause disease.
Managing
Infectious Waste
The
Division of Solid and Hazardous Waste uses the Infectious
Waste Management Guidance to interpret Rule R315-316 in
the management of infectious medical waste. To protect
human health and the environment, the Infectious Waste
Requirements (Rule R3150316 of the Utah Solid Waste Permitting
and Management Rules) became effective on July 15, 1993. These
requirements are applicable to infectious waste after it
has been removed from the health care facility to be stored,
transported or disposed. The OSHA Bloodborne Pathogen
Standard regulates the handling of infectious waste inside
health facilities. The OSHA standard requires that all
infectious waste be isolated in conspicuously colored or
labeled containers and for sharps, the containers must
be puncher-proof. The Utah rule sets minimum standards
for the storage, transportation, and disposal of infectious
waste from health facilities that generate more than 200
pounds of infectious waste per month. If infectious waste
has been rendered noninfectious, the waste material may
be managed as other noninfectious waste provided it is
not an otherwise regulated hazardous or radioactive waste.
Large
Health Facilities
The
Utah Infectious Waste Requirements apply to larger health
facilities such as hospitals and clinics that generate more
than 200 pounds of infectious waste per month. Several
local health departments have rules that are different in
some ways from the state requirements. The local health
department should be contacted for specific requirements
for the management of infectious waste. A general summary
of the state requirements for the management of infectious
waste by a large health facility follows:
- Prepare,
maintain on file, and follow an infectious waste management
plan and otherwise meet the requirements of the OSHA Bloodborne
Pathogen Standard.
- Except
for sharps, isolate infectious waste in secured plastic
bags or rigid containers. The containers must be red or
orange or clearly identified with the international biohazard
sign and labeled “INFECTIOUS WASTE,” OR “BIOHAZARD”.
- If
storage is necessary, protect infectious waste from the
elements in a storage area which is ventilated to the outside
and accessible only to authorized persons. The storage
area must be marked with prominent warning signs. If infectious
waste is to be stored longer than seven days, it must be
stored at or below 40 Fahrenheit (5 Celsius).
Infectious
Waste Transportation
Transporters
of infectious waste are regulated when they have more than
200 pounds in the vehicle at one time. Transporters must:
- Transport
infectious waste separate from other waste unless the waste
is contained in a separate, fully enclosed leak-proof container
with in the vehicle compartment or unless all of the waste
in the vehicle is to be treated as infectious waste. Vehicles
transporting infectious waste must meet all requirements
of the Department of Transportation.
- Transport
infectious waste using equipment that will contain all waste
so that there are no releases of infectious waste to the environment.
- Provide
training for drivers in waste handling and spill cleanup
methods.
- Label
vehicles by DOT standards.
- Have
spill kit available.
- Clean
all surfaces of transport vehicles when spills have occurred.
- Store
waste no longer than 7 days without refrigeration and no
longer than 30 day total.
Infectious
Waste Treatment and Disposal
Infectious
waste must be treated or disposed at a facility with a
permit or other form of approval. After being rendered
noninfectious, the waste may be managed as a noninfectious
solid waste. Approved treatment or disposal methods include:
- Infectious
waste may be incinerated in an incinerator that has a permit
or other approval from both the Division of Solid and Hazardous
Waste and the Division of Air Quality.
- Infectious
waste may be sterilized by heating in a steam sterilizer
to render the waste noninfectious. After sterilization,
the waste may be managed as a noninfectious solid waste.
- Other
methods may be used to render infectious waste noninfectious. Prior
to its use, any other method must be approved, on a site-specific
basis, by the Executive Secretary of the Utah Solid and Hazardous
Waste Control Board.
- Liquid
or semisolid infectious waste may be discharged to a sewage
treatment system that provides secondary treatment of waste
if approved by the operator of the sewage treatment system.
- Infectious
waste may be disposed in a permitted Class I, II, or V Landfill. Upon
entering the landfill, the vehicle operator must declare
that the load contains infectious waste and must follow any
procedures required by the landfill operator.
Small
Health Facilities and Small Quantity Transporters
Small
health facilities that generate 200 pounds or less, of infectious
waste per month and transporters that transport less than
200 pounds per load are not regulated by the Utah Infectious
Waste Requirements. Several local health departments have
requirements that apply to health facilities that generate
lower amounts of infectious waste and transporters that transport
small amounts of infectious waste. One should contact their
local health department for requirements that may be different
from the state rule.
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. Utah
is one of 24 states operating an approved occupational
safety and health program. This program is operated by
the Utah Occupational Safety and Health. 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
Home
Health Care
Infectious
waste generated by home health care activities is not regulated
by state rules. Local health departments may have rules
that differ from the state rules. Contact them for specific
rules. The following procedures should be followed to minimize
the potential risk from exposure to infectious waste.
- Except
for sharps, materials must be isolated that have come in
contact with body fluids, in a plastic bag or a leak resistant
rigid container. The containers of infectious waste may
be placed in the regular household waste container for
curbside collection.
- Isolate
sharps in leak-proof, rigid, puncture-resistant containers
such as a plastic soft drink bottle, a plastic milk bottle,
or a sharps container commercially available at many pharmacies. When
the container is full of sharps, the lid should be tightly
secured and taped on. The sharps container may then be
placed in the regular household waste container for curbside
collection.
- Liquid
and semisolid infectious waste may be washed down the sewer
using plenty of water.
Statutes,
Regulations and Guidelines
Environmental
Quality, Solid and Hazardous Waste Infectious Waste Requirements
R315-316
Infectious
Waste Rule
Contacts
Utah Department of Environmental
Quality, Division of Solid and Hazardous Waste
More Information
Utah
Division of Solid and Hazardous Waste Guidance Document
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