Regulations that medical waste managers must account for include workplace/occupational safety regulations, emissions that exit to the environments (during storage or treatment), and final disposal of solid refuse. In the United States, federal regulations apply to hazardous and radioactive wastes; any regulations on infectious waste are set by state or local governments.
In the US, environmental laws that sometimes (but usually do not) have an impact on treatment or disposal of medical waste include:
The hospital industry has an organization - "The Joint Commission" - that accredits individual facilities and offers guidance on operations. As part of their accreditation, commission auditors look into waste and hazardous material management practices. The commission offers advice on waste management for hospital administrators.
OSHA (Occupational Safety and Health Administration) has rules to protect healthcare workers who work with hazardous and dangerous materials. OSHA has a lot to say about about "regulated waste" (blood products). Even the Drug Enforcement Agency sometimes gets involved when pharmaceutical waste is involved.
Regulators take a multi-media approach to emissions. Early on in environmental regulation - the 1960s and 70s - land, water, and air were considered separately. But they are interwoven today. One reason medical waste poses such a headache is that a portion - maybe 15 percent - is regulated by more than one agency in the US. In the United States, federal government and state government agencies regulate aspects of medical waste management, as do some local governments. RCRA hazardous waste is regulated by the Environmental Protection Agency. Radioactive waste is regulated by the Nuclear Regulatory Commission. The federal Department of Transportation has regulations on transport of infectious and pathological waste. The Drug Enforcement Agency even gets involved sometimes. Treatment of biological waste is subject to state laws; the federal government does not get involved for the most part, although the EPA regulates air emissions from medical waste incinerators.
The EPA released standards and guidelines in 1997 for emissions from medical waste incinerators. Partly as a result of the regulations, there are fewer incineration units operating in the US than there were decades ago, and the remaining ones are larger and cleaner.
In 1989 Congress enacted this law partly as an experiment to test regulation of the medical industry’s waste production, storage, treatment and disposal. (The MWTA was actually an amendment to the Solid Waste Disposal Act.) While MWTA was in effect the EPA regulated waste in New York, Connecticut, New Jersey, Rhode Island, and Puerto Rico. The law took effect in June 1989 and the findings were reported to Congress by September 1991. At that time Congress declined to extend the act and make EPA authority over medical waste permanent.
EPA authorities stated that they hoped the regulations under MWTA would be adopted by states in formulating their own regulations.
The majority of regulations for the treatment and disposal of potentially infectious medical waste are enforced by state and local agencies. For example, in Massachusetts the regulations on medical waste are under the jurisdiction of the commonwealth’s Department of Public Health for the state, and Boards of Health on the local level. The Department of Public Health administers the State Sanitary Code, part of which regulates the storage, treatment and disposal of medical waste. In California, the Environmental Management Branch of the California Department of Public Health regulates the storage, treatment and disposal of medical waste. Information on state regulations can generally be found on the state government web sites under the department of public health.
A major international treaty on trade involving medical waste is the Basel Convention, formally called the Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and Their Disposal. While the convention speaks of “hazardous” waste, this is hazardous in its more general sense, not as defined by US RCRA law. One section is “H 6.2 – Infectious substances – substances or wastes containing viable microorganisms or their toxins which are known or suspected to cause disease in animals or humans.” It also refers to pharmaceuticals waste and medical waste from hospitals. It tries to apply the “prior informed consent” principle and to prohibit exploitation, it outlaws shipments without consent to and from people who did not explicitly agree to be involved.