Regulations


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. 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.

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.

In the US, environmental laws that sometimes (but usually do not) have an impact on treatment or disposal of medical waste include:

Toxic Substances Control Act (TSCA)

Federal Insecticide, Fungicide and Rodenticide Act (FIFRA)

Clean Air Act (CAA)

Clean Water Act (CWA)

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.

The Medical Waste Treatment Act (MWTA)

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.

State Agencies

Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

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.

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.

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.