Hospital Waste Management Rules

Hospital waste management is governed by the Resource Conservation and Recovery Act (RCRA) passed by Congress on Oct. 21, 1976. It is the primary law governing the disposal of solid and hazardous waste in the United States. Amended and strengthened several times by Congress, the RCRA established three programs called the solid waste program, the hazardous waste program and the underground storage tank program. Specifically, these programs create guidelines for the disposal of all types of waste and a "cradle to grave" system for the treatment and disposal of hazardous waste.

The Environmental Protection Agency

• Although regional and state offices oversee compliance to the rules and regulations set forth in the RCRA, they are answerable to the Environmental Protection Agency (EPA), which is the federal agency responsible for achieving the main goal set forth in the RCRA of protecting human health. The EPA not only ensures compliance to these guidelines, but also makes information available on a national basis. The agency maintains a website that offers numerous materials for training and general information and links to each state compliance authority.

Hospital Waste Management Rules

• Hospitals have special regulations concerning the management of their waste. These regulations are governed by each state, so there is not one specific set of "rules." Each hospital is required to have a strategic plan of management that includes provision for hazardous and nonhazardous waste segregation and, if employed, the use of a hospital/medical/infectious waste incinerator.

  Defining the different types of hospital waste can also be confusing because they overlap in definition and regulation. The EPA recognizes the basic breakdown of hospital waste components to administrative waste, medical/infectious waste, and pathological waste. Accordingly, hospitals are required to separate their waste and dispose of it in accordance to the prescribed guidelines of the state and the RCRA.

  Hospital administrative waste should be handled as nonhazardous municipal waste. Medical noninfectious and infectious waste should be strictly handled using RCRA guidelines for solid waste and hazardous waste.

Hospital Medical Infectious Waste Incinerator

• According to the EPA website, 90 percent of hospital waste is incinerated. Consequently, the use of the hospital/medical/infectious (HMIWI) waste incinerator is strictly regulated. There are guidelines concerning size, output and disposal of ashes. According to the EPA website, there are new laws governing emissions from the incinerators that were built prior to 2008 and new requirements for those built afterward. The ashes from the incinerators and other waste may also have to be shipped off site.

Packaging and Transport

• Hospital waste that has to be shipped off site has to be placed in containers that are rigid, leak-resistant, moisture resistant, strong enough to prevent tearing or bursting under normal handling conditions and sealed to prevent leakage during transport. Sharps containers must also be puncture resistant.

  Containers must have a water-resistant label or tag indicating the hospital's name, address and phone number. Additionally, biohazard signage must be used along with the international biohazard symbol. Haulers of such waste must also be certified.

Uniform Hazardous Waste Manifest

• Hospitals must also adhere to the guidelines certifying a shipment of hazardous waste material. The completion of the Uniform Hazardous Waste Manifest form requires three signatures but is a record of where the material was generated, who transported it, and what designated facility received it.