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 California
Medical
Waste
Definition of Medical Waste
OSHA Regulations
Contact
Definition of Medical
Waste
"Medical waste" means waste
which meets both of the following requirements:
(1) The waste is composed of waste
which is generated or produced as a result of any of the following
actions:
- Diagnosis, treatment, or immunization
of human beings or animals.
- Research pertaining to the above.
- The production or testing of
biologicals.
- The accumulation of properly
contained home-generated sharps waste that is brought by a patient,
a member of the patient's family, or by a person authorized by
the enforcement agency, to a point of consolidation approved
by the enforcement agency.
- Removal of a regulated waste
from a trauma scene by a trauma scene waste management practitioner.
(2) The waste is either of the following:
- Biohazardous waste.
- Sharps waste.
Medical waste does not include
any of the following:
- Waste generated in food processing
or biotechnology that does not contain an infectious agent.
- Waste generated in biotechnology
that does not contain human blood or blood products or animal
blood or blood products suspected of being contaminated with
infectious agents known to be communicable to humans.
- Urine, feces, saliva, sputum,
nasal secretions, sweat, tears, or vomitus, unless it contains
fluid blood.
- Waste which is not biohazardous,
such as paper towels, paper products, articles containing non-fluid
blood, and other medical solid waste products commonly found
in the facilities of medical waste generators.
- Hazardous waste, radioactive
waste, or household waste.
- Waste generated from normal and
legal veterinarian, agricultural, and animal livestock management
practices on a farm or ranch.
Large vs. Small Waste Generators
The Medical Waste Management Act
(MWMA) considers any person whose act or process produces medical
waste to be a "medical waste generator" in California (e.g. a facility
or business that generates, and/or stores medical waste onsite). Medical
waste generators may be either:
- large quantity generators (LQG
= >200lbs/month), or
- small quantity generators (SQG
= <200lbs/month).
Registration
Medical waste generators must register
with their enforcement agency (click here for a list of Local Enforcement Agencies ). CA
state map depicting the enforcement agency by county.
Medical waste generators, whether
large quantity generators or small quantity generators, located
in counties where the state acts as the local enforcement agency
(see the CA state map link above to determine the enforcement agency
in each county) must complete the Generator Registration Application
(see below) and mail it along with the fee page (below) to the
address provided. For those medical waste generators treating medical
waste on-site, an on-site treatment permit application must also
be completed and submitted. Each application, along with a check
made payable to the Medical Waste Management Fund must be mailed
to:
California Department of Health
Services
Medical Waste Management Program
P.O. Box 997413, MS 7405
Sacramento, CA 95899-7413
Management Plan
LQG's or SQG with on-site treatment
are required to submit a Medical Waste Management Plan (Plan) with
their medical waste enforcement agency. A Plan Checklist is provided
to assist medical waste generators in developing their Plan.
Segregation and Storage
Rules for containerizing and storing
medical waste vary depending or the type of waste. The following
rules apply (for complete rules see Chapter 9 of the Medical Waste
Management Act, below):
- Medical waste must be contained
separately from other waste at the point of origin in the healthcare
facility. Sharps containers may be placed in biohazard bags
or in containers with biohazard bags.
- Biohazardous waste must be placed
in a red biohazard bag conspicuously labeled with the words "Biohazardous
Waste" or with the international biohazard symbol and the word "BIOHAZARD."
- Sharps waste must be contained
in a sharps container.
- Biohazardous waste that is contaminated
through contact with, or having previously contained, chemo-therapeutic
agents, must be segregated for storage, and, when placed in a
secondary container, that container must be labeled with the
words "Chemotherapy Waste", "CHEMO", or other label approved
by the department on the lid and on the sides, so as to be visible
from any lateral direction.
- Biohazardous waste comprised
of human surgery specimens or tissues which have been fixed in
formaldehyde or other fixatives, must be segregated for storage
and, when placed in a secondary container, that container must
be labeled with the words "Pathology Waste", " PATH", or other
label approved by the department on the lid and on the sides,
so as to be visible from any lateral direction.
To containerize biohazard bags,
a person must do all of the following:
- The bags must be tied to prevent
leakage or expulsion of contents during all future storage, handling,
or transport.
- Biohazardous waste must be appropriately
bagged and placed for storage, handling, or transport in a rigid
container which may be disposable, reusable, or recyclable.
- Containers must be leak resistant,
have tight-fitting covers, and be kept clean and in good repair.
- Containers may be of any color
and must be labeled with the words "Biohazardous Waste" or with
the international biohazard symbol and the word "BIOHAZARD" on
the lid and on the sides so as to be visible from any lateral
direction.
- Biohazardous waste must not be
removed from the biohazard bag until treatment is completed.
- Biohazardous waste must not be
disposed of before being treated.
- If a facility generates 20 or
more pounds of biohazardous waste per month, the facility must
not contain or store biohazardous or sharps waste above 0 degrees
Centigrade (32 degrees Fahrenheit) at any onsite location for
more than seven days without obtaining prior written approval
of the enforcement agency.
- If a facility generates less
than 20 pounds of biohazardous waste per month, the person must
not contain or store biohazardous waste above 0 degrees Centigrade
(32 degrees Fahrenheit) at any onsite location for more than
30 days.
- A facility may store biohazardous
or sharps waste at or below 0 degrees Centigrade (32 degrees
Fahrenheit) at an onsite location for not more than 90 days without
obtaining prior written approval of the enforcement agency.
- A facility may store biohazardous
or sharps waste at a permitted transfer station at or below 0
degrees Centigrade (32 degrees Fahrenheit) for not more than
30 days without obtaining prior written approval of the enforcement
agency.
- A facility must not store biohazardous
or sharps waste above 0 degrees Centigrade (32 degrees Fahrenheit)
at any location or facility which is offsite from the generator
for more than seven days before treatment.
To containerize sharps waste, a
facility must do all of the following:
- Place all sharps waste into a
sharps container.
- Tape closed or tightly lid full
sharps containers ready for disposal to preclude loss of contents.
- Store sharps containers ready
for disposal for not more than seven days.
- Label sharps containers with
the words "sharps waste" or with the international biohazard
symbol and the word "BIOHAZARD".
Treatment of Medical Waste
A person generating or
treating medical waste shall ensure that the medical waste is treated
by one of the following methods, thereby rendering it solid waste
prior to disposal:
- Incineration at a permitted medical waste treatment
facility in a controlled-air, multi-chamber incinerator, or other
method of incineration approved by the department which provides
complete combustion of the waste into carbonized or mineralized
ash.
- Treatment with an approved alternative technology
that, due to the extremely high temperatures of treatment in excess
of 1300 degrees Fahrenheit, has received express approval from
the department.
- Steam sterilization at a permitted medical waste
treatment facility or by other sterilization, in accordance with
all approved operating procedures for steam sterilizers or other
sterilization
- Other alternative medical waste treatment methods
which are approved by the department and result in the destruction
of pathogenic micro-organisms.
Disposal of Medical Waste
- A medical waste may be discharged to a public
sewage system without treatment if it is not a biohazardous waste,
it is liquid or semiliquid, and its discharge is consistent with
waste discharge requirements placed on the public sewage system
by the California regional water quality control board with jurisdiction.
- A medical waste that is a biohazardous waste
may be treated by a chemical disinfection if the medical waste
is liquid or semi-liquid and the chemical disinfection method is
recognized by the National Institutes of Health, the Centers for
Disease Control and Prevention, or the American Biological Safety
Association, and if the use of chemical disinfection as a treatment
method is identified in the site's medical waste management plan.
If the waste is not treated by chemical disinfection, it shall
treated by one of the other approved methods. Following treatment
by chemical disinfection, medical waste may be discharged to the
public sewage system if the discharge is consistent with waste
discharge requirements placed on the public sewage system by the
California regional water control board, and the discharge is in
compliance with the requirements imposed by the owner or operator
of the public sewage system. If the chemical disinfection of the
medical waste causes the waste to become a hazardous waste, the
waste shall be managed in accordance with applicable requirements
- Recognizable human anatomical parts, with the
exception of teeth not deemed infectious by the attending physician
and surgeon or dentist, shall be disposed of by interment or in
accordance with the regulations, unless otherwise hazardous.
- Sharps waste shall be rendered noninfectious
prior to disposal by Incineration; steam sterilization; or disinfection,
using an alternative treatment method approved by the department.
Sharps waste rendered noninfectious may be disposed of as solid
waste if the waste is not otherwise hazardous.
- Onsite medical waste treatment facilities treating
sharps waste shall ensure that, prior to disposal, the treated
sharps waste is destroyed or that public access to the treated
sharps waste is prevented.
- An operator of a permitted hazardous waste incinerator
may also accept medical waste for incineration.
- Each medical waste treatment facility issued
a medical waste permit shall provide the enforcement agency with
an emergency action plan that the facility shall follow to ensure
the proper disposal of medical waste in the event of equipment
breakdowns, natural disasters, or other occurrences.
- Animals that die from infectious diseases shall
be treated in accordance with the regulations, if, in the opinion
of the attending veterinarian or local health officer, the carcass
presents a danger of infection to humans.
Waste Tracking Documents
Tracking documents are provided
to the generator by the transporter. Medical waste generators
are required to maintain a completed tracking document of all medical
waste removed for treatment or disposal for a period of three years.
Contacts
Inquiries to the Medical Waste Management
Program may be sent via e-mail to: MedWasteInfo@dhs.ca.gov.
For more information on Medical
Waste Management Program activities contact either the Medical
Waste Management Program HQ at (916) 449-5671, or the Southern
California Regional Office at (213) 977-7379 or (213) 977-6877.
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. California is one of 24 states operating an approved occupational
safety and health program. This program is operated by Cal/OSHA. 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 VetCA section entitled OSHA Standards for Regulated Waste.
Regulations
The Medical
Waste Management Act (MWMA) governs the management of medical
waste in all jurisdictions of the State.
Additional Resources
Managing Pharmaceutical Waste Training Materials (Mar. 2009) posted by the Bay Area Pollution Prevention Group (view presentations and documents).
California
Medical Waste Management Program Overview
The California Department of Health
Services has been working with hospitals statewide to develop plans
that will assist in pollution prevention (see Hospital
Pollution Prevention Program).
List
of Permitted Medical Waste treatment Facilities in California
Department of Health Services (DHS)
Licensing and Certification program consulted with the DHS Medical
Waste Management Program (MWMP) and have made a letter explaining
the use of reusable sharps containers from these companies offering a reusable sharps container system.
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