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Mississippi RegulationsGoverning Medical Wastes

Sustainability and Compliance inthe Healthcare Industry

J uly 30, 2008


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Medical Wastes

z According to the U.S. EPA, solid wastes

generated by hospitals representapproximately 1% of the municipal solidwaste stream (about 15 lbs per patient

daily);z On average, about 15% of that is

potentially infectious wastes and the

remaining 85% is comprised of paper,packaging, plastics and food wastes.


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Applicable State Laws/Regulations

z Adopted Standards For the Regulation of

Medical Waste in Healthcare FacilitiesLicensed by the Miss. State Departmentof Health (Nov. 1989);

z Mississippi Nonhazardous Solid WasteManagement Regulations; and

z Mississippi Solid Waste Law (Miss. CodeSection 17-17-1, et seq.)


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MSDOH Medical Waste Standards

z Definitions

z Infectious Medical Wastes solid or liquid wasteswhich may contain pathogens with sufficient virulenceand quantity such that exposure to the waste by asusceptible host has been proven to result in aninfectious disease.

z Medical Wastes all waste generated in direct patientcare or in diagnostic or research areas that is non-

infectious but aesthetically repugnant if found in theenvironment


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MSDOH Medical Waste StandardszThe following wastes are to be considered

infectious wastes:z Wastes from care of patients with Class I/II diseases

transmitted by blood or body fluids

z Cultures and stocks of infectious agents;

z Blood and blood products (serum, plasma, other);z Pathological wastes (tissues, organs, body parts, fluids);

z Carcasses, parts and bedding of animals exposed topathogens in research;

z All discarded sharps contacted by infectious agents;

z Others wastes determined infectious by generator orclassified by State Dept of Health.


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z A Medical Waste Management Plan is

required for generators to include thefollowing:

z Storage and containment provisions forinfectious medical waste and medicalwaste;

zTreatment and disposal provisions forinfectious medical waste and medicalwastes.


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z Storage and Containment Standards

z Must be conducted in a manner that is protected fromanimals, weather conditions, does not provide breedingplace or food source for insects and rodents and mini-mizes exposure to the public;

z Infectious waste (untreated -except for sharps) may notbe stored for more than seven days above atemperature of 38F

z Infectious waste may not be stored above a temper-ature of 32F for a period of more than 90 days.


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z Storage and Containment Standardsz

Containment of infectious wastes must be conductedseparate from other wastes;


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z Enclosures or containers used for infectious wastesshall be secured to discourage access to unauthorizedpersons and shall be marked with prominent warning

signs on or adjacent to the exterior of any entry door,gates or lids;z Infectious wastes, except for sharps, shall be contained

in double disposable bags or single bags that are 1).impervious to moisture, 2). Strong enough to preclude

ripping, tearing, or bursting 3). Securely tied to preventleakage or expulsion of wastes during handling.


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z All bags used for containment and disposal ofinfectious wastes shall be distinctive in colorand display the universal symbol for infectious

wastes;z Compactors nor grinders shall be used to

process infectious medical wastes unless the

waste has been rendered non-infectious;


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z Universal Symbol forInfectious MedicalWastes


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z Storage & Containment

Standards for Sharps

z All sharps must becontained in leak-proof,

rigid, puncture resistantcontainers tightly liddedto prevent loss ofcontents and shall be

labeled accordingly;


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z Storage & Containment

Standards for Sharps

z Sharps containers maynot be compacted exceptin the institution itselfand shall not be placedfor disposal in a mobiletrash compactor;


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z Storage and Containment Standardsz

Wastes in disposable containers must be placed forstorage or transport in disposable or reusable drumsor bins with leak proof secure covers and shall bekept clean and in good repair;

z Reusable containers for wastes shall be thoroughlywashed and decontaminated each time they areemptied unless the surfaces are protected bydisposable liners, bags or other devices;

z Decontamination may occur through exposure to hot

water or a chemical sanitizer;zTrash chutes shall not be used for transfer of

infectious medical wastes.


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zTreatment and Disposal Standards

zTreatment of infectious waste may occur byon of the following methods:

z Incineration (requires MDEQ air permit);

z Steam sterilization;

z Chemical sterilization.

z Recognizable human remains must be

disposed by incineration or internment or inanother manner approved by the MSDOH.


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z Operating Standards for Steam Sterilizers:

z Written operating procedures must bedeveloped including time, temp, pressure,waste types, containers, loading pattern, water

content and load maximum;z Must attain sterilization cycle temp of at least

250 F for one half hour or longer (variant on

load sizes to achieve sterilization of entire load;zThermometers must be calibrated annually.


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MSDOH Medical Waste Standardsz Operating Standards for Steam Sterilizers:

z Use of heat sensitive tape or other similar device foreach container processed to indicate adequatesterilization conditions;

z Use of biological indicator (Bacillus stearotherm-ophilus) placed on the center of a load processedunder standard operating conditions at least monthlyto confirm adequacy of sterilization conditions;

z Maintain records of procedures for at least one year;

z

Disposal of sterilization fluids by sewer systemunless prohibited by MSDOH, MDEQ or Owner ofSewer System.


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MSDOH Medical Waste Standardsz Operating Standards for Chemical Sterilizers:

z

Shall only use chemical sterilants recognized by theU.S. EPA (e.g. ethylene oxide, glutraldehyde, &hydrogen peroxide);

z Sterilants must be used according to manufacturer

specifications;z Sterilants must render infectious waste non-

infectious;

z

Process must be tested with indicator Bacillus subtilisspores or other equivalent organisms on a quarterlybasis to ensure effectiveness of treatment.


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MDEQ Solid Waste Regulations

z Infectious medical wastes and medical

wastes are regulated as solid wastes inMississippi and not as hazardous wastes(except where such wastes meet thedefinition of hazardous wastes);

zThe processing of solid wastes on the

site of generation are exempt from theNonhaz. Solid Waste Mgt. Regs. (I.B.8).


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MDEQ Solid Waste Regulationsz Storage, Collection and Transportation

Standardsz Must be stored in a manner to prevent fire, safety orhealth hazards, providing food or harborage foranimals or vectors, contained so as not to result inlitter;

z Containers must be of sufficient size and strengthand in sufficient numbers to adequately contain theamount of waste generated and stored betweencollection events;

z Collection must occur on a sufficient frequency toprevent attraction of vectors and public nuisanceconditions.


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MDEQ Solid Waste Regulationsz Storage, Collection and Transportation

Standardsz Vehicles and equipment used for transport must beoperated to prevent loss of liquids, solid wastes andto minimize health and safety hazards to collectionpersonnel and to the public;

z Vehicles must be maintained & cleaned in sanitarycondition to prevent odors and vector attraction;

z Any spillage of wastes during collection or transportmust be promptly cleaned and remediated;

z MDEQ does not currently require identification orcertification of medical waste transporters.


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MDEQ Solid Waste RegulationszTreatment and Disposal Standards

z All commercial infectious waste treatment facilitiesmust have a solid waste management permit fromMDEQ (Commercial facilities includes those thataccept wastes for compensation or from more than

one generator not owned by the facility owner);

z Commercial infectious waste treatment facilitiesmay require other environmental permits from

MDEQ if the facility has air emissions, processwater discharges, or storm water releases thatexceed permitting thresholds.


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z Solid Waste Management Permit requires:z Local Approval (planning and zoning);

z Demonstration of Siting Criteria Compliance;

z

Completed Disclosure Statement;z Plan of operation and facility design that must

minimally comply with MSDOH standards forstorage & treatment of infectious medical wastes;

z Recordkeeping to certify the receipt & adequacy oftreatment for the generator & the receivingdisposal facility.


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MDEQ Solid Waste Regulations

z Waste Disposal at

Landfills


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z All medical wastes and infectious wastes renderednon-infectious by treatment must be minimallydisposed at a municipal solid waste landfill orsimilar facility;

z All MSW landfills must prevent the disposal ofinfectious medical wastes at their landfill facilitiesunder individual solid waste permit restrictions;

z MDEQ conducts unannounced inspections of allcommercial treatment and disposal facilities.


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Mississippi Solid Waste Lawsz Solid Waste Law, MS Code, Section 17-17-1,

et seqz Provides minimum standards for transport,

management and disposal of solid wastes andprohibits the unauthorized dumping and open

burning of such wastes;z Grants MDEQ authority to inspect property or

vehicles where a regulated activity is occurring;

z Provides that solid wastes become the property of

the commercial collection enterprise at the point ofcollection and the property of the treatment facilityoperator upon delivery to the facility.


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Mississippi Solid Waste Lawsz Solid Waste Law, MS Code, Section 17-

17-1, et seqz Provides that Local Governments have both

the duty and authority to direct the flow of

solid wastes locally through a 20 year solidwaste management plan;

z Sets the waste reduction and recycling goalof 25% for the State of Mississippi andrequires that the shall implement actions toachieve that goal.


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Other State Environmental Lawsz Prevents the management of wastes in

such manner so as to cause pollution ofthe air or waters of the state (49-17-29);

z Provides that the unauthorized dumpingof solid wastes in certain quantities or forcommercial purposes may be a

misdemeanor or felony crime (97-15-30).


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Issues on the Horizonz Household Sharps Outreach Program to be

developed by MDEQ & implemented byJ anuary 1, 2010

z Additional focus nationally on the management

of pharmaceutical wastes;z MDEQ developing a medical waste assistance

web page on the MDEQ web site;

z MDEQ is beginning the process to revise oursolid waste regulations governing solid wastemanagement facilities.


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Contact InformationMark Williams

MDEQSolid Waste Programs

P.O. Box 2261

J ackson, MS 39225

Phone: 601-961-5304

Fax: 601-961-5785Email: [email protected]

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