Medical Waste Management

Offices with on-site waste treatment must keep an informational document that states how waste is contained, stored, treated, and disposed. Treatment facility operating records must be kept on-site for three years.

Offices using a hazardous waste hauler for off-site waste treatment must have an informational document that states how waste is contained, stored, treated, and disposed. Records of the quantity and type of waste transported, date transported, and the name of the registered hazardous waste hauler must also be maintained. These tracking documents must be maintained on-site for three years.

A small quantity medical waste generator or parent organization that employs health care professionals who generate medical waste may transport medical waste generated in limited quantities up to 35.2 pounds to the central location of accumulation, provided that all of the following are met:

1. The principal business of the generator is not to transport or treat regulated medical waste.
2. The generator shall adhere to the conditions and requirements set forth in the materials of trade exception, as specified in Section 173.6 of Title 49 of the Code of Federal Regulations.
3. A person transporting medical waste pursuant to this section shall provide a form or log to the receiving facility, and the receiving facility shall maintain the form or log for a period of two years, containing all of the following information:
   • The name of the person transporting the medical waste.
   • The number of containers of medical waste transported.
   • The date the medical waste was transported.

A generator transporting medical waste pursuant to this section must not be regulated as a hazardous waste hauler pursuant to Section 117660.

When storing medical waste, the following guidelines must be observed:

1. Contain medical waste separately from other waste at the point of origin.
2. Contain biohazardous waste in a biohazard bag conspicuously labeled with the words "BIOHAZARDOUS WASTE" or with the international biohazard symbol and the word "BIOHAZARD."
3. Sharps containers must be rigid and puncture and leak resistant when sealed, cannot be reopened without great difficulty, and properly labeled.
4. No bagged medical waste is to be removed from the bags.

When containing biohazardous waste in a biohazard bag, the following steps must be taken:

1. Tie bags to prevent leakage or expulsion of contents during all future storage, handling or transport.
2. Place biohazardous bags in a rigid or disposable container for storage, handling or transport. The containers must be:
   1. leak-resistant and fitted with tight covers
   2. sanitary and in good repair
   3. labeled with the words "BIOHAZARDOUS WASTE" or with the international biohazard symbol and the word "BIOHAZARD" on the lid and sides so as to be visible from any lateral direction
   4. washed and decontaminated each time they are emptied. Approved methods of decontamination include:
      1. exposure to hot water at 180 degrees F for a minimum of 15 seconds
      2. rinsing or immersing in Hypochlorite solution (500 ppm available chlorine), phenolic solution (500 ppm active agent), iodoform solution (100 ppm available iodine), or quaternary ammonium solution (400 ppm active agent) for a minimum of three minutes

   When containerizing sharps, take the following steps:

1. Place all sharps into a Sharps container.
2. Tape closed or tighten the lid of the full sharps containers to prevent spills and prepare for disposal.
3. Label sharps containers with the words "SHARPS WASTE," the international biohazard symbol and the word "BIOHAZARD."

Storage enclosures must be clean and orderly, secured to deny access to unauthorized persons and posted with a warning sign stating "CAUTION - BIOHAZARDOUS WASTE STORAGE AREA - UNAUTHORIZED PERSONS KEEP OUT," and, "CUIDADO - ZONA DE RESIDUOS - BIOLOGICOS PELIGROSOS - PROHIBIDA LA ENTRADA A PERSONAS NO AUTORIZADAS."

Staff handling medical waste must wear the correct type of personal protective equipment (for example, gloves, goggles and lab coats).

Trash chutes, laundry chutes, compactors, and grinders must not be used to transfer or process untreated medical waste.

Recognizable human anatomical remains must be incinerated or buried (teeth are exempt).

In accordance with the Department of Health Care Services (DHCS) facility site inspection requirements, providers must have a medical waste management hauler contract.

Any facility planning to treat medical waste on-site using an autoclave, incinerator or microwave technology must obtain a permit from the local enforcement agency prior to commencing operations. Treated medical waste becomes solid waste and is no longer hazardous. An emergency action plan must be in place at locations where medical waste is being treated.

Any facility treating medical waste on-site using autoclaves or similar forms of sterilization must adhere to the following guidelines:

1. Follow standard written operating procedures for each steam sterilizer, including time, temperature, pressure, type of waste, type of container, pattern of loading, water content, closure on containers, and maximum leak quantity.
2. Check recording or indicating thermometers during each complete cycle to ensure 250 degrees F (121 degrees C) for 30 minutes or longer. Check thermometers for calibration at least annually. Operating parameters for each autoclave load must be documented.
3. Use heat-sensitive tape or other device for each container that is processed to indicate attainment of adequate sterilization conditions.
4. Use bacillus stearothermophilus placed at the center of a load processed under standard operating conditions at least once a month to check adequate sterilization.
5. Maintain records of procedures specified in one, two and four for a period of not less than three years.

Biohazardous waste less than 20 pounds may be stored on-site for up to 30 days above 0 degrees C or up to 90 days below 0 degrees C in a non-member secured area. Full Sharps containers ready for disposal and any biohazardous waste of 20 pounds or more may be stored on-site for up to seven days (longer storage times may be requested from the local enforcement agency). Biohazardous waste stored inside an office must be picked up by a licensed waste hauler every seven days.