EPC & Project Management in Waste Management

Medical Waste

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A Guide to the Handling and Disposal of Medical Waste


In 1990 the Alabama Department of Environmental Management (ADEM) issued regulations concerning the storage, transportation, treatment and disposal of medical waste. In accordance with these regulations the Office of Safety and
Environmental Health established a medical waste management program for Auburn University. This guide is intended to serve a general summary of the regulations and provide guidance on the proper management of your medical waste. If you have
questions or need additional information, for situations not addressed in this guide, please contact this office at 844-4870.


Medical waste is defined as the disposal of any human infectious agent or equipment that is capable of transmitting that disease to humans. An example of a human disease agent is Histoplasma capsulatum. Equipment that would be
regulated as medical waste includes syringes and scalpel blades. All medical waste must be either treated and disposed of as solid waste or shipped off-site for additional processing to render it non-recognizable.

Biological waste is defined as the disposal of any non-human disease agent or equipment that has come in contact with the non-human disease agent. Examples of biological waste are general zoonotic vectors used in research and cultures used
in plant pathology research. The equipment could include petrie dishes and disposal pipettes as long as they do not contain human disease agents. Biological waste is not regulated under the ADEM medical waste requirements.
However, good laboratory practice would include autoclaving of all biological waste prior to disposal. All biological waste material can be disposed with normal trash provided it does not have any wording or symbols indicating that it
contains infectious material.

Solid Waste includes all other waste and materials which have not been exposed to human infectious agents. Solid wastes are items that may be recycled or disposed in the trash. Chemical and radioactive waste must not be disposed of
as solid waste or medical waste.

Types of Medical Waste

Human Blood and Blood Products

Human blood and blood products are classified and managed as medical waste because of the possible presence of infectious agents that cause blood-borne disease. Wastes in this category include bulk blood and blood products as well
as smaller quantities of blood samples drawn for testing or research. Waste human blood must be treated by steam sterilization. After sterilization, the liquid portion may be safely poured off into a sanitary sewer drain. Animal blood is not regulated as medical waste unless it has been intentionally exposed to a human infectious agent and is capable of transmitting the disease back to humans.

Cultures and Stocks of Infectious Agents

Cultures and stocks of human infectious agents, regardless of storage method, must be managed as medical waste. Cultures and stocks of zoonotic disease are not regulated as medical waste if they have neither been intentionally exposed to a
human infectious agent nor capable of transmitting that disease to humans.

Pathological Waste

Animal pathological wastes are considered to be medical waste only if the animal has been intentionally exposed to a human infectious agent and it is capable of transmitting the disease back to a human. Animals that are accepted at the University that may be carriers of human infectious agents, e.g., rabies, are not regulated as medical waste. As long as the human disease agent was not deliberately introduced to the animal as part of a treatment or research regimen at the University and the animal is not capable of transferring this disease back to humans it is not regulated as a medical waste.


All hypodermic needles and syringes, intravenous needles and tubing, scalpel blades, lances, and other such devices are regulated as medical waste. Even if these materials are unused they are still regulated. All sharps must be placed
in an approved sharps container. Sharps that have been exposed to human disease agents must be autoclaved prior to pickup by Safety and Environmental Health.


Glassware exposed to a human infectious agent must be managed as a sharp until it has been autoclaved. This includes pipettes, capillary tubes, test tubes, stir rods, and other laboratory equipment. All glassware that has been exposed to human infectious agents must be autoclaved prior to disposal. After the glassware has been autoclaved it can be thrown in the trash.Glassware that has not been exposed to a human disease agent is not regulated as a sharp.

Broken glassware should be placed into a container designed for such materials and either recycled or disposed. Currently, there is no locally available market for Pyrex glass so it should be disposed of as solid waste. At a minimum, broken
glassware should be disposed of in small double lined cardboard boxes and clearly labeled as broken glassware. Small double lined boxes minimize the potential for injury and excessive accumulation in the laboratory.

Contaminated Equipment

This includes any equipment not mentioned above which may come into contact with human infectious agents. Equipment that has been contaminated with human disease agents must be treated as a medical waste and either autoclaved or shipped
off-site for treatment.



The sharps container must be red in color and display the International Biohazard Symbol or one of the following phrases:

                    * Medical Waste
                    * Infectious Infectious Waste Biohazardous

All sharps must be packaged in an approved sharps container. We are unable to accept sharps that are in plastic milk containers, cardboard boxes or other types of unapproved containers. The Scientific Supply Store in Saunders Laboratories
carries a selection of various size sharps containers and they are available from most general scientific supply companies.

The generator must ensure that the container is properly sealed and labeled. If the container is not properly sealed, or there is any doubt about the integrity of the sharps container it will not be accepted for disposal. Sharps containers should not be used for the disposal of aluminum drink cans, paper, gloves, laboratory glass, culture tubes, bodily fluids or any other similar types of
materials. Sharps containers shall not be used for the disposal of chemicals or radioactive materials. Sharps containers should only be used for sharps. If the sharps have been exposed to human disease agents they must be autoclaved prior to being picked up by Safety and Environmental Health.


Since sharps must be rendered non-recognizable prior to disposal all sharps are shipped off-site to an approved medical waste treatment facility on a weekly basis.

The generator or contact person must complete a medical waste internal manifest prior to the collection of any medical waste. Waste pickup personnel normally carry extra copies of the internal manifest for circumstances when the generator
may not have one. When you have a sufficient number of sharp containers to warrant a pickup you should call the Office of Safety and Environmental Health at 4870 and request a pickup. Please see the attached "Request for Pickup of
Medical Waste Form" so that you can provide the appropriate information to the secretary. Medical waste will normally be picked up within 3 days of your request. During quarter breaks pickup times may be restricted due to reduced
waste volume and limited personnel.

Autoclavable Waste


ADEM regulations have specific prohibitions on the disposal of all items bearing either an international biohazard symbol or any wording indicating that the items contain infectious waste, biohazardous waste or medical waste. In order to dispose of treated medical waste as trash the autoclave bag must not be red or orange nor contain any wording or symbols indicating that it contains medical waste. The state prohibits using an orange/red bag for autoclaving and then placing it into a black trash bag for disposal.

This office, in consultation with the Scientific Supply Store, has identified a manufacturer of blue autoclave bags that meet the ASTM dart test standard. These bags are the same as those sold by companies such as Fisher and Baker. The
only difference is these bags are black with no symbols or wording. These black autoclave bags are available at a lower cost than bags from commercial vendors since the Supply Store orders them in bulk.

To provide for proper identification of biohazardous materials in the laboratory it is suggested that you acquire outer secondary containers such as a trash receptacle and affix a biohazard symbol on their exterior surface. The black autoclave bag can then be placed inside the secondary container. This allows the material to be clearly identified in the lab and still allows disposal of the bagged material in the solid waste stream. Most general science catalogs contain a listing for small clear autoclave bags which fit into wire frame holders, if your lab uses small tabletop biohazard bags. Again, the holder can be marked
with a biohazard symbol, if necessary. These clear bags must be placed into a black autoclave bag prior to disposal.

Sharps are prohibited from disposal in autoclave bags. If you generate sharps they must be placed into an approved sharps container. Glassware that contains human disease agents should be autoclaved and placed into double lined cardboard
boxes for disposal.

Recordkeeping and Testing

Autoclaves used for the treatment of medical waste must be operated in accordance with ADEM medical waste regulations.

Steam sterilizers should be equipped to continuously monitor and record temperature and pressure during the entire length of each cycle. Sterilizers not so equipped shall have affixed a temperature sensitive tape to each bag or container of medical waste or obtain approval from ADEM of an equivalent test.

Each bag or container shall be exposed to a minimum temperature of 250 degrees Fahrenheit and at least 15 pounds of pressure for 30 minutes. Processing requirements may be altered if proper decontamination is assured by appropriate
testing, and approval is received from ADEM.

Each sterilizer shall be evaluated for effectiveness under full loading by an approved method at least once for each 40 hours of combined operation. (Note: The 40 hour testing requirement is for every 40 hours of operation treating medical waste. Treating non-medical waste does not count toward the 40 hours.) Bacillus stearothermophilus is the only biological indicator that can be utilized without ADEM approval.

A written log or other means of documentation as approved by ADEM shall be maintained for each steam sterilization unit and shall contain the following:

· The date, time (including duration), and operator for each cycle.

· Approximate weight or volume of medical waste treated during each cycle.

· The temperature and pressure maintained during each cycle.

· Method utilized for confirmation of temperature and pressure; and

· Dates and results of calibration and maintenance.

Owners or operators of steam sterilizers shall not place untreated regulated medical waste in areas or containers designated for pickup and delivery to a solid waste disposal facility.

Sterilizers utilized for waste treatment shall not be utilized for sterilization of equipment, food or other related items. (Note: This only applies to units that are used to sterilize equipment, i.e., syringes, that will be used on humans. Equipment used on animals is not covered under this requirement.)


ADEM requires that units treating medical waste retain the operating log for a minimum of three years.