Biohazard waste is any type of waste that can contain elements that can be infectious or potentially infectious to humans, animals, the community or the environment. Hospitals are the largest generators of biohazard waste and are responsible for over 5.9 million tons each year. However, biohazardous waste can be generated from a number of facilities including but not limited to: dental, pharmacy, home healthcare, veterinarians, funeral homes, coroners, research laboratories, and physician’s offices. There are local, state, and federal guidelines designed for the handling, labeling, storage, transportation, and ultimate rendering of the waste as harmless for safe disposal. In addition, there are OSHA (Occupational Safety and Health Administration) guidelines for the training of staff within the generator facilities.
Biohazard medical waste is referred to by a few names: medical waste, infectious waste, red bag waste, healthcare waste, regulated medical waste (RMW), pathological waste, and biohazard. The 1988 Medical Waste Tracking Act:
Defined medical waste and established which medical wastes would be subject to program regulations.
Established a cradle-to-grave tracking system utilizing a generator initiated tracking form.
Required management standards for segregation, packaging, labeling and marking, and storage of the medical waste.
Established record keeping requirements and penalties that could be imposed for mismanagement.
In addition, the Act defined the waste as any that is created during testing, treatment, research, immunization, or diagnoses of humans and animals.
What is Biohazardous Waste?
Laboratory waste that can include but is not limited to:
Human and animal specimen cultures from pathology and medical labs.
Stocks and cultures of infectious agents from research labs, defined as any bacteria, microorganism, parasite, mold, or virus that can cause or significantly contributes to the cause of increased morbidity or death of humans or animals.
Waste from the production of viruses, bacteria, spores, discarded attenuated or live vaccines in human or animal health care, discarded animal vaccines (including contagious Ecthyma and Brucellosis), culture and specimen devices and dishes used in the transference, inoculation, and the mixing of cultures.
Specimens or tissues from human surgeries removed during surgery or during autopsy which are suspected or known to be contaminated with agents that are infectious or contagious to humans.
Animal body parts, fluids, tissues, or carcasses that are suspected or known to be contaminated with agents infectious or contagious to humans.
Any waste that contains recognizable fluid blood products, fluid blood, equipment or containers that contains blood that is fluid or blood from animals that are known or suspected of being infected with diseases that are highly communicable to humans.
Examples of Biohazardous Waste
Biohazardous waste can also be listed in additional subcategories. The World Health Organization (WHO) has defined eight categories of:
Infectious waste:waste contaminated with blood and other bodily fluids (e.g. from discarded diagnostic samples),cultures and stocks of infectious agents from laboratory work (e.g. waste from autopsies and infected animals from laboratories), or waste from patients with infections (e.g. swabs, bandages and disposable medical devices);
Pathological waste:human tissues, organs or fluids, body parts and contaminated animal carcasses;
Sharps waste:syringes, needles, disposable scalpels and blades, etc.;
Chemical waste:for example solvents and reagents used for laboratory preparations, disinfectants, sterilants and heavy metals contained in medical devices (e.g. mercury in broken thermometers) and batteries;
Pharmaceutical waste:expired, unused and contaminated drugs and vaccines;
Cyctotoxic waste:waste containing substances with genotoxic properties (i.e. highly hazardous substances that are, mutagenic, teratogenic or carcinogenic), such as cytotoxic drugs used in cancer treatment and their metabolites;
Radioactive waste:such as products contaminated by radionuclides including radioactive diagnostic material or radiotherapeutic materials; and
Non-hazardous or general waste:waste that does not pose any particular biological, chemical, radioactive or physical hazard.
Important Biohazard Waste Facts
Airborne pathogens can be a grave danger. While most people may be more focused on contaminants that are solid or liquid, airborne pathogens can be absorbed through the skin or through cuts. Improperly handled and stored biohazard waste can allow pathogens to enter the air processing system of a facility and quickly spread throughout.
Improperly discarded needles from a vaccine can spread the disease. A majority of vaccines are made from an active form of a disease and if the needle is left out it can spread the disease to others if they come into contact with it.
The CDC (Center for Disease Control) indicates that there are around 385,000 needle pricks every year. Medical professionals are exposed to hypodermic needles as part of their daily routine, and no matter how careful they are, needle pricks happen.
Of the almost 6 million tons of medical waste produced each year, only about 15% of it is biohazardous waste.
Who is Responsible for Regulating Biohazard Waste?
Biohazardous waste is a subcategory of medical waste and in the past was completely regulated by the Federal government and the Environmental Protection Agency (EPA). As of 2020, each state became responsible for setting their own guidelines and laws for handling, labeling, storing, transporting, and proper disposal. In the case that the state did not have specific laws, guidelines default to the federal laws.
The various parts of the government responsible for regulating biohazard waste include the CDC (U.S. Centers for Disease Control), OSHA (Occupational Safety and Health Administration, DEA (the Drug Enforcement Administration), DOT (the Department of Transportation), the U.S. Postal Service, and the FDA (Food and Drug Administration). Many states have established their own OSHA divisions that reinforce safe handling, labeling and training of employees.
Handling and Labeling of Biohazard Waste
Special bins are designated as biohazard and must be lined with a special biohazard bag, as well as clearly designated as biohazard with the universal biohazard logo and the word “biohazard.”
Each type of waste has specific packaging and storage rules that are required to be complied with.
Sharps must be in an approved sharps container that is rigid, leak proof, and puncture resistant. The container must have the biohazard symbol on the outside.
Animal carcasses are placed in a leak proof bag and then transferred to a red pathological waste container that has a tight-fitting lid and a red bag liner. Maximum time is typically set per state or defaulted to maximum of 7 days. Outside label must include the biohazard symbol and many states require the date, species, and some specific information.
Solid biohazard waste such as solid lab waste, can include items such as pipette tips, plastic pipettes, syringes without needles, culture flasks, petri dishes, paper towels, biohazardous animal bedding, bench paper, gloves that have been contaminated with infectious or potentially infectious diseases, and genetically modified materials or organisms including invertebrates. These items must be placed into two red biohazard bags and then placed in a leak proof, rigid container with a lid that fits tightly. Exterior labeling must include the biohazard symbol. Some states require the label on both the lid and the sides of the container.
Pathological human anatomical specimens are placed in a colorless bag and then inside a red pathological waste container that has a red bag liner and a lid that fits tightly. The container can be stored in a freezer or refrigerator. Maximum time is typically set per state or defaulted to maximum of 7 days. Exterior of the container must have the biohazard symbol.
Liquid biohazard waste can be placed in a vacuum flask with a stopper that is then placed in a secondary container. Exterior must have the biohazard symbol label.
Types of Biohazard Treatment
Incineration is a process of burning specific types of biohazard wastes which include pathological, trace chemotherapy and non-hazardous pharmaceutical wastes. It is considered to be one of the safest methods of treatments as it prevents harm to the health of the population and the environment.
Steam/autoclaving makes use of both pressure and steam to sterilize solids and liquids and kills bacteria, germs, spores, and viruses.
Chemical Decontamination is the use of specific chemicals to render the biohazardous materials harmless. Some biohazard waste cannot be treated using chemical decontamination because the addition of the chemicals can create an alternative toxin.
Combinations of the above treatments may be required for certain types of biohazardous wastes to render them harmless prior to disposal in a sanitary landfill.
Biohazard Treatment and Disposal
Treatment and disposal of biohazardous waste is dependent upon the subcategory of the waste. Treatments are required to render the biohazard waste harmless and in many cases, the residue can be placed in a sanitary landfill. The rules and guidelines are state specific and many will require hiring a licensed, trained and professional medical waste removal company. There are a few on-site organizations that have in-house methods, however, most use off-site autoclave and incinerators.
Sharps must be steam sterilized in an autoclave through the use of a vendor that is licensed. The autoclave is required to have quality control checks. Prior to autoclave, the containers must be closed and taped. States regulate disposal based on the type of contaminant.
Animal carcasses are treated with incineration so that remains are rendered harmless. Prior to incineration the containers must be closed and taped.
Solid lab waste is treated with off-site steam/sterilization via an autoclave method with containers sealed and taped.
Pathological biohazard waste is treated with steam/sterilization via an autoclave method with containers sealed and taped.
Liquid biohazard materials can be diluted with the use of bleach (1 part bleach to 9 parts liquid) Some states allow the resulting liquid mixture to be poured down the drain after it has sat in the mixture for thirty minutes while wearing recommended PPE (personal protective equipment). Liquid biohazard materials may also be steam sterilized via autoclave.
Transporting Biohazard Waste
All states comply with the Department of Transportation guidelines regarding the transportation of biohazard waste. However, some local and state laws have added steps and requirements to ensure that the transport is safe. Transportation must be through a licensed and trained medical waste transport company.
Regulations by state can also include creating detailed emergency procedure documentation and carrying PPE (Personal Protection Equipment) as well as being trained on actions to take during an emergency.
Best Practices and Color Coding
A general process is to establish a basic understanding of a color coding as it pertains to all waste and specifically biohazardous waste. The color coding system is used for the containers and bags that will hold medical and biohazardous waste and is an easier way to identify as well as assist in keeping everyone safe from contamination.
Grey = non-hazardous, regular trash
Red = blood, tissue, and sharp wastes
Yellow = clinical waste that is infectious
Orange = anything that is highly infectious
Blue = pharmaceuticals and medicines
Black = RCRA-hazardous
Purple = cytotoxic medicines
White = waste from a dental source
Best practices require that everyone be aware of all of the local, state, and federal laws. It is critical to keep up on any and all changes and requirements for the handling, labeling, storage, transportation and disposal of biohazardous waste.
Biohazardous waste makes up the nearing 15% of medical waste that must be rendered harmless prior to disposal. Making sure that all staff are trained on how to handle and dispose of this type of waste will ensure their safety.
Keeping your waste separated by type is another crucial step. Make sure that all biohazardous waste is separated and identified as sharps, pathological, chemical, and pharmaceutical, are in the appropriate leak-proof and puncture-resistant bags and are labeled with the biohazard symbol.
Use the correct containers for storing biohazardous waste for transportation and comply with all rules and guidelines for maintaining information that is required by the state.
Make sure all containers are sealed and taped prior to transportation and comply with the DOT waste packaging laws for volume and weight.
Store containers in a location that is safe, cool, dry, secure, and away from access by anyone except authorized personnel.
Make sure all documentation is maintained and the paper trail complete. This will ensure that there won’t be any fines in the case of an audit and will help if there are incidents. Paperwork that is completed will have to accompany all containers for transit.
Maintain a strict shipping and collection schedule so that waste doesn’t sit in storage for too long of a period of time. Some states have specific restrictions on the time.
Bags and containers should be ¾ full to reduce the possibility of spillage or leakage.
Use the color coded system that WHO (World Health Organization) recommends and train all staff to understand and know the color codes and the type of waste for each color.
Make sure that you use a licensed and professional medical waste removal company that has trained staff. These companies understand the methods of transporting biohazardous waste and comply with ensuring that those that generate the waste receive proper documentation.