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Biohazard Waste Disposal for Hospitals



April 29, 2021



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Biohazard Waste Disposal for Hospitals

Biohazard Waste Disposal for Hospitals. Biohazard waste is any kind of waste that is from a biological source that contain or potentially contain dangerous pathogens that can be transmitted to people and/or the environment. A majority of biohazard waste is generated in hospitals and, according to WHO (World Health Organization) approximately 0.5 kg of hazardous waste is created per hospital bed per day.   There are four categories of biohazard waste:

There are strict state and federal guidelines regarding biohazard waste handling, segregating, storage, transportation, and disposal that all medical organizations must comply with. There are also federal organizations that work to ensure compliance including: DOT (Department of Transportation), EPA (Environmental Protection Agency), OSHA (Occupational Health and Safety Administration, CDC (Center for Disease Control, NIOSH (National Institute for Occupational Safety and Health, and the DEA (Drug Enforcement Agency).

Given the laws and requirements in dealing with medical waste and specifically biohazard medical waste, many hospitals use a licensed and professional waste disposal company such as Healthcare Waste Management for compliance.  Some states require that hospitals complete reports to state organizations regarding each type of medical waste, how the waste was disposed of, and a certificate of destruction.

Segregation of Hospital Medical Waste

A first step in assuring that medical waste is dealt with in compliance of all laws involves segregating by waste types. This allows medical waste disposal companies to address the required destruction according to official guidelines.

Biohazard Waste/Hazard Waste Packaging for Storage and/or Transport

In some states, hospitals may use a licensed medical waste disposal company such as Healthcare Waste Management for direct pickup and disposal. In other situations, a hospital may opt to have the PIMW transported to a temporary off-site to await pickup for disposal.  Many states have limitations set for the duration of time a hospital can keep biohazard waste both on and offsite before it must be disposed of. In most cases, PIMW that is considered to be “oversized” cannot be shipped off-site.

All PIMW must be placed in FDA-cleared containers that are sturdy, puncture-proof (for sharps), leak-proof, cannot be torn or burst under normal handling and use, impervious to moisture, can be completely sealed so that there is not any leakage during transport. There may be specific state laws dictating rules for not allowing sharps to be packaged with oversized PIMW.

Labeling Biohazard Waste Prior to Transport

Proper labeling for PIMW is not only a priority, but also required by both state and federal guidelines. Hospitals are required to package PIMW and mark the exterior of the container with the word “Biohazard” large enough to be seen at a distance or use the international symbol label. Sharps containers should have the word “Sharps” large enough to be able to be viewed from a distance. These markings should be done at a minimum of two sides of each container.

Hospitals are also required to attach a tag or label that is water-resistant that includes detailed information about the hospital: Hospital name, address, phone number, and 24-hour phone number (when available). Some states require additional information such as the location that the hazardous waste will be sent to.

Any inner packages must also have the word “Biohazard,” “Sharps” (if they contain sharps), and the international biohazard symbol.

PIMW/Biohazard Waste Storage, Disposal, and Transport Prior to Treatment

Whether the PIMW is stored and/or transported on or off-site, hospitals are required to comply with the following rules:

Authorized Biohazard Waste Transporters and Requirements

The Department of Transportation has a complete list of detailed rules regarding the transportation of PIMW/biohazard waste. Each state may have additional requirements that include permits and reporting schedules. In many cases there are transportation fees and completed manifests. 

Hospitals that use a professional medical disposal company must be sure that the company complies with all state and federal laws regarding transport of PIMW. Licensed and certified companies such as Healthcare Waste Management are knowledgeable of all laws for the states serviced and supply customers with all required documentation.

Individuals that are transporting PIMW that has been solely generated by their activities are not required to comply with all of the state and federal laws if it is between facilities/sites owned/controlled/operated by that individual and/or if the PIMW is 50 lbs or less at one time/non-commercially. 

Hospitals That Act as Medical Waste Receivers

Some states allow hospitals to act as a “transfer station or facility” that can accept waste temporarily prior to further transfer to a storage facility, waste disposal or treatment facility. This can occur when the hospital is approved to receive waste from individuals or smaller generators. States that offer this as an option have strict permit guidelines. The waste received must comply with the standard state and federal containment rules for storage and transport.

Hospitals with On-Site PIMW Treatment Facilities

There are hospitals that have their own on-site PIMW treatment facilities. These hospitals are required to comply with all laws and guidelines set by both state and federal for the purpose of eliminating the infectious and/or potentially infectious materials that they generate. There are typically both permits and reporting procedures that the hospital must accommodate, and they must comply with the rules for storage and destruction rules for amounts and duration of time on-site. As treatment facility hospitals are required to certify to the transporter (if other than the generator), as well as certify to the facility receiving the product post-treatment that the contents are in accordance with stipulated laws. Hospitals are required to submit confirmed reports verifying the efficacy of the treatment unit on a regular basis.

Requirements for PIMW Treatment:

Compliance with state and federal laws for PIMW treatment includes that the treatment process:

Residuals Left Over from PIMW Cleaning/Treatment

All residuals that remain after treatment or cleaning must be disposed of in accordance with all state and federal laws. Residues that remain after disinfecting and/or cleaning any item that was PIMW contaminated are considered to be PIMW, with the exception of those that are approved to be disposed of via combined or sanitary sewer. There may be specific local and state laws that govern the approval of sewer disposal including the prohibition of any solid matter.

Any resident that has been treated as PIMW and are no longer considered to be PIMW may be allowed to be placed in a landfill. However, each state may have specific rules and it is best to confirm with state regulations. Some states have exceptions to placing residues in landfills that could include:

Hospital Units that Treat PIMW

There is a rigorous list of requirements that a hospital must abide by when they have a unit designed for PIMW treatment. The standards of the unit are governed by both their state laws and federal laws and can include:

There may be specific state rules that dictate whether a hospital treatment unit is not required to have a permit for treatment. 

Rules for Untreated Hazardous Medical Waste

Untreated PIMW is banned from being placed in any landfills. Only when treated can the PIMW be considered to have had the potential infectious materials removed. At that point, it is no longer PIMW and can be placed in landfills following state and federal rules. Specific rules for sharps are required so that they are rendered both non-infectious and harmless prior to disposal.

PIMW Treatments: Incineration and Autoclaving

States require a permit for a hospital to use its own incinerator. Different or additional permits may be required if a hospital acts as an off-site facility and accepts waste from outside sources. Ash that results from the incineration process of PIMW must comply with the individual state rules which could categorize the ash as “special waste” and require a special waste manifest for transport. This type of waste is required to be transported by a permitted special waste hauler such as Healthcare Waste Management and may have limitations as to the location or type of landfill where it can be disposed of.

When a hospital has its own autoclaving unit, it may/may not be required to have a state permit for PIMW on-site treatment. However, other permits may be required if the hospital acts as a facility in accepting waste from outside sources.

Required PIMW Records and Reports

Each state may have its own requirements for the type of records and reports required by a PIMW generator and the duration of time that is required for retention. Some of the most common include:


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