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Medical Waste Regulations Missouri

Medical Waste in the State of Missouri

Medical Waste Regulations Missouri

The federal government has established strict guidelines on the handling and disposal of medical waste. Each state has stepped in to add to these laws so that they are protecting people, the community and the environment from potential hazards. In the state of Missouri, medical waste is referred to as “infectious waste.” According to the Missouri Department of natural resources, they define infectious waste as: “waste capable of producing an infectious disease because it contains pathogens of sufficient virulence and quantity so that exposure to the waste by susceptible human host could result in an infectious disease.”

In addition to the state guidelines, any facility that generates medical/infectious waste is required to be in compliance with other government guidelines such as DOT (Department of Transportation) for the transportation of medical waste. Missouri, like many states hold those that generate medical waste to the “cradle-to-grave” requirements. This means that the facilitator is responsible for all aspects of the medical waste from the moment that it is generated to confirmation and documentation that it has been handled, transported, and disposed of according to state and federal laws. The lack of compliance can result in the loss of business and fines.  When there aren’t specific state laws for compliance, each state regulatory guidelines reverts to the federal guidelines.

In “Rules of Department of Natural Resources Division 80—Solid Waste Management Chapter 7—Infectious Waste Management, Chapter 10:

The State of Missouri identifies infectious wastes to include:

Who Generates Medical/Infectious Waste

Any facility or location that has the potential for exposure to human or animal blood, tissue, bloodborne pathogens, cultures, and specimens is considered to be a generator or medical/infectious waste. The State of Missouri defines an infectious waste generator as:

“A generator of infectious waste who operates a single or multiple site research facility for research and experimental activities as defined in section 174 of the 1986 Internal Revenue Code, who generates such waste as a part of research and experimentation activities, who manages such waste onsite and who accepts no infectious waste from off-site, is exempt from the infectious waste processing facility permit requirements of this rule. The generator may accept infectious waste from other sites of the parent research company located in Missouri but shall not accept infectious waste from other sources and shall comply with all other requirements and provisions of the Missouri Solid Waste Management Law and the rules and regulations promulgated thereunder. The University of Missouri Ellis Fischel Cancer Center and the other facilities of the University of Missouri-Columbia shall be considered a multiple site research facility for the purposes of this rule. 5. Hospitals.”

While a majority of the infectious waste is generated by medical facilities, it can also be generated by mortuaries, tattoo parlors, body piercing businesses, veterinarians, coroner’s offices, independent and university research labs, and biological companies.

The State of Missouri does include the following exemptions with restrictions:

“Pharmacies, as defined in Chapter 338, RSMo, and home health agencies, as defined in Chapter 197, RSMo, are exempt from the infectious waste processing facility permitting requirements of this rule provided that the only waste accepted is single dose hypodermic units presented in person by small quantity generators as defined by paragraph (1)(A)2. of this rule. Pharmacies and home health agencies operating under this exemption shall be limited to a maximum of ten (10) kilograms of infectious waste on-site at any time and process no more than one hundred (100) kg of infectious waste per month. All waste received under this exemption must be managed in accordance with this rule.”

Medical Waste Storage Requirements

The State of Missouri defaults to Federal Code 29 CFR 1910.1030 for packaging and storage of infectious waste:

“Packaging of Infectious Waste. Prior to transport, all infectious waste shall be placed in rigid or semi-rigid, leak-resistant containers clearly marked with the universal biohazard symbol prominently displayed and labeled Infectious Waste or Biohazard Waste and sealed. All containers shall be closed in such a manner as to completely contain all waste and the outside of the container shall be kept free of contamination. For the purpose of this rule, leak-resistant containers are defined as containers that are closable with a tight fitting lid and are leakproof [sic] on the bottom and sides. Containers meeting the requirements of 29 CFR 1910.1030 are acceptable. (A) Plastic bags. Plastic bags shall be tear resistant and leak resistant. Plastic bags shall not be used as primary containers for transportation of infectious waste. Infectious waste contained in plastic bags shall be placed within rigid or semi-rigid containers prior to transport. (B) Sharps containers. Sharps shall be packaged in rigid, leak-resistant and puncture-resistant containers and sealed. (C) Glass Containers. Glass containers shall not be used as primary containers for transportation of infectious waste. Glass containers must be placed into a rigid or semirigid leak-resistant container and protected from breakage. (D) Reusable containers. Reusable containers shall be constructed of either heavy wall plastic or noncorrosive metal. Each container shall be cleaned and sanitized before it is reused.”

Medical Waste Transport Requirements

“Certification of treated infectious waste, at a minimum, shall contain the following information: the name, mailing address, location (when different from the mailing address) and phone number of the office/facility treating the infectious waste; the printed name and the signature of the facility/office manager or person responsible for the treatment process; a brief description of the treated waste (sharps in metal containers, sharps in heavy gauge plastic containers, incinerator ash, laboratory wastes in autoclave bags); and a brief description of the method(s) of treatment (for example, steam sterilization, incineration, disinfection with bleach solution). In addition to these minimum requirements, the generator need only include a statement that the waste has been managed in accordance with the Missouri Solid Waste Management Law and rules and may legally be placed in a sanitary landfill. The certification shall be revised when changes in the operation of the office/facility result in a change to the information required by this paragraph. 3. In addition to the requirements of paragraphs (1)(B)1. and 2. of this rule, incinerator residue from a permitted infectious waste processing facility shall be considered to be a special waste. and handled accordingly. Prior to departmental approval, and at a minimum, every six (6) months after that, the incinerator residue shall be tested for hazardous waste characteristics as per 40 CFR part 261 subpart C, as incorporated in 10 CSR 25-4.261, as applicable.”

The State of Missouri does allow individuals that generate small amounts of infectious waste to transport their own infectious waste and be exempt from the transportations laws and fees. In addition, under specific conditions, Missouri allows hospitals to receive and accept infectious waste.

“A person generating one hundred (100) kg or less per month of infectious waste as defined by 19 CSR 20-20.010 and who transports his/her own infectious waste for processing is exempt from the transportation and fee requirements of this rule, except that the vehicle used for transport of the infectious waste shall be a closed and secured vehicle. 4. A generator of infectious waste who operates a single or multiple site research facility for research and experimental activities as defined in section 174 of the 1986 Internal Revenue Code, who generates such waste as a part of research and experimentation activities, who manages such waste onsite and who accepts no infectious waste from off-site, is exempt from the infectious waste processing facility permit requirements of this rule. The generator may accept infectious waste from other sites of the parent research company located in Missouri but shall not accept infectious waste from other sources and shall comply with all other requirements and provisions of the Missouri Solid Waste Management Law and the rules and regulations promulgated thereunder. The University of Missouri Ellis Fischel Cancer Center and the other facilities of the University of Missouri-Columbia shall be considered a multiple site research facility for the purposes of this rule.”

Source Separation

Onsite locations of infectious waste must be stored away from access by anyone other than authorized personnel. The storage containers must be identified with the appropriate labels and colors to identify it as infectious waste.

“Disposal of Infectious Waste. All sharps shall be packaged in rigid, leak-resistant and puncture-resistant containers and sealed prior to disposal. 1. Infectious waste treated to render it innocuous may be disposed as a solid waste provided the treater certifies to the transporter, if other than the generator, and certifies to the sanitary landfill operator or processing facility operator that the waste has been rendered innocuous as required by section 260.203, RSMo.”

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