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580 Waste Management Practices: Municipal, Hazardous, and Industrial

TABLE 20.1
Estimated U.S. Medical Facilities and Annual Waste Generated

Generator Category Number of Annual Infectious Waste Annual Total Waste
Generated (tons) Facilities Generated (tons) (tons)
Hospitals 7,000 360,000 2,400,000
Laboratories
Medical 4,900 17,600 117,500
Research 2,300 8,300 55,500
Total 7,200 25,900 173,000
Clinics (outpatient) 41,300 26,300 175,000
Physicians’ offices 180,000 35,200 235,000
Dentists, offices 98,000 8,700 58,000
Veterinarians 38,000 4,600 31,000
Long-term care facilities
Nursing homes 18,800 29,700 198,000
Residential care 23,900 1,400 9,000
Total 42,700 31,100 207,000
Blood banks 900 4,900 33,000
Funeral homes 21,000 900 6,000
Health units in industry 221,000 1,400 9,000
Fire and rescue 7,200 1,600 11,000
Corrections 4,300 3,300 22,000
Police 13,100 100 1,000
Total 682,400 504,000 3,361,100
Source: U.S. EPA, 1994. With permission.

management and tracking program. The Resource Conservation and Recovery Act (RCRA) was
amended by adding a Subtitle J.
In a fashion analogous to RCRA, the Act established a cradle-to-grave medical waste tracking
protocol; however, this program was implemented in only a limited number of states. New York,
New Jersey, and Connecticut were required to participate in the program. Additionally, the program
was open to any state wishing to petition the U.S. EPA for inclusion. The Commonwealth of Puerto
Rico petitioned for participation in the program. The states contiguous to the Great Lakes were des-
ignated by the MWTA to participate in the program; however, the Act provided the option for them
to voluntarily withdraw. These states did indeed choose to opt out.
The medical waste tracking program had limited participation and the program expired in June
1991 without being reauthorized by Congress; however, the course of United States medical waste
management changed significantly as a result of this legislation. With the American public’s
increasing fear of the AIDS epidemic along with washups of medical waste on beaches, United
States medical waste policy shifted in response to the potential risks associated with this waste
stream.

20.3 DEFINITIONS AND SOURCES OF MEDICAL WASTE
As is the case for municipal and hazardous wastes, one of the first steps in managing medical waste
is to identify its sources. A logical next step is to determine the types and quantities of waste gen-
erated. Third is the determination as to whether the waste should be classified as solid, potentially
infectious, hazardous, radioactive, etc. Definitions of medical waste to be managed and disposed as
potentially infectious will vary depending on which regulation or guideline is chosen.