Page 610 - Materials Chemistry, Second Edition

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Medical and Infectious Wastes 581
Definitions for infectious waste also vary widely in different federal regulations and from state
to state; there is no national standard defining which wastes comprise infectious wastes. Some of
the federal designations of infectious waste include those by the CDC (1985), the EPA Guide for
Infectious Waste Management (U.S. EPA, 1986), the Medical Waste Tracking Act of 1988 (U.S.
EPA, 1988), and others. The CDC definition of infectious waste is any waste from microbiology
laboratories, pathological waste, sharps, and blood or blood-product waste (CDC, 1985). The defi-
nitions provided in the EPA Guide were more specific (U.S. EPA, 1986):

Isolation waste, cultures and stocks of infectious agents, human blood and blood products, pathological
waste, contaminated sharps (e.g., hypodermic needles, syringes, Pasteur pipettes, scalpel blades, blood
vials) and contaminated animal carcasses, body parts, and bedding all are considered infectious.

‘Optional infectious waste’ is also listed in the Guide and includes surgery and autopsy wastes,
miscellaneous laboratory wastes, dialysis unit wastes, and contaminated equipment. These are not
considered to pose a risk, and the decision as to whether optional waste should be handled as infec-
tious is left to an authorized representative at the facility. The MWTA now defines regulated med-
ical waste to include cultures and stocks of infectious agents, human pathological wastes, human
blood and blood products, sharps (used and unused), contaminated animal wastes, and isolation
wastes (40 CFR Part 259). These are described further below.
Based on the MWTA definition of medical waste, sources of medical and infectious wastes
were identified as: (1) hospitals, (2) physicians’offices, (3) dentists’offices, (4) biomedical research
facilities, (5) clinical laboratories, (6) manufacturing facilities, (7) veterinary offices and clinics, (8)
funeral homes, (9) in-home medical care, (10) other healthcare and residential care facilities, (11)
illicit intravenous drug use, and (12) other sources (e.g., cruise ships and naval vessels).
Because medical and infectious wastes are defined in many ways, because the general public
tends to consider all medical wastes as potentially infectious, and because off-site disposal contrac-
tors may define any medical waste as potentially infectious, some institutions categorize all patient-
contact wastes as potentially infectious. Each healthcare facility must formulate its own definition of
medical and infectious wastes based on definitions established at the federal and state levels.

20.3.1 POTENTIALLY INFECTIOUS WASTE

A portion of the medical waste stream from healthcare and similar institutions is categorized as being
potentially infectious. Other terms for infectious waste are biohazardous waste, biological waste, bio-
medical waste, contaminated waste, pathogenic waste, pathological waste, red-bag waste, and regu-
lated medical waste (RMW). Regardless of regulatory definition, however, a waste is infectious when
all of the following conditions are met simultaneously (U.S. EPA, 1991, 1989a, 1989b, 1989c):
● The presence of a virulent pathogen
● Sufficient concentration of the pathogen
● Presence of a host
● Portal of entry
● Host susceptibility

20.3.2 REGULATED MEDICAL WASTE (40 CFR PART 259.30)
The MWTA of 1988 defined regulated medical waste as follows (40 CFR 259.1):

Medical waste means any solid waste which is generated in the diagnosis, treatment (e.g., provision of
medical services), or immunization of human beings or animals, in research pertaining thereto, or in the
production or testing of biologicals. The term does not include any hazardous waste identified or listed
under Part 261 or this chapter or any household waste as defined in 261.4(b)(I) of this chapter.