Background: Overview of Medical Waste in Kentucky
Medical waste in simple terms is any waste that may be contaminated by blood, bodily fluids, or potentially infectious materials. Although the EPA provides some oversight of medical waste storage and disposal, the majority of medical waste is regulated on a state or local level.
In Kentucky, there are no specific regulations pertaining to medical waste and there is no one agency with jurisdiction over medical waste. There are, however, regulations that reference the characterization, treatment, handling, labeling, storage, transport and disposal of this type of waste. These state regulations overlap between environmental, public health, labor and transportation agencies. They are intended to protect personnel, the public and the environment from exposure, injury or contamination of potentially infectious wastes.
Management: Aspects of Medical Waste Management
Characterization: Medical waste in Kentucky is characterized as municipal solid waste and is subject to the same disposal requirements; therefore, it can legally be disposed of in a permitted contained landfill according to approved practices. It is important to note, however, that some medical waste may contain toxic chemicals, chemotherapy agents or radioactive materials and may be subject to state and federal regulations specific to hazardous wastes and radioactive wastes.
Generators: Generators of medical waste range from hospitals, nursing homes, clinics and laboratories to households and even illicit drug users. Depending on the waste generator, treatment may or may not be required to render the waste non-infectious prior to disposal.
Households: Medical waste generated in households may be legally disposed of with regular household garbage. Nevertheless, waste collectors and disposal companies serving this sector should be aware of the potential for medical waste hazards.
Needles and Sharps: Safe disposal methods for needles and sharps generated as household medical waste include the following:
Place needles, syringes, lancets and other sharp objects in a hard plastic or metal container with a screw-on lid. Laundry detergent bottles or metal coffee cans may be used or containers specifically designed for the disposal of medical sharps may be purchased.
Reinforce the lid of the container with heavy-duty tape, label “Not Recyclable” and place container in regular trash or take it to a household hazardous waste collection event.
Place soiled bandages, disposable sheets, medical gloves and other types of medical waste in securely fastened plastic bags to be placed with regular trash.
Treatment: Treatment is any method, technique or process designed to eliminate pathogens from potentially infectious waste. Under the Kentucky Cabinet for Health and Family Services regulations, hospitals, nursing homes and certain other public health facilities in Kentucky are required to treat medical waste on or off-site. Basically, this means that items contaminated with a potentially infectious material must be rendered nonhazardous prior to disposal or managed through a medical waste disposal contractor. Infectious waste autoclaves that use steam (moist heat), followed by landfilling, is the most common treatment and disposal method. Some medical waste is still incinerated; however, the requirements for lower emissions from air pollutants have resulted in less expensive waste disposal alternatives, such as autoclaving.
Handling, labeling and storing medical waste in the workplace: The risks associated with medical waste are especially important to those exposed to it in their jobs. Such occupations include healthcare, janitorial work, waste collection and landfill workers. The Kentucky Safety and Health (OSH) Program, under the Kentucky Labor Cabinet, regulates several aspects of medical waste including management of sharps, requirements for containers that hold or store medical waste, labeling of medical waste bags and containers, and employee training.
Transportation of medical waste: In Kentucky, anyone who transports solid waste to a landfill is required to register with the Kentucky Transportation Cabinet (excepting from a private residence or a vehicle 10,000 pounds or less). In addition to vehicle registration, collectors of municipal solid waste, including medical waste haulers, must register with and report annually to any county in which they do business. The registration and reporting form, DEP 5033, may be obtained from county solid waste coordinators or downloaded from http://waste.ky.gov/RLA/Pages/forms.aspx.
Disposal of medical waste: In Kentucky, medical waste is disposed of in the same manner as household waste, meaning that it can legally be disposed of in a permitted, contained landfill. Treatment and sterilization prior to disposal, however, depends on the type of facility that generates the waste. Hospitals, nursing homes and certain other public health facilities are required to segregate sharps and infectious waste from other waste and then incinerate or render nonhazardous before permanent disposal. Most sanitary landfills in Kentucky will not accept medical waste unless it has been treated at a medical waste transfer station prior to being transported. Medical waste transfer stations and contained landfills are required to obtain a permit from the Kentucky Division of Waste Management. Permit requirements include the types of waste that may be accepted at contained landfills.
Regulatory Summary: Regulatory Overview
The current roles and responsibilities for regulating medical waste in Kentucky are summarized in Table 1 – Regulatory Overview of Medical Waste in Kentucky.
Complete details for each regulation can be accessed from Kentucky Administrative Regulations.
In addition to state regulations, there may be accompanying restrictions set forth by the landfill accepting medical waste. Many landfills do not accept medical waste from health care facilities unless it has been incinerated. Incinerated waste would not be recognized as medical waste.
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