What is Infectious Medical Waste?
The following information is referenced from the West Virginia Infectious Medical Waste Rule, 64 CSR 56.
Infectious medical waste is medical waste which is capable of producing an infectious disease. Medical waste shall be considered capable of producing an infectious disease if it has been, or is likely to have been, contaminated by an organism likely to be pathogenic to healthy humans, if such organism is not routinely and freely available in the community, and such organism has a significant probability of being present in sufficient quantities and with sufficient virulence to transmit disease. Infectious medical waste includes the following materials:
- Cultures and stock of microorganisms and biologicals:
Discarded cultures, stocks, specimens, vaccines and associated items likely to have been contaminated by an infectious agent, discarded etiologic agents, and wastes from the production of biologicals and antibiotics likely to have been contaminated by an infectious agent.
- Blood and blood products:
Liquid waste human blood and blood products in a free-flowing or unabsorbed state. Note: All tubing with any visible blood, must be disposed of as infectious waste.
- Pathological wastes:
Human pathological wastes, including tissues, organs, body parts, and containers of body fluids, exclusive of those fixed in formaldehyde or another fixative.
Discarded articles that may cause punctures or cuts and that have been used in animal or human patient care or treatment, or in pharmacies or medical, research or industrial laboratories, including, but not limited to, hypodermic needles, syringes with attached needles, scalpel blades, lancets and broken glassware.
- Animal carcasses, body parts, bedding and related wastes:
Contaminated animal carcasses, body parts, and bedding of animals that are known to have been exposed to infectious agents during research, production of biologicals, testing of pharmaceuticals, or for any other reason.
- Isolation wastes:
Wastes generated from the care of a patient who has or is suspected of having any disease listed as Class 4 in "Classification of Etiologic Agents on the Basis of Hazard," published by the United States Centers for Disease Control.
- Definition of Class 4: Agents that require the most stringent conditions for their containment because they are extremely hazardous to laboratory personnel or may cause serious epidemic disease. This class includes Class 3 agents from outside the United States when they are employed in entomological experiments or when other entomological experiments are conducted in the same laboratory area.
- Class 4 Viral Agents:
- Alastrim, Monkey pox, Smallpox, and White pox.
- Hemorrhagic fever viruses: Congo-Crimean, Ebola, Hantavirus, Junin, Machupo, and Marburg viruses
- Herpesvirus simiae (Monkey B virus)
- Lassa fever virus
- Tick-borne encephalitis viruses including: Central European encephalitis, Kyasanur forest disease, Omsk hemorrhagic fever, and Russian spring-summer encephalitis viruses
- Venezuelan equine encephalitis virus
- Yellow fever virus
- Any residue or contaminated soil, water, or other debris resulting from the cleanup of a spill of any infectious medical waste; and Waste contaminated by or mixed with infectious medical waste.
What is Not Infectious Medical Waste?
As reported in the CDC's Morbidity & Mortality Weekly Report 36(2S); 12S, August 21, 1987:
"There is no epidemiological evidence to suggest that most hospital waste is any more infective than residential waste. Moreover, there is no epidemiological evidence that hospital waste has caused disease in the community as a result of improper disposal. Therefore, identifying wastes for which special precautions are indicated is largely a matter of judgment about the relative risks of disease transmission. The most practical approach to the management of infective waste is to identify those wastes with the potential for causing infection during handling and disposal and for which some special precautions appear prudent. Hospital wastes for which special precautions appear prudent include microbiology, laboratory waste, pathology waste, and blood specimens or blood products. While any item that has had contact with blood, exudates, or secretions may be potentially infective, it is not usually considered practical or necessary to treat all such wastes as infective."
The WV Infectious Medical Waste Rule specifies that the following items are not infectious medical waste:
- Used personal hygiene products such as tissues, diapers, and feminine products:
- Gauze and dressing material containing small amounts of blood or other body secretions with no free flowing or unabsorbed liquid;
- Fixed pathological tissues; and
- Medical tubing and devices that have not been contaminated;
- Hair, nails, and extracted teeth;
- Human remains and body parts being used or examined for medical purposes which are under the control of a licensed physician or dentist and are not abandoned materials;
- Human remains lawfully interred in a cemetery or in preparation by a licensed mortician for interment or cremation;
- Waste generated by veterinary hospitals, with some exceptions (see 64 CSR 56 Infectious Medical Waster Rule for more information).
Other Types of Infectious Medical Waste Combined With Other Hazardous Waste
Infectious medical waste contaminated with radioactive waste is considered to be radioactive waste and is subject to State and federal law and regulation as radioactive waste.
Infectious medical waste contaminated with hazardous chemical waste is considered to be hazardous chemical waste and is subject to State and federal law and regulation as hazardous chemical waste.