Medical Waste Disposal
This guidance document is advisory in nature but is binding on an agency until amended by such agency. A guidance document does not include internal procedural documents that only affect the internal operations of the agency and does not impose additional requirements or penalties on regulated parties or include confidential information or rules and regulations made in accordance with the Administrative Procedure Act. If you believe that this guidance document imposes additional requirements or penalties on regulated parties, you may request a review of the document.

Form #:  06-225
Guidance Documents
Revised: 11/23/16
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415 KB 06-225 Medical Waste Disposal.pdf


The management of medical waste is not specifically addressed in Nebraska Title 132 - Integrated Solid Waste Management Regulations. Most medical or veterinary wastes may be disposed at a permitted municipal solid waste disposal area as long as they have not been contaminated with something that is considered infectious. These wastes may include dressings, laboratory wastes, animal bedding, waste or carcasses. The landfill or hauler of medical or veterinary wastes may have additional restrictions or disposal requirements specific to the disposal facility. All guidance documents and regulations are accessible on the NDEQ web site at http://deq.ne.gov/

One type of medical waste specifically restricted by NDEQ regulations is infectious waste. Infectious waste is a special waste and is defined in Title 132, Chapter 1, §053. The citation states “infectious waste” shall mean a solid waste capable of causing an infectious disease to humans. Therefore, if it is not capable of causing an infectious disease, it is not classified as an infectious waste. Non-infectious medical wastes must be disposed of in a permitted solid waste disposal area. It is the responsibility of the generator of the waste to determine if it is infectious and to handle it properly. Infectious wastes may include dressings, lab wastes and a host of other items. See Title 132 regulations listed below for more detail.

According to Title 132, Chapter 13, §004, “infectious wastes shall not be disposed of at any solid waste disposal area unless such wastes are first rendered non-infectious by incineration, autoclaving, or other treatment method”. This provision does not apply to infectious waste from households (Title 132, Chapter 13, §004). Prior written approval from the Nebraska Department of Environmental Quality for disposal at a municipal solid waste landfill is not required for infectious wastes that have been rendered non-infectious.

Note: See the Guidance Document “Handling Household Medical Waste” for information on packaging and disposal of medical waste from home health care activities.

The department is sometimes asked what does “or other treatment method” in the citation above mean? The general answer is a method that is efficacious in rendering waste non-infectious. That is often not a particularly helpful description. The department recognizes the work the California Department of Health Services (CDHS) has done to address this very question. The CDHS publishes a document titled “Alternative Medical Waste Treatment Technologies Approved by the California Department of Health Services” that provides technologies that have been demonstrated to destroy pathogens if the conditions stipulated for the specific technology are met. You can access this document at this link to the cpdh.ca.gov website.*

Do not mix hazardous wastes with medical biological or infectious wastes. This practice could cause your medical waste disposal contractor to refuse your load. Additionally, Title 128 – Nebraska Hazardous Waste Regulations specifically requires Small Quantity and Large Quantity Generators (SQGs & LQGs) of hazardous waste to dispose of that waste at permitted hazardous waste facilities. See Fact Sheet titled “Comparison of Hazardous Waste Generator Requirements” for more information.

TITLE 132 – INTEGRATED SOLID WASTE MANAGEMENT REGULATIONS (excerpt)

Chapter 1, §053, states:

Infectious waste’ shall mean a solid waste capable of causing an infectious disease. For a waste to be deemed infectious, consideration will be given to those elements required in order for infection to occur. These elements include the presence of a pathogen or causative organism, of significant virulence, in an adequate dose, which is able to gain a portal of entry in a susceptible host. Infectious waste shall include, but not be limited to, substances from the following classifications:
  • Blood, Blood Products and Body Fluids. This classification includes fluid blood, blood products and body fluids, and any items contaminated with any of these fluids, if a pourable quantity (ability of a liquid or semi-solid form to drip or flow) is present. The term blood and blood products includes serum, plasma, and other blood components. The term body fluid includes semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid, amniotic fluid and any other body fluid visibly contaminated with blood.

  • Infectious Sharps Waste. This classification includes all discarded items from diagnosis, treatment, or immunization which can potentially transmit disease by breaking the human skin, and includes hypodermic needles, scalpels, razor blades, breakable glass containers, blood vials, culture dishes, used slides, glass products and broken glass or other sharp items that have come into contact with or have been contaminated by material considered infectious.

  • Laboratory Waste. This classification includes all cultures and stocks of infectious agents, including specimen cultures from medical and pathological laboratories, cultures and stocks from research and industrial laboratories, wastes from the production of biologicals, discarded live and attenuated vaccines, and culture dishes and devices used to transfer, inoculate, and mix cultures.

  • Contaminated Animal Waste. This classification includes blood and body fluids, carcasses, body parts, excrement and bedding from animals contaminated with agents that may cause human disease.

  • Waste Identified by Infectious Waste Generators. This classification includes those wastes determined by the infectious waste generator or the infectious waste generator's infectious control staff/committee to be treated as infectious waste because of the risk of disease posed by such waste.

RESOURCES:
Contacts:
  • NDEQ Waste Management Section - (402) 471-4210
  • NDEQ Toll Free Number - (877) 253-2603
  • NDEQ Hazardous Waste Compliance Assistant - (402) 471-8308
  • Email questions to: NDEQ.moreinfo@nebraska.gov
NDEQ Publications:
Titles are available on the NDEQ Home Page under “Laws/Regs & EQC”, “Rules & Regulations”
* This document contains links to non-NDEQ websites; these links will open in a new tab or window.

Produced by: Nebraska Department of Environmental Quality, P.O. Box 98922, Lincoln, NE 68509-8922; phone (402) 471-2186. To view this, and other information related to our agency, visit our web site at http://deq.ne.gov.