HR3515-Medical Waste Tracking Act of 1988

Legislation

By: United States Code

Date: January 25, 1988

Source: U.S. Code. "Medical Waste Tracking Act of 1988. An Amendment to the Solid Waste Disposal Act."

About the Author: The U.S. Code is the set of general and permanent laws that govern the United States. The House of Representatives prepares the Code and revisions are published every six years. The Code is arranged into fifty Titles. Title 42 deals with Public Health and Welfare. Chapter 82 describes the laws pertaining to solid waste disposal.

INTRODUCTION

Medical waste is legally defined by individual states. It most often includes solid materials that have been used in the medical treatment of humans or animals or in research directed toward the treatment of humans or animals. Medical waste can include used bandages, swabs, surgical gloves, medical instruments, needles, and lancets. It also includes discarded glassware, microbial culture dishes, microbial cultures, and anything used to transfer cultures from one medium to another. Discarded blood, body fluids, and body parts are also usually included in the definition of medical waste.

In July of 1988, medical waste was found washing up on the shores of the East Coast of the United States. Visitors to beaches along the coast of northern New Jersey, New York, Connecticut, Rhode Island, and Massachusetts found a variety of medical debris including vials, syringes, prescription drug bottles, and packages of sutures. Several dozens of vials of blood were also discovered. Some of these vials contained blood that tested positive for the hepatitis B virus and others contained blood with antibodies to the AIDS virus. More than fifty miles of beaches in New York and New Jersey were closed to swimming because of medical waste pollution.

In response to the pollution of beaches by medical waste, Congress enacted the Medical Waste Tracking Act of 1988 (MWTA) as an amendment to the Solid Waste Disposal Act. The MWTA established a two-year program that studied the disposal of medical wastes in several states on the East Coast as well as states adjacent to the Great Lakes. The program had four major goals. The first was to develop clear definitions of medical waste. The second was to develop a tracking system for medical waste from the point of origin through the final disposal point. The program also developed standardized measures for packing, labeling, and storing medical waste. Finally, it established penalties for not adhering to the medical waste tracking system.

PRIMARY SOURCE

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE

This Act may be cited as the "Medical Waste Act of 1988".

SEC. 2. TRACKING OF MEDICAL WASTE

(a) Amendment of Solid Waste Disposal Act.—The Solid Waste Disposal Act is amended by adding the following new subtitle at the end:

"Subtitle J—Demonstration Medical Waste Tracking Program

"SEC. 11001. SCOPE OF DEMONSTRATION PROGRAM FOR MEDICAL WASTE

"(a) Covered States.—The States within the demonstration program established under this subtitle for tracking medical wastes shall be New York, New Jersey, Conneticut, the States contiguous to the Great Lakes and any State included in the program through the petition procedure described in subsection (c), except for any of such States in which the Governor notifies the Administrator under subsection (b) that such State shall not be covered by the program….

"SEC. 11002. LISTING OF MEDICAL WASTES

"(a) List.—Not later than 6 months after the enactment of this subtitle, the Administrator shall promulgate regulations listing the types of medical waste to be tracked under the demonstration program. Except as provided in subsection (b), such list shall include, but need not be limited to, each of the following types of solid waste:

"(1) Cultures and stocks of infectious agents and associated biologicals, including cultures from medical and pathological laboratories, cultures and stocks of infectious agents from research and industrial laboratories, wastes from the production of biologicals, dicarded live and attenuated vaccines, and culture dishes and devices used to transfer, inoculate and mix cultures.

"(2) Pathological wastes, including tissues, organs, and body parts that are removed during surgery or autopsy.

"(3) Waste human blood and products of blood, including serum, plasma, and other blood components.

"(4) Sharps that have been used in patient care or in medical, research, or industrial laboratories, including hypodermic needles, syringes, pasteur pipettes, broken glass, and scalpel blades.

"(5) Contaminated animal carcasses, body parts, and bedding of animals that were exposed to infectious agents during research, production of biologicals, or testing of pharmaceuticals.

"(6) Wastes from surgery or autopsy that were in contact with infectious agents, including soiled dressings, sponges, drapes, lavage tubes, drainage sets, underpads, and surgical gloves.

"(7) Laboratory wastes from medical, pathological, pharmaceutical, or other research, commercial, or industrial laboratories that were in contact with infectious agents, including slides and cover slips, disposable gloves, laboratory coats, and aprons.

"(8) Dialysis wastes that were in contact with the blood of patients undergoing hemodialysis, including contaminated disposable equipment and supplies such as tubing, filters, disposable sheets, towels, gloves, aprons, and laboratory coats.

"(9) Discarded medical equipment and parts that were in contact with infectious agents.

"(10) Biological waste and discarded materials contaminated with blood, excretion, excudates or secretion from human beings or animals who are isolated to protect others from communicable diseases.

"(11) Such other waste material that results from the administrationof medical care to a patient by a health care provider and is found by the Administrator to pose a threat to human health or the environment….

"SEC. 11003 TRACKING OF MEDICAL WASTE

"(a) Demonstration Program.—Not later than 6 months after the enactment of this subtitle, the Administrator shall promulgate regulations establishing a program for the tracking of the medical waste listed in section 11002 which is generated in a State subject to the demonstration program. The program shall (1) provide for the tracking of the transportation of the waste from the generator to the disposal facility, except that waste that is incinerated need not be tracked after incineration, (2) include a system for providing the generator of the waste with assurance that the waste is recieved by the disposal facility, (3) use a uniform form for tracking in each of the demonstration States, and (4) include the following requirements:

"(A) A requirement for segregation of the waste at the point of generation where practicable.

"(B) A requirement for placement of the waste in containers that will protect waste handlers and the public from exposure.

"(C) A requirement for appropriate labeling of containers of the waste.

"(b) Small Quantities.—In the program under subsection (a), the Administrator may establish an exemption for generators of small quantities of medical waste listed under section 11002, except that the Administrator may not exempt from the program and person who, or facility that, generates more 50 pounds or more of such waste in any calender month.

"(c) On-Site Incinerators.—Concurrently with the promulgation of regulations under subsection (a), the Administrator shall promulgate a recordkeeping and reporting requirement for any generator in a demonstration State of medical waste listed in section 11002 that (1) incinerates medical waste listed in section 11002 on site and (2) does not track such waste under the regulations promulgated under subsection (a). Such requirement shall require the generator to report to the Administrator on the volume and types of medical waste listed on section 11002 that the generator incinerated on site during the 6 months following the effective date of the requirements of this subsection.

"(d) Type of Medical Waste and Types of Generators.—For each of the reuirements of this section, the regulations may vary for different types of medical waste and different types of medical waste generators.

SIGNIFICANCE

The major finding of the MWTA was that medical wastes pose the greatest risk to health at the point where they are generated. The risk falls off markedly the farther in distance and time that the wastes are removed from their origin. Accordingly, the study determined that the risk posed to the general public by medical waste was exceedingly small. On the other hand, the health risk to those occupationally involved with disposing of medical waste was significant. The study recommended that the state and local governments where medical waste was generated should be responsible for regulating and tracking the disposal of medical waste.

The formal outcome of the Medical Wastes Tracking Act of 1988 was a set of recommendations called Standards for the Tracking and Management of Medical Waste. These Standards were enacted by New York, New Jersey, Connecticut, Rhode Island, and Puerto Rico between 1989 and 1991.

Although the Standards were only in place for two years, the MWTA resulted in stricter laws and regulations for the disposal of medical wastes in state and local governments. A multi-billion dollar industry developed in response to these requirements. Facilities that are properly equipped to autoclave, incinerate, microwave, chemically disinfect, or thermally inactivate medical wastes have become an important part of the medical waste disposal stream. Businesses that contract with hospitals, doctors and dentists offices, veterinarians, and research laboratories are required to obtain permits and to adhere to strict performance standards.

An investigation by the Environmental Protection Agency (EPA) found that the source of the medical waste that washed up on the beaches along the East Coast in the summer of 1988 likely did not result from improper handling of medical waste from hospitals, laboratories, or other medical facilities. Instead, the source was most likely poor management of ordinary garbage that contained medical waste generated by home health care or illegal drug use. The garbage containing syringes, blood soaked bandages, and other medical waste generated in homes was probably dumped offshore, but unusual currents are thought to have brought the waste back toward the coast, where it washed up on beaches.

FURTHER RESOURCES

Web sites

"EPA Tracking Program for Medical Waste Starts Today." Press release, March 13, 1989. U.S. Environmental Protection Agency. 〈http://www.epa.gov/history/topics/medical/01.htm〉 (accessed March 10, 2006).

"Medical Waste." U.S. Environmental Protection Agency. 〈http://www.epa.gov/epaoswer/other/medical/index.htm〉 (accessed March 10, 2006).

"Regulated Medical Waste." New York State Department of Environmental Conservation. 〈http://www.dec.state.ny.us/website/dshm/sldwaste/medwaste.htm〉 (accessed March 10, 2006).