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Regulated Medical Waste: Autoclaving, Incineration, and Landfill Disposal

February 3, 2015

Dealing with regulated medical waste (RMW) can pose a problem for both generators, e.g. hospitals, healthcare facilities, general practitioner clinics, and to a lesser extent, owners of landfills and solid waste disposal facilities.

Medical waste generators are liable for their actions regarding the safe storage and eventual treatment of their particular waste stream. Landfill operators can also be put in a bad spot if the waste they receive is untreated (and therefore still considered hazardous or bio-hazardous by state environmental agencies).

biohazardous regulated medical waste

Regulation of Medical Waste: Then and Now

The Environmental Protection Agency (EPA) no longer has a role in the regulation of medical waste, but the federal agency did have a strong formative influence on the current handling procedures of RMW. Most current state definitions of regulated medical waste stem from the EPA’s Medical Waste Tracking Act (MWTA) of 1988.

This now defunct federal law was a two-year program enacted in four coastal states and Puerto Rico (a reaction to medical waste washing up on the shores of public beaches on the East Coast) was an information gathering period for the EPA on the issue of the then-unregulated waste stream.

Acting in much the same capacity as the Resource Recovery and Conservation Act (RCRA) for hazardous waste, the MWTA was a federal system of tracking, recording, managing, and defining medical waste. The two-year gestation period of the MTWA program also allowed the EPA to conduct examinations on the safety, disease-causing potential, and newest available treatment technologies of medical waste.

The conclusions of the demonstration program were also likely the reason the agency decided to allow states to regulate medical waste by their own standards instead of playing an active role in medical waste “cradle-to-grave”.

The EPA’s investigations found that infectious waste has a much greater potential to spread disease at the point of its generation (hospitals, veterinarians, funeral homes, etc.), but that the potential is slowly attenuated the farther away it is from that point. Thus, the general public’s risk of exposure is much lower than occupationally-exposed individuals.

As of the present, states enforce their own rules on all aspects of medical waste, with some following a slightly-modified MWTA program, while others have much stricter statutes in addition to utilizing the regulatory skeleton of the Medical Waste Tracking Act.

Treatment of Regulated Medical Waste

When the EPA examined the technologies of the day for treating and reducing the infectious quality of some medical wastes, the agency looked at the two principal methods, autoclaving and incineration, among others, such as microwave and chemical technologies.


Autoclaving is a heat-based treatment process in which saturated steam and pressure destroy microorganisms. Autoclaving is a safe, efficient option for the treatment of RMW. Most medical waste can be treated by autoclaving, with the exceptions of chemotherapy, pharmaceutical, and chemical wastes. Once the waste was been through an autoclave, it becomes sterilized and devoid of any possible pathogenic qualities it may once have carried.

Yet at times, landfills or solid waste disposal facilities have been reluctant to accept waste that has been treated by an autoclave (and for some, barred by state law, such as those in Louisiana), as there is no reasonable way to tell if the waste has been treated or not. This is because—unless it is further treated by melting, shredding, tearing, or breaking—it is still “recognizable” as medical waste, meaning unchanged in appearance.


Incineration is probably the most widely-used method of treating all bio-hazardous, infectious, and other medical waste (though autoclaving is becoming more popular for both on-and-off site treatment), with an estimated 90% of medical waste being incinerated today.

However, incineration does have a downside—it produces emissions, which can pose a danger to public health and the environment. In response, on August 15th 1997, the EPA started to regulate these emissions, and due of the cost of complying with these standards,many facilities are considering alternative treatment methods for their medical waste.

Medical Waste Disposal Controversy in Recent Memory

Public concern over the disease-causing potential of medical waste can sometimes play a large role in where treated medical waste—even when treated according to state regulatory and compliance standards—finally ends up.

A recent case of this happening was the 2014 Ebola waste scare, which saw many landfills in different states turn away even fully-incinerated Ebola waste. However, these landfill managers (and also, solid waste disposal facilities) do have the right to not accept any treated medical waste they do not feel comfortable taking on.

If you would like to learn more about medical waste treatment options available to generators, or have questions regarding regulated medical waste, call us at 800-936-2311 to speak with an expert today. Or, if you prefer, click here to email us.

Photo credit:gosheshe via compfight

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