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INTRODUCTIONThis document is provided to help you understand the North Carolina medical waste management rules. If you would like further information, please contact the Solid Waste Section in the Department of Environment and Natural Resources (DENR). Contact Bill Patrakis at (919) 707-8290, email: william.patrakis@ncdenr.gov. You may also contact a local Waste Management Specialist in one of the seven DENR regional offices. GENERAL INFORMATIONThe Solid Waste Section regulates the packaging, labeling, storage, transportation, treatment and disposal of medical waste in North Carolina. Treatment, storage and disposal facilities that accept waste from outside of the facility cannot operate without a permit from the Solid Waste Section. Please read this entire document. Due to the complex nature of medical waste regulations, failure to read this entire document may result in failure to comply with the rules. This guide is not intended as legal advice, but as an aid to understanding the current North Carolina medical waste management rules. Effective Date Enforcement of the Rules Pre-Emption of Local Solid Waste Laws on Medical Waste Joint and Several Liability Medical Waste Definition Regulated Medical Waste Definition Percentage of the Medical Waste Stream That Is Regulated Medical Waste Microbiological Waste Pathological Waste Blood and Body Fluids Blood and Body Fluids in Individual Containers in Volumes Equal to or Less Than 20 ml Medical waste such as dressings, bandages, gloves, tubing These items are not included in the definition of regulated medical waste and may be disposed without treatment.(.1201(10)) Urine and Feces Registration of Medical Waste Generators Artificial Body Parts and Implants Removed or Replaced During Surgical Procedures Medical Waste Reduction Techniques SHARPSSharps .1201(11) "Sharps" means and includes needles, syringes with attached needles, capillary tubes, slides and cover slips, and scalpel blades. Disposal of Sharps Compaction of Sharps Sharps Generated in Private Households PACKAGING AND STORAGEStorage of Regulated Medical Waste That Will Be Shipped Off Site for Treatment Packaging Requirements for Regulated Medical Waste Which Will Be Treated On Site Packaging Regulated Medical Waste for Off-Site Treatment Storage of Regulated Medical Waste Prior to Shipment Off Site for Treatment Storage Requirements for Medical Waste Which Is Not Classified as Regulated Medical Waste TRANSPORTATIONManifesting Requirements Generator Responsibilities for Proper Disposal by Commercial Facilities Self-Transporting Regulated Medical Waste Shipping Non-Regulated Medical Waste Off-Site for Treatment Packaging and Labeling Requirements for Regulated Medical Waste That Will Be Treated On Site TREATMENT AND DISPOSALTreatment Facilities for Regulated Medical Waste Permitting of Medical Waste Treatment Facilities >Disposal of Large Volumes of Blood and Body Fluids Urine and Feces Arranging for Incineration of Regulated Medical Waste by a Neighboring Hospital The "50 Pound per Month" Record-Keeping Exemption Rejection of Properly Packaged Sharps or Treated Regulated Medical Waste at the Local Municipal Landfill Managing Medical Waste After It Has Been Treated FUNERAL HOME PRACTICESDisposal of Regulated Medical Waste with Casketed Remains Special Cases Where Religious Practices Require That a Body Be Interred with Removed Organs as Well as Tubing and Sharps Sharps Used During the Course of Preparing a Body for Interment, Including Scalpels, Needles and Other Instruments Using Crematoriums for Incineration of Regulated Medical Waste Contracts with Commercial Medical Waste Treatment Companies to Treat Funeral Home Waste SPECIAL ARRANGEMENTS FOR TREATING WASTE GENERATED OFF-SITE - EXAMPLESFacility "G" (the generator) sends its regulated medical waste to facility "T" for treatment. What packaging, labeling, record-keeping, transportation and treatment requirements apply? To answer this question, two determinations must be made: After determining whether a facility is an integrated medical facility and/or on or off- site, the table below may be used to find out what requirements apply. See examples.
Definitions: (a) located in a single county or two contiguous counties; "Health service facility" means a hospital; long-term care hospital; psychiatric facility; rehabilitation facility; nursing home facility; adult care home; kidney disease treatment center, including freestanding hemodialysis units; intermediate care facility for the mentally retarded; home health agency office; chemical dependency treatment facility; diagnostic center; hospice office, hospice inpatient facility, hospice residential care facility; and ambulatory surgical facility.NCGS 131E-176(9b)) Funeral homes, veterinary hospitals, dental and research labs are not integrated facilities.
The following examples will help to determine what requirements apply under a variety of situations. Example A Example B Example C Example D INTERFACE WITH OSHA REGULATIONSImpact of the OSHA Bloodborne Pathogen Standards on Medical Waste Disposal Requirements Comparison of the Definition of Regulated Medical Waste with the OSHA Definition of Regulated Waste Disposal of Blood and Body Fluids into the Sanitary Sewer Different Labeling Requirements Disposal of Red Bags That Contain Only Medical Waste Not Classified as Regulated Medical Waste by the State Medical Waste Management Definition The Solid Waste Section has alerted North Carolina landfills to expect increased disposal of non-regulated medical waste in red bags or biohazard-labeled bags as the OSHA rules are implemented. In some counties, landfill operators initially may not accept such bags, even though they had previously accepted the same waste in plain, unlabeled bags. In most cases, this can be worked out through local discussions and better communications with the landfill. Landfill operation is regulated by the Solid Waste Section, and local waste management specialists are available to provide assistance, guidance, and education for landfill operators. As described in paragraphs (g)(1)(i)(B),(C),(D), and (E) of the OSHA standards, the OSHA labeling requirements can be satisfied by the use of either red bags or bags with a biohazard label. Facilities sending waste to the landfill may find plain bags with the appropriate biohazard label an easy solution. Risks to Waste Industry Workers
Problems with Using the OSHA Definition of Regulated Waste to Designate Waste That Must Be Treated and Cannot Be Disposed at the Landfill Adopting Uniform Definitions for the Department of Labor and Department of Environment and Natural Resources |
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