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This 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: firstname.lastname@example.org. You may also contact a local Waste Management Specialist in one of the seven DENR regional offices.
The 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.
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
Blood and Body Fluids
Blood and Body Fluids in Individual Containers in Volumes Equal to or Less Than 20 ml
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
Sharps .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
Storage 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
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 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
Disposal 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
Facility "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.
(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.
Impact 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