of Regulated Medical Waste
To ensure the safe
transport of regulated medical wastes within the generating facility,
generators must comply with the following requirements:
- The regulated medical waste must be properly
packaged to ensure containment of the waste and all containers
and packages containing regulated medical wastes must be sealed
to prevent leakage or spillage while in transport.
- The handling, transfer, and loading of packages
and containers of regulated medical wastes must be performed in
a manner that does not destroy the integrity of the packaging.
- Regulated medial waste will not be subjected
to violent mechanical stress during on-site transport.
- Wheeled carts will be used for the transport
of packages or containers of regulated medical wastes if these
packages or containers will be moved more than a short distance
or if these packages or containers cannot be easily handled by
one person regardless of the distance to be moved.
- Any regulated medical waste which is contained
in plastic bags will not be moved or transported in mechanical
devices, dumb waiters, or chutes, unless the chutes are designed
to prevent accumulation of wastes in corners and edges and are
lined with materials which can be easily cleaned.
- Carts used for the transport of packages and
containers or regulated medical wastes must be sturdy and will
be routinely cleaned and disinfected, and immediately cleaned and
disinfected after use if the cart has been contaminated by medical
- Items other than regulated medical waste must
not be placed in the same cart with regulated medical waste at
any point during on-site transportation.
Marking Regulated Medical Waste for Off-Site Transport
All containers used
for the packaging and containment of regulated medical wastes must
be labeled with the universal biological hazard symbol or must be
clearly labeled as containing regulated medical waste. In addition
all packages or containers which will be transported or offered for
transport off-site must meet the labeling and marking requirements
of the regulations.
Generators must label
each package or container of regulated medical waste wit a water-resistant
label affixed to or printed on the outside of the container. The
label must include the words “Medical Waste”, or display the universal
biohazard symbol. Red plastic bags used as inner packaging need
not display a label.
Generators and intermediate
handlers must mark each package or container or regulated medical
waste according to the following marking requirements before the
waste transported or offered for transport off-site. Refer to the
State Department of Environmental Management Regulations (DEM-DAH-MW-01-92)
and/or Destruction of Regulated Medical Waste
Generators are subject
to the requirements of all applicable State solid waste and air emission
regulations. Generators must notify in writing all employees involved
with on-site treatment and/or destruction of regulated medical wastes.
Generators that accept
regulated medical waste from other generators for treatment must
apply for a license.
must keep an operating log at their incineration facility that includes
information pertaining to operation of the incineration facility. Generators
must retain the operating log for at least three years from the date
of the last entry in the log.
The owner or operator
of an on-site incinerator must prepare and submit copies of the on-site
incinerator report to the Rhode Island Department of Environmental
The report must be
submitted on the form provided in Appendix II of the Rhode Island
Steam Sterilization. A
steam sterilizer used to convert untreated regulated medical waste
into treated regulated medical waste must be operated in accordance
with the following requirements:
- The sterilizers must be dedicated for waste
only. They must be operated in accordance with the manufacturer’s
specifications for waste in regard to time, temperature, pressure,
and capacity, provided that these specifications change the biological
character or composition of the regulated medical waste so as to
substantially reduce or eliminate its potential for causing disease.
- If no manufacturer’s specifications for waste
exist, or if another combination of time, temperature, pressure
and capacity is used, such combination must be proven, on the basis
of thorough tests, to render the regulated medical waste treated.
- Regulated medical waste must be steam sterilized
in its primary container.
- Unless a steam sterilizer is equipped to continuously
monitor and record temperatures during the entire length of each
sterilization cycle, the operator of such sterilizer must affix
to the primary container temperature-sensitive tape which will
indicate when the desired temperature is reached.
- At least once during every forty hours of operation,
tests must be conducted to evaluate the effectiveness of the sterilization
process, including tests of the capacity of such process.
- At least once during ever forty hours of operation,
a sterilization unit must be evaluated to determine whether it
is operating properly with respect to temperature and pressure. A
log must be maintained recording the dates and results of such
evaluations and the dates of calibration. The log must be kept
for at least three years from the date of the last entry in the
Treatment. Any method or process other that incineration or
steam sterilization used by a generator for treatment and/or destruction
of regulated medical waste on-site must be approved by the Director
in accordance with Section 15.07 of
the regulations. Each generator must maintain records concerning
quantity, weight, date the waste was treated and/or destroyed,
results of required quality assurance. Records must be maintained
by the generator for a period of at least three years from the
date the waste was treated and destroyed.
for Off-Site Transportation of Regulated Medical Waste
Licensed Transporters. Generators
must use transporters who have been issued a Rhode Island Regulated
Medical Waste Transporter Permit number by the Rhode Island Department
of Environmental Management, except:
- Generators of fifty pounds or more of regulated
medical waste per calendar month
- Small quantity generators
- Shipments between generator’s facilities
- Shipments of sharps through the U.S. Postal
Service and/or private courier service
Tracking Forms, Reporting and Recordkeeping. Generators
must prepare a tracking form for off-site shipment of RMW (see exceptions
above). Multi-page tracking forms can be obtained from Rhode
Island Department of Environmental Management, Office of Waste Management. The
generator must sign the certification statement on the tracking form,
obtain the signature of the initial transporter, and retain one of
copy of the form. Copies of the tracking forms must be retained
for at least three (3) years. See “Tracking Form Instructions” below
under Additional Resources.
Generators who are exempt from use of the tracking
form (e.g., small quantity generators) must maintain a shipment log
that contains shipment dates, quantity shipped, address of the destination
and the signature of an employee who is transporting the waste. The
log must be kept in the facility’s records for at least three (3)
years and semiannual reports must be sent to the Rhode Island Department
of Environmental Management, Office of Waste Management. See “Small
Quantity Generator Report Form” below under Additional Resources.
In addition to the state medical waste environmental
regulations there are some Occupational Safety and Health Administration
(OSHA) rules that apply to medical/infectious waste. Rhode Island
is one of 26 states covered entirely by the federal OSHA program. This
program is operated by the Occupational Safety and Health Administration. OSHA
rules (Occupational Exposure to Bloodborne Pathogens Standards) impact
various aspects of medical/infectious waste, including management
of sharps, requirements for containers that hold or store medical/infectious
waste, labeling of medical/infectious waste bags/containers, and
employee training. These requirements can be found in the HERC section
entitled OSHA Standards for Regulated Waste.