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Regulated Medical Waste Management
Medical Waste

Course Author(s): Géza T. Terézhalmy, DDS, MA

Medical Waste

The primary objective of medical waste management is to minimize the risk of disease transmission. In reality, a significant portion of medical waste is actually considered to be non-infectious. To reduce both the risk of infection and the cost of disposing of infectious waste, non-infectious waste must be segregated from infectious or RMW at the point of generation as determined primarily by state rather than federal regulations (Table 4).9,17

Table 4. Examples of Medical Waste Generated in Oral Healthcare Settings.9,17
WastesComments
  • Sharps contaminated with blood and OPIM
  • e.g., needles, scalpel blades, suture needles, endodontic files, orthodontic wires, local anesthetic cartridges, and glass slides
    • Disposed sharps, even if unused, must be considered RMW
    • Require special handling by both OSHA and U.S. DOT
  • Contaminated disposable items
    • Items that would release blood or OPIM in a liquid or semiliquid state if compressed
    • Items caked with dried blood or OPIM and are capable of releasing these materials during handling
  • e.g., disposable absorbent materials
    • Generally, gauze, cotton balls or rolls, swabs, and used dressings containing small amounts of blood or OPIM are not considered RMW
  • e.g., disposable non-absorbent materials
    • Generally, gowns, gloves, drapes, bracket table covers, rubber dams, patient bibs, and face masks, are not considered RMW
  • Pathological waste
  • e.g., unfixed oral tissues removed during surgery, biopsies, and extracted teeth
    • Teeth properly disinfected and returned to patients after extraction are not considered RMW
    • Extracted teeth with amalgam restorations are considered both RMW and hazardous waste
  • Microbiological waste
  • e.g., all culture media, disposable culture dishes, and devices used to inoculate media are considered RMW
  • Liquid or semi-liquid blood and OPIM
  • e.g., blood or OPIM in suction canisters collected during surgical procedures
    • Discharge into a sanitary sewer is acceptable, unless considered as RMW by county or local laws or regulations

In general, guidance pertaining to non-infectious medical waste disposal falls under the same state and/or local regulations as office waste.4,9,17,18 Liquid RMW generated by suctioning during surgical procedures must be collected in leak-proof, burst resistant suction canisters and disposed of into the sanitary sewage system in compliance with state and/or local regulations. Contaminated sharps must be placed into a sharps container and other RMW must be placed into a “biohazard bag” stored inside a container.4,9,17,18

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