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Regulated Medical Waste Management
On-site Treatment and Disposal

Course Author(s): Michaell A. Huber, DDS; Géza T. Terézhalmy, DDS, MA

On-site Treatment and Disposal

Most states require that RMW be treated before disposal and most states allow on-site treatment.7 The most common on-site treatment methods include (1) steam sterilization (autoclaving), (2) microwave sterilization, (3) chemical disinfection, and (4) sewer discharge for liquid RMW. Some states require permits for any type of on-site treatment. Other states leave it up to the generator to select a treatment method based on current best practices.7

If only a small amount of RMW is generated, with the exception of sharps, it may be conveniently treated on-site by steam-sterilization (Table 5). Once decontaminated, it is no longer considered infectious waste.4 In some states, it may be disposed of with ordinary office waste. However, other states require that the treated RMW remain segregated and that a written notice must accompany the treated waste to its disposal location.17

Table 5. Steam Sterilization of Solid RMW in Oral Healthcare Setting.
  • Open the neck of the biohazard bag to facilitate steam penetration
  • Set the physical parameter of the sterilizer to 121ºC (250ºF) for a minimum of 90 minutes (longer for large loads)
  • Include a Bacillus stearothermophilus spore biological indicator in each pack
  • After sterilization, place biohazard bag into a non-biohazard polyethylene bag and dispose of in office waste

Current guidelines for most healthcare clinical/research facilities working with infectious microorganisms recommend on-site decontamination by a known effective method to reduce the potential of exposure during the handling of infectious material. The OMWM can consult the State-by-State Regulated Medical Waste Resource Locator to identify acceptable methods for inactivating amplified stocks and cultures of microorganisms before disposal.7

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