Posted on May 10, 2016

Medical Waste Disposal in the State of Texas

Texas chili does not have beans. While many regions define their dish around this humble ingredient, Texans are known for their opposition to it. In much the same way, definitions of what constitutes “medical waste”, and how to properly deal with medical waste disposal, vary regionally as well.

When needles and other medical waste began washing up on American beaches in the 1980s, the issue of medical waste disposal was dragged into the public consciousness. Since the early 1990s, individual states have been responsible for regulating their own medical waste disposal. As a result, all fifty states differ in their definitions and level of regulation – from those with no regulations to those that are very strict. Texas recognises that medical waste and its proper disposal remain a major concern for America and so it is important to understand why, and how, to stay compliant in The Lone Star State.

Beautiful Texas

Texans are proud of their beautiful wide-open lands and fresh, home grown produce. The state provides the perfect balance between the bustle of big city life and peacefulness of the country. Much of Texas remains unspoilt and so the state and its citizens appreciate the importance of protecting it and keeping it that way.

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The Texas Commission on Environmental Quality (TCEQ) defines medical waste as treated and untreated special waste from health care-related facilities that is comprised of animal waste, bulk blood, bulk human blood, bulk human body fluids, microbiological waste, pathological waste, and sharps, as well as “regulated medical waste”. Generally speaking this will include any solid waste that is generated in the diagnosis, treatment or immunization of humans and animals. This definition includes, but is not limited to:

  • Sharps, such as needles
  • Laboratory waste
  • Contaminated disposal material
  • Used equipment and instruments
  • Dialysis tubing and filters
  • Blood, blood products and bodily fluids
  • Removed body organs
  • Trace-contaminated chemotherapy waste
  • Empty drug vials
  • Spill kits, IV catheters, tubing and bags

Any hazardous waste that is contaminated by blood, feces and other bodily fluids, as well as materials that may be considered potentially harmful, is considered infectious waste. A common misunderstanding is the assumption that any medical product that comes into contact with bodily fluids or any infectious materials is automatically considered medical waste. By OSHA definitions however, items with trace levels of contamination can be placed in the normal garbage.

In Texas, the term medical waste does not include:

  • Medical waste produced on a farm or ranch
  • Artificial, non-human materials removed from a patient including, but not limited to, orthopedic devices and breast implants

Generators of biomedical waste have a responsibility and duty to ensure their waste is treated and disposed of in accordance with state regulations and that it does not expose health care workers, waste handlers and patients to infection, toxic reactions and injury. Improper disposal of healthcare waste also poses a risk to the environment by wasting up in lakes and rivers or by being illegally dumped in landfill sites. Inadequate incineration of medical waste can also release pollutants and toxins into the air.

The correct way of disposing medical waste varies drastically from state to state and Texas has it’s own specific rules. Dealing with this your self can be a huge headache and it is easy to feel confused about how to discard your waste in a legal fashion.

Storing and transporting medical waste

Any generator of untreated medical waste in Texas must ensure that the waste is stored appropriately and in a secure manner. This means that the location of storage should provide protection against human and animal exposure, theft and vandalism, as well as defending from the natural elements rain, wind and temperature. The most common example used for this is how we dispose of sharps in dedicated, protective sharps containers. Generators of medical waste in Texas are not required to refrigerate the waste, but it must be managed so as not to create a nuisance or provide a breeding ground of food for insects or rodents. It must also not generate any unpleasant odors.

It is essential that all medical and infectious waste materials are segregated from ordinary garbage at the point of generation and disposed of safely. Many medical waste and biohazard disposal companies will provide you with compliant boxes, containers and liners at no extra cost. You should periodically observe and maintain your protective devices so that they do not become a source of transmitting infections.

Healthcare providers generating untreated medical waste are allowed to transfer their own waste to an authorized treatment facility or they may employ a registered Texas medical waste disposal company. If more than 50 pounds per month of medical waste is being generated then the transporter must notify the TCEQ that they are transporting their own waste and must comply with strict transportation regulations. These rules specify the requirements for the type of transportation vehicles that may be used, the individual records of transportation that must be kept, and the annual registration fees that transporters are required to pay (based on the annual weight of waste being transported). You are also required to have automobile liability and pollution liability policies for the vehicle(s) in your service.

The majority of smaller medical waste producers will choose to use a medical waste removal and disposal company because these companies will already have:

  • Compliant transportation vehicles
  • Trained and insured personnel to collect, handle and transport hazardous waste
  • State certified operating permits

If you wish to become a self-transporter of medical waste you must register your intentions with the TCEQ, provide specific additional details about your facilities and submit an annual summary of your activity. For smaller clinics and practices, such as funeral parlours and nursing homes, this level of regulation can prove very impractical and expensive. Many businesses will turn to medical waste disposal companies to fulfil their transportation needs.

Some facilities (usually medium sized healthcare providers) may wish to become medical waste collection stations. This allows them to receive household levels of waste from individuals before being collected and transported away. Collection stations are not allowed to treat the medical waste and must receive and store it in appropriate containers.

Biomedical waste that has already been treated may be transported and disposed of as routine municipal solid waste (trash!), provided it is correctly labelled.

Disposing of and treating medical waste

Medical waste must be treated and disposed of properly to eliminate its infectious potential and protect waste handlers. The most common processes for treating medical waste are autoclaving (using high pressures to force air out of units) and then incineration (using extremely high temperatures to kill bacteria). At such high temperatures, no bacteria are able to survive and the items are deemed safe for recycling or disposal. The incineration process converts the waste into ash, gas and heat. Over 90% of potentially infectious waste is incinerated in this way in the United States. Disposing of pathological waste (tissues, body parts or carcasses) may require a special local or state government permit.

The state of Texas allows treatment to take place ‘on-site’ (a facility generating and storing its own medical waste) or ‘off-site’ (a facility authorized to accept untreated medical waste). In practical terms, this means that bigger healthcare providers, such as large hospitals and laboratories, may provide ‘on-site’ treatment. This is because the significant investment in infrastructure is generally cost effective for them due to the amount of waste they produce and the size of their premises. ‘On-site’ treatment centres must use approved treatment methods and adhere to stringent record keeping regulations.

Smaller clinics, such as doctors offices, dental practices and veterinary hospitals, are likely to transfer their waste to ‘off-site’ facilities due to the lack of physical space and the amount of capital required to acquire treatment equipment. It is not only an autoclave and incinerator that is required. Infrastructure and equipment must be in place to cover the entire treatment process ranging from handling, carting, shredding, conveying, size reducing, compacting, to sterilizing or recycling. Many facilities will often use a Texas medical waste disposal company to fulfil this service.

Medical waste may be transported by the United States Postal Service in accordance with the Domestic Mail Manual. Some medical waste disposal companies will offer a mail-back service for the disposal of sharps such as needles and syringes. This provides a cost effective solution for small quantities of medical waste and avoids the need to store larger volumes of waste for collection.

In Texas, once the generators of medical waste disposal have adhered to regulations for collecting, storing, transporting, and treating their waste, they may then use permitted municipal landfill and sanitary sewer systems as their final disposal location. The treated decontaminated biomedical waste no longer poses a risk to humans, animals or the environment.

Medical waste at home

The state of Texas does not consider single or multi-family dwellings to be health care related facilities. This means that people who might have needles, sharps or generate other potentially infectious waste in the household are not required to obtain authorisation or a permit. People generating household levels of untreated medical waste (less than 50 pounds per month) must transport their own waste to an authorized medical waste storage or processing facility. In many cases your local hospital will function as your medical waste collection and transfer facility. It is your responsibility to store and package the waste in a secure manner and not create a risk or nuisance. You can take the following steps to protect yourself and other handlers of your waste:

  • Seal sharps in a sealed, puncture proof container.
  • Consider purchasing a sharps container from a pharmacy or a medical waste disposal company.
  • When full, seal the container and tape it shut.
  • Mark the container “DO NOT RECYCLE” and transfer to an authorized medical waste storage or processing facility as quickly as possible.
  • Do not give your medical waste to a relative, or other person, to transfer on your behalf.

Always keep your saddle oiled

This blog has been written to give you a broad understanding of medical waste disposal in Texas. The TCEQ, EPA, OSHA and DOT each have their own detailed rules and regulations surrounding biomedical waste management and disposal. Becoming familiar with these rules is crucial in order to protect your business or healthcare service. Each agency has developed its own strict guidelines that will impact everything from transportation of the waste to its treatment and final disposal, as well as ensuring that the final disposal follows ecological protocols.

MedPro provides a number of medical waste disposal services in Texas to ensure you stay on the right side of regulation. We always strive to make sure you are not paying for more than you generate. Services offered:

  • Medical waste disposal
  • Infectious waste disposal
  • Biohazard removal
  • Sharps disposal
  • Expired RX Pharmaceutical
  • Safety compliance solutions
  • Mail back program

We offer biohazard and medical waste disposal services throughout Texas, including: El Paso, Houston, Dallas, Amarillo, San Antonio and Austin.

Please note that it is always good to check with your city and even your facility as their medical waste disposal regulations may be stricter or more clearly defined than simply state or national regulations.

Texas health and safety resources

In addition to the EPA, other agencies help regulate potentially infectious medical waste treatment and disposal. If you have questions or want more information you should contact:

  • TCEQ
  • OSHA
  • DOT

If you have questions or comments please share with us in the comments section below!