It’s amazing the amount of waste that is created in the practice of caring for and healing people. The healthcare industry, including physicians offices, dental offices, hospitals, rehab facilities, and urgent care offices, just to name a few, creates a staggering amount of waste each year.

  • Hospitals in the U.S. produce more than five million tons of waste annually
  • That’s the equivalent of 25.1 pounds of waste per staffed bed in just one day
  • The OR produces between 20-33% of the total waste generated in a hospital, the largest departmental generator of regulated medical waste
  • Food services waste makes up approximately 25% of the overall healthcare waste production

As with the waste stream in any industry, less sustainable waste management practices can lead to increased reliance on the nation’s landfills and the creation of greenhouse gases. However, medical waste poses additional threats to the environment and individuals, as it includes hazardous, infectious, and drug materials.

Categories of Medical Waste

Here is a breakdown of the types of waste created at medical facilities which are unique to the healthcare industry and may require special considerations for management, transportation and waste disposal.

Regulated Medical Waste (RMW)

This category represents potentially infectious materials, like blood or other bodily fluids, as well as materials that have been saturated with infectious materials, like gloves, gowns, or dressings. It also includes contaminated “sharps,” which in the healthcare industry refers to tools like needles, syringes, scalpels, or glassware. This category is also referred to as biohazard waste.

Non-infectious Medical Waste

This category includes medical materials like used IV bags, medicine containers, non-infectious gloves or dressings.

Pharmaceutical Waste

This category is mostly comprised of expired or unused medicine, drugs, and other controlled substances. Although some pharmaceutical waste is considered hazardous, most is not.

Hazardous Waste

This category describes non-infectious waste that has the possibility to affect humans, such as chemicals used in sterilants and disinfectants, cleaning chemicals, or laboratory chemicals. It also includes any listed hazardous waste or materials that meet one of the EPA’s characterized waste categories: toxic, corrosive, ignitable, or reactive.

Special Regulation Concerning Medical Waste Management

Medical Waste Tracking Act

You might be familiar with news stories from the 1980s about healthcare waste, including hypodermic needles washing up on beaches, mercury released from medical waste incinerators, or pharmaceutical companies contaminating drinking water with hazardous waste. It was the result of these many instances that prompted Congress to enact the Medical Waste Tracking Act of 1988. The act served the following purposes:

  • Defined medical waste and established which medical wastes would be subject to program regulations
  • Established a cradle-to-grave tracking system, utilizing a generator-initiated tracking form
  • Required management standards for segregation, packaging, labeling, and storage of medical waste
  • Established record-keeping requirements and penalties that could be imposed for mismanagement

HIPAA Compliant Waste Management

We’re all familiar the basic idea behind HIPPA (Health Insurance Portability and Accountability Act) regulation. In a nutshell, it requires that healthcare facilities protect patient confidentiality. You wouldn’t necessarily think this would affect medical waste management, but consider the fact that 2 billion pounds of paper/cardboard waste are created in U.S. healthcare facilities each year; paper that can include old medical records or patient information.

HIPAA requires that paper waste must be broken down to an illegible state, through shredding or pulping. In most cases this means holding and transporting paper waste in locked containers and working with recycling experts who are certified as HIPAA compliant.

Managing Medical Waste


The healthcare industry uses a color-coding system for medical waste segregation. Each container or bag holds a very specific type of waste, which is treated and disposed of accordingly. The segregation process helps to ensure that unnecessary and inappropriate wastes are not put through specialized, and costly, processes reserved for infectious or hazardous waste.

  • Red Containers – Sharps
  • Red Bags – Regulated Medical/ Hazardous Waste
  • Yellow Container – Chemotherapy Waste
  • Black – RCRA Hazardous Waste
  • Blue – Pharmaceutical Waste


Incineration is typically used to process pathological waste, chemotherapy waste, and certain pharmaceutical wastes. The waste is converted into ash, gas, or heat. Incineration has been on the decline since the mid-1990s, as it was found to be a source of dioxin pollution which is a potent carcinogen.

On-Site Treatment

Although the regulations concerning on-site treatment of regulated medical waste are state-specific, there may be some opportunity to implement an approved method of waste treatment.

Approved methods of on-site treatment include:

  • steam sterilization
  • microwave sterilization
  • chemical disinfection
  • sewer discharge of certain liquids

In some states, waste that has been treated to meet non-infectious standards can be mixed with ordinary waste, while in other states it must continue to be segregated.

If you need a partner to handle the medical or pharmaceutical waste that your healthcare facility generates, contact ERC for additional information on medical waste management.

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