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Forum Questions and Answers : 
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Q:  Does any type of cleaner kill C-Dif?

A:  The CDC recommends the use of a hypochlorite-based, EPA registered product - where chlorine is the active ingredient in the disinfectant.  For more information, review the CDC's Clostridium difficile web page.

The EPA disinfectant registration program lists products that are registered and labeled as effective in destroying several specific organisms: Mycobacterium tuberculosis, HIV, Hepatitis B, Hepatitis C, MRSA & VRE.  In West Virginia, spills of infectious medical waste must be disinfected with a product labeled as effective against Mycobacterium.

Reviewing List B, you will find that there are numerous products that are labeled as effective against Mycobacterium and are hypochlorite based.  Unfortunately there is no single hypochlorite-based product that is labeled as effective against every organism.

Q:  Are wound dressings which show visible blood but are not saturated required to be disposed of as medical waste?

A:  The presence of visible blood is not what defines a waste item.  The West Virginia IMW Rule and the OSHA Bloodborne Pathogen Standard require that items that contain free-flowing, unabsorbed blood; or an amount of absorbed blood that would drip if the bandage is compressed, be disposed as infectious medical waste.

Q:  Regarding sharps disposal, if the container is not full, what is the maximum time that is can be kept on a shelf, and should it always be kept closed?

A:  The West Virginia Infectious Medical Waste Rule requires that sharps containers be snapped shut and replaced before the contents reach the full line indicated on the box.  There are no time requirements for sharps containers, they can remain in place as long as it takes to fill them (without overfilling).

  The design of most sharps containers prevents persons from contacting the contents of the container.  However, some models have an open hole that would permit someone to stick their fingers into the container.  It is recommended that these type of containers not be used for the obvious reason of having someone receive a needle stick.  However, if this type of open container is used, it would be advisable to close the hole when the container is not in use.  There is no requirement that they be kept closed while in use, but they must be sealed shut when full, before being changed.

Q:  Does biological waste need to be locked in a storage room or is it okay for the door to have a positive latch?

A:  Depending on the location of the storage room, the door may not require a lock.  If the room is located in an area where staff are routinely present then the room may remain unlocked because the staff's presence provides security to the area.

  If the storage room is located away from staff (in a storage area, outside, etc.), it must be kept locked, and appropriate biohazard and authorized personnel only signage must be provided.

Q:  Can latex exam gloves be autoclaved?

A:  The appropriate answer to your question depends upon the intent in autoclaving exam gloves. If the purpose is re-use, then the answer is that exam gloves are not designed for re-use and cannot be processed through an autoclave and used again.

  If the purpose of autoclaving the gloves is to render them non-infectious for disposal, the process must be done in accordance with Section 10.3. of the West Virginia Infectious Medical Waste Rule, 64 CSR 56, for the treatment of infectious medical waste.

Q:  Does a sharp contained in a retractable needleless system device (i.e., an angiocath post IV insertion or a retractable lancet for a finger stick) need to be placed in a sharps container?

A:  Yes they do. The fact that they are contained within a protective sheath does not change the fact that they are a sharps. The sheath is an employee safety device. They must be disposed of as a sharp to protect the health of everyone who handles the waste from the point of disposal to its final destination. Furthermore, there have been no changes made to either the West Virginia Infectious Medical Waste Rule or the OSHA Bloodborne Pathogen Standard in recent years that would recognize these safety devices as anything other than a sharp.

Q:  Are used urine specimen containers containing urine considered to be infectious waste? Are the same containers when emptied into the sewerage system considered to be infectious and are used urine dip sticks considered to be infectious?

A:  The answer is no, unless there was/is visible blood present in the urine. The West Virginia Infectious Medical Waste Rule and the OSHA Bloodborne Pathogen Standard both consider urine and feces, without visible blood, non-regulated body fluids.  Therefore, neither urine specimen containers nor urine test dip sticks would be treated as infectious.  If the urine did contain visible blood, the fluid could be poured down a sanitary sewer; and the container and dip stick would need to be discarded as infectious medical waste.

Q:  The regulation states that IMW cannot be stored for more than 30 days.  Does the 30 days start from when an item is placed in a canister in the doctor's office or from when the bag is sealed and placed in storage for offsite disposal.

A:  The following is the waste storage policy of the West Virginia Infectious Medical Waste Program:

  Waste storage time refers to the storage of waste in a shipping container.  If the container contains only filled sharps boxes, the storage time begins when the shipping container is filled.  If the container contains infectious medical waste other than just sharps containers, the container must be shipped off-site every thirty days.

Q:  What are the requirements for handling Chemotherapy waste?  Is PPE worn during the preparation and administration of Chemo drugs considered Chemo waste or can they be disposed of in the regular garbage?

A:  Chemical and radiological wastes do not fall under the purview of the West Virginia Infectious Medical Waste Program and are specifically exempted in the regulation.  Hazardous wastes are regulated by the West Virginia Department of Environmental Protection and the United States Environmental Protection Agency.
The World Health Organization (WHO) indicates that antineoplastic compounds are destroyed at or above 1000 degrees F.  Medical waste incinerators in West Virginia are required to maintain 1400 degrees F in the primary chamber, and 1800 degrees in the secondary chamber, with a one second exhaust retention time in the secondary.  These parameters are in excess of what is stipulated by the WHO. 

  Preventing Occupational Exposure to Antineoplastic and Other Hazardous Drugs in Health Care Settings, a NIOSH publication, indicates that all wastes that have come into contact with hazardous chemicals should be placed in special waste receptacles for hazardous wastes only.  This would include PPE generated during preparation and administration of chemotherapy drugs, as well as any chucks or covers, alcohol prep pads, etc.  It is also recommended by the Oncology Nursing Society that any disposable items contaminated with urine or feces from the patient within 48 hours of chemotherapy administration should be discarded as hazardous waste.  All bulk P-listed and U-listed wastes should be disposed by via a RCRA permitted hazardous waste firm.

Q:  How should empty glass vials and ampoules that contained a vaccine for human use be disposed of?

A:  The West Virginia Infectious Medical Waste Rule defines vaccine vials as medical waste that must be disposed of as infectious.  The Rule makes no exceptions for live, dead, or attenuated vaccines.  All vials and ampoules that contain any type of vaccine must be placed into a biohazard container, and should be placed into a sharps box.

Q:  How can razors be safely returned for disposal by inmates in a correctional facility?

A:  In West Virginia when razors are not used in the treatment of a patient for medical purposes, they are not considered infectious medical waste and can be disposed of in the regular trash.  However, it is the policy of this Program that razors be collected in a safe manner to protect the employees.  We recommend using a sharps container, or a container with similar puncture-resistance.  Often times a five-gallon bucket is used for broken glass and this can be used for razors as well, especially if the bucket has a small opening that can be used to keep people aware from the contents of the bucket.

Q:  Is there a law/regulation set by OSHA governing how frequently biohazardous waste must be removed from medical offices? (i.e.: every 30 days, 60 days, etc)?

A:  OSHA's Bloodborne Pathogen Standard does not address this issue. In fact, there are no federal infectious medical waste disposal regulations. This issue was left to each State to regulate.

In West Virginia, health care facilities are required to have packaged containers of infectious medical waste removed from their facilities within thirty days. Additionally, hospitals and nursing homes are under other State regulations that require biohazard and regular trash to be removed from their facilities every day or sooner if needed. Once the accumulated waste fills a box it is to be packaged and the thirty day time limit for having the box removed would begin.

  Sharps containers are not included in the daily removal requirement so that they can remain in place until they are ready to be changed (just slightly before the level reaches the full line).

Q: Is there a standard for bio-hazardous waste bags pertaining to the thickness of the bag?

A:  In West Virginia there is a standard pertaining to bag thickness, but I am not aware of any such federal requirement.  Section 6.2.b. of the WV Infectious Medical Waste Rule requires that bags used for infectious waste be 3 mils thick, or pass the American Society for Testing and Materials drop test 959-80 using 125 pounds.  However ASTM has withdrawn this test and replaced it with an updated drop test method, ASTM-D5276-98.

Q:  What is the actual process inolved in the incineration of medical wastes?

A:  When infectious medical wastes are incinerated the operational parameters of the incinerator are very closely monitored. Medical waste incinerators are comprised of two compartments, a lower, primary chamber where the wastes are combusted, and an upper, secondary chamber that is maintained at a higher temperature to volatilized gases produced during the combustion of the waste in the primary chamber.  In West Virginia, the incinerator must be capable of maintaining the primary chamber at 1400o F, and the secondary chamber at 1800o F.

At the incinerator, wastes are loaded into a hopper. Generally, a door will close over the hopper, another door into the primary chamber will open, and a hydraulic ram will activate, pushing the waste into the primary chamber. Once inside, West Virginia law requires that the waste be in maintained at 1400 degrees F for at least one hour. The gases that travel through the secondary chamber must remain in the secondary chamber for at least one second at 1800 degrees F.

Once the above requirements have been met you are left with ash. In WV the ash must be tested quarterly for fixed carbon. This test determines whether the incinerator was successful in properly combusting the waste. Additionally, the ash must be tested annually for heavy metals. This test is based on EPA guidelines and is used to determine if the waste must be discarded as hazardous waste or whether it can safely be disposed of in a solid waste landfill.

Due to strengthening EPA and in WV, Dept. of Environmental Protection, regulations there are fewer medical waste incinerators in operation in WV. The remaining incinerators have been required to install emission scrubbers to ensure that their emissions are cleaner and meet the new requirements.

Q:  Explain "nosocomially transmitted"

A:  Nosocomial is defined as: Pertaining to or originating in the hospital, said of an infection not present or incubating prior to admittance to the hospital, but generally occurring 72 hours after admittance, the term is usually used to refer to patient disease, but hospital personnel may also acquire nosocomial infection.
  Nosocomially transmitted would mean an infection that is transmitted within a healthcare facility. There are numerous causes for nosocomial infections, the most significant of which include antimicrobial resistant organisms, improperly cleaned and disinfected environmental surfaces, failure to follow glove changing and hand washing procedures, and ill healthcare workers.
Visit these CDC web sites for more information about antimicrobial resistance, and infection control guidelines for health care personnel.
 

Q:  We are a free standing pediatric clinic. Are we required to have Biohazard cans in every pt room due to potentially infectious diarrheal diapers/waste or can the potentially infectious material be placed into a bag and carried to the red bag in another room. Also, where are the guidelines that state that every patient room in a clinic needs a biohazard can? If there is a diaper changing station in a bathroom, do we need a can in this area also for potentially infectious diarrheal diapers?

A:  First, are biohazard cans required in every exam room?  In West Virginia, Infectious Medical Waste is regulated by the Department of Health and Human Resources' Bureau for Public Health, via the WV Infectious Medical Waste Rule, 64CSR56.  Section 6.2. of the Rule states that infectious medical waste must be contained and sealed at the point of generation, in a leak-proof plastic bags. The bags must be red, or orange if the waste will be treated in an autoclave, and must have the international biohazard symbol and be imprinted with the words "biohazard," "biomedical waste," "infectious medical waste," or "regulated medical waste."
     OSHA's Bloodborne pathogens standard stipulates that regulated wastes must be placed in containers that are closeable, constructed to contain all contents and prevent leakage of fluids, labeled or color-coded appropriately, and closed prior to removal to prevent spillage or protrusion of contents during handling, storage, transport or shipping.
     Neither of these rules require a biohazard container to be in the exam room.  Both rules allow for the waste to be contained in a bag inside the room, provided the bag is closed before being taken to an appropriate waste storage area.

  Second, are biohazard cans required in the vicinity of a diaper changing table.  In West Virginia, diapers are not infectious medical waste pursuant to Section 3.9.c. of the Rule, which states:  3.9.c. For the purposes of this rule, infectious medical waste does not include the following materials. 3.9.c.3 Used personal hygiene products, such as diapers, facial tissues and sanitary napkins.
     OSHA's bloodborne pathogens standard defines Regulated Waste as: liquid or semi-liquid blood or other potentially infectious materials; contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed; items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or other potentially infectious materials.
     The Standard further defines Other Potentially Infectious Material as: (1) The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids; (2) Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and (3) HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV.
     Neither rule defines diapers that contain feces with no visible blood, as infectious medical waste. Therefore there is no need for a biohazard container in a diaper changing area.

Q:  Where can I find a listing of medical wastes that are safe to dispose of via the sewer system?

A:  There is no list of approved medical wastes that are safe to dispose via a sewer system.  Section 10.4. of the West Virginia Infectious Medical Waste Rule states that liquid infectious medical wastes may be discharged to an approved sanitary sewer system.  Therefore, the only requirement for liquid waste discharge to a sewer is that the sewer must be approved.  See below for more details on approved sewer systems.
Note:  The use of a grinder to reduce infectious solid matter to a size or consistency which can be discharged to a sewer is prohibited.

Q:  What effect does magnetism have on health?

A:  The human health effects of Electric and Magnetic Fields (EMF) are not fully understood.  The National Institute for Occupational Safety and Health (NIOSH), a division of the Centers for Disease Control and Prevention, has ongoing research in this area.  For more information about the findings of their research, please visit the NIOSH EMF web site.

Q:  Is there a particular statute in the WV code that permits or describes the circumstances under which liquid IMW can be disposed of into the sanitary sewer?

A:  Section 10.4. of the West Virginia Infectious Medical Waste Rule addresses disposal of liquid wastes into a sanitary sewer:

Liquid infectious medical waste may be discharged to a sanitary sewer through a drainage fixture of a size and type adequate to discharge the waste in a sanitary manner to a sewer system approved by the department according to Sewage System Rules, 64 CSR 9. The use of a grinder to reduce infectious solid matter to a size or consistency which can be discharged to a sewer is prohibited.

  In order for liquid wastes to be disposed to a sanitary sewer, the facility's sewage system must have been:  permitted, installed, inspected, and approved by the health department.  It must be designed and sized appropriately for its current usage, and must currently meet any and all requirements stipulated for its permitted operation.

Q:  How long should speculums be autoclaved?

A:  Autoclaving of medical devices is not addressed by the West Virginia Infectious Medical Waste Program as it is not covered by the West Virginia Rule.  Please visit the CDC's medical device webpage for more information on disinfection of medical devices, or email the FDA Center for Devices and Radiological Health.

Q:  Do you discard a glass carpal (used medicine contained in a glass carpal) into the sharps container even though it does not appear to be broken?

A:  Yes, and no. Medicine vials can be collected and disposed of as regular trash in any facility so long as the employer addresses employee safety. It is our recommendation that intact glass vials be collected in a small cardboard box or similar container that can be taped shut and labeled as glass. However, if the vials contain vaccine in any form, they must be disposed of in a sharps container just like broken medicine ampoules.
  However, if the facility has a "broken glass collection system," all medicine vials that are not vaccines can be collected and disposed of in the regular trash. There are numerous manufacturers of broken glass collection containers, some are reusable and many are sealed closed and placed directly in the regular waste.

Q:  I work in a nursing home. If a resident has C'dif my understanding is that unless something is drippable/flakable as outlined in the bloodborne pathogen standard you would not need to red bag items the resident uses.

A:  That is correct.  Clostridium difficile infections typically result in watery diarrhea. Therefore the bacteria are contained in feces, a substance that is not classified as infectious by the Bloodborne Pathogen Standard nor the WV Infectious Medical Waste Rule.
  The procedures for handling this contact isolation (recommended until the cessation of diarrhea) would be to provide ample solid waste containers for the disposal of employee PPE and patient waste that do not contain visible blood or OPIM (semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids).
  Any wastes that do contain visible blood or OPIM in a free-flowing, unabsorbed state should be disposed in appropriately color-coded and labeled biohazard bags.  For more information about gastro-intestinal infections, such as C. dif., please visit the CDC's website.

Q:  Here at our hospital, we transport specimens in bags with a biohazard label. If this bag is not contaminated with blood or fluids, can this bag with the biohazard label be disposed of in the regular trash?

A:  Yes, under one condition.  You must have approval from the landfill servicing your facility in order to dispose of un-contaminated biohazard sample bags.  Your facility should create a letter that is signed by both the landfill and your facility, in which your facility certifies that the waste will not be contaminated with biohazardous waste of any kind, and accepts full responsibility should the landfill discover biohazardous waste in your facility's solid waste.
  There are several medical facilities that are currently disposing their un-contaminated biohazard sample bags in the landfill.  This practice is subject to the acceptance of the landfill authority, however.

Q:  Is emesis considered infectious medical waste if there is no visible blood in it?

A:  No, emesis without visible blood is not considered infectious medical waste.  Neither the West Virginia Infectious Medical Waste Rule, nor OSHA's Bloodborne Pathogen Standard consider emesis infectious, so long as there is no visible blood.

Q:  Is the use of solidifiers required in (surgery) suction canisters, or is it optional?

A:  Solidifiers are optional under all conditions.  Their use is beneficial in preventing fluids from leaking when suction canisters are disposed of.  If suction canisters are disposed of as regular trash, one of two approved solidifiers must be used, and the appropriate hold time must be met in the facility.  For specific information on approved solidifiers and hold times, click here.

Q:  Who picks up sharp containers from private owned and run business' such as tattoo shops and piercing studios?  Where can you go online to get this information?

A:  Tattoo and body piercing studio businesses are required to dispose of their waste according to the West Virginia Infectious Medical Waste Rule, 64CSR56.  The Rule allows for three methods of disposal for these wastes.
  First, the wastes can be collected, packaged, and shipped off-site for treatment.  This website contains a listing of the permitted waste hauling companies operating in West Virginia, click on the highlighted words for that information.  These are the ONLY companies authorized to transport infectious medical waste in West Virginia.
  Second, the facility can utilize a mail-in sharps system.  Several companies provide sharps containers and postage-paid U.S. Postal Service approved mailing containers, as well as the required waste tracking documents for facilities to send their infectious medical wastes off-site for treatment.  If such a service is used, the facility must have waste tracking documentation (manifests) and retain them for 3 years.
  Third, the facility can utilize an autoclave to sterilize their infectious medical wastes.  Autoclaved wastes can be deposited into the regular waste provided that they are appropriately labeled.  For more information about autoclaving infectious medical waste please visit our page on this topic.

Q:  What are the requirements for storage and disposal of biohazardous medical wastes?

A:  Section 8 of the Infectious Medical Waste Rule, 64CSR56, addresses storage of medical wastes.  In summary it states that wastes:  shall not be stored onsite for more than thirty (30) days, shall be stored at or near the point of pickup or treatment in a manner that maintains the integrity of the containers (prevents leakage, provides protection from water, rain, and wind). The storage area shall be:  constructed of easily cleanable, impermeable, durable materials, the floor shall not be carpeted or have open seams, and floor drains must discharge to a sanitary sewer disposal system.  Storage areas must be kept clean and in good repair, have access control to prohibit unauthorized entry, and be posted with the international biohazard symbol.
  Disposal of infectious medical wastes can be achieved by treatment onsite or offsite.  Section 10 of the Rule addresses treatment of infectious medical wastes.  There are many approved treatment technologies in West Virginia (for a complete list see our Alternative Treatment Technologies Page), however the most commonly used treatment method is autoclaving.  Facilities that do not treat their wastes onsite must employ a waste hauling service (for a complete list see our Permitted Waste Haulers Page).  The transportation of infectious medical wastes is addressed in Section 9 of the Rule.

Q:  What is C-dif?   

A:  Please click here for a description of Clostridium difficile.

Q:   What happens when C-diff. is left untreated?

A:  Death can result if a Clostridium difficile infection is left untreated.  The most common treatment for these infections is with vancomycin.  Most important, however, is the prevention of disease transmission.  This disease is most commonly acquired nosocomially, in a healthcare facility.  Therefore, proper hand washing by medical staff as well as stringent environmental disinfection of the rooms of patients with diarrhea, and confirmed C-diff infections are paramount.  For more information, go to the CDC's website on Gastrointestinal Infections.
  Note:  CDC environmental infection control recommendations issued June 6, 2003, stipulate that bleach is the best disinfectant for environmental cleaning where C. difficile is a concern.  At this time there is no recommendation for use of a specific EPA-registered hospital disinfectant regarding C. difficile.

Q:   What safety precautions have taken place on West Virginia landfills?

A:  The answer to this question may be best discussed by the West Virginia Department of Environmental Protection who regulate West Virginias landfills.  However, treated infectious medical wastes that are disposed in landfills in West Virginia pose no biological risk to the environment.  Treatment methods employed in West Virginia are incineration, autoclaving, and some limited chemical disinfection of liquid wastes.  These methods have been tested, and continue to be monitored, to ensure their effectiveness at killing pathogenic organisms.  Additionally, treated medical wastes that are intended for disposal into sanitary landfills must be manifested and documented to make landfill operators aware of the contents of the waste they are receiving.

Q:   What is PPE?

A:  PPE is the acronym for Personal Protective Equipment.  PPE is specialized clothing or equipment worn by an employee for protection against a hazard.  PPE such as gloves, masks, gown or apron, and booties or shoe covers should be worn during an infectious medical waste spill clean up.  General work clothes (e.g., uniforms, pants, shirts or blouses) not intended to function as protection against a hazard are not considered to be personal protective equipment.  OSHA's Bloodborne Pathogens Standard requires employers to provide the necessary PPE for employees to safely complete their normal duties.

Q:   How does medical waste affect the public?

A:  Medical facilities have policies and procedures in place to ensure that wastes are properly handled, treated, and disposed of.  As long as these systems are functioning properly, medical waste does not affect the public.  The West Virginia Infectious Medical Waste Program performs inspections of transport vehicles used to haul waste in West Virginia, annual inspections of all of West Virginia's large quantity generators (facilities generating in excess of fifty pounds of infectious medical waste per month), and monthly inspections of the treatment facility.  These inspections assist facilities in ensuring that their procedures are operating correctly and provides a means to facilitate changes and updates to infectious medical waste procedures.

Q:  How can medical waste be disposed?

A:   Wastes can be disposed of by various methods.  These methods must meet criteria for their effectiveness at inactivating microorganisms (efficacy).  Approved methods may employ one or more of the following categories of treatment: chemical, mechanical, microwave, hammer mill, plasma arc, encapsulation, heat, shredder, grinder, irradiation, radio wave, or other process demonstrating efficacy.
   There is only one limiting factor regarding waste treatment in West Virginia, West Virginia law stipulated that infectious medical wastes can not be commercially incinerated.  This means that a waste treatment business cannot operate an incinerator in West Virginia.  However, a facility that generates waste can treat their wastes onsite via incineration.  The use of this method continues to decline due to environmental regulation of incinerator exhaust.
   The most common method of treatment for infectious medical waste in West Virginia is autoclaving.  At this time in West Virginia, more healthcare facilities autoclave their wastes than incinerate them.  Additionally, the majority of infectious medical waste generated in facilities that do not treat their wastes onsite, are sent to commercial facilities that autoclave those wastes.

Q:   What is MRSA?

A:  MRSA - Methicillin Resistant Staphylococcus aureus
For a complete description of MRSA, as well as methods of prevention and treatment, please click on the words above to be taken to the CDC's information page on MRSA.

Q:   What type of things are classified under medical waste?

A:   Medical waste, definition provided below, includes ALL wastes generated during a medical procedure and during the research, testing, and production of biologicals.

Q:  What is the definition of medical waste?  Please click here for a complete definition.

Q:  How much does it cost to dispose of infectious waste?

A:  The cost of infectious medical waste disposal varies and depends on several variables.  If wastes are treated at the medical facility where they are generated, the cost to treat infectious medical waste is relatively low.  Autoclaving costs approximately $0.20 per pound where steam is readily available.  The cost would increase if steam had to be created for the process.  The cost of incineration is similar to that of autoclaving , but tends to be more expensive due to environmental regulations that require the operation of scrubbers to clean exhaust emissions.
   For facilities that do not treat their waste onsite, the cost of having their waste disposed of increases depending on the volume of waste generated.  The increased cost is due to the cost of having the waste shipped offsite for treatment.  The average price per pound to have waste shipped offsite in West Virginia in 2002 was $0.67 per pound.  The cost of disposing infectious medical waste, both onsite and offsite, will continually increase as the costs to haul and treat waste increase.

Q:  What is the meaning of infection?

A:  Infection is defined as: an invasion by and multiplication of pathogenic microorganisms in a bodily part or tissue, which may produce subsequent tissue injury and progress to overt disease through a variety of cellular or toxic mechanisms.

Q:  Is genital piercing legal in West Virginia?

A:  Section 13.1. of the West Virginia Body Piercing Studio Business Rule addresses this question.  It states that:
  A person under the age of eighteen (18) years may receive body piercing provided he or she is accompanied by his or her parent or guardian. The parent or guardian shall have valid picture identification. Nipple and genital piercing is prohibited on minors regardless of parental consent. Persons eighteen (18) years or older may receive body piercing without parental consent.
  Therefore, genital piercing is legal in West Virginia so long as the person is at least eighteen (18) years of age.

Q:  What is Bio Medical Waste?

A:  Bio Medical Waste, Bio-hazardous Waste and Infectious Medical Waste are essentially all the same things.  They are wastes that have been, or potentially have been, exposed to a biological agent that is capable of producing an infectious disease.

Q:  What are the requirements for the disposal of sharps generated in a private residence?

A:  Infectious medical waste generated during self health care or by the provision of health care services within the residence are exempt from the requirements of the West Virginia Infectious Medical Waste Rule, 64CSR56 (Section 2.2.a.).  Except that sharps must be disposed of in a container with a high degree of puncture resistance.
  It is the recommendation of this office that sharps be collected in a hard-plastic container with a screw-on lid.  The container should be stored where the syringes will be used, but in a location that is child and animal proof.  Needles should not be recapped, removed, broken, or bent. 
  When the container is 3/4 full, add one pint of water and one teaspoon of bleach.  With a permanent marker, print "NOT RECYCLABLE - TREATED SHARPS" on the container, place it in a plastic bag, seal the bag with tape in case leakage occurs, and place it in the garbage.

Q:  Are there health risks for those who live in close proximity of a facility that autoclaves and shreds medical waste?

A:  There are no significant health risks associated with living in close proximity to a medical waste treatment facility.  When treatment facilities are run properly there should be NO health risks to the public, nor the employees of the facility.  The following factors contribute to the safety associated with medical waste treatment facilities in West Virginia.
  West Virginia requires all facilities who generate, store, or treat infectious medical waste to ensure that any storage areas maintain the integrity of the containers, prevent leakage of the contents, and protect them from water, rain and wind. 
  At a medical waste treatment facility, the waste remains in its packaging until it is autoclaved, sterilizing the waste, at which point it no longer poses a threat.  In fact, after autoclaving it is essentially less hazardous than ordinary household waste. 

Q:  After medical waste has been autoclaved and shredded...does it pose a health risk?

A:  Autoclaved waste, regardless of whether is it shredded or whether it remains intact, is sterile so long as the autoclave is functioning properly.  In West Virginia, all facilities that employ the use of an autoclave are required to do regular testing with bacterial spores to ensure that their autoclave units are functioning properly.

Q:  What is c-dif?

A:  C-dif is the common name of a bacterium, Clostridium difficile, which causes a gastro-intestinal infection.  C. difficile, an anaerobic gram-positive rod, is the most frequently identified cause of antibiotic-associated diarrhea, and is most often transmitted via the hands of health care personnel who have had contact with contaminated feces or environmental surfaces. 
  Patients who are at highest risk for infection are those who:  are currently taking or have recently taken antimicrobials, have had GI surgery/manipulation, have had a long length of stay in healthcare settings, have a serious underlying illness, are immunocompromised, or are of advanced age. 
  The clinical features of the disease include:  watery diarrhea, fever, loss of appetite, nausea, abdominal pain/tenderness. 
  Recommendations for prevention and control of the disease include:  judicious use of antibiotics, contact precautions for the patient until diarrhea ceases, and adequate environmental cleaning.
Note:  this information was obtained from the CDC website on C. difficile infections. For more information on the subject please visit their website  (click on the link above).

Q:  Where does the garbage go in West Virginia?

A:  Infectious Medical Waste generated in West Virginia is disposed in various locations, a large portion of the waste is treated in state, and the remainder is shipped to treatment facilities in Kentucky, Maryland, and Ohio; depending on which company is contracted to ship and treat the waste.
  Non-infectious wastes are sent to solid waste landfills around the state and in our neighboring states.  For more information about solid waste landfills, the appropriate regulatory agency is the West Virginia Department of Environmental Protection.

Q:  What are the basic contents in a medical waste disposal program?

A:  Effective medical waste management programs must all consider the procedures for handling, storage, proper separation, and volume reduction efforts for both infectious and non-infectious medical wastes.  Additionally, procedures for waste treatment, transportation, disposal and record-keeping must be addressed.  But the single most important factor in any waste management program is employee training.

Q:  Once Infectious Waste has been autoclaved, is it still considered infectious waste or can you dispose of it in the regular garbage?

A:  Infectious Medical Waste that has been autoclaved in compliance with the West Virginia Infectious Medical Waste Rule, 64CSR56, is no longer infectious and can be safely landfilled.  However, chemical, radiological, and pathological wastes are not properly treated by autoclaving. 
  The Infectious Medical Waste Rule stipulates that wastes which are recognizable as medical waste, after autoclaving, must either be shredded to pass through a 1/2" screen, or the waste must be accompanied to the landfill with a label stating that the waste was treated.  For more information on the exact requirements of the label, refer to Section 6.3.b. of the Rule.

Q:  Who sends copies of a uniform manifest to the state?

A:  The West Virginia Infectious Medical Waste Rule addresses the requirements of a manifest in Section 12.  The Infectious Medical Waste program reviews the manifests used by permitted waste haulers who operate in West Virginia.  Healthcare facilities that are permitted by our office are required to submit an Annual Generators Report as well a copy of one manifest from each month of the year.  These copies serve as verification that waste was removed from the facility every thirty days.

Q: Since it is very common to nick a patient when shaving, are razors considered a contaminated sharp and should they be placed in bio-hazardous, puncture proof, leak proof containers?

A:  In West Virginia, where disposable razors are used for patient grooming in a long-term care or nursing home setting, they do not meet the definition of Medical Waste. The West Virginia Infectious Medical Waste Rule section 3.13. defines Medical Waste as - "Infectious and noninfectious solid waste generated in the course of the diagnosis, treatment or immunization of human beings or animals, or in research pertaining thereto, or in the production or testing of biologicals. . . ."
  Because razors generated in long-term care and nursing home settings are not used in treatment or diagnosis of patients, they do not meet the definition of Medical Waste. Therefore, they are not considered Infectious Medical Waste.  However, OSHA's Bloodborne Pathogen Standard requires that razors be collected in a sharps container. 
  The WV Infectious Medical Waste program and OSHA have come to an agreement on handling of disposable razors in extended care and nursing home settings.  Razors can be collected in any container that meets the definition of a sharps container (leak-proof, puncture resistant, and bearing the "Biohazard" symbol).  The container must also be labeled for Razors Only.  When the container is full, it must be sealed shut, and the biohazard label removed at the point it is placed in the general waste stream.  This container is also an ideal location to collect broken glass and empty medication vials, in which case the label should state Razors and Glass Only.
  This container may be carried from one patient room to the next while patient grooming takes place.  However, infection control issues prevent the use of these procedures for patients under isolation precautions.

Q:  Can red bag waste generated in an Outpatient Clinic in Hagerstown Maryland be transported in a sealed container to our main facility in West Virginia and there be disposed of by contract?

A:  Section 9 of the West Virginia Infectious Medical Waste Rule addresses transportation.  Section 9.2. states that a small quantity generator, those generating less than fifty (50) pounds of Infectious Medical Waste per month, may transport their own waste to a permitted infectious medical waste management facility. 
  If the Outpatient Clinic in Hagerstown generates less than fifty (50) pounds of Infectious Medical Waste per month and transports their own waste, they would be required to:  provide training in the proper handling of infectious medical waste to the employee who transports the waste, deliver the waste to a permitted management facility within forty-five (45) days of generation, and the vehicle shall carry a spill containment and cleanup kit as required by Section 7 of the Rule.
  If the Outpatient Clinic in Hagerstown generates in excess of fifty (50) pounds on Infectious Medical Waste per month and transports their own waste, they would be required to obtain a transport vehicle permit and meet all of the requirements in Section 9 of the Rule, as well as Section 12.5., which states that a waste manifest must accompany all waste transported from a Large Quantity Generator.  There is no requirement for manifesting waste from a Small Quantity Generator.

Q:  If we generate less than 50 pounds of infectious waste a month, how often does our waste need to be picked up?

A:  Section 8 of the West Virginia Infectious Medical Waste Rule addresses storage.  Section 8 defines storage as, any time after packaging (sealing) for transport.  It states that waste, other than sharps, shall not be stored for more than thirty (30) days prior to transportation, even if refrigerated. 
  Once the shipping container (box) is filled, it should be sealed and removed from your facility within thirty (30) days.  This section does not give any exemption to facilities that generate less than fifty (50) pounds of infectious medical waste per month.

Q:  What is the average density of infectious medical waste used in calculating autoclave size necessary to treat a specific weight or tonnage of waste?

A:  The average density of infectious medical waste is roughly 3.5 to 5.5 pounds per cubic foot.  This information was obtained from several autoclave design and manufacturing companies. 

Q:  Where can I find information about technical specifications of masks, gloves, and shoes for protecting people on incineration of pathological wastes?

A:  Questions regarding the technical specifications of personal protective equipment may best be addressed to the individual manufacturers of these products as these specs may vary by product as well as manufacturer. 
  Section 7.1.d. of the West Virginia Infectious Medical Waste Rule addresses the requirements for personal protective equipment to be used in a spill clean up.  It states that overalls, boots, and caps shall be made of materials impermeable to liquids.  Boots may be of thick rubber and gloves shall be of heavy neoprene or equivalent material.

Q:  How can the health of a worker whose job is incineration of pathological wastes be protected?

A:  Employees who work with/around Infectious Medical Waste must be aware of the hazards they face in their duties.  These wastes are likely to have a high concentration of infectious agents, and therefore should be handled with caution.  Ideally, the handling of Infectious Medical Waste should be minimized.  Other methods of employee protection include: all employees with reasonable anticipation of exposure to human blood or blood products receiving the Hepatitis B vaccination series, the use of barrier items such as face shields, masks, gloves and gowns, and one of the most important factors is employee hygiene:  washing hands after handling Infectious Medical Waste is a must.

Q:  What is the trend in total volume of IMW since 1998?

A:  1996 was the year of peak Infectious Medical Waste generation in West Virginia, roughly 9 millions pounds were generated.  By 1998 those numbers had been greatly reduced, to roughly 6 million pounds.  This was due to facilities' efforts at reduction and increased in-service training events.  Since 1998, the amount of Infectious Medical Waste generated annually in West Virginia has continued to decrease.  However, this reduction is very minimal when compared to the 1996 to 1998 reduction.  West Virginia's medical facilities generated a little less than 6 million pounds of Infectious Medical Waste in 2001.  One factor lending to this trend might be the increased use of disposable medical devices, rather than reusable devices.

Q:  It seems that OSHA, the CDC and these rulings sometimes contradict each other. How are we to know which pathogens are to be treated as infectious waste and which can go into the main trash stream...and example is C-Difficile and a "contaminated" diaper.

A.  OSHA, the CDC, and the West Virginia Infectious Medical Waste program generally agree as to what constitutes Infectious Medical Waste.  However, there are no Federal guidelines on Infectious Medical Waste disposal.  Each state was left to decide how best to handle their Medical Waste.  Some states strongly restrict what items are to be placed in the general waste and other states do not regulate Infectious Medical Waste at all.  In West Virginia, the enforcement of Infectious Medical Waste disposal is according to 64CSR56 the Infectious Medical Waste Rule.  Our policy is that we do not fine facilities for over-classification, but at the same time we expect each facility to reduce over-classification and safely minimize the amount of Infectious Medical Waste they generate.
  As far as Clostridium difficile, information obtained from a CDC web site stated that C. difficile infections result in watery diarrhea, fever, loss of appetite, nausea, and abdominal pain/tenderness.  Because of the risk of spread of this bacterium, Contact Precautions are recommended.  Contact Precautions are just that, precautions used for care givers when treating a patient.  They do not change how waste is to be disposed.  They do stress the need for frequent hand-washing, the use of gloves and other personal protective equipment, and the proper disinfection with an EPA registered disinfectant of the patient room and equipment.

Q:  What are the medical waste collection procedures and the types/specifications of containers and bags used.

A.  The West Virginia Infectious Medical Waste Rule outlines the requirements for waste collection and packaging.  These requirements can be found in Section 6.2. of the Rule.
  Infectious medical waste shall be contained and sealed on-site in leak-proof plastic bags capable of passing the American Society for Testing and Materials drop weight test (ASTM-D-959-80) using one hundred twenty-five (125) pounds, or in three (3) mil plastic bags or containers with equivalent containment properties. Free liquids shall be contained in break-resistant, tightly stoppered containers. Heavier materials shall be supported in double-walled corrugated fiberboard boxes or equivalent rigid containers.
  Sharps shall be collected at the point of generation in rigid, leak-proof and puncture-resistant containers clearly marked as infectious medical waste.  Containers shall be compatible with selected treatment processes to preclude contact with waste materials, and sealed before handling. Sharps containers shall not be completely filled.

Q:  What are the requirements for disposal of blood tube holders in West Virginia?

A.  Blood tube holders would not be considered Infectious Medical Waste because they are generally not contaminated with blood after a phlebotomy procedure.  However, the reuse of blood tube holders is not addressed by the West Virginia Infectious Medical Waste Rule 64CSR56 and therefore is not within our jurisdiction.
  Click here for
OSHA's interpretation of the Bloodborne Pathogens Standard on this issue.

Q:  What is "Off-Site" waste?

A.   In the West Virginia Infectious Medical Waste Rule 64CSR56, Off-Site is defined as - "a facility or area for the collection, storage, transfer, processing, treatment, or disposal of infectious medical waste which is not on the generator's site, or a facility or area that receives infectious medical waste for storage or treatment that has not been generated on-site at that facility or area." 
 Therefore, off-site wastes are those generated somewhere other than where they are collected, stored, transferred, processed, treated or disposed.

Q:  What dangers are there in building an autoclave for treating medical waste in an area near three schools and homes?

A.   The use of an autoclave is clean, safe, and a very effective method for treating infectious medical waste.  In an autoclave, waste is treated by high temperature steam in combination with high pressure for a certain duration of time.  Together temperature, pressure and time kill the infectious agents present in the waste.  After steam treatment the waste is sterile and can be land filled safely. 
  The drawbacks of autoclaving are the possibility for foul odors, the inability to treat pathological, chemical and radiological wastes, and the generation of Volatile Organic Compounds (VOC).  VOC's create a stress on wastewater treatment systems because a greater amount of dissolved oxygen in the wastewater is required to break down the VOC's.  This problem can be minimized by capturing and recycling the water generated during autoclave use.

Q:  Are vaginal swabs, speculums, etc., considered infectious medical waste?

A.   The definition of Infectious medical waste is: medical waste which is capable of producing an infectious disease. Medical waste shall be considered capable of producing an infectious disease if it has been, or is likely to have been, contaminated by an organism likely to be pathogenic to healthy humans, if such organism is not routinely and freely available in the community, and such organism has a significant probability of being present in sufficient quantities and with sufficient virulence to transmit disease.
  Therefore, classification of items such as vaginal swabs and speculums is subject to interpretation of the definition of Infectious Medical Waste.  If these items contain large amounts of fluids (...such organism has a significant probability of being present in sufficient quantities and with sufficient virulence to transmit disease...) then they would be Infectious Medical Waste.  On the other hand, if these items contained a small amount of fluid, they could be classified as regular waste.  OSHA has given a Standard Interpretation on this issue, more information can be found on our "Related Sites" page, under OSHA Standard Interpretation on Regulated Waste Items.

Q:  How can I obtain a copy of the West Virginia Infectious Medical Waste regulations?

A.  A copy of the Infectious Medical Waste Rule, 64-CSR-56, is available for downloading in WordPerfect and MS Word format from the West Virginia Secretary of State's office.  A printed version can also be obtained from the Secretary of State.

Q:  What are the rules/laws governing sewage in West Virginia?

A.  Sewage Systems Regulations 64-CSR-09, and Sewage Treatment and Collection System Design Standards 64-CSR-47.  A copy of these, and all Public Health Sanitation, rules can be obtained from the West Virginia Secretary of State's website or office.

Q:  What is the threat posed by sewage overflows to the public health and the environment?

A.  Sewage can contain large amounts of pathogenic bacteria, parasites, and viruses.  Exposure to these contaminants can lead to illnesses in humans and animals.  More information about the hazards associated with sewage is available from the Centers for Disease Control.  In addition to problems with direct exposure to the harmful constituents of sewage, overflows of sewage can also lead to the contamination of drinking water supplies. 

Q:  What and where are the rules concerning Medical Waste Incinerator licensing and incinerator operator certification?

A.  The Federal Clean Air Amendments of 1990 are the basis for the authority to regulate incinerators, as well as various rules promulgated by the West Virginia Department of Environmental Protection: 45CSR16, 45CSR23, 45CSR24, & 45CSR25. 
The West Virginia Infectious Medical Waste Rule, 64CSR56, addresses incineration in sections 10 & 11.
  Section 10.2.a. - All owners and operators of infectious medical waste incinerators are required to comply with applicable State laws and with rules of the West Virginia Air Pollution Control Commission.
  Section 10.2.f. - Incinerator operators are required to be registered with the Infectious Medical Waste program.  Operators shall obtain a registration number only after having completed a course of study approved by the program, obtaining a passing score on a written examination; and paying the applicable fee. 
  Section 11.2 - a Commercial Infectious Medical Waste Management Facility, one that received more than 35% of their total waste from off-site, can not utilize incineration technology in any form.
Click here for more
detailed information about incinerator operator training requirements and information about requirements to install a new incinerator at a medical facility.
In West Virginia, the Department of Environmental Protection, Division of Air Quality regulates the permitting and operation of incinerators.  More information can be obtained from the
WVDEP website.

Q:  How can liquid infectious wastes be properly disposed?

A.  In West Virginia, liquid Infectious Medical Wastes can be disposed of in several ways:
  Liquid infectious wastes can be poured down a sanitary sewer, provided that it is approved by the department, and no grinder is used in the process.  There are splash hazards associated with this method, and the container would still be disposed of as infectious medical waste.
  Liquid infectious wastes can be contained in a leak-proof container to which an approved disinfectant solidifier can be added, provided the
appropriate hold time is adhered to, and disposed in the regular solid waste.  There are chemical hazards associated with these products, as well as hold time issues that must be addressed.
  Liquid infectious wastes can also be contained in a leak-proof container and disposed of in the biohazardous waste.  This method allows for increased potential for leakage and spills.

Q:  What is the meaning of Infectious Disease?

A. An infectious disease is a clinically manifest disease, one which shows recognizable clinical signs or symptoms, of humans or animals resulting from an infection. 
An infection occurs after the entry and development (of many parasites) or multiplication of an infectious agent in the body of humans or animals. 
  Infection is not synonymous with infectious disease; the result of an infection may be unapparent (showing no recognizable clinical signs or symptoms) or manifest (shows clinical signs or symptoms, as in an infectious disease).  The presence of living infectious agents on exterior surfaces of the body, or on articles of apparel or soiled articles, is not infection, but represents contamination of such surfaces and articles.

Q:  What are the laws governing the burial of the dead in WV?

A. The burial of human remains does not fall under the jurisdiction of the Infectious Medical Waste rule. The Laws related to cemeteries are: 16-5-21 and 22, 16-9-2 and 3, 35-5-1 through 8, 35-5A-1 through 8, 35-5B-1 through 19, 37-13-1 through 7, 37-13A- 1 through 6, and 61-8-14. Copies of these laws may be downloaded from the Legislative web page.

Q:  Is PPE worn during Anthrax sampling considered a medical waste?

A.  No. Most of these items can be decontaminated and reused therefore are not waste. The PPE can be treated by washing in hot soapy water followed by the application of a 1 to 10 dilution of household bleach (5.25% available Chlorine). The PPE can also be autoclaved following cleaning.

Q.  Would untreated bulk blood and body fluids be permitted to be discharged to the sanitary sewer?

A.  Yes, if the sewer system is capable of treating the blood and body fluids. A system is considered capable of treating liquid infectious medical waste if it’s treatment plant meets secondary or better discharge standards. If the sewage system does not meet these standards it will not adequately treat the liquids and other disposal options must be employed.  The system must have been permitted and approved by the Health Department before discharge of infectious medical wastes is permissable.

Q:  Can syringes, with needle attached, which did not contain blood or body fluid, be placed in the regular trash?

A.  No. Sharps must be treated before they can be discarded. The generators of sharps in the medical community usually employ a transporter to treat their sharps. Small quantity generators also use haulers or transport their sharps to a permitted facility for treatment and disposal. Individuals who self medicate at home may employ a procedure which is delineated in a pamphlet titled "A Household Guide for the Proper Disposal of Syringes and Sharps" available on this web site under the documents section. There is also a presentation that will play on your computer on the presentations page based on the pamphlet.

Q:  How long can a generator keep infectious waste prior to disposal?

A.  Infectious medical waste, other than sharps, can not be stored for more than 30 days even if refrigerated. Infectious waste is not considered in storage until the package is sealed however. It is therefore possible to accumulate infectious waste in its transportation package until it is full. When the package is full and sealed the clock on the storage time starts. Sharps may be accumulated in a sharps container until they reach the full mark.

Q:  What is the process involved in becoming an IMW hauler?

A.  Haulers must register with the Infectious Medical Waste Program and obtain a permit for each cargo carrying portion of the vehicles used to transport the infectious waste. If they have a transfer station within West Virginia that too must be permitted. They must delineate what treatment facility they plan to employ on their application for a permit. The forms necessary to apply to become a hauler are available on this web site on the Applications page, the Documents page, and the Forms page. After receipt of the applications and supplemental documentation the program will review the information provided and determine if the proposed operation can operate in compliance with the rule. If it is determined that the applicant can comply with the requirements of the Infectious Medical Waste Rule a permit is issued. Haulers are then required to report to the program quarterly thereafter. Compliance with the rule is necessary for keeping a permit.

Q:  How does the new WV Body Piercing rule pertain to ear rings?

A.  This is not an infectious medical waste issue. I refer you to the Secretary of State’s home page where you can down load the Body Piercing Studio Business Rule, 64CSR80, or to your local health department. Follow this link to download the Rule from the website of the West Virginia Secretary of State.

Q.  What is the definition of: medical, medical waste, medical waste treatment technology, treatment technology?

A.  Infectious Medical Waste -- click here for definition.

Medical -- Of, relating to, or concerned with physicians or the practice of medicine.

Medical Waste. -- Infectious and noninfectious solid waste generated in the course of the diagnosis, treatment or immunization of human beings or animals, or in research pertaining thereto, or in the production or testing of biologicals. The term "medical waste" does not include low-level radioactive waste, any hazardous waste identified or listed under Subtitle C of the federal Resource Conservation and Recovery Act of 1976, 42 U.S.C. 6921 et seq., as amended, or any household waste as defined in the regulations promulgated pursuant to Subtitle C of that Act.

Medical waste treatment technology --Any of several methods used to render infectious medical waste non-infectious. Medical waste is considered non-infectious when the process inactivates vegetative bacteria, fungi, lipophilic/hydrophilic viruses, parasites, and mycobacterium at a 6 log10 reduction or greater; and inactivation of Bacillus stearothermophilus spores or B. subtilis spores at a 4 log10 reduction or greater.

Treatment technology – Any of several methods employed to inactivate microorganisms which employs one or more of the following categories which are chemical, mechanical, microwave, hammer mill, plasma arc, encapsulation, heat, shredder, grinder, irradiation, radio wave, or other process demonstrating efficacy.

Q.  How can I obtain medical and infectious waste regulations?

A copy of the West Virginia Infectious Medical Waste Rule 64CSR56 can be downloaded from the website of the West Virginia Secretary of State.  From there, choose the format (MS Word or WordPerfect) you wish to download the Rule in.

You may also order a copy of the rule by contacting the Secretary of State,
note: the Secretary of State charges a fee for hard copies.

West Virginia Secretary of State
Building 1, Suite 157K
1900 Kanawha Blvd., East
Charleston, WV 25305-0770
(304) 558-6000

Q.  Does the body of a rabies specimen fall under IMW rules for disposal?

A. No. In the West Virginia Infectious Medical Waste Rule (64 CSR 56) the definition of infectious medical waste is broken down into several segments one of which is Animal Carcasses, body parts, bedding and related wastes. The definition of Animal Carcasses, body parts, bedding and related wastes means: contaminated animal carcasses, body parts, and bedding of animals that are known to have been exposed to infectious agents during research, production of biologicals, testing of pharmaceuticals, or for any other reason. The definition of medical waste is: Infectious and noninfectious solid waste generated in the course of the diagnosis, treatment or immunization of human beings or animals, or in research pertaining thereto, or in the production or testing of biologicals.

Animal carcasses which were the subject of a rabies examination do not fit within the classification of infectious medical waste because they do not meet the definition of medical waste to begin with, and because they do not meet the definition of infectious medical waste under the specific category of animal carcasses, body parts, bedding and related wastes. The carcass remaining after the collection of a sample for rabies was not generated in the course of the diagnosis, treatment or immunization of an animal. The sample submitted for examination would have been generated in an attempt to diagnose rabies, however, the remaining carcass was not so generated since it was already in existence. Also, since the carcass was not known to have been exposed to infectious agents during research, production of biologicals, testing of pharmaceutical, or for any other reason it does not meet the definition of infectious medical waste.

Q.  How many biohazardous waste generators are in West Virginia?

A. Currently there are 159 permitted infectious medical waste management facilities in West Virginia.  These facilities are large quantity generators of infectious medical waste, which simply means that they generate more than 50 pounds of infectious medical waste per month.
As far as the small quantity generators within the state, we do not have an exact number.  It is almost impossible to keep track of each doctor, dentist, veterinarian, etc.  We estimate that there are approximately 3000 infectious medical waste generators within West Virginia.

Q.  Are Long term care facilities responsible for updating employees of contractible diseases a resident has?

A. This question does not fall under the umbrella of the Infectious Medical Waste Rule. It should be directed to OSHA (304) 347-5937 or the West Virginia Division of Surveillance and Disease Control (304) 558-5358.