The Biohazardous Waste Law of 1988

The Florida Legislature has adopted sweeping new changes in the regulations governing the disposal of bio-hazardous waste in response to a dramatic ten-fold increase in the use of disposable hospital supplies in the last decade and a hypersensitivity to infection from the AIDS virus.

The new law will affect all physicians who store, dispose and arrange transport of any solid or liquid waste which may present a threat of infection to humans. The Department of Health and Rehabilitative Services (HRS) is working in conjunction with the Department of Environmental Regulation (DER) to formulate the rules that will govern the storage, disposal and transportation of the waste. But because the law went into effect on October I, 1988, there are some general rules which you should follow in the interim.

There are only two permissible ways to handle bio-hazardous waste. It must be either autoclaved or "red bagged" for incineration. In the past, there have been some misconceptions as to just what medical waste must be "red bagged" State officials said that, under the new law, all sharps, blood products, lab waste and pathological waste must be either autoclaved or incinerated. Lab wastes include all urine and blood vials, Petri dishes and inoculating needles. This material may not be disposed of at county landfill. Bio-hazardous waste should not be compacted and sharps should not be clipped prior to disposal.

Tongue depressors, IV tubing, gowns, drapes, examination materials and bloody gauze that is not grossly contaminated need not be autoclaved or incinerated, according to Steve Chick, an environmental planner with the Department of Environmental Regulation.

Essentially, the new law is an attempt to target for "red bagging" only those wastes that poses a threat of infection. Health providers should find that only about ten to twenty percent of their patient waste is actually bio-hazardous waste. By focusing only on those wastes that pose a threat of infection to humans, officials hope they can curtail the much publicized illegal dumping of infectious waste.

The enormity of the problem is best exemplified by the sheer volume of the nation's infectious wastes. According to the Occupational Health and Safety News Digest, disposable hospital supplies average forty to fifty pounds per patient in an acute care hospital.

The money spent on disposable supplies also is staggering. In 1966, health care providers spent $30 million for disposable medical supplies. By 1987, this figure had risen to $900 million and there is no reason to expect anything less than a continual upward spiral.

Florida is not alone in its efforts to deal with the burgeoning infectious waste problem. Currently, no less than eighteen federal and private bureaus and commissions have regulations and guidelines for the management of infectious waste. These include the Food and Drug Administration, the Occupational Safety and Health Act, the Joint Commission on Accreditation of Hospitals, the Department of Transportation, the American Association of Blood Banks, the U.S. Environmental Protection Agency, the U.S. Public Health Service's Center for Disease Control the National Safety Council and the American Hospital Association.

Emerging from this labyrinth of bureaucratic rules and regulations is one central theme. The transporter of the infectious waste does not have the ultimate burden for safe management of that waste, nor does the disposal site operator. The burden rests with those health care providers generating the infectious waste. "Doctors cannot limit their responsibility. They are ultimately responsible," Barry Swihart, chief of the Bureau of Waste Planning and Regulation at the State Department of Environmental Regulation said.

Although transporters of the bio-hazardous waste do not have to be registered with the state until July of 1990, doctors in the interim should obtain some sort of assurances from their hauler that the waste is being properly disposed of, according to Swihart.

Florida's new law is a response to what is viewed as one of the most pressing problems confronting state, and local authorities. That is, just what should be "red-bagged," and how should these wastes be disposed of. For a number of years, the State of Florida had identified "infectious waste" as:

Those wastes which may cause disease or reasonably be expected of harboring pathogenic organisms; included are wastes resulting from the operation of medical clinics, hospitals, and other facilities producing wastes which may consist of, but are not limited to, diseased human and animal parts, contaminated bandages, pathological specimens, hypodermic needles, contaminated clothing and surgical gloves.

The new law eliminates this category and creates a new category of "bio-hazardous' waste which is defined as:

any solid or liquid waste which may present a threat of infection to humans. The term includes, but is not limited to, non-liquid human tissue and body parts; laboratory veterinary waste which contains human-disease-causing agents; used disposable sharps; human blood, and human blood products and body fluids; and other materials which in the opinion of the department represent a significant risk of infection to persons outside the generating facility.

Under the new law, HRS has the statutory authority to regulate the packaging, storage and treatment of bio-hazardous waste at the facility where the waste is generated. DER has the authority to regulate the waste once it leaves the facility where it was generated. The DER will regulate the bio-hazardous waste once it leaves the hospital or doctor's office, and also will regulate incineration of the bio-hazardous waste on-site and off-site.

Since physicians' offices, laboratories, hospitals and even dental offices are considered "bio-hazardous waste generators" under the statute, each can expect new rules and regulations between March and June of 1989 regarding safe packaging, segregation, storage, treatment and disposal of their bio-hazardous waste.

Swihart said that those facilities which currently incinerate their infectious waste should pay particular attention to the new rules because some of their newly defined bio-hazardous waste may not be eligible for incineration under new stricter standards.

In the coming months, HRS and DER will either issue an informational brochure to doctors and hospitals detailing the steps that need to be taken to comply with the Act, or the agencies will be holding regional question and answer sessions.