Waste Prevention Information Exchange

Health Care Waste

In California, medical waste is regulated by the Department of Health Services' Medical Waste Management Program and the Radiologic Health Branch. Hazardous waste and solid waste generated by health care facilities are regulated by the Department of Toxic Substances Control and the California Integrated Waste Management Board, respectively. Local agencies also play major roles in regulating waste from health care facilities.

CIWMB Programs and Services
CIWMB Publications
Other Resources
- Other Documents
- Websites
Health Care Subtopics

CIWMB Programs and Services

Reusable Medical Equipment and Supplies--From the CIWMB Reuse website:
- Organizations that Accept Donations of Medical Supplies
- Reusable Sharps Containers
- Reuse of Single Use Devices
- Other Resources

CIWMB Publications

CIWMB has printed or web publications on this topic that can be found at either our publication search page or our main search page. However, not all of these publications apply to "waste prevention" in the most literal use of that term. CIWMB publications that do apply to waste prevention include:

Waste Reduction Activities For Hospitals--The statistics cited in this 1994 document are a little out of date, but the suggestions for waste reduction are still valid.

Poster
11 X 14 Inches

Know Where to Throw Poster

Details and Downloads

Text--Know Where to Throw. Biohazard red bag waste: fluid blood, blood saturated items, bags and IV tubing containing blood products, suction canisters, hemovacs, chest drainage units, hemodialysis products. These don't go in the red bag: garbage, sharps, pathology specimens, hazardous waste, medication. Check with your facility and/or procedure manual for disposal requirements of IV bags.

Sticker
4 X 5 Inches

Biohazard Sticker

Details and Downloads

Text--Biohazard Red Bag Waste: fluid blood, blood saturated items, bags and IV tubing containing blood products, suction canisters, hemovacs, chest drainage units, hemodialysis products.

Other Resources

Other Documents

An Ounce of Prevention: Waste Reduction Strategies for Health Care Facilities--American Hospital Association (AHA), ASHES, 1993. May be purchased from AHA $29.95 (member), $50 (nonmember); order number 057-007. Call 1-800-AHA-2626 to order. Also available in some university medical center libraries. Available for interlibrary loan from the U.S. EPA Region 9 library.
Case Studies in Hospital Waste Reduction--From Hospitals for a Healthy Environment. Portable Document Format (PDF), various sizes.
A Guide for Dentists: How to Manage Waste from Your Dental Practice--This guide offers tips on reducing waste from common dental office operations, including mercury amalgam wastes, x-ray processing chemicals, and other common materials found in dental practices. The guide features a checklist of waste sources with options for proper handling and disposal. Also includes a list of environmentally preferable alternatives to traditional amalgam, plus information on U.S. amalgam and mercury recyclers. From GreenBiz.com. Portable Document Format (PDF), 73.5 KB.
Going Green: A Resource Kit for Pollution Prevention in Health Care--Health Care Without Harm, 2001. Information on mercury, dioxin, polyvinyl chloride (PVC) and di-ethylhexyl phthalate (DEHP), waste minimization, environmentally preferable purchasing, worker health and safety, latex, needle sticks, glutaraldehyde, and cleaning chemicals. Consists of several Portable Document Format (PDF) files of various sizes.
H2E 10-Step Guide for Composting in Healthcare Facilities--A three-page outline of composting food and yard waste at hospitals. Portable Document Format (PDF), 393 KB.
H2E Self Assessment Guide--This self-assessment guide from Hospitals for a Healthy Environment can help you evaluate your facility’s waste streams, identify opportunities for improvements, and enhance your environmental and waste programs. Portable Document Format (PDF), 173 KB.
Microfiber Mops
- Should you Microfiber?--From Healthcare Purchasing News Online. Portable Document Format (PDF) 60 KB.
- Sustainable Hospital Project Documents and Resources
  - Are Microfiber Mops Beneficial in Hospitals?--This study by the Sustainable Hospitals Project focuses on the environmental and health and safely aspects of microfiber mops, in order to help hospitals fully evaluate microfiber mops as an alternative to conventional loop mops. Portable Document Format (PDF), 257 KB.
  - Microfiber Mops and Cloths--A list of vendors.
  - 10 Reasons to use Microfiber Mopping--Portable Document Format (PDF), 189 KB.
- Using Microfiber Mops in Hospitals--Detailed cost information for switching from conventional wet loop mops to microfiber mops for floor cleaning. Highlights the benefits including shorter cleaning times, reduced chemical and water use, and easier ergonomics. Includes a case study. This document was produced by U.S. EPA Region 9 Pollution Prevention Program. (Mention of trade names, products, or services does not convey, and should not be interpreted as conveying, official EPA or CIWMB approval, endorsement, or recommendation. Other disclaimers apply.) Portable Document Format (PDF), 359 KB.

Nonincineration Medical Waste Treatment Technologies--This report from Health Care Without Harm explores environmental issues, economic impacts, and other considerations of about 50 medical waste treatment technologies. Consists of several Adobe Acrobat PDF* files of various sizes.
Pollution Prevention Guide for Hospitals (Excluding Medical Wastes)--From the California Department of Toxic Substances Control, Office of Pollution Prevention and Technology Development.
Ten Steps to Implementing a Regulated Medical Waste Reduction Plan--From Hospitals for a Healthy Environment (H2E).
Replacing Ethylene Oxide and Glutaraldehyde--Information on the hazards of EtO and glutaraldehyde, and alternatives to their use. Includes a detailed case study, and cost information to help your hospital evaluate making the switch. Produced by U.S. EPA Region 9 Pollution Prevention Program. (Mention of trade names, products, or services does not convey, and should not be interpreted as conveying, official EPA or CIWMB approval, endorsement, or recommendation. Other disclaimers apply.) Portable Document Format (PDF), 308 KB.
Reusable Totes, Blue Wrap Recycling, and Composting--Detailed information on costs, savings, and implementation issues. Includes case studies of paper (including cardboard), plastics, and food waste, three of the largest components of hospitals' solid waste stream. Produced by U.S. EPA Region 9 Pollution Prevention Program. (Mention of trade names, products, or services does not convey, and should not be interpreted as conveying, official EPA or CIWMB approval, endorsement, or recommendation. Other disclaimers apply.) Portable Document Format (PDF), 462 KB.
Tri-TAC Memo to POTW Pretreatment Coordinators and Managers, September 23, 2003, With Attachment--Tri-TAC is a statewide technical advisory organization that represents publicly owned treatment works (POTW) that collect, treat and reclaim more than two billion gallons of wastewater each day and serve most of the sewered population of California. This memo primarily addresses the disposal to sewers of pharmaceuticals at hospitals, but also contains information relevant to household disposal. Item number 7 of the memo addresses one of the pages in the section of WPIE that you are now reading. Please note that the use of the term, policy, in item number 7 is technically incorrect. The California Integrated Waste Management Board has not formally passed a policy about pharmaceutical waste.
- Portable Document Format (PDF) version of the Memo with the Attachment Included (207 KB).
- Microsoft Word Version of the Memo (47 KB) and of the Attachment (177 KB).
Waste Minimization Starter Tool Kit--Kaiser Permanente. Includes instructions, poster, fact sheet, training slides, and tent cards. May be purchased from Kaiser Permanente, $100. Call (510) 625-4737 to order.
Waste Reduction Guide: Cutting Costs and Minimizing Waste From Your Facility--This guide from Hospitals for a Healthy Environment was designed to provide health care professionals with a plan of action to accomplish waste volume reduction throughout the facility. Consists of several Portable Document Format (PDF) files of various sizes.
Waste Source Reduction Hospital Case Study--This study from the Minnesota Office of Environmental Assistance addresses several common hospital waste streams. Portable Document Format (PDF), 136 KB.

Websites

Bay Area Dioxins Project--Among other dioxin issues, this website addresses medical waste management as it relates to methods to prevent dioxin emissions.
California Department of Health Services (DHS)
- Medical Waste Management Program--Provides compliance information, lists of permitted offsite treatment facilities, transfer stations, medical waste transporters throughout the state, information on alternative treatment technologies, state and local enforcement agency contacts, pollution prevention publications (same as publications available through Hospital Alliance Association below). Contact the Medical Waste Management Program at (916) 449-5671, or MedWasteInfo@dhs.ca.gov.
- Radiologic Health Branch--Located within DHS' Food, Drug, and Radiation Safety Division, the branch enforces the radiation control laws and regulations designed to protect the public, radiation workers, and the environment. It is responsible for providing public health functions associated with administering a radiation control program. This includes licensing of radioactive materials, registration of X-ray-producing machines, certification of X-ray and radioactive material users, inspection of facilities using radiation, investigation of radiation incidents, and surveillance of radioactive contamination in the environment.
CleanMed--An international health care conference on environmentally preferable products and green buildings.
Clipart--Over a thousand health care-related clipart images from CoolCLIPS.com. (See also Graphics, for a broad range of environmental clipart.)
Energy Star for Healthcare--This energy performance benchmarking tool for hospitals allows acute care and children's hospitals to compare their energy performance with other similar facilities nationwide using a scale of 1–100. This tool will benchmark campus or stand-alone hospitals over 10,000 square feet in size.
Health Care Without Harm--Seeks to transform the health care industry worldwide, without compromising patient safety or care, to be ecologically sustainable and no longer a source of harm to public health and the environment. This site has good information on mercury reduction.
Hospital Alliance Association (HospAA)--Provides a forum for training and the exchange of ideas between the wide spectrum of hospital staff, suppliers, and regulators that promotes the cost-effective and efficient operation of hospital systems and results in cleaner, safer, and healthier facilities for patients, staff, and surrounding communities.
Hospitals for a Healthy Environment (H2E)--Useful tools for hospitals seeking to improve environmental performance, including a comprehensive list of mercury reduction resources and a step-by-step guide to minimizing waste. An H2E listserv provides a forum for health care professionals to discuss technical information and practical strategies for pollution prevention. This website is a project of the U.S. EPA, the American Hospital Association, the American Nurses Association, and Health Care Without Harm. This site also has good information on mercury reduction.
PharmEcology Associates, LLC--Provides services to help organizations identify, segregate, manage, and dispose hazardous pharmaceutical waste. A web-based application provides subscribers with pharmaceutical waste disposal information, including RCRA requirements.
RN No Harm/Pollution Prevention--This page on the American Nurses Association's (ANA) Web site is designed specifically for nurses. It provides information about health care-related pollution and pollution prevention, resources from the ANA, and links to other sites of value.
San Francisco Bay Area Hospital Pollution Prevention Partnership--Established by U.S. EPA in 1999, this partnership of hospitals, governmental agencies, and community groups works to reduce the amount of mercury, medical, and solid wastes generated by six major hospitals in the Bay Area. CIWMB is a member of this partnership. Visit the above link, or read about the history and accomplishments of this group.
Sustainable Hospitals Project--Provides technical support to the health care industry for selecting products and practices that reduce occupational and environmental hazards, maintain quality patient care, and contain costs.