Overview of Waste Management at Health Care Facilities

Facilities where people or animals receive health care, such as hospitals, clinics, nursing homes, dentist offices and veterinary offices, generate a wide variety of wastes. Below, you will find general information about managing the many different types of waste generated at health care facilities.

Management of Waste at Health Care Facilities

Physicians, nurses, dentists, veterinarians, laboratory technicians, pharmacy staff, maintenance staff and IT support staff can all generate waste. All employees who generate waste are responsible for its proper management and disposal. One or more employees, such as the owner; an environmental, health and safety specialist; or the manager of each department, may be responsible for developing waste handling and disposal procedures at the health care facility.

Environmental and Health Concerns

Products used in the health care industry, such as chemotherapy drugs, some pharmaceuticals, disinfectants and sterilants, can harm the environment and human health if they are not disposed of properly. For many years, flushing excess amounts of chemicals down the drain has been a common practice.

However, recent studies indicate that some of these chemicals are passing through wastewater treatment systems and entering our waterways, which may serve as drinking water supplies for local municipalities. Some fish and aquatic life now have detectable levels of hormones, antibiotics, antidepressants and other chemicals in their bodies; are showing signs of being "feminized"; or are sterile. Some of these chemicals are classified as human mutagens, carcinogens, or teratagens. These recent findings indicate that in addition to handling these products safely in the workplace, they must be managed properly as a waste to minimize the potential impacts to human health and the environment.

Types of Waste Health Care Facilities Generate and How Should They Be Managed

Various types of pharmaceutical waste.

Health care facilities may generate hazardous waste, infectious (red bag) waste, solid waste, recyclable materials, universal waste, chemotherapy waste and radioactive waste. Each of these waste types is subject to certain rules requiring the waste be managed and disposed of properly.

Proper Management of Wastes

Burning any waste materials in incinerators and industrial or utility boilers is subject to air management requirements contained in chs. NR 400 to 499, Wis. Adm. Code, as well as hazardous waste, solid waste or used oil requirements, depending on the materials burned. Open burning of waste materials is strictly prohibited. Contact your local DNR waste management specialist and air management compliance specialist for more information.

Before discharging any non-domestic waste, such as pharmaceuticals or certain laboratory wastes, to a sanitary sewer, you must notify and receive permission from your local wastewater treatment plant or sewer authority. Non-domestic waste should never be discharged to a septic system or drain field. Contact your wastewater treatment authority to determine if blood and body fluids can be discharged to the sanitary sewer. Do not discharge blood and body fluids other than urine to a septic system or drain field.

Some hazardous wastes can lawfully be discharged to a sanitary sewer, but only if approved by the local sewer authority. If you discharge more than 15 kg of non-acute hazardous waste in a calendar month or any amount of acute hazardous waste, you must submit a hazardous waste discharge report to the sewage treatment authority, the U.S. EPA and the DNR. The hazardous waste notification must include a certification that you have a waste minimization program in place. For more information on the hazardous waste discharge reporting requirements, see ch. NR 211, Wis. Adm. Code, [PDF 143KB, exit DNR].

Materials that may potentially interfere with the operation of the sewerage treatment plant cannot be discharged to the sanitary sewer. See s. NR 211.10, Wis. Adm. Code, for information on materials prohibited from discharge. Your wastewater regulatory authority will tell you which wastes are prohibited and which wastes may be treated and discharged. Examples of wastes that may be discharged are X-ray or photo fixer that has been treated to remove silver and acids or caustics that have been neutralized.

The Consequences of Improper Waste Management

The mismanagement of wastes can increase the risks to waste haulers and landfill operators (dermal contact with harmful substances, inhalation hazards, explosions, fires, etc.) and sewer maintenance employees (noxious gases in sewer or potentially explosive mixtures); and can result in environmental contamination. Those causing environmental contamination are responsible for cost of cleanup and other remedial activities.

The DNR and U.S. EPA can take enforcement action when businesses do not properly manage their wastes. Civil enforcement penalties for noncompliance may range from $10 to $25,000 per day per violation, depending on the type of waste mismanaged and the seriousness of the violation. That means that violating one requirement, such as keeping containers of hazardous waste closed, for three days could result in a penalty ranging from $30 to $75,000. The DNR and U.S. EPA can also seek criminal penalties for intentional hazardous waste violations. So the consequences of not complying with environmental rules can be substantial.

More Information

Contact Information

For questions and comments about waste management at health care facilities, please contact:

DNR Waste Materials@Wisconsin.gov

Last Revised: Thursday January 22 2009