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Pennsylvania, Ohio, Indiana, Illinois, Michigan, Wisconsin, and Minnesota
must adopt a tracking program to trace the wastes from generation to disposal
for the next 2 years.  Any of the Great Lakes states may "opt out" of the
program, and other states may "opt in" to the program.
4.4.6.1  Generators and handlers of more than 50 lb of medical
waste a month are required to complete a tracking for each waste shipment for
offsite treatment or disposal.  Generators of less than 50 lb of medical
waste a month must keep logs at the generating site.  All regulated medical
waste managed offsite must be labeled and packaged in rigid leak-resistant
containers in accordance with the regulations.  Medical wastes are defined by
the Act to include:
! cultures and stocks of infectious agents and associated biologicals
! cultures and infectious agents from research and industrial labs
! discarded live and attenuated vaccines
! culture dishes and transfer devices
! human blood and blood products
! organs and tissues removed during surgery and autopsy
! sharp instruments used in patient care
! contaminated animal bodies and parts exposed to agents in research and
production of biologicals and drugs
! other lab wastes and equipment that may have come into contact with
infectious agents.
4.4.6.2  The disposal of surplus medical supplies (FSC 6505) must
also be considered.  Some items contain silver, which can be recycled. Others
such as outdated drugs and vaccines must be disposed of according to
prescribed procedures.  Procedures for disposal of surplus medical items are
currently under development and revision.
4.4.6.3  EPA Guidance.  Regulations for infectious waste management
can be found in Environmental Quality, Preventative Medicine for Medical
Services (e.g., AR 40-5).  The EPA Office of Solid Waste has also published a
document that provides guidance on the management of infectious waste, "EPA
Guide for Infectious Waste Management," 1986, 530-SW-86-014.  This document
outlines procedures for designation, segregation, packaging, storage,
transport, treatment, and disposal of infectious waste.  The categories of
wastes listed in Table 4-4A are recommended by EPA to be designated as
infectious waste.  EPA believes that the decision to designate the
miscellaneous contaminated wastes presented in the table as infectious shall
be made by a responsible authorized person or committee at the facility.  EPA
recommends that wastes from patients that are known to be infected with
blood-borne diseases be treated as infectious waste.
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