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What Needs To Go in Red Bag?

Q: Is there a minimum limit to what must be placed in a biohazard container and what can put in regular office trash?

A: I've cut and pasted the list of what must be put in the biohazard container from Quality America's OSHA Safety Program Manual below:

Regulated waste is also called "biohazardous waste and infectious waste" and is defined by OSHA 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.

Biohazardous Waste Examples
-- Gauze bandage saturated with blood
-- Tubes containing blood
-- Used lab culture plates
-- Exam gloves coated with blood or vaginal fluid

Regular Waste Examples
-- Urine specimens (without visible blood)
-- Used diapers
-- One drop of blood on a bandage
-- Exam gloves that are not visibly contaminated
-- Feminine hygiene products*

*OSHA does not generally consider discarded feminine hygiene products such as sanitary napkins, to fall within the definition of regulated waste, since their intended function is to absorb and contain blood. The absorbent material of which they are composed is expected to prevent the release of liquid or semi-liquid blood or the flaking off of dried blood. Discard used feminine hygiene products into waste containers lined with plastic or wax paper bags to protect employees from physical contact with the contents. OSHA would issue a citation if there were sufficient evidence of regulated waste (e.g., a pool of blood in the bottom of the waste container) in a regular wastebasket.

For more information on biohazardous waste disposal and containers check out Tab 8 of the Quality America OSHA Safety Program Manual or Tab 5 of the Dental OSHA Safety Program Manual.

Posted by Quality America on December 20, 2007 | Comments (4)


Thank you for your recent post explaining what should go into a biohazard container in a Doctor's office. I just wanted to clarify one point. Would an ob/gyn need to place his exam gloves in a biohazard container after a pelvic examination?

Posted by: Rose Adwell at December 20, 2007 10:37 AM

OSHA says that for an item to be considered biohazardous waste, it must be "dripping" or have enough OPIMs (blood or vaginal fluid) on it such that it would drip if squeezed. That may be the case in some vaginal exams and not in others. The question is do we want staff (physicians) making such judgment calls with each vaginal exam?

If not, we suggest stipulating in a practice's OSHA program manual that all gloves that were used in vaginal exams be placed in a biohazard container.

From an infection control standpoint, it certainly makes more sense to put them in a covered biohazard container than just tossing them in a trash can, but again, if the doctors want to save money on biohazard pickups, and they only want to comply with the minimal requirements of OSHA, they are not breaking a law when they make the judgment call outlined above.

Posted by: Dr. Sheila Dunn at December 20, 2007 10:38 AM

When disposing of plastic disposable vaginal speculums, do they need to go into the biohazard waste or the regular trash? I am assuming that they do not have visible blood on them.

Posted by: Nancy Donohue of Burke Family Practice at January 11, 2008 04:25 PM

Thank you for your question. From an OSHA perspective, only items that are dripping with infectious material need to be disposed in the biohazardous waste.

Since this is not the case with most speculums, you could legally dispose of them in the regular garbage. Despite this, many facilities elect to dispose of them as biohazardous waste. If you wish to bypass the red bag, be aware that some patients and employees might be concerned if they saw a disposable speculum in the regular trash.

To avoid this problem, soak them in a 1:10 bleach solution for at least 15 minutes, then place them in an opaque (e.g., black) bag and discard in the regular trash.

Posted by: Sarah Alholm at January 11, 2008 04:28 PM

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