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Wisconsin's infectious waste regulations

Managing healthcare waste from COVID-19

The U.S. Centers for Disease Control is recommending routine management and disposal of healthcare waste from COVID-19 patients or persons under investigation. For more information on requirements and recommended practices for healthcare facilities, households and waste management professionals handling COVID-19-related healthcare waste, see the COVID-19 tab on this page.

Infectious waste -- also known as biohazardous, red bag or regulated medical waste -- must be segregated from other waste types and disinfected before it is disposed of in a solid waste landfill. Businesses and institutions should review the information on this page. Households are only required to manage their sharps separately.

Infectious waste basics

The difference between infectious waste and medical waste

Basically, infectious waste is waste that can pass on infectious diseases to people or animals, such as sharps (including hypodermic needles, syringes and lancets), blood or human tissue. Medical waste is infectious waste plus any non-infectious waste that may be mixed with them.

  • Infectious waste means solid waste that contains pathogens with sufficient virulence and in sufficient quantity that exposure of a susceptible human or animal to the solid waste could cause the human or animal to contract an infectious disease [s. 287.07(7)(c)1.c., Wis. Stats.].
  • Medical waste means infectious waste, as defined above, and other waste that contains or may be mixed with infectious waste [s. 299.51(1)(b), Wis. Stats.].

Note that medical waste does not mean all of the waste produced in a healthcare setting. Non-infectious materials from a healthcare facility are considered to be "medical waste" only if the generator mixes them with infectious waste or manages them as though they are infectious waste. Any other waste materials from a healthcare facility are not considered "medical waste" under Wisconsin law. If possible, these non-infectious items should be reused or recycled.

Items considered to be infectious waste

The following items are presumed to be infectious waste.

  • Sharps, including unused or disinfected sharps that are being discarded, such as hypodermic needles, syringes with needles, scalpel blades, lancets, broken glass or rigid plastic vials and laboratory slides.
  • Bulk blood or body fluids, including pourable or dripable amounts of blood or body fluids or items saturated with blood or body fluids.
  • Microbiological laboratory waste, such as cultures derived from clinical specimens and discarded laboratory equipment that has contacted cultures.
  • Human tissue, including teeth but not hair or nails.
  • Tissue, bulk blood or body fluids from an animal carrying a zoonotic infectious agent such as rabies, anthrax or tuberculosis.

For legal definitions of infectious and medical waste and related terms, see:

Note: Households are only required to manage their sharps as infectious waste. The rest of these items, when managed by households, may be put in the regular trash. The DNR recommends wrapping them in plastic first.

Items usually not considered to be infectious waste

The following are presumed not to be infectious waste.

  • Items soiled or spotted, but not saturated, with human blood or body fluids, such as gloves, gowns, dressings, bandages, surgical drapes and feminine hygiene products.
  • Items containing non-infectious body fluids, such as diapers.
  • Containers, packaging, waste glass, laboratory equipment or other materials that have had no contact with blood, body fluids, clinical cultures or infectious agents.
  • Animal manure and bedding.
  • Tissue, blood or body fluids from animals not known to be carrying a zoonotic infectious agent.
  • Teeth that individuals take home from the dentist. Get more information on dental waste.

Note: If these items were mixed with infectious waste, they would have to be managed as though they were infectious. Also, see s. NR 526.05(2), Wis. Adm. Code [exit DNR].

If you are unsure whether an item is infectious waste

Contact the Wisconsin Department of Health Services.

Healthcare-Associated Infection (HAI) Prevention Program
608-267-7711

Items that are both infectious waste and hazardous waste

Some wastes can be both hazardous waste and infectious waste. For example, laboratory samples of blood mixed with a reagent containing mercury is both an infectious waste and a hazardous waste. People handling wastes that are both hazardous and infectious should send them to a hazardous waste facility that can also handle infectious waste.

Additional information

Legal requirements

Legal requirements for medical and infectious waste

Anyone generating or managing infectious waste must follow Wisconsin's medical waste rules.

Those who generate or manage small quantities of infectious waste must segregate wastes and follow all safety-related requirements but may be exempt from administrative requirements such as licensing and paperwork. This fact sheet will help you manage your infectious waste safely and may also help reduce your costs.

Businesses and institutions may have to file annual reports on the amounts they send off-site for treatment.

EPA ID numbers for infectious waste generators

The DNR does not require infectious waste generators to obtain EPA ID numbers. However, some infectious waste vendors require their customers to obtain an EPA ID number. The DNR provides EPA ID numbers at no cost upon request.

To apply for an EPA ID number, you must file a Notification of Regulated Waste Activity (EPA Form 8700-12).

Segregating infectious waste

Segregation of wastes, also known as source separation, is mandatory at the time they are generated for all non-household infectious waste generators according to NR 526.06.

All facilities that generate infectious waste must keep adequate records

Regardless of whether your facility is exempt from filing a report, you need to maintain adequate records of the amounts of waste you generate, treat on-site and send off-site for treatment.  These records can include any of the following:

  • Your infectious waste manifests or records of waste sent off-site for treatment (hospitals, clinics and nursing homes must retain for 5 years, all others for three years).
  • Your certificates of destruction or treatment (hospitals, clinics and nursing homes must retain for 5 years, all others for three years).
  • Logs of the amounts sent off-site for treatment and the destination facility.
  • Logs of the amounts generated.
  • Records related to on-site treatment (see s. NR 526.12, Wis. Adm. Code).

In addition, hospitals, clinics and nursing homes (unless exempt) must retain:

  • Your waste audits (must retain all past audits).
  • Your current medical waste reduction policy (recommend retain any previous versions of the policy for 5 years after they are retired).
  • Your medical waste reduction plan and updates to the plan (recommend retain previous versions of the plan for 5 years after they are retired).
  • Copies of the annual reports you have submitted to DNR (must retain for 5 years, recommended retain for 10 years).
  • Infectious waste manifests (hospitals, clinics and nursing homes must retain for 5 years, all others for 3 years).
  • Certificates of destruction or treatment (hospitals, clinics and nursing homes must retain for 5 years, all others for 3 years).
  • Training records (recommend retain for 5 years).
  • Any other documentation that supports how and when you implemented your plan’s goals and objectives (recommend retain for 5 years).

Documentation may be paper or electronic. You should store these records at your facility in a file that is secure yet accessible, in case the DNR or EPA asks to see them.  Be sure they are not discarded when people change positions or leave your facility. Recordkeeping requirements are in s. NR 526.14, Wis. Adm. Code [exit DNR].

Reducing healthcare waste

Hospitals, clinics and nursing homes, unless exempt, must write and implement plans for reducing healthcare waste (see ss. NR 526.16 through .22).

If your hospital, clinic or nursing home has a medical waste reduction plan, it must be made available to the public, according to s. NR 526.22, Wis. Adm. Code [exit DNR].

Treating infectious waste

Healthcare facilities must ensure their infectious waste is properly treated before it is sent to the landfill. Generators may treat their own wastes if they follow the requirements of ss. NR 526.11 and 12.

Generators treating fewer than 500 pounds of infectious waste per day are exempt from licensing. All others must obtain DNR approval and an operating license. Prospective treatment facility operators should contact the DNR Medical Waste Coordinator before submitting the facility plan of operation to ensure the plan will address DNR concerns, particularly about testing protocols.

Transportation

Requirements for transporting infectious waste

You may either hire a licensed infectious waste transporter or transport the waste yourself as an exempt or licensed transporter.

All transporters, exempt from licensing or not, must follow minimum safety requirements in s. NR 526.10(3), Wis. Adm. Code.

Determining whether you need a license

Those transporting less than 50 pounds per month, in every month of a calendar year, may transport infectious waste without a special license. Special licenses and license exemptions are in s. NR 526.10 (2). Those transporting 50 pounds or more of infectious waste must obtain an infectious waste transportation license.

If a vehicle carrying infectious waste is traveling through Wisconsin without stopping to pick up, drop off or transfer waste, the vehicle does not need to have a Wisconsin infectious waste transportation license.

For more information or to obtain a license application form, see:

If you are starting a trauma scene or crime scene cleanup business, please see the questions about trauma scene requirements in the Healthcare waste treatment FAQ.

COVID-19

Managing healthcare waste from "Coronavirus Disease 19" or "COVID-19" (previously referred to as "Novel Coronavirus" or "2019-nCoV") in Wisconsin

Recommended practices for managing COVID-19 waste

The U.S. Centers for Disease Control is recommending routine management and disposal of healthcare waste from COVID-19 patients or persons under investigation.

Status of COVID-19 in Wisconsin

To learn more about the current status of COVID-19 in Wisconsin and all information pertaining to management, visit the Wisconsin Department of Health Services COVID-19 webpage

Due to the recommendations for routine management of healthcare wastes, an overview of Wisconsin's requirements for managing healthcare waste is described below, along with additional recommended practices. If at any time the CDC makes additional recommendations for managing COVID-19 healthcare waste, we will update this information as soon as possible. Recommendations from a reputable source such as the CDC, World Health Organization and U.S. Occupational Safety and Health Administration can always be used in accordance with the minimum requirements covered below. Healthcare facilities may also want to work directly with their infectious waste management facility, as they may establish additional protocols.

OSHA is recommending routine personal protective equipment (PPE) and safe handling practices for all solid waste and wastewater workers and employers when managing confirmed or potential COVID-19 healthcare waste.

Infectious waste requirements for non-household generators

Non household generators of healthcare waste are required to keep wastes that meet the statutory definition of infectious waste separate from other solid wastes and manage it accordingly.

The statutory definition of infectious waste is “solid waste that contains pathogens with sufficient virulence and in sufficient quantity that exposure of a susceptible human or animal to the solid waste could cause the human or animal to contract an infectious disease.” [s. 287.07(7)(c)1.c., Wis. Stats.]

Section NR 526.06 of the Wisconsin Administrative Code lists the categories of healthcare wastes that should be assumed to be infectious unless demonstrated otherwise. Regardless of whether these wastes are generated by COVID-19 healthcare measures or not, the following should be managed as infectious waste:

  • Sharps, including:
    • contaminated sharps which are both infectious and may easily cause punctures or cuts in the skin, including but not limited to: hypodermic needles, syringes with needles attached, scalpel blades, lancets, broken glass vials, broken rigid plastic vials and laboratory slides; and
    • unused or disinfected sharps which are being discarded, including hypodermic needles, scalpel blades, lancets and syringes with needles attached.
  • Bulk (dripable or pourable quantities or items saturated with) blood and body fluids from humans (whole blood or blood components, blood specimens, semen, vaginal secretions, cerebrospinal fluid, synovial fluid, amniotic fluid, peritoneal fluid, peritoneal dialysate, pericardial fluid, pleural fluid and other body fluids visibly contaminated with blood).
  • Human tissue (including teeth but not including hair or fingernails).
  • Microbiological laboratory waste.
  • Tissue, bulk blood or body fluids from an animal which is carrying a zoonotic infectious agent (Zoonotic infectious agents include Bacillus anthracis (anthrax), Brucella abortus (brucellosis), Chlamydia psittaci (psittacosis), Coxiella burnetii (Q fever), Lyssa virus (rabies), Mycobacterium bovis and Mycobacterium tuberculosis).

Full requirements for the management of infectious waste can be found in ch. NR 526, Wis. Adm. Code. Infectious wastes other than sharps (which must be placed in rigid, puncture-resistant, labeled containers) shall be placed in a bag that meets or exceeds 165 grams of resistance and is tear resistant, a double bag that meets the same standards or a rigid reusable container. The container must be securely sealed to prevent the expulsion of waste. Once the wastes are placed in the container they cannot be opened, separated or mixed with other solid wastes. Infectious waste must be stored in an enclosed building, vehicle, or container and on a surface impermeable to liquids.

Mail-back programs are also commonly available for small-volume generators.

Healthcare wastes that are not hazardous waste (per NR 661.03, Wis. Adm. Code) and not listed above must be properly managed and disposed of as solid wastes, per chs. NR 500-599, Wis. Adm. Code. This includes items soiled but not saturated with blood or body fluids, items soiled with body fluids from humans not included in the definition of “bulk blood and body fluids" (such as urine), intravenous tubing after needles have been detached, and other solid wastes, including but not limited to containers, packages, waste glass, laboratory equipment and other materials which have had no contact with blood, body fluids, clinical cultures or infectious agents. Solid wastes shall be stored in durable, leak-proof containers and be transported by a licensed solid waste hauler or self-hauled to a licensed solid waste transfer facility or landfill if transporting less than 20 tons per year. Full requirements for the management of solid waste can be found in chs. NR 500, Wis. Adm. Code.

The CDC recommends managing and disposing of any non-hazardous waste (as defined by ch. NR 661.03, Wis. Adm. Code) generated by COVID-19 healthcare measures as solid waste unless they otherwise meet the definition of infectious waste.

“Medical waste (trash) coming from healthcare facilities treating COVID-2019 patients is no different than waste coming from facilities without COVID-19 patients. CDC’s guidance states that management of laundry, food service utensils, and medical waste should be performed in accordance with routine procedures. There is no evidence to suggest that facility waste needs any additional disinfection.” (CDC FAQ for Healthcare Professionals)

Additional recommendations for non-household generators

The National Waste and Recycling Association’s Healthcare Waste institute recommends the use of single use infectious waste containers for COVID-19 infectious wastes and notifying your infectious waste hauler and/or treatment facility of infectious waste that was generated by COVID-19 healthcare measures.

Requirements for household generators

Household generators of infectious waste are exempt from the infectious waste requirements except for the management and disposal of medical sharps.

Additional recommendations for household generators

The CDC’s page for environmental cleaning and disinfection for U.S. households with suspected/confirmed COVID-19 has laundering recommendations for clothing, towels and linens and for washing reusable food service items. These items are not required to be disposed of. Recommendations for disinfection of surfaces include the use of diluted bleach solutions and alcohol solutions of 70% alcohol.

The page also makes recommendations to:

  • dedicate a specific-lined trash can for waste from the ill person;
  • use gloves when handling and disposing of the trash bag; and
  • wash hands after handling and disposing of the trash bag (and removal of gloves).
Contact information
For questions about the infectious waste requirements and how they apply to COVID-19 waste, contact:
Casey Lamensky
DNR Waste and Materials Management Program

Ebola

Ebola-contaminated waste

There are no known cases of Ebola virus disease in Wisconsin at this time. If there were, Wisconsin's medical waste regulations would apply to Ebola-contaminated waste because Ebola virus disease is an infectious disease. The Department of Health Services is the lead agency for Ebola response in Wisconsin and will post any Wisconsin-specific guidance about Ebola waste.

The U.S. Department of Transportation Pipeline and Hazardous Materials Safety Administration [exit DNR] has issued guidance regarding packaging and transportation of Ebola-contaminated waste. Although U.S. DOT requirements about packaging and transportation supersede Wisconsin's, Wisconsin requirements would still apply to licensing of vehicles transporting Ebola-contaminated waste. See the Transporting infectious waste tab.