The Medical Waste Tracking Act of 1988

In the summers of 1987 and 1988, a substantial amount of trash, which had presumably dumped offshore, floated up onto eastern beaches, much of which was infectious medical waste such as used hypodermic syringes. This created grave concerns about the possibility of the spread of disease from medical waste in swimming areas. Because it was difficult to determine both the source and the extent of the problem, Congress passed the Medical Waste Tracking Act (MWTA) in 1988, which established a two-year demonstration program administered by the Environmental Protection Agency (EPA) that required the detailed tracking of infectious medical waste from its creation to its ultimate disposal. The program was modeled after the regulatory scheme for handling other hazardous waste under the Resource Conservation and Recovery Act (RCRA), which requires "cradle-to-grave" regulation and tracking of hazardous waste.

The demonstration tracking program as initially designed applied only to the eastern states of Connecticut and New Jersey and the Great Lakes-bordering states of Illinois, Indiana, Michigan, Minnesota, New York, Ohio, Pennsylvania, and Wisconsin. However, the MWTA allowed the designated states to opt out of the program and allowed other states that wished to participate to petition the EPA for permission to do so. Ultimately, the demonstration program was run in Connecticut, New Jersey, New York, Puerto Rico, and Rhode Island.

The MWTA demonstration program employed a tracking form that was to be initiated by each waste generator; required management standards for handling medical waste, including its segregation from ordinary waste; packaging and labeling; and storage. The program also established certain recordkeeping requirements and imposed penalties for mismanagement of medical waste. The EPA determined from the demonstration program that medical waste posed the largest hazard for causing disease at the point at which it was generated and that the hazards tapered off from that point until the ultimate disposal of the waste. Accordingly, it was concluded that, although medical waste poses a substantial occupational hazard, the general environmental hazard posed by medical waste is not a significant problem.

The MWTA also required the EPA to explore various treatments of medical waste that were available to minimize or eliminate its potential to spread disease. The EPA examined on-site and offsite incineration and autoclaving, microwaving, and various chemical and mechanical treatments. Although the most common treatment for medical waste is incineration, the EPA has promulgated emissions-control regulations for incinerators that will make it expensive to continue that practice. The EPA predicts that it is unlikely that new medical waste incineration facilities will be built and anticipates a gradual shift to alternative disposal treatments. The EPA has developed several fact sheets, technical assistance, and other resources to facilitate the adoption of alternative treatments.