The log shall include the quantity, the date of transport and the name of the receiving facility. Logs shall be maintained on file at the generator's facility for three (3) years from the date of shipment. Commercial medical waste transportation must comply with Section VII, requirements for transporters of commercial medical waste.
Quality control of the sterilization process shall be performed at least once a month or after every forty (40) hours of operation, whichever comes later, using physical, chemical, and biological monitors (thermo chemical indicators and integrators such as autoclave tape, spore strips, ampoules, thermocouples, etc.) placed in or on the outside of the waste containers and distributed throughout the load, chamber, or vessel during treatment as listed in Section VI.G to evaluate the effectiveness of the treatment process. Unless the sterilization unit is equipped to continuously monitor and record temperatures during the entire length of each sterilization cycle, except for treatment using ethylene oxide, the operator of such sterilization equipment shall affix to the medical waste a temperature-sensitive tape which will indicate that the required temperature was reached.
Thermal inactivation must allow for sufficient heat to access and penetrate the waste. The waste must be packaged according to the recommendations of the manufacturer and loaded into the chamber as to not exceed the capacity limits set by the manufacturer.
The Department shall maintain a list of those approved alternate technologies, including manufacturer, product name, model number, or other appropriate identifying information. The list shall be made available by the Department's Medical Waste Program.
Wet heat | Geobacillus stear othermophilus |
Dry heat | Bacillus atrophaeus |
Gas (ethylene oxide) | Bacillus atrophaeus |
(formaldehyde) | Geobacillus stear othermophilus |
Radiation | Bacillus pumilus or |
Bacillus atrophaeus or | |
Geobacillus stear othermophilus | |
Liquids | Bacillus atrophaeus or |
Clostridium sporogenes |
The Department must approve of biological monitors not listed above used for efficacy (Quality Control) testing. Total destruction technologies must receive approval from the Department for the type, use, or waiver of efficacy testing.
The log shall be completed during and after all treatment of medical waste in the treatment unit. The log shall also record the required quality control process using biological monitors including the type of organism used as listed in Section VI.G and the results when achieved. The treatment log shall be maintained for three (3) years from the date of last treatment.
Weight tabulations and fees are calculated each calendar quarter. Weight tabulations and fee payment for the previous quarter are due forty-five (45) days from the end of the quarter. Quarters are based on the periods January 1 to March 31, April 1 to June 30, July 1 to September 30, and October 1 to December 31. Payments are to be made to the Medical Waste Disposal Program.
The commercial medical waste transporter shall provide the medical waste generator with a copy of the manifest/tracking paper after the treatment, storage and/or disposal facility accepts the waste or treats the medical waste, if requested. If the medical waste is going out of the state and the receiving state has different requirements for a manifest/tracking paper, the stricter of the state's requirements shall be used. In case of conflict, the Department should be contacted for a determination of the requirements on the manifest/tracking paper.
waste, including notification of the appropriate authorities as outlined in Section VII.N.
vehicle and the Department shall be notified of the incident verbally as soon as possible within twenty-four (24) hours and a follow-up written report within five (5) working days. The incident report shall list all vehicles involved in transporting the medical waste and the cause of the vehicle malfunction.
After the Department approves the proposed technology, on-site treatment efficacy testing is required before an operation license is issued, with the exception of incineration technologies. Total destruction technologies must receive approval from the Department for the type, use, or waiver of efficiency testing. One or more representative surrogate microorganisms from each microbial group shall be used in the treatment efficacy evaluation, unless waivered by the Department. The Department shall determine the appropriate microorganisms to serve as representative surrogate microorganisms. Protocols developed for efficacy testing shall incorporate, as applicable, recognized, standard procedures. Guidelines for testing and approval of medical waste treatment technologies may be obtained from the Department. The Department shall be notified at least twenty (20) working days before efficacy testing begins.
Fahrenheit or less for medical waste held for more than seventy-two (72) hours and shall also meet the requirements of Section VI.D.1.2. and 3.
Weight tabulations and fees are calculated each calendar quarter. Weight tabulations and fee payment for the previous quarter are due forty-five (45) days from the end of the quarter. Quarters are based on the periods January 1 to March 31, April 1 to June 30, July 1 to September 30, and October 1 to December 31. Payments are to be made to the Medical Waste Disposal Program.
Arkansas Mechanical Code, the Arkansas Fire Code, the Arkansas Plumbing code and the National Electrical Code.
The Department may levy up to one hundred dollars ($100.00) per hour not to exceed five thousand dollars ($5,000.00) for permit application processing costs incurred by the Department. All costs imposed by the Department, such as outside consultants, will be documented and submitted on a billing form.
The Department may levy up to one hundred dollars ($100.00) per hour not to exceed five thousand dollars ($5,000.00) for permit modification application processing costs incurred by the Department. All costs imposed by the Department, such as outside consultants, will be documented and submitted on a billing form.
Any person generating, transporting, treating, storing or disposing of medical waste, unless exempted as outlined in Section V, or transporting or treating, storing, and/or disposing of commercial medical waste shall be responsible for compliance with these rules and regulations and all other federal, state and local laws related to medical waste.
NOTE: Transporters, mobile treatment systems and facilities that treat, store and/or dispose of commercial medical waste must have a permit from the Department (Incineration facilities must obtain an incinerator permit from the ADEQ). All facilities that treat, store and/or dispose of commercial medical waste must have an operating license. Application forms and information may be obtained by contacting the Arkansas Department of Health's Medical Waste Program, 4815 West Markham, Slot 32, Little Rock, AR 72205-3867 Phone (501) 661-2621.
TABLE I
METHODS FOR TREATMENT AND DISPOSAL OF REGULATED MEDICAL WASTE
Any one of the treatment methods listed for a given type of waste may be used; however, a disposal method is generally dependent on the treatment method used. Alternate technologies or technologies not listed below shall receive approval from the Department for the types of waste approved for treatment and disposal methods. The Department may grant approval in writing for treatment methods not approved below. For addition information, contact the Medical Waste Program at (501) 661-2621.
METHODS FOR TREATMENT
Type of Regulated Medical Waste | Incineration | Sterilization | Disinfection Thermal or Chemical | Discharge To POTW | Encapsulation | Other |
(1) PATHOLOGICAL WASTES | ||||||
(a) Material from surgical, obstetric, dental, autopsy and laboratory procedures | ||||||
(i) Body parts, bones | A | C | ||||
(ii) Teeth | A | A | C | |||
(iii) Tissues, fetuses, organs | A | C | ||||
(b) Laboratory specimens -blood and tissues | A | A, B | A, B | B | B | |
(c) Spontaneous human abortion products | A | C | ||||
(d) Anatomical human remains | C | C | ||||
(2) LIQUID/DRIED BLOOD | ||||||
Blood, blood components and products; regulated body fluids | A | A, B | B | B | B | |
(3) CONTAMINATED ITEMS | ||||||
Sponges, cotton rolls, gloves, dressings, wraps | A | A | A | |||
(4) MICROBIOLOGICAL WAS | TES | |||||
Cells and tissue cultures, stocks of infectious agents | A | A | A | |||
(5) CONTAMINATED SHARPS | ||||||
Needles, scalpels, broken glass, breakable containers | A | A | A | A | ||
(6) VETERINARY WASTE | A | A | A | A | ||
(7) TRACE CHEMO WASTE | ||||||
Masks, empty drug vials, gloves, gowns, IV tubing, empty IV bags/ bottles | A | A | A | A | ||
(8) SPILL/CLEAN-UP WASTE | A | A | A | A | ||
(9) TRAUMA SCENE WASTE | A | A | A | A |
METHODS FOR DISPOSAL
MEDICAL WASTE RELEASE AND ACCIDENT REPORT
All incidents involving the release of medical waste to the environment or other incidents/accidents involving commercial medical waste shall be reported verbally as soon as possible but within twelve (12) hours to the Department with a follow-up written report on this form in five (5) working days from the incident as required by the Rules and Regulations Pertaining to the Management of Medical Waste from Generators and Health Care Related Facilities. The Department shall be notified at (501) 661-2621 or (501) 661-2000 during working hours and (501) 661-2136 after normal working hours.
Name: __________________________________________________________________
Telephone #: _____________________________________________________________
Name: __________________________________________________________________
Telephone Number: _______________________________________________________
_________________________________________
_________________________________________
____________________________________________
Name & Title: ___________________________________________________________
Signature: _______________________________________________________________
Date: ___________________________________________________________________
Mail or Fax Completed Report To:
Arkansas Department of Health
Medical Waste Program
4815 W. Markham, Slot 32
Little Rock, AR 72205-3867
Phone (501) 661-2621 Fax (501) 280-4090
This is to certify that the foregoing Rules and Regulations Pertaining to the Management of Medical Waste from Generators and Health Care Related Facilities were adopted by the Arkansas State Board of Health at a regular session of said Board in Little Rock, Arkansas on the 25th day of July, 2013.
____________________________________________
Nathaniel Smith, MD, MPH
Interim Director and State Health Officer
Arkansas Department of Health
007.05.13 Ark. Code R. § 002