Written by Amy Piser
13 Jul 2021

Guide to Massachusetts Medical Waste Regulations

Known as the Pilgrim State, the Commonwealth of Massachusetts is one of the original 13 colonies, the sixth state admitted to the union in 1788 although its history dates back to more than a century earlier. While Boston is one of the state’s largest cities, the overall population of the state ventures close to seven million, which also means hundreds of healthcare facilities that serve its residents.

Medical waste disposal in Massachusetts is a serious undertaking. Any business that provides any medical treatment or care, including tattoo parlors, body piercing facilities, and funeral homes, is responsible for proper waste management and adherence to Massachusetts medical waste regulations.




1 / Where to Find What

2 / Medical Waste Definitions 

3 / About Sharps

4 / Storage, Shipping and Disposal Requirements 

5 / Penalties


Where to Find What

Massachusetts regulations regarding medical waste management can be found in a number of locations. One of the primary resources for biological medical waste management is found under the Massachusetts code of regulations, specifically 105 CMR 480.000.

Another valuable resource is the Massachusetts Department of Environmental Protection, which provides easily accessible guidelines regarding permitting, reporting, laws, and rules, as well as policies and guidance. We can’t cover them all in this article, but we can get you started.

Guidelines of the Massachusetts Department of Transportation as well as the federal government’s Department of Transportation rules and regulations also apply in regard to shipping and transportation of medical waste for disposal.

Daniels Health encourages healthcare providers and medical waste generators to start with the ‘definitions’ of medical waste applicable to a particular state as they can differ. Medical waste segregation processes are built on certain definitions used by the state of Massachusetts.

For example, the code of Massachusetts devotes an entire section to definitions. Why? Because they’re important! Refer to section 480.010 under the code and you’ll find that the state of Massachusetts defines medical or biological waste as waste that because of its characteristics may cause, or significantly contribute to, an increase in mortality or an increase in serious irreversible or incapacitating reversible illness; or pose a substantial present potential hazard to human health or the environment when improperly treated, stored, transported, disposed of, or otherwise managed.”

Keywords here that are important to note include ‘improperly treated, stored, transported, disposed of, or otherwise managed.’ It’s not just about fines and penalties. It’s about protecting your employees, patients, and the general public. Daniels Health has decades of experience reducing the volume of waste heading to landfills and supporting regulations that protect our environment.


Medical Waste Definitions in Massachusetts 

In Massachusetts, medical or biological waste that is subject to the requirement listed above includes:

  • Blood and blood products
  • Pathological waste
  • Contaminated animal waste
  • Cultures and stocks of infectious agents and associated biologicals

Each of these medical waste streams must be handled and properly segregated at the point of origin to ensure proper and compliant storage and disposal options.

In the state of Massachusetts, a medical waste generator is any person, facility, or public agency that creates or generates medical or biological waste. This does not apply to medical waste generated by private homeowners (which also includes sharps used in the home). Medical waste generators include not only the obvious hospitals or physician or dental offices, but funeral homes, tattoo parlors, home health agencies, as well as schools or trauma scene responders.

The regulations found in this single document (105 CMR 480.000) also provide specific information about storage guidelines, approved disinfection methods, and disposal processes. It also clearly defines requirements for packaging, labeling, and shipping (Section 480.300)

Appropriate shipping papers and tracking of medical or biological waste pre-treatment is also covered in the document, as are requirements for record-keeping. Exact guidelines for the disposal of blood and blood products, pathological waste, contaminated animal waste, and sharps as well as other waste streams are found under Section 480.200: Disposal, of the Massachusetts code of regulations.

About Sharps

Under Massachusetts code, sharps are defined as any discarded medical article that has the potential to cause punctures or cuts. This includes more than just needles. It also includes syringes, pen needles, Pasteur pipettes, scalpel blades, dental wires, suture needles, and yes, disposable razors – if they’ve been used in connection with a medical procedure.

Sharps are to be segregated from other wastes immediately after use. Place in red or fluorescent orange-red containers that are puncture resistant, shatterproof, and rigid. These containers must also meet current industry standards and must be prominently marked with biohazard warning symbols and the word “biohazard” written in a contrasting color.

Sharps containers [per 105 CMR 480.200(E)] should be either disposed of through incineration at an approved incineration facility, or rendered non-infectious. Follow guidelines of section 480.150 for guidelines and processing by grinding or other methods for sharps disposal in sanitary landfills (which are approved by the Massachusetts Department of Environmental Protection).

Disinfection methods

Approve disinfection methods in the state of Massachusetts include:

  • Chemical disinfection
  • Steam disinfection/autoclaving
  • Incineration at an approved incineration facility
  • Any other method approved in writing by the department

For additional details, refer to section 480.150: Approved Disinfection Methods of the Massachusetts code of regulations.

Storage, Shipping and Disposal Requirements

Massachusetts is serious about storage, shipping, and disposal requirements for all medical waste, with an emphasis on potentially infectious or hazardous waste. Biological waste must always be properly prepared. Shipping papers are a must. Shipping papers are forms that accompany any medical waste material that is shipped off-site and must contain relevant information. In this regard, Massachusetts also mandates that federal hazardous material transportation laws and regulations also be followed.

The guidelines (480.100: Storage) state that all medical or biological waste (except sharps) are to be contained in red/ fluorescent orange or orange-red plastic bags or containers that are “impervious to moisture and has sufficient strength to resist ripping, tearing, or bursting under normal conditions of use and handling.” They must also be appropriately marked with biohazard warning symbols and be secure enough to prevent any damage, loss, or leakage of their contents during all processes of handling, storage, and transport.

The importance of record-keeping

Record-keeping logs are required for any medical or biological waste that is shipped off-site for treatment. Per Massachusetts regulations, these logs should contain specific information such as:

  • The type of waste
  • Exact date of each shipment
  • Total number of containers
  • Total combined weight or volume

Refer to the guidelines for requirements pertaining to transporter identification numbers (if applicable).

A Brief Word about Penalties

Massachusetts has the right to fine individuals or facilities who violate provisions of specific sections of 105 CMR. Upon convictions, such entities can be fined up to $500 per day of the violation, and penalties of violations found under 105 CMR 480.200 can face fines of up to $25,000.

Of course, we don’t want to see anyone fined or penalized, but responsibility for knowing the rules and regulations of the state of Massachusetts is on you - the medical waste generator. This is called the cradle-to-grave approach. Be aware that the generator is also responsible for the disposal of such medical waste even after it leaves the property or facility.

Call Daniels Health today for additional information about resources, products, and guidance regarding medical waste management in the state of Massachusetts. With decades of experience, we provide the resources and in-depth knowledge of state as well as federal guidelines when it comes to healthcare waste management.


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Amy Piser

Amy Piser

Clinical Waste Educator

With 26 years experience working in healthcare, Amy has implemented sustainability initiatives for over 100 hospitals across the United States and brings unique practice and compliance expertise to healthcare waste management.