Written by Amy Piser
16 Sep 2021

OSHA and Healthcare Waste Management Processes

In the healthcare profession and medical waste industries, completion of required documentation seems endless and often redundant. Yet compliance means following federal, state and sometimes often even municipal guidelines for healthcare waste management – without it, you face potential penalties and fines. 

Many governmental agencies oversee healthcare waste management compliance, including the Occupational Safety and Health Administration (OSHA). What does OSHA, an arm of the Labor Department, have to do with healthcare waste management anyway?

As a regulatory agency focused on safety in the workplace, OSHA’s health safety regulations are designed to protect everyone in all industries in the country. They also protect workers in medical care and related waste environments and industries from illness or injury that might be caused by biological, hazardous, and infectious waste.

1 / Why does OSHA exist?

2 / OSHA and Healthcare Waste

3 / Regulations for PPE and Pathogens Standards   

4 / OSHA Guidelines Protecting Healthcare Workers

5 / Daniels Health Encourages Compliance 

Why does OSHA exist?

The focus of OSHA is to reduce and prevent worker related injuries and illnesses. Why was the agency formed? OSHA began in an environment where safety practices and regulations in the workplace – not just limited to the healthcare industry – were rather lax. Reports of serious accidents and deaths increased every year. By the late 1960s, it was reported that disabling injuries had increased by 20% and an alarming 14,000 workers died at their jobs every year.1

In the late 1960s and into 1970, senators and representatives began drafting and finalizing a new bill known as the Occupational Safety and Health Act of 1970 (at the time it was also known as the Williams-Steiger Act). The act contained three primary components:

  • The Occupational Safety and Health Administration (OSHA) to determine and enforce workplace safety and health standards;
  • The Occupational Safety and Health Review Commission (OSHRC) – an independent agency that adjudicated enforcement actions challenged by employers;
  • The National Institute for Occupational Safety and Health (NIOSH), which was formed to conduct research on occupational safety and health.

The act was signed into law by President Nixon in 1970. The Occupational Safety and Health Administration was and still is overseen by the US Department of Labor. As the agency grew and developed over the years, it created a massive amount of red tape. Hence paperwork and documentation for nearly all workplace environments – all of it designed to protect workers in all fields from injuries, illnesses, and death that had been occurring in the workplace for decades.

But what does OSHA have to do with healthcare waste?

OSHA and Healthcare Waste

Because of its focus on health and safety and, most importantly, to protect workers, employees, and professionals working in medical settings and healthcare facilities, a number of OSHA's regulations today pay special attention to risks in healthcare environments. 

In the beginning, OSHA’s guidelines focused on specific hazards such as physical injury due to lifting and transporting patients and slips and falls. The focus continued to grow to involve exposures to potentially dangerous drugs including those used in chemotherapy. Then, radiation hazards. As time passed and technology advanced, assessment of risks included exposure to MRI magnets and so forth. In 1991, OSHA first introduced the dangers of biological hazards in the Bloodborne Pathogens Standard. It was during the ‘90s that the agency also refined inspection processes and began to penalize serious violators in amounts ranging from $1,000–$7,000 for serious violations, while fines for "careless and repeat violators" ranged from $10,000–$70,000.

Needlestick and sharps injuries are among the most common healthcare industry hazards for workers, applicable to not only doctors, nurses, and surgical staff, but housekeeping, janitorial staff, and even patients and their families. OSHA has estimated that over 5.5 million workers within the healthcare industry and ancillary occupations are at risk of exposure to bloodborne pathogens, including HIV, hepatitis B and C, and others. Nursing staff are among the most frequently poked or otherwise experiencing sharps injuries. Such injuries involve patient rooms, operating rooms, and waste management processes.

Proper handling and compliant use of sharps containers has vastly improved sharps and needlestick injuries. OSHA standards require that sharps containers must be:

  • Closable, puncture resistant, and leak-proof on sides and bottom
  • Accessible, maintained upright, and not allowed to overfill
  • Labeled or color-coded according to 29 CFR 1910.1030(g)(1)(i)
  • Colored red or labeled with the biohazard symbol
  • Labeled in fluorescent orange or orange-red with lettering and symbols and contrasting color. Red bags or containers may be substituted for labels

Regulations for PPE and Bloodborne Pathogens Standard 

Rules also apply to the use of personal protective equipment (PPE). According to OSHA, potential hazards associated with lack of personal protective equipment increases the risk of employee exposure to infectious materials, chemicals, and/or hazardous processes. OSHA’s Bloodborne Pathogens Standard requires PPE if exposure to blood and other potentially infectious materials (OPIM) is anticipated and where occupational exposure remains, after institution of engineering and work practice controls.Proper use of PPE has the potential to provide a barrier to protect mucous membranes and skin from contact with potentially infections blood or other materials. 

Additional guidelines of OSHA standards of practice in the healthcare waste industry emphasize accurate record keeping, handling of healthcare waste, and potential post-exposure evaluations. They recommend appropriate worker training processes and procedures to minimize risk and exposure of employees to dangerous healthcare scenarios.

OSHA also assists medical facilities, their employees, and associated waste management companies by devising standards for the handling and disposal of biohazard wastes. Many of these guidelines are found under the Bloodborne Pathogens Standard, which includes the use of PPE, adequate training, mandatory hepatitis B vaccinations, communication of biohazardous materials to employees, and development of an exposure control plan.

It is the responsibility of all healthcare employees and healthcare waste management companies and personnel to be able to identify healthcare waste streams and identify those that may potentially contain hazardous, biomedical, or infectious waste. 

OSHA Guidelines Protecting Healthcare Workers

One of the most recognized guidelines in the healthcare industry today is OSHA’s Bloodborne Pathogens Standard (29 CFR 1910.1030), designed to provide employers with guidelines regarding the importance of PPE, employee training, use of equipment, medical surveillance, vaccinations, and other safety provisions in the healthcare workplace.

While OSHA may be a “pain in the neck” for some, its successes in reducing and even preventing workplace fatalities since 1971 is impressive. By its 30th anniversary in 2001, OSHA had reduced workplace fatalities by 60% and occupational illness and injury rates by 40%. This was all while employment nearly doubled.

Though still a relatively small agency, as of 2019 and five decades after its conception, OSHA, along with other workplace safety advocates, have had a huge and impressive influence on workplace safety. As of 2019, worker injury and illnesses have decreased from 10.9 incidents per every 100 workers in 1972 to 2.8 incidents per 100 in 2019.

Everyone has the right to work in a safe environment. For more information about OSHA and its standards, enforcement capabilities, as well as resources, visit their website at osha.gov

Daniels Health Encourages Compliance

As leading experts in the field of medical waste management, Daniels Health encourages all medical facilities, from hospitals to outpatient clinics to dental providers and yes, even mortuaries, to follow OSHA guidelines when it comes to safety and training for your employees. Doing so reduces the risk of exposure to injury and illness.

Daniels Health provides resources, guidance, and regulatory knowledge for every state in the country when it comes to healthcare waste management. Maintain compliance, reduce injury risks, and avoid the penalties for noncompliance. For more information on Daniels Health and our products, services, and resources, call us today.

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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.