Regulated medical waste (RMW) is waste that poses a "significant risk" to human health through infection. Usually generated by healthcare facilities, medical waste can include body parts, body tissues, blood, and items contaminated by blood or other bodily fluids. In the United States, the disposal of medical waste, also known as biohazardous waste, is regulated by the Environmental Protection Agency (EPA) and enforced by state agencies. Medical waste is also closely regulated in many other countries.
Regulated medical waste came to the public's attention in the US in the late 1980s, after several incidences of needles and other biohazardous materials washing up on beaches. Media attention on the AIDS epidemic brought the importance of proper disposal of contaminated waste to the forefront, and a public outcry ensued. This led the US Congress to enact the Medical Waste Tracking Act in 1988, requiring that all biohazardous materials be disposed of separately from ordinary office and household waste.
As late as 1997, 90% of all regulated medical waste in the US was incinerated, but concerns over incinerator emissions prompted the EPA to establish guidelines concerning incinerator emissions. The new guidelines are estimated to have reduced emissions of dioxin, mercury, particulate matter, and hydrogen chloride by 90 to 98%. As a result of the EPA's guidelines, an estimated 50 to 80% of existing medical waste incinerators were discontinued.
The new laws increased the cost of disposing of regulated medical waste tenfold. Many healthcare centers could not sustainably cover the increased cost, and a movement arose to discover alternative means of disposal. The safest and most economically feasible methods involve sterilizing the waste to remove the contaminates, then disposing of it in a landfill.
Regulated medical waste can be sterilized with heat. The most common treatment is with a steam autoclave, which combines extreme heat and high pressure to kill microorganisms. Other treatments involve microwave sterilization, dry heat systems, or plasma arc technology. All of these methods are effective, although the cost of the equipment can be high and the waste must be treated for a certain period of time to ensure that all contaminating organisms have been killed.
Another way to sterilize regulated medical waste is through contact with an oxidizing chemical agent, usually chlorine. This method is better suited to small amounts of waste, as it consumes chemicals and produces toxins such as chloroform. Ozone has also been used to sterilize medical waste because it does not produce harmful byproducts, although there is a risk to workers during treatment due to ozone's negative effects on the lungs.