Medical waste rules in Missouri

Missouri regulates infectious waste through the Department of Natural Resources (DNR) under 10 CSR 80-7.010, with the Department of Health and Senior Services defining what small quantity generators must treat as infectious (19 CSR 20-20.010) and setting hospital rules (19 CSR 30-20.021). The dividing line is 100 kilograms (about 220 pounds) a month.

  • Small quantity generators (10 CSR 80-7.010(1)(A)2; 19 CSR 20-20.010(21)): at 100 kg a month or less, the infectious waste a practice must manage is discarded sharps, cultures and stocks of infectious organisms with their culture dishes and transfer devices, and any other waste the responsible medical authority designates as capable of producing an infectious disease.
  • Packaging (10 CSR 80-7.010(2)): before transport, infectious waste goes in rigid or semi-rigid, leak-resistant containers, sealed, marked with the universal biohazard symbol and labeled Infectious Waste or Biohazard Waste. Plastic bags are never the primary container for transport and go inside a rigid container; sharps go in rigid, leak-resistant, puncture-resistant sealed containers. Containers meeting OSHA 29 CFR 1910.1030 are acceptable.
  • Tracking documents (10 CSR 80-7.010(3)): the generator prepares a tracking document naming itself, the designated permitted processing facility (and an alternate), the transporter with its Missouri transporter identification number and the quantity, signs it, obtains the transporter's signature and keeps a copy. The processing facility returns the completed document within 35 days of the transporter accepting the waste.
  • Transport (10 CSR 80-7.010(4)): untreated infectious waste leaves the site only with a transporter licensed by the DNR under 10 CSR 25-6.263, in a closed and secured vehicle, to a permitted infectious waste processing facility, a hospital operating under the hospital exemption or an out-of-state facility. A generator of 100 kg a month or less may carry its own waste in a closed, secured vehicle without a transporter license or the $2-per-ton fee; sharps may also travel by US Postal Service under 39 CFR 111.
  • Treatment and disposal (10 CSR 80-7.010(1)(B), (5)): permitted facilities treat by incineration or steam sterilisation. Waste treated on site to render it innocuous may go out as solid waste with a written certification to the hauler and landfill describing the waste and the treatment method; sharps stay in rigid, puncture-resistant containers even after treatment unless shredded.
  • Storage: the rule's 24-hour unrefrigerated and 72-hour refrigerated limits apply to processing facilities, not generators. Generators keep waste sealed, labeled and secure; hospital storage is governed by 19 CSR 30-20.021.

Source: Missouri DNR, 10 CSR 80-7.010, Infectious Waste Management.

Reviewed September 2026.

This summary is general information, not legal advice. Requirements change; we confirm what applies to your facility during onboarding.Regulations by state

Services in Missouri

  1. Regulated Medical Waste and Biohazard Waste DisposalScheduled or on-call pickup of regulated medical waste, also called biohazard or red bag waste, from healthcare facilities: compliant containers, permitted transport and a manifest for every collection.Red bag, cardboard box
  2. Sharps Waste DisposalSharps container supply, exchange and disposal for practices of every size, from a single dental office to a hospital network.Red sharps container
  3. Pharmaceutical Waste DisposalCompliant collection and disposal of expired, unused and partially used non-hazardous pharmaceuticals, with the right stream for each drug.Blue container
  4. Trace Chemotherapy Waste DisposalYellow-container collection for trace chemotherapy waste from oncology, infusion and specialty practices.Yellow container
  5. RCRA Hazardous Pharmaceutical WasteBlack-container programs for RCRA-listed and characteristic hazardous pharmaceutical waste, with generator-status guidance and cradle-to-grave documentation.Black container
  6. Pathological Waste DisposalDedicated, labeled collection for tissues, organs and surgical specimens from surgery centers, labs, dermatology practices and veterinary clinics.Red bag, pathology label

Facilities we serve in Missouri

All facility types

Missouri service questions

Do you serve every part of Missouri?

We coordinate service through a network of qualified providers, and coverage in Missouri is confirmed address by address. Tell us your address and operations confirms whether a route is available before anything is promised.

Which rules apply to medical waste in Missouri?

Medical waste is regulated at the state level, alongside the federal OSHA, DOT and EPA rules that apply everywhere. The summary above covers the Missouri requirements that most affect small and mid-size generators. See our regulations guide for the federal picture and links to every state.

What waste streams can you pick up in Missouri?

Regulated (biohazardous) medical waste, sharps, pharmaceutical waste, trace chemotherapy waste, RCRA hazardous pharmaceutical waste and pathological waste, subject to verification of each stream at onboarding.

We are under contract. Can we still talk?

Of course. Most facilities are. Share your renewal date and we will follow up before it, so you can compare options without being rushed.

Medical waste pickup in Missouri

Send us your facility list and current schedule. We reply with a clear quote and a start date operations has confirmed.