Medical waste regulations by state
Medical waste is regulated state by state, with a handful of federal rules layered on top. This guide explains the federal layer in plain language, what a state rule usually covers, and links to the summary for every state.
The federal rules that apply everywhere
States regulate medical waste, not the EPA
The federal Medical Waste Tracking Act expired in 1991. Since then each state health or environmental agency defines what counts as regulated medical waste, how long it can be stored on site, who may transport it and how it must be treated. That is why the same dental office has different obligations in Texas and in New York, and why every state page on this site carries its own summary.
OSHA Bloodborne Pathogens standard (29 CFR 1910.1030)
Applies to every employer whose staff can be exposed to blood or other potentially infectious materials. It sets the rules for sharps containers, red bags and biohazard labels, the exposure control plan, training and record keeping inside the facility. OSHA does not regulate what happens after the waste leaves your door.
DOT hazardous materials rules (49 CFR 173.134 and 173.197)
Regulated medical waste is a Division 6.2 infectious substance in transport. The rules cover packaging, marking, shipping papers and the permits a hauler needs. Your transporter is responsible for meeting them; the shipping paper or manifest you receive is part of that record.
EPA RCRA Subpart P (40 CFR part 266, subpart P)
In force since 2019 for healthcare facilities and reverse distributors that generate hazardous waste pharmaceuticals. It bans flushing hazardous waste pharmaceuticals down the drain nationwide and sets simplified accumulation, labeling and shipping rules for facilities that opt in. States adopt it on their own schedules.
DEA rules for controlled substances (21 CFR part 1317)
Expired or unwanted controlled substances follow DEA disposal rules, separate from medical waste rules, and go through a DEA registrant such as a reverse distributor. They are not part of a regulated medical waste pickup.
What a state rule usually covers
- Definitions: which materials count as regulated (biohazardous, infectious, special) medical waste
- Generator registration or notification, sometimes only above a monthly weight threshold
- On-site storage limits: maximum days at room temperature and when refrigeration is required
- Container, bag and labeling requirements beyond OSHA's
- Transporter permits or registration and vehicle requirements
- Approved treatment methods (autoclave, incineration, alternative technologies) and treatment-facility permits
- Manifests, tracking documents and how long records must be kept
- Rules for sharps and pharmaceutical waste from small generators and households
Regulations by state
States marked with a green dot have a written summary with agency sources. The rest carry a general note until their summary is published.
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- District of Columbia
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
Common questions
Is there one federal medical waste law?
No. The federal Medical Waste Tracking Act expired in 1991 and the EPA has not regulated medical waste since. OSHA, DOT, EPA (for hazardous pharmaceutical waste) and the DEA (for controlled substances) each cover one part; the state rule covers the rest.
How do I know which state rules apply to my facility?
Start with the state page linked below. Each carries a summary of the requirements that most affect small and mid-size generators and links to the agency source. We confirm what applies to your facility, including any county or city rules, during onboarding.
Does Clean Waste Medical tell me whether I am compliant?
Not on a first call. We describe what the rules require and set up documentation that supports your compliance file. Any statement about your facility's compliance comes only after qualified personnel have reviewed the facts.
Need a program that matches your state's rules?
Tell us your state, facility type and waste streams. We reply with a clear quote and the documentation your compliance file needs.