ILLINOIS

POLLUTION CONTROL BOARD

March

19,

1981

In The Matter Of:

)

Hazardous Hospital Wastes,

)

R80-19

Sections

3(jj)

and 21(h)

of the

Environmental Protection Act

)

PROPOSED RULE.

SECOND NOTICE.

ORDER OF THE BOARD

(by 3. Anderson):

On December 18,

1980, the Board ordered publication, for

public hearings and comment,

of the First Notice of

a new Part

IX to Chapter

9:

Special Waste.

These proposed rules were pub-

lished in the Environmental Register #330,

January

6,

1981 and

in the Illinois Register, Vol.

5,

Pp.

14—17, January

2,

1981.

After reviewing the record of hearings held in this proceeding

on January

26,

1981

(Springfield) and January

28,

1981

(Chicago),

and subsequent written comments, the Board has made some changes

in language,

for the reasons expressed in the accompanying Opinion

of the Board.

The Board therefore directs that second notice of

these proposed rules be submitted to the Joint Committee on

Administrative Rules.

The Board proposes to adopt

a new Part IX to Chapter

9:

Special Waste to read as follows:

Chapter

9:

Special Waste

Part IX

Hazardous (infectious) Hospital Waste

Rule 901 Definitions

For the purposes of

this

Part IX of Chapter

9 only:

“HAZARDOUS (infectious) HOSPITAL WASTE” means waste which

has been generated by a hospital in connection with patient

care that is contaminated with or may be contaminated with an

infectious agent that has the potential of inducing an infection

and which has not been rendered innocuous by sterilization or

incineration.

More specifically,

“HAZARDOUS

(infectious) HOSPITAL

WASTE” means:

a.

medical and patient care items contaminated by, and human

excreta produced by,

persons who have been placed in strict

or enteric isolation for the control and treatment of an

4 1—145

---

infectious disease by the hospital’s Infection Control Commit-

tee pursuant to the infection control policies and procedures

required of

it by Section D of Part IX of the Rules of the

Illinois Department of Public Health,

4 Ill.

Req.

553 et seq.

(1981),

as from time to time amended,

and

h.

medical and patient care items that are contaminated by or

have been in contact with,

either the wound or skin of

patients who have been placed in wound or skin isolation or

strict isolation,

or the mucous or other respiratory fluids

of patients who have been placed in respiratory isolation

or strict isolation by the hospital’s Infection Control

Committee pursuant to the infection control policies and

procedures required of

it by Section D of Part IX of the

Rules of the Illinois Department of Public Health,

4

Ill.

Req.

553 et

seq.

(1981),

as from time to time amended, and

c.

medical and patient care items contaminated during suryery

when the case is infectious,

and

d.

tissues

(human or animal), pathological waste, and items that

are contaminated by an infectious agent,

and

e.

bacteriological cultures and blood or other excreta that are

products from bacteriological testing, and

f.

any other waste which, because of its infectious nature,

is

ordered to receive special handling and disposal by the hos-

pital’s Infection Control Committee pursuant to the infection

control policies and procedures required of

it by Section D

“Infectious Control” of Part IX of the Rules of the Illinois

Department of Public Health,

4 Ill.

Reg.

553 et seq.

(1981),

as

from time to time amended.

“HOSPITAL” means any institution, place, building, or agency,

public or private, whether organized for profit or not, devoted

primarily to the maintenance and operation of facilities for the

diagnosis and treatment or care

of two or more unrelated persons

admitted for overnight stay or longer in order to obtain medical,

including obstetric,

psychiatric and nursing, care of illness,

disease,

injury,

infirmity,

or deformity.

“HOSPITAL” includes

general and specialized hospitals,

tuberculosis sanitaria,

mental

or psychiatric hospitals and sanitaria, maternity homes,

lying-in

homes,

and homes

for unwed mothers

in which care is given during

delivery.

“HOSPITAL” does not include,

for example, nursing

homes, offices of human or animal health care providers, out-

patient clinics,

or veterinary hospitals.

“INCINERATION” means the complete reduction

of a substance

to ashes by means of combustion.

“INNOCUOUS HOSPITAL WASTE”

is not a special waste, hut for

the purposes of this Part IX means any hazardous hospital waste

which has been properly sterilized or incinerated so as to render

it incapable of causing infection.

41—146

---

“NORMAL HOSPITAL WASTE” is not

a special waste, hut for

the

purposes of this Part IX includes, but

is not limited to, garbage,

refuse, such as packaging materials removed before a product

reaches patient care areas;

disposable medical and patient care

items such as basins and water pitchers which have

not

come in

contact with a patient in isolation;

and facial tissue and other

patient contact items which have not been generated by

a patient

in isolation.

“STERILIZATION” means the complete destruction of microorgart-

isms by moist or dry heat or by bactericidal chemical compounds.

Rule 902

Disposal methods for hospital waste

a.

No person shall cause or allow hazardous

(infectious)

hospital waste to be deposited in any landfill.

b.

Hazardous

(infectious) hospital waste

shall he rendered

innocuous pursuant to Rules

903 and

904,

or may he disposed

of, where

lawful, by deposit into a municipal or private

sewerage system.

c.

Innocuous hospital waste and normal hospital waste may he

disposed of by any lawful means,

including incineration in

any incinerator appropriate

for such waste and for which

the Agency has issued

a permit,

by deposit in any sanitary

landfill or by deposit into a municipal

or private

sewer tqe

system.

Rule 903

Rendering hazardous (infectiou~

ital waste

innocuous by sterilization

Any hazardous

(infectious) hospital waste may be rendered

an innocuous hospital waste by:

a.

Sterilization of

the waste

in an autoclave, provided that

the unit

is operated

in accordance with

the

manufacturer’s

recommendations and the autoclave’s effectiveness

is ~.rerified

at least weekly with a biological

spore assay containing

B.

stearothermophilus, or

h.

Sterilization of the waste in a commercial ethylene

ce~IJe

unit that provides controlled temperature and humility

conditions,

provided

that

the

unit

is

operated

in

accordance

with

the

manufacturer’s

recommendations

and

the

unit’s

effectiveness

is

verified

during

each

use

with

a

bioloqic:~1

spore assay containing 13.subtilis.

Rule 904

Rendering hazardous

(infectious) hospital

waste

innocuous by incineration

a.

Any hazardous

(infectious) hospital waste may be

rendered

an innocuous hospital waste by incineration provided that:

41—147

---

1.

The combustion apparatus is an incinerator

designed to destroy the type or class of waste

introduced into it, and is operated according

to the manufacturer’s instructions, and

2.

All permits required by Chapter

2 have been

obtained from the Agency,

and the conditions

of those permits have been met.

b.

The ash produced by the incineration of hazardous

(infectious)

hospital waste shall be disposed of as required by the Rules

of this Chapter and Chapter

7 for disposal of any other

incinerator

ash.

Rule 905

Recordkeeping requirements

for generators of hazardous

(infectious) hospital waste

a.

Generators of hazardous

(infectious) hospital waste who

render such waste into innocuous hospital waste

shall keep

and make reasonably available for Agency inspection:

1.

Records

of any required biological

spore assay

tests.

2.

Records describing the approximate amount of

waste sterilized or incinerated.

3.

Records which demonstrate proper operation of the

sterilization or incineration equipment

(such

as

time and temperature maintenance for each load).

b.

The requirements of Rule 905(a)

may be satisfied by

maintenance of the records

in the form required to be

kept

by any hospital licensing or accreditation body, provided

that such records

include information sufficient to comply

with subsection

(a).

Rule 906

Defense

to enforcement action

Reasonable reliance on a waste generator’s identification of

waste as innocuous or normal hospital waste shall be

a complete

defense to

an action against

a person other than the waste genera-

tor for violation of Rule 902(a).

Mr.

Werner concurred.

IT IS SO ORDERED.

I, Christan L. Moffett,

Clerk of the Illinois Pollution

Control Board, hereby certify that the above Order was adopted

on the

~

day of

~

1981,

by

a vote of

___

~‘.

/\~~L

~

~

Christan L. Mofffe~Clerk

41-148

Illinois Pollution Control Board