ILLINOIS POLLUTION CONTROL BOARD
May
14, 1981
In The Matter Of:
)
Hazardous Hospital Wastes,
)
R80—19
Sections
3(jj)
and 21(h) of the
)
Environmental Protection Act
)
ADOPTED RULE.
FINAL ORDER.
FINAL ORDER OF THE BOARD
(by J.
Anderson):
The Board hereby adopts the following new Part IX to Chapter
9.
As a result of a suggestion made by the Joint Committee on
Administrative Rules
(JCAR) during the second notice period, the
word “enforcement” has been inserted before the word “action” in
Rule 906.
No other changes have been made.
The JCAR has stated
that it has no objection to these rules.
The Clerk is directed to
file these rules with the Secretary of State.
They shall become
effective May
31,
1981.
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
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.
Reg.
553 et seq.
(1981),
as from time to time amended, and
41—455
nedical and patient care items that are contaminated by ~r
have been
in contact with, either the wound or skin of
patients who have been placed
in wound or skin isolation ~r
strict isolation,
or the mucous or other respiratory
fluids
oC patients who have been placed in respiratory isolation
or strict isolation by the hospital’s Infection Control
Committee pursuant to the infection control polictes and
procedures required of
it by Section D of Part IX of
the
Rules of the Illinois Department of Public Health,
4 Iii.
Reg.
553 et seq.
(1981),
as from time to time amended,
an~3
c.
medical and patient care items contaminated during surqery
when the case is infectious,
and
d.
tissues
(human or animal), pathological waste, and iter~s Lb
are contaminated by an infectious
agent,
and
e.
bacteriological cultures and blood or other excreta that
ir~~
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 ir~fection
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
111.
Reg.
553 et seq.
(1981),
as from time to time amended.
“HOSPITAL” means any institution,
place, building,
or agerlcj,
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
hones, 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 ~.iastc
which has been properly sterilized or incinerated
so as to render
it incapable of causing infection.
“NORMAL HOSPITAL WASTE” is not a special waste, hut for the
purposes
of this Part IX includes, but is not limited to,
garhaqo,
refuse,
such as packaging materials removed before a product
reaches patient care areas; disposable medical and patient care
4 1—456
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 microorgan-
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 he deposited in any landfill.
h.
Hazardous
(infectious) hospital waste shall be rendered
innocuous pursuant to Rules
903 and 904, or may be 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 sewerage
system.
Rule 903
Rendering hazardous
(infectious) hospital 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 verified
at least weekly with a biological spore assay containing
B.
stearothermophilus, or
b.
Sterilization of the waste in a commercial ethylene oxide
unit that provides controlled temperature and humidity
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 biological
spore assay containing B.
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:
4 1—457
4
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 hazardou’;
(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
he
a
complete
defense
to
an
enforcement
action
against
a
person
other
than
the
waste
generator
for
violation
of
Rule
902(a).
Mr.
Werner
concurs.
IT
IS
SO
ORDERED.
I,
Christan L. Moffett,
Clerk of the Illinois Poiltition
Control Board, hereby certify that the above Order was, adopted
on
the
(4
day of
~
1981,
by
a
vote
of
~
~Y_\
~4/~A
ristan L. Moffett,~Clerk
Illinois Pollution Gofttrol Boarl
4~—458