Medical Waste Tracking Act
Encyclopedia
The Medical Waste Tracking Act of 1988 is a United States federal law that addressed the handling and disposal of medical waste
Medical waste
Medical waste, also known as clinical waste, normally refers to waste products that cannot be considered general waste, produced from healthcare premises, such as hospitals, clinics, doctors offices, veterinary hospitals and labs.-Europe:...

 in coastal areas. The law created a two year program that went into effect in New York
New York
New York is a state in the Northeastern region of the United States. It is the nation's third most populous state. New York is bordered by New Jersey and Pennsylvania to the south, and by Connecticut, Massachusetts and Vermont to the east...

, New Jersey
New Jersey
New Jersey is a state in the Northeastern and Middle Atlantic regions of the United States. , its population was 8,791,894. It is bordered on the north and east by the state of New York, on the southeast and south by the Atlantic Ocean, on the west by Pennsylvania and on the southwest by Delaware...

, Connecticut
Connecticut
Connecticut is a state in the New England region of the northeastern United States. It is bordered by Rhode Island to the east, Massachusetts to the north, and the state of New York to the west and the south .Connecticut is named for the Connecticut River, the major U.S. river that approximately...

, Rhode Island
Rhode Island
The state of Rhode Island and Providence Plantations, more commonly referred to as Rhode Island , is a state in the New England region of the United States. It is the smallest U.S. state by area...

 and Puerto Rico
Puerto Rico
Puerto Rico , officially the Commonwealth of Puerto Rico , is an unincorporated territory of the United States, located in the northeastern Caribbean, east of the Dominican Republic and west of both the United States Virgin Islands and the British Virgin Islands.Puerto Rico comprises an...

 on June 24, 1989, and expired on June 21, 1991.

History

Beginning on August 13, 1987, a “30-mile garbage slick” composed primarily of medical
Medical waste
Medical waste, also known as clinical waste, normally refers to waste products that cannot be considered general waste, produced from healthcare premises, such as hospitals, clinics, doctors offices, veterinary hospitals and labs.-Europe:...

 and household wastes prompted expansive closures of numerous New Jersey
New Jersey
New Jersey is a state in the Northeastern and Middle Atlantic regions of the United States. , its population was 8,791,894. It is bordered on the north and east by the state of New York, on the southeast and south by the Atlantic Ocean, on the west by Pennsylvania and on the southwest by Delaware...

 and New York
New York
New York is a state in the Northeastern region of the United States. It is the nation's third most populous state. New York is bordered by New Jersey and Pennsylvania to the south, and by Connecticut, Massachusetts and Vermont to the east...

 beach
Beach
A beach is a geological landform along the shoreline of an ocean, sea, lake or river. It usually consists of loose particles which are often composed of rock, such as sand, gravel, shingle, pebbles or cobblestones...

es . Investigations ongoing throughout the year indicated that the waste likely originated from “New York City
New York City
New York is the most populous city in the United States and the center of the New York Metropolitan Area, one of the most populous metropolitan areas in the world. New York exerts a significant impact upon global commerce, finance, media, art, fashion, research, technology, education, and...

’s marine transfer stations
Marine transfer operations
Marine Transfer Operations are conducted at many ports around the world between tanker ships, barges, and marine terminals. Specifically, once the marine vessel is secure at the dock a loading arm or transfer hose is connected between a valve header on the dock and the manifold header on the vessel...

 … and the Southwest Brooklyn Incinerator and Transfer Station in particular…” The then-assistant commissioner of the New Jersey Department of Environmental Protection
New Jersey Department of Environmental Protection
The New Jersey Department of Environmental Protection is a government agency in the U.S. state of New Jersey that is responsible for managing the state's natural resources and addressing issues related to pollution...

 stated his belief that the cause of pollution
Pollution
Pollution is the introduction of contaminants into a natural environment that causes instability, disorder, harm or discomfort to the ecosystem i.e. physical systems or living organisms. Pollution can take the form of chemical substances or energy, such as noise, heat or light...

 was intentional rather than accidental; “sealed plastic garbage bags, he said, were cut at the top, so their contents could disperse through the ocean.” Such a deliberate action may have arisen given the high cost (~$1500/ton) associated with the legal disposal of the waste, thus incentivizing private waste contractors to dump illegally to avoid high fees.

Ultimately the Medical Waste Tracking Act of 1988 (MWTA) arose from the aftermath of this situation. It was designed primarily to monitor the treatment of medical wastes through their creation, transportation and destruction, i.e. from “cradle-to-grave.” Congress
United States Congress
The United States Congress is the bicameral legislature of the federal government of the United States, consisting of the Senate and the House of Representatives. The Congress meets in the United States Capitol in Washington, D.C....

 approved the bill “to amend the Solid Waste Disposal Act to require the Administrator of the Environmental Protection Agency (EPA) to promulgate regulations on the management of infections waste.” In short, Congress enacted the MWTA as a pilot study to better determine how the life cycle of medical wastes played out under federal regulations.

Definitions

Section 11002 of the MWTA, “Listing of Medical Wastes,” provides a listing of definitions on what materials will be classified as “medical wastes” under the act. The list includes within its definitions: “cultures and stocks of infectious agents,” “pathological wastes” such as body tissues, blood wastes and blood byproducts, sharps
Sharps waste
Sharps waste is a form of medical waste composed of used sharps, which includes any device or object used to puncture or lacerate the skin. Sharps waste is classified as biohazardous waste and must be carefully handled...

, contaminated carcasses and beddings of animals, surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 or autopsy
Autopsy
An autopsy—also known as a post-mortem examination, necropsy , autopsia cadaverum, or obduction—is a highly specialized surgical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present...

 wastes that were once in contact with infectious agents, “laboratory wastes,” “dialysis wastes that were in contact with the blood of patients undergoing hemodialysis
Hemodialysis
In medicine, hemodialysis is a method for removing waste products such as creatinine and urea, as well as free water from the blood when the kidneys are in renal failure. Hemodialysis is one of three renal replacement therapies .Hemodialysis can be an outpatient or inpatient therapy...

,” medical equipment
Medical equipment
Medical equipment is designed to aid in the diagnosis, monitoring or treatment of medical conditions.-Types:There are several basic types:* Diagnostic equipment includes medical imaging machines, used to aid in diagnosis...

 having come in contact with infectious agents, and further contaminated biological materials. Defining what objects were to be classified as medical wastes was crucial to ensure that all municipalities
Local government in the United States
Local government in the United States is generally structured in accordance with the laws of the various individual states. Typically each state has at least two separate tiers: counties and municipalities. Some states have their counties divided into townships...

 under the MWTA would be monitoring similar materials.

Management and tracking

Section 11003, “Tracking of Medical Waste,” outlined how the program should manage the transportation of waste materials. Four requirements were primarily identified; first, to provide a means of monitoring “the transportation of waste from the generator to the disposal facility” unless said waste had previously been incinerated
Incineration
Incineration is a waste treatment process that involves the combustion of organic substances contained in waste materials. Incineration and other high temperature waste treatment systems are described as "thermal treatment". Incineration of waste materials converts the waste into ash, flue gas, and...

. Secondly, to be able to ensure the “generator of the waste” that the waste had been “received by the disposal facility.” Next to develop a uniform form for the tracking of materials across states and finally to develop a means to label and contain the wastes for the safety of the handlers.

Following this, Section 11004 on “Inspections” provides provisions allowing for agents of the EPA to “enter… any establishment… where medical wastes are or have been generated” so as to conduct “monitoring”, “testing”, or to “obtain samples from any person.”. This process would allow for the Agency to legally enter generating facilities for the purpose of determining if infectious agents and materials were being handled as prescribed by the EPA Administrator.

Enforcement

A major point of importance within the MWTA involves its inclusion of enforcement laws within the legislation
Legislation
Legislation is law which has been promulgated by a legislature or other governing body, or the process of making it...

. This becomes notable as it allows for one of the first instances in which an agency of the federal government
Federal government of the United States
The federal government of the United States is the national government of the constitutional republic of fifty states that is the United States of America. The federal government comprises three distinct branches of government: a legislative, an executive and a judiciary. These branches and...

 may prosecute those charged with violation of regulations dealing with medical wastes. Following enactment of the MWTA the EPA Administrator may be allowed to “commence civil action in the United States district court
United States district court
The United States district courts are the general trial courts of the United States federal court system. Both civil and criminal cases are filed in the district court, which is a court of law, equity, and admiralty. There is a United States bankruptcy court associated with each United States...

 in the district in which the violation occurred” against those being charged with the violation.

Penalties ranged based on the level of violation, whether it was done with intention, and if such acts endangered the lives of other individuals. Minor violations of compliance orders
Compliance (regulation)
In general, compliance means conforming to a rule, such as a specification, policy, standard or law. Regulatory compliance describes the goal that corporations or public agencies aspire to in their efforts to ensure that personnel are aware of and take steps to comply with relevant laws and...

 would have resulted in a fine of $25,000 per day of “continued noncompliance.” Criminal penalties against those knowingly and intentionally violating the regulations of the MWTA may face two years of imprisonment
Imprisonment
Imprisonment is a legal term.The book Termes de la Ley contains the following definition:This passage was approved by Atkin and Duke LJJ in Meering v Grahame White Aviation Co....

 or a $50,000 fine while those guilty of knowingly endangering the life of another through noncompliance may face upwards of fifteen years imprisonment and a $1,000,000 fine.

Outcomes

Through the information gathered during the promulgation of regulations for the MWTA, over a period of ten years the EPA eventually "concluded that the disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...

-causing potential of medical waste is greatest at the point of generation and naturally tapers off after that point... Thus, risk to the general public of disease caused by exposure to medical waste is likely to be much lower than risk for the occupationally exposed individual."

See also

  • Resource Conservation and Recovery Act
    Resource Conservation and Recovery Act
    The Resource Conservation and Recovery Act , enacted in 1976, is the principal Federal law in the United States governing the disposal of solid waste and hazardous waste.-History and Goals:...

    - current U.S. federal law regulating medical waste
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