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Management of Regulated Medical Waste

The Virginia Regulated Medical Waste (RMW) Management Regulations (9VAC20-120) establish standards and procedures for the management of all RMW in order to protect public health and safety. Standards for the management of RMW include proper packaging, labeling, storage, transfer, treatment, and disposal. The regulations primarily affect generators, transporters, transfer stations, and treatment facilities managing regulated medical waste.

Types of solid wastes considered to be regulated medical waste include:

  •  cultures and stock of microorganisms and biologicals
  •  human blood and body fluids, and items contaminated with human blood or body fluids
  •  tissues and other anatomical wastes
  •  sharps (such as needles, syringes with attached needles, suture needles, and scalpels)
  •  animal carcasses and related wastes when animals are intentionally infected
  •  mixtures and residues of regulated medical waste (such as from cleanups of RMW spills)
  •  solid waste suspected by the health care professional in charge of being capable of producing infectious disease in humans

Certain solid wastes and other materials are exempt or excluded from management as RMW.

All RMW must be properly treated at a permitted RMW treatment facility (e.g. autoclave, incinerator) prior to disposal.. RMW treated in accordance with the requirements of the VA RMW Management Regulations is solid waste that can be disposed of at a solid waste management facility (e.g. landfill), provided the facility’s permit allows acceptance of the material.

Permitting for Regulated Medical Waste Management Facilities

Transfer Stations and Treatment Facilities for the management of regulated medical waste are required to obtain and operate under a permit-by-rule in accordance with the VA RMW Management Regulations, 9VAC20-120. RMW treatment facilities include any facility treating regulated medical waste through steam sterilization (autoclaving), incineration, and any other alternative treatment method.

Generators only storing regulated medical waste prior to treatment offsite may be exempt from permitting requirements provided the generator meets certain storage requirements.

Transporters of Regulated Medical Waste

RMW transporters are subject to all transportation requirements of the U.S. Department of Transportation’s Hazardous Materials Regulations (49 CFR Parts 171 through 180) as well as the Special Requirements for Transportation in Part VI (9VAC20-120-400 through 9VAC20-120-500) of the RMW Management Regulations.

Transporters of RMW are not required to register with DEQ or obtain a permit from DEQ as long as the transporter is not operating as a Transfer Station or Treatment Facility. Any vehicle containing RMW that is parked 24 hours or more during transport will be considered an RMW Transfer Station that requires a permit-by-rule.

Links and Information

Status of Amendment 3 to the RMW Regulations

The Virginia RMW Management Regulations (9VAC20-120) are currently being amended in order to modernize the standards for general handling and treatment of RMW based on industry best management practices. The goals of Amendment 3 of the RMW Regulations are to clarify the requirements for generators and permitted facilities, improve permitting procedures, and streamline the regulations for ease of use while still protecting natural resources and human health. No changes to the RMW regulations will be in effect until the full standard regulatory process is complete.

For information regarding Amendment 3 of the RMW Regulations, please visit the Virginia Regulatory Town Hall webpage. To receive email notifications of all regulatory actions, register as a public user on Virginia Regulatory Town Hall. This is a free service.


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Virginia Department of
Environmental Quality
P.O. Box 1105
Richmond, VA 23218
(804) 698-4000

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