A Guide to State-by-State Medical and Hazardous Waste Regulations in New England States


As humans, it is only natural to generate waste in our daily lives. In New England, waste we generate could do much damage if we do not take responsibility and manage it properly. Now, one essential sector that generates a lot of waste is the medical field. 

According to the United States Environmental Protection Agency (EPA), medical waste, also known as regulated medical waste, is healthcare waste contaminated by blood, bodily fluids, or other potentially infectious materials.

This type of waste is considered hazardous; however, not all medical waste is dangerous. A report by the World Health Organisation (WHO) states that only 15% of medical waste is bio-hazardous. 

Biohazardous waste is defined in the 1988 Medical Waste Tracking Act as waste generated during medical research, testing, diagnosis, immunization, or treatment of humans or animals. Culture dishes, bandages, gloves, and discarded sharps like needles or scalpels are examples of biohazardous waste.

Who Regulates Medical Waste?

From 1988 until 1991, the EPA was responsible for regulating and tracking medical waste. The Medical Waste Tracking Act of 1988 was effective in New York, New Jersey, and two states in New England (Connecticut and Rhode Island). The Act was able to achieve the following:

  • Define medical waste, and determine which medical wastes would be subject to program regulations.
  • Create a cradle-to-grave tracking system that would be responsible for tracking hazardous waste from its point of manufacture to its final disposal using a generator-initiated tracking form.
  • Manage and determine the standards for the segregation, packaging, labeling, marking, and storage of medical waste.
  • Establish requirements for record-keeping and sanctions for mismanagement of medical waste.

Since the medical waste disposal act expired in 1991, medical waste disposal has been primarily regulated by state environmental and health departments. Each state in the United States has its biomedical and general medical waste disposal regulations. They also have departments in charge of regulating this disposal. 

In New England, privately owned medical waste disposal services have been doing their bit to ensure that medical waste is properly disposed of.

What Is Regulated Medical Waste (RMW)?

Regulated medical waste is medical waste that requires special handling and treatment before disposal. Examples of solid waste materials that are considered regulated medical waste are;

  • Pathological waste
  • Sharps
  • Animal waste
  • Human blood and other bodily fluids
  • Cultures and stocks of infectious agents
  • Infectious isolation waste
  • Chemotherapy waste 

Medical Waste Regulation in New England

New England is comprised of Maine, New Hampshire, Vermont, Massachusetts, Connecticut, and Rhode Island. Since New England is a larger region, local  authorities pay extra attention to regulating waste in New England.  

Hence, the regulation of New England Waste Disposal is a collective effort of the individual states in the region.

Regulation of Medical Waste Disposal in Vermont

Waste Minimisation

Preventing waste minimization and pollution is the first step in managing RMW. This step includes recycling, source separation, product substitution, and using less toxic materials. 

All RMW generators are encouraged to conduct a waste minimization and pollution prevention audit for their facility.

Requirements for the Handling, Treatment, and Disposal of Regulated Medical Waste

Handling Requirements
  • The generator must label all containers with their generator’s name and address.
  • Containers must not leak when shipped.
  • Generators must not bulk transport untreated RMW, such as roll-off containers.
Treatment Requirements
  • When waste is delivered to a treatment facility, it must be date stamped.
  • Generators must dispose of pathological waste in a crematorium or a certified RMW treatment facility.
  • Operators must autoclave or treat all other RMWs with the approval of the Secretary.
  • Before disposal, all treated waste must be accompanied by a Certification of Treatment with the following information;
    • Date treated,
    • Name and address of treatment facility,
    • Contact person,
    • Method of treatment,
    • Signature of a duly authorized person, certifying waste was treated following the Treatment Standard, and
    • The technique employed in making the waste inaccessible.
Transport Requirements
  • Transporters of RMW, under the category of commercial haulers, must have a solid waste transporter permit and comply with the packaging requirements.  
  • Transporters must have a Certificate of Treatment in the vehicle during transportation and should not accept boxes showing signs of leakage.
Requirements for Disposal
  • Once RMW has been treated according to the Treatment Standard, it may be disposed of following the requirements at a certified solid waste discrete disposal facility. 
  • Sharps treated and rendered inaccessible may be mixed in with municipal solid waste.  
  • A Certificate of Treatment must accompany all treated waste offered for disposal. 
  • All in-state landfills must maintain Treatment Certification for one year.

Regulation of Infectious Waste Disposal in New Hampshire

Requirements for Collection, Storage, and Transfer of Infectious Waste

  • Facilities must store the waste in a predetermined location devoid of water, rain, and wind.
  • Storage containers and packaging must be labeled “infectious waste,” “bio-hazard waste,” or the universal biohazard symbol.
  • Waste stored at generator facilities must be preserved from rotting, with refrigeration used as needed.
  • Facilities must not store the waste at room temperature for more than 72 hours.
  • Outdoor waste storage areas, such as dumpsters, tractors, trailers, and other storage areas, must be secured to prevent unauthorized access.
  • Facilities must restrict unauthorized persons from gaining access to on-site storage areas. 
  • The waste must be protected from animals and should not be a breeding ground or food source for insects and rodents.
  • Storage containers and packaging must have the sufficient structural integrity to prevent waste from being released into the environment during storage.
  • The contents of damaged containers must be repackaged.
  • The generator shall transfer infectious waste only to authorized facilities.
  • Facilities that receive infectious waste from off-site generators must not store the waste for more than seven days.

Requirements for Processing and Treatment of Infectious Waste

  • The infectious waste generator must treat the waste at an authorized facility to achieve high-level disinfection. 
  • All infectious waste managed by the facility must be collected and stored per the regulations, pending treatment.
  • If the facility uses a different method from incineration to process or treat infectious waste, that method’s effectiveness must be tested. Alternatively, if the facility uses an incinerator to treat infectious waste through combustion, it must comply with all relevant regulations.
  • Unless authorized by the receiving disposal facility, infectious waste that has been properly handled per the requirements must not be mixed with other garbage before disposal.

Requirements for Disposal of Infectious Waste

  • In New Hampshire, infectious waste cannot be landfilled unless it has been treated to the standards outlined in the regulations.
  • Only authorized establishments may dispose of treated infectious waste.
  • Before disposing of treated infectious waste, the transporter must inform the receiving institution.
  • Under local sewage regulations, liquid infectious waste may only be disposed of through a sanitary sewer, provided the receiving wastewater treatment plant also offers secondary treatment.

Regulation of Biomedical Waste Disposal in Maine

Maine’s biomedical waste rules require biomedical waste generators to be registered. It also establishes requirements for biomedical waste packaging, labeling, handling, storage, transportation, treatment, and disposal.

Moreover, it necessitates the acquisition of a license by all transporters and owners or operators of transfer facilities or treatment and disposal facilities.

Treatment and Disposal Methods for Biomedical Waste

Biomedical waste must be treated or disposed of as follows:

  • Pathological waste must be either incinerated or buried.
  • Discarded blood, blood products, and body fluids shall be:
    • Incinerated or
    • Discharged through a sewer to a publicly owned treatment works (POTW) as long as the Clean Water Act and local ordinances are followed.
  • All other biomedical waste shall be incinerated.
  • All biomedical waste incinerators must be licensed. 
  • Existing facilities obtaining a license may accept biomedical waste generated on or off-site for treatment.

In addition, an individual may appeal to the board for permission to use another method asides from incineration. 

Medical Waste Disposal in Massachusetts

Massachusetts emphasizes the storage, shipping, and disposal of all medical waste, particularly potentially infectious or hazardous waste. According to Massachusetts regulations, generators must properly prepare biological waste and get their shipping papers in order. Massachusetts also requires that federal hazardous material transportation laws and regulations be followed.

Furthermore, Massachusetts regulations require that logs be kept for any medical or biological waste transported off-site for treatment. The logs that are kept are mandated to contain the following details;

  • The kind of waste
  • Shipment date
  • Number of containers in total
  • Total weight or volume combined

Massachusetts may approve additional methods for disposal provided the method has been verified through scientific studies; the waste treatment facility has been approved by the Department of Environmental Protection (DEEP) or any other appropriate regulatory agency.

Medical Waste Disposal in Rhode Island

Rhode Island is particularly keen on the state’s medical waste disposal and destruction. In this manner, the destruction of medical waste in Rhode Island is only done by Incineration or Steam sterilization.


As regards incineration requirements, the generators must keep an operating log at the facility that is pertinent to the operation of the facility. In addition, they must maintain the operating log for at least three years and submit copies of this report to the Rhode Island Department of Environmental Management.

Steam Sterilization

Steam sterilization converts untreated regulated medical waste into treated regulated medical waste. The following regulations apply to any steam sterilizer used to treat medical waste:

  • The sterilizers must only be used for waste.  
  • They must be operated by the manufacturer’s waste specifications as long as these specifications change the biological character or composition of the regulated medical waste to significantly reduce or eliminate its potential for disease transmission.
  • If no waste manufacturer’s specifications exist, the operator must prove any other combination of time, temperature, pressure, and capacity through extensive testing.
  • Medical waste that is regulated must be steam-sterilized in its primary container.
  • Unless a steam sterilizer is equipped to monitor and record temperatures throughout each sterilization cycle continuously, the operator must affix temperature-sensitive tape to the primary container to indicate when the desired temperature is reached.
  • Tests must be performed at least once every forty hours to determine the efficiency of the sterilizing process.
  • A log must be maintained recording such evaluations and calibration dates and results.
  • The generator must keep the log book from the previous log entry for at least three years. 

Disposal of Biomedical Waste in Connecticut

Connecticut uses various methods to dispose of different types of medical waste. Here’s a brief rundown. 

  • Incineration is used to dispose of chemotherapy waste.
  • Pathological waste (human tissue, organs, and body parts) is either incinerated or buried.
  • Infectious waste (body fluids, discarded sharps, biological waste generated from research) is disposed of by incineration, sanitary sewer discharge, or treatment with steam sterilization or other approved alternative treatment technology (ATT).
  • These disposal requirements do not apply to syringes designed to deliver drugs into the human body in ways other than injection.

What Is Hazardous Waste?

Hazardous waste is waste that possesses the tendency to harm human health and the environment. Hazardous waste can come in various forms, including liquids, solids, gases, and sludges. 

Hazardous waste is regulated by the Resource Conservation and Recovery Act (RCRA). This Act adequately described the waste management program for hazardous and non-hazardous solid waste.

State and Federal Hazardous Waste Regulations

Hazardous waste is regulated following Subtitle C of RCRA. In this case, the EPA may grant the states permission to carry out important hazardous waste standards without the federal government’s involvement. 

The EPA enforces the state’s waste regulations if there is no active hazardous waste program in that state. However, state hazardous waste programs take precedence over federal regulations if they exist.

Subtitle C sets regulations for facilities that generate, transport, treat, store, and dispose of hazardous materials. 

Hazardous waste regulation in New England is an outgrowth of federal hazardous waste regulations. Each of New England’s states has its own rules that the state’s environmental health agency enforces.

Discussed below are the different hazardous waste regulations of states in New England.

Hazardous Waste Regulations in Vermont

Vermont has a hazardous waste management program that regulates the generation, transportation, storage, treatment, recycling, and disposal of hazardous waste. This program includes the following regulations:

  • The evaporation of hazardous waste is prohibited in Vermont.
  • Releasing hazardous materials to groundwater or state land is prohibited.
  • When completing a manifest, a generator must use the EPA identification number assigned to the generator site at the time of shipment.

Hazardous Waste Regulations in New Hampshire

In the state of New Hampshire, infectious waste disposal is subject to the following rules: 

  • Waste packing must be leakproof.
  • Waste cannot be stored for more than 72 hours at room temperature.
  • Waste must be clearly labeled as infectious or biohazardous waste.

In addition, New Hampshire does not require medical waste transporters to carry manifests or special licensing. However, states that haulers pass through must follow the hazardous waste regulations of the federal Department of Transportation.

Hazardous Waste Disposal in Maine

Hazardous waste is disposed of by the health and environmental agencies in Maine. Household hazardous materials are collected at the Environmental Depot in Lewiston and The Riverside Recycling Facility in Portland.

Some common regulations regarding hazardous waste in Maine include:

  • Except for small-quantity generators, no one shall generate hazardous waste without first obtaining a generator identification number specific to the site of waste generation.
  • A generator may not provide hazardous wastes to a transporter unless the transporter has obtained an identification number. 
  • A generator may not provide hazardous wastes to a disposal facility unless the disposal facility has obtained an identification number or is exempt from the requirement for such a number.
  • A generator shall retain a copy of all test results, waste analyses, and other pertinent findings for at least ten (10) years after the waste was last sent to on-site or off-site disposal.
  • A generator must keep the necessary log books for at least one (1) year. 

Hazardous Waste Regulation in Massachusetts

The state of Massachusetts takes extra caution in handling, treating, and tracking hazardous waste. Some key requirements to note from the handbook include the following;

Requirements for Transporting Hazardous Waste

Unless exempted by 310 CMR 30.401, no one shall transport hazardous waste without first obtaining and maintaining the following:

  • An identification number from the Department’s EPA.
  • A valid permit from the Department to transport hazardous waste.
  • A written certification from The Massachusetts Department of Telecommunications and Energy.
  • Written proof of taking the hazardous waste transporter training.
  • Any vehicle used by the licensee to transport hazardous waste must have a vehicle identification device.

Hazardous Waste Regulation in Rhode Island

Rhode Island employs the use of the national hazardous waste manifest. However, there are few regulations peculiar to the state. These include, but are not limited to:

  • All waste containers must be kept closed and only opened when necessary to add or remove waste.
  • Transfer any hazardous waste in a compromised container to one that is in good condition and is compatible with containing the hazardous waste.
  • Containers containing ignitable or reactive waste must be at least 50 feet from the treatment facility.
  • Generators should conduct a weekly inspection of the storage area to look for leaks or deterioration of hazardous waste containers, and the results should be documented.

Hazardous Waste Regulation in Connecticut

These are general waste management regulations for Connecticut state.

  • A generator shall not offer hazardous waste to a transporter with no current valid transporter permit.
  • If the generator is located in Connecticut, the generator must send a copy to the commissioner within seven days of the transporter accepting and signing the manifest.
  • If the transporter was given an oral instruction, it should be followed by written communication to the transporter and the commissioner within three days, containing the same instructions.
  • Primary exporters must comply with the Notification Notifications of Intent to Export, Exception Reports, and Annual Reports Requirements in 40 CFR 262.53, 262.55, and 262.56, respectively.

Connecticut’s book of regulations explains the above rules in more detail. 


The regulation of medical and hazardous waste in New England waste disposal is a priority of the Federal and State governments. Due to the collaborative effort between both levels, most states abide by the Federal Rules of hazardous waste management, tracking, and disposal or make slight variations to protect the environment.

All in all, the efficient tracking and management of hazardous waste has greatly improved residents’ quality of life and the environment at large.

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