(1) A TBI
residential home must develop, maintain and implement written policies and
procedures for the definition and handling of its infectious waste. These
policies and procedures must comply with the standards of this rule.
The following waste shall be considered
to be infectious waste:
contaminated by residents who are isolated due to communicable disease, as
provided in the U.S. Centers for Disease Control "Guidelines for Isolation
Precautions in Hospitals";
Cultures and stocks of infectious agents including specimen cultures collected
from medical and pathological laboratories, cultures and stocks of infectious
agents from research and industrial laboratories, wastes from the production of
biologicals, discarded live and attenuated vaccines, and culture dishes and
devices used to transfer, inoculate, and mix cultures;
(c) Waste human blood and blood products such
as serum, plasma, and other blood components;
(d) Pathological waste, such as tissues,
organs, body parts, and body fluids that are removed during surgery and
(e) All discarded sharps
(e.g., hypodermic needles, syringes, Pasteur pipettes, broken glass, scalpel
blades) used in resident care or which have come into contact with infectious
agents during use in medical, research, or industrial laboratories;
(f) Other waste determined to
be infectious by the TBI residential home in its written policy.
(3) Infectious and hazardous waste
must be segregated from other waste at the point of generation (i.e., the point
at which the material becomes a waste) within the TBI residential
Waste must be packaged in
a manner that will protect waste handlers and the public from possible injury
and disease that may result from exposure to the waste. Such packaging must
provide for containment of the waste from the point of generation up to the
point of proper treatment or disposal. Packaging must be selected and utilized
for the type of waste the package will contain, how the waste will be treated
and disposed, and how it will be handled and transported, prior to treatment
(a) Contaminated sharps must be
directly placed in leak proof, rigid, and puncture - resistant containers which
must then be tightly sealed.
Whether disposable or reusable, all containers, bags, and boxes used for
containment and disposal of infectious waste must be conspicuously identified.
Packages containing infectious waste which pose additional hazards (e.g.,
chemical, radiological) must also be conspicuously identified to clearly
indicate those additional hazards.
(c) Reusable containers for infectious waste
must be thoroughly sanitized each time they are emptied, unless the surfaces of
the containers have been completely protected from contamination by disposable
liners or other devices removed with the waste.
(d) Opaque packaging must be used for
After packaging, waste must be handled and transported by methods ensuring
containment and preservation of the integrity of the packaging, including the
use of secondary containment where necessary. Plastic bags of infectious waste
must be transported by hand.
Waste must be stored in a manner which preserves the integrity of the
packaging, inhibits rapid microbial growth and putrefaction, and minimizes the
potential of exposure or access by unknowing persons.
(a) Waste must be stored in a manner and
location which affords protection from animals, precipitation, wind, and direct
sunlight, does not present a safety hazard, does not provide a breeding place
or food source for insects or rodents, and does not create a
(b) Pathological waste
must be promptly treated, disposed of, or placed into refrigerated
event of spills, ruptured packaging, or other incidents where there is a loss
of containment of waste, the TBI residential home must ensure that proper
actions are immediately taken to:
the area from the public and all except essential personnel;
(b) To the extent practicable, repackage all
spilled waste and contaminated debris in accordance with the requirements of
paragraph (4) and/or (6) of this rule;
(c) Sanitize all contaminated equipment and
surfaces according to written policies and procedures which specify how this
will be done appropriately; and
Complete an incident report and maintain a copy on file.
Except as provided otherwise in this
rule, a TBI residential home must treat or dispose of infectious waste by one
or more of the methods specified in this paragraph.
A TBI residential home may treat
infectious waste in an on-site sterilization or disinfection device, or in an
incinerator or a steam sterilizer, which has been designed, constructed,
operated and maintained so that infectious waste treated in such a device is
rendered non-infectious and is, if applicable, authorized for that purpose
pursuant to current rules of the Department of Environment and Conservation. A
valid permit or other written evidence of having complied with the Tennessee
Air Pollution Control Regulations shall be available for review, if required.
Each sterilizing or disinfection cycle must contain appropriate indicators to
assure that conditions were met for proper sterilization or disinfection of
materials included in the cycle, and appropriate records kept. Proper operation
of such devices must be verified at least monthly, and records of the monthly
verifications shall be available for review. Waste that contains toxic
chemicals that would be volatilized by steam must not be treated in steam
Infectious waste that has been rendered to carbonized or
mineralized ash shall be deemed non-infectious. Unless otherwise hazardous and
subject to the hazardous waste management requirements of the current rules of
the Department of Environment and Conservation, such ash shall be disposable as
a (non-hazardous) solid waste under current rules of the Department of
Environment and Conservation.
(b) A TBI residential home may discharge
liquid or semi-liquid infectious waste to the collection sewerage system of a
wastewater treatment facility which is subject to a permit pursuant to T.C.A.
69-3-101, et seq., provided that
such discharge is in accordance with any applicable terms of that permit and/or
any applicable municipal sewer use requirements.
(c) Any TBI residential home accepting waste
from another state must promptly notify the Department of Environment and
Conservation, county, and city public health agencies, and must strictly comply
with all applicable local, state and federal regulations.
(9) A TBI residential home may have waste
transported off-site for storage, treatment, or disposal. Such arrangements
must be detailed in a written contract, available for review. If such off-site
location is located within Tennessee, the TBI residential home must ensure that
it has all necessary State and local approvals, and such approvals shall be
available for review. If the off-site location is within another state, the TBI
residential home must notify in writing all public health agencies with
jurisdiction that the location is being used for management of the TBI
residential home's waste. Waste shipped off-site must be packaged in accordance
with applicable federal and state requirements. Waste transported to a sanitary
landfill in this state must meet the requirements of current rules of the
Department of Environment and Conservation.
(10) Human anatomical remains which are
transferred to a mortician for cremation or burial shall be exempt from the
requirements of this rule.
garbage, trash and other non-infectious waste shall be stored and disposed of
in a manner that must not permit the transmission of disease, create a
nuisance, provide a breeding place for insects and rodents, or constitute a
safety hazard. All containers for waste shall be water tight, constructed of
easily-cleanable material, and shall be kept on elevated platforms.