OSHA requirements are set by statute, standards and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA's website at https://www.osha.gov.

January 9, 2007

Kendall Mower, DMD
15306 Featherchase Dr.
Chesterfield, VA 23832

Dear Dr. Mower:

Thank you for your May 11, 2006 letter to the Occupational Safety and Health Administration's (OSHA's) Directorate of Enforcement Programs (DEP). This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any question(s) not delineated within your original correspondence. You had specific questions regarding OSHA requirements as they relate to the disposal of dental anesthetic carpules which are contaminated with blood. For clarification, your specific questions are paraphrased below, followed by OSHA's response.

Scenario: Dental carpules are small cylindrical glass tubes containing dental anesthetics which are screwed onto dental syringes and are commonly aspirated while the practitioner injects the patient. In a recent informal review, 500 anesthetic carpules were collected from 16 dentists in order to determine whether these carpules become contaminated with blood following hypodermic injections. It was discovered from this review that 10 (approximately 2%) of the carpules had visible signs of blood inside.

Question 1: Are dental anesthetic carpules considered sharps and must they be disposed of in the sharps container?

Reply 1: As you know, the bloodborne pathogens standard defines "contaminated sharps" as any contaminated object that can penetrate the skin, including but not limited to, needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental wires [29 CFR 1910.1030(b)]. Pharmaceutical containers, including anesthetics carpules used in dentistry, are generally not considered to be contaminated sharps unless they are broken and can penetrate the skin. Intact anesthetic carpules are not required by OSHA to be discarded in a sharps container.

Question 2: Are dental anesthetic carpules considered regulated waste?

Reply 2: The bloodborne pathogens standard defines regulated waste as liquid or semi-liquid blood or other potentially infectious material (OPIM); contaminated items that would release blood or OPIM in a liquid or semi-liquid state if compressed; items that are caked with dried blood or OPIM and are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or OPIM. Dental anesthetic carpules are not usually expected to become contaminated with blood. However, when there is visible blood inside the carpules, they are to be regarded as regulated waste. OSHA requires that the contaminated carpules be placed in containers that are closable, constructed to contain all contents and prevent leakage of fluids during handling, storage, transport, or shipping, and color-coded or labeled appropriately and closed prior to removal [29 CFR 1910.1030(d)(4)(iii)(B)]. if contaminated carpules are broken, the sharps container requirements of 29 CFR 1910.1030(d)(4)(iii)(A) would apply to the disposal of any contaminated carpules.

Question 3: If they are not contaminated sharps or other regulated waste, may they be thrown away in the trash?

Reply 3: The ultimate disposal of pharmaceutical vials must be in accordance with municipal, state and federal regulations (e.g., those of the Environmental Protection Agency, EPA). OSHA does not regulate the disposal of medical wastes which are not "regulated waste" within the meaning of the bloodborne pathogens standard. Product material safety data sheets may provide guidance on proper disposal of anesthetic carpules.

Question 4: If they can be thrown away in the trash, would placing them inside of a plastic container (e.g., milk jug or other empty plastic container) be required, or could they simply be discarded individually?

Reply 4: Please see response #3.

for your information, Virginia is one of the states that operates an OSHA-approved State plan. Virginia's occupational safety and health program is administered through the Virginia Department of Labor and Industry's Occupational Safety and Health Program (VOSH). State plans are responsible for adopting and enforcing occupational safety and health standards that are at least as effective as those promulgated by Federal OSHA. VOSH has adopted the federal bloodborne pathogens standard. We suggest you contact the VOSH at:

Virginia Occupational Safety and Health
Attn: Glenn Cox, Director
13 South 13th Street
Richmond, VA 23219
(804) 786-7776

Thank you for your interest in occupational safety and health. We hope you find this information helpful. OSHA requirements are set by statute, standards, and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA's website at http://www.osha.gov. If you have any further questions, please feel free to contact the Office of Health Enforcement at (202) 693-2190.

Sincerely,



Richard E. Fairfax, Director
Directorate of Enforcement Programs