Compliance Assistance & Pollution Prevention in New England
Use this site to find information to help you understand and comply with environmental requirements. Keep in mind that this site and its associated links may not list all regulatory requirements that might apply to your healthcare facility. State and local governments may also have additional or stricter regulations than the federal government. For more information contact your state/local agencies.
In addition, many of the links below (e.g., Colleges & Universities, Other/General Information) take you to non-healthcare sites. While the information on these sites may not be specific to healthcare facilities, it may provide useful background and general compliance information.
This page provides links to non-EPA web sites that provide additional information about Healthcare. You will leave the EPA.gov domain and enter another page with more information. EPA cannot attest to the accuracy of information on that non-EPA page. Providing links to a non-EPA Web site is not an endorsement of the other site or the information it contains by EPA or any of its employees. Also, be aware that the privacy protection provided on the EPA.gov domain (see Privacy and Security Notice) may not be available at the external link.
Information Specific to Healthcare
of the Healthcare Industry, February 2005 (PDF) (155 pp, 1.4MB)
Designed to give readers an understanding of the major environmental issues associated with the industry. Includes industry background and trends, pollutant releases, pollution prevention, compliance history, voluntary initiatives, and other information.
Resource Center (HERC)
Find pollution prevention and compliance assistance information for the healthcare sector.
Commission on Accreditation of Healthcare Organizations (JCAHO)
Environmental Compliance and Improvement Guide
Guide relates each JCAHO Element of Performance to specific federal regulations, to help facilities achieve compliance with both. The Guide also suggests steps that facilities can take to encourage environmental performance improvements.
- Common Violations and Problems Found at Hospitals
EPA Region II has conducted inspections resulting in enforcement actions with penalties.
- P2 healthcare Industry
- The "Green Team" Promoting Green Construction & Operations
Several Green MOU healthcare examples!
Pharmaceutical Waste: A 10-Step Blueprint for Health Care Facilities
In the United States, Revised August 2008 (PDF) (93 pp, 489K,
Updated in August 2008, this Guide will help you develop and implement a comprehensive pharmaceutical hazardous waste management program that combines regulatory compliance and best management practices with waste minimization.
EPA 's Pharmaceuticals and Personal Care Products in the Water
Draft Best Management Practices for Unused Pharmaceuticals at Healthcare Facilities (2010) and the interim study on the subject of pharmaceuticals and personal care products (PPCPs) and our Nation's waters. Pharmaceuticals refer to prescription and over-the-counter therapeutic drugs and veterinary drugs. Personal care products refer to products used for personal and cosmetic reasons such as soaps, fragrances, and cosmetics.
Regulatory Interpretations – Healthcare
These links provide information to help hospitals comply with some basic environmental regulatory requirements, but do not include all regulatory interpretations that might be applicable to a facility.
- Containers that Once Held P-listed Pharmaceuticals: RCRA Online # 14827, 11/4/11 (PDF) (6 pp, 1.1MB)
- Scope of Hazardous Waste Listing PO42 (Epinephrine), October 15, 2007, See RCRA Online #14778 (PDF) (8 pp, 1.2MB, about PDF)
- Epinephrine fact sheet, Healthcare Environmental Resource Center (PDF) (3 pp, 55K, about PDF)
This fact sheet provides developed by HERC contains information to assist healthcare facilities with hazardous waste determinations regarding epinephrine wastes (PO42).
- Epinephrine Syringe Interpretation RCRA Online #14788, 4/14/08 (PDF) (1 pg, 470K, about PDF)
- EPA Requirements for Sterilizing Medical Equipment to Protect Hospital and Healthcare Facility Workers, February 2010
- Scope of Hazardous Waste Listing P046 (PHENTERMINE), February 17, 2012, RCRA Online #14831
- Medicinal Nitroglycerin RCRA Online #14654 (PDF) (2 pp, 19K, about PDF)
- Mixed Waste Rule
- Regulation of Unused Dermal Nicotine Patches, 8/23/10, See RCRA Online #14817
- Region 1 healthcare RCRA healthcare policy letters
- Policy Letter to Acadia Hospital: Management of P-listed Pharmaceutical Waste (nicotine, nitroglycerine and epinephrine) in a Hospital, 12/30/08 (PDF) (5 pp, 388K)
- Policy Letter to Mabbett & Associates: Satellite Accumulation in Hospitals Inquiry, letter dated 2/24/11 (PDF) (4 pp, 1.2MB)
- Policy Letter to Holyoke Medical Center: Hazardous waste status of used and unused pharmaceuticals (i.e., nicotine gum/patches and wrappers; and warfarin wrappers, letter dated 7/22/11 (PDF) (3 pp, 824K)
- Policy Letter to VISN 1: Management of empty Coumadin (warfarin) stock bottles at various VA facilities throughout New England, letter dated 10/19/11 (PDF) (5 pp, 1.5MB)
- Policy Letter to The Miriam Hospital: Inquiry regarding satellite accumulation in hospital patient rooms, letter dated 2/1/12 (PDF) (8 pp, 2.2MB)
Colleges & Universities