# COMAR Title 10 — Maryland Department of Health

## Subtitle 06 — Diseases

### Chapter 06 — Communicable Disease Prevention — Handling, Treatment, and Disposal of Special Medical Waste

#### Regulation .06 Alternative Treatment Systems.

*COMAR 10.06.06.06*

A. Except as provided in §B of this regulation, a person may not use a method for treatment of special medical waste other than those set forth at Regulations .04A(2) and .05B of this chapter.

B. Criteria for Alternative Treatment System. A person may use a method for treatment of special medical waste that complies with the following standards for treatment and microbial test procedures:

  (1) The method inactivates vegetative bacteria, fungi, parasites, lipophilic or hydrophilic viruses, and mycobacteria at a 6 log reduction or greater;

  (2) The method inactivates bacterial spores at a 4 log reduction or greater; and

  (3) The tests have been performed on a representative from each of the following microbial groups:

    (a) Staphylococcus aureus (ATCC 6538) or Pseudomonas aeruginosa (ATCC 15422);

    (b) Candida albicans (ATCC 18804) or Penicillium chrysogenum (ATCC 24791);

    (c) Polio 2 or Polio 3 or MS-2 Bacteriophage, (ATCC 15597-B1);

    (d) Cryptosporidium spp. oocysts or Giardia spp. cysts;

    (e) Mycobacterium terrae, Mycobacterium phlei, or Mycobacterium bovis (BCG) (ATCC 35743); and

    (f) Bacillus stearothermophilus (ATCC 7953) or Bacillus subtilis (ATCC 19659).

C. A person may not use a method for treating of special medical waste that:

  (1) Creates a threat to health or safety; or

  (2) Violates applicable federal and State environmental laws or regulations.