COVID-19 Waste Packaging Guidelines

Preparing Your Medical Waste: What Goes in the Red Biohazard Bag?

Proper waste segregation is important to make sure your medical practice’s trash, regulated medical waste, and hazardous waste are disposed of properly. Just as it is your responsibility to make sure you properly dispose of regulated medical waste, it is also your responsibility to determine whether or not the waste your practice generates is actually regulated waste. Properly segmenting your medical waste and trash will save your practice money. Here’s what you need to know about what goes in the red biohazard bag.

What Is Regulated Medical Waste and Why Does It Go in a Red Bag?

Regulated medical waste (RMW) is defined by The Occupational Safety and Health Administration (OSHA) as waste that contains enough blood or other potentially infectious materials (OPIM) to spread bloodborne pathogens.

OSHA defines RMW in its Bloodborne Pathogens Standard as:

  • Liquid or semi-liquid blood or other OPIM
  • Items contaminated with blood or OPIM that would release those substances in a liquid or semi-liquid state if compressed
  • Items that are caked with dried blood or OPIM that are capable of releasing these materials during handling
  • Pathological and microbiological wastes that contain blood or OPIM

In general, state guidelines follow OSHA’s definition of RMW.

Red bags are used to contain RMW because they give a visible warning to healthcare employees and medical waste disposal workers that the waste should be handled with extra caution. Several governmental agencies, including OSHA, the Environmental Protection Agency (EPA), and the Department of Transportation (DOT), mandate the use of special containers such as red bags for RMW disposal. The red bags should be properly tied (preferably using a gooseneck knot secured with packing tape or a zip tie) and placed into another container that is approved for medical waste. You should not be able to see the bag after the secondary container is closed.

How to Determine If Your Medical Waste Is Regulated

The red-bagged lined RMW container or the regular plastic-lined trash can . . . how do you decide where your medical waste goes? It all boils down to how much blood or other potentially infectious materials (OPIM) the item contains.

It is your responsibility to determine what is and is not RMW. You can not use the actual volume of blood to determine the method of disposal; rather, you should consider the potential for generation of bulk blood or OPIM through dripping or flaking off of material that may contain blood or OPIM.

Think of it this way: If half an ounce of blood was on a cotton ball, it would probably be saturated and need to be disposed of as RMW. If that amount of blood was on a disposable bed sheet, it would appear as a spot. Therefore, items that are simply contaminated with small amounts of blood or OPIM that is absorbed may be placed in a regular plastic-lined trash can.

Remember to always wear personal protective equipment (PPE) when handling, changing or transporting red bags.


  • Anything contaminated with OPIM (Items such as used glucose test strips, urine dipsticks. blood-soaked drapes and gloves)
  • All body fluids in a situation where it is difficult to identity and differentiate between them
  • Visibly contaminated PPE
  • Any unfixed human tissue
  • Visibly bloody empty intravenous bags and tubing
  • Saturated gauze and bandages
  • A sharps container that is closed and locked


  • Sharps that are not in a container
  • Pharmaceutical waste (medication)
  • Chemotherapy waste
  • Chemicals such as alcohol, waste oils, fixatives and preservatives
  • Human remains
  • Materials that contain lead or mercury
  • Inhalers or aerosol cans (even if the container is empty)
  • Radioactive waste
  • Garbage

Finally, remember that red bags can only be collected and disposed of by a licensed medical waste contractor. Municipal and city waste collectors can not transport medical waste. Only biohazardous waste should be placed inside red bags for disposal, and it is your responsibility to determine what waste meets that definition. Using the red biohazard bag correctly is a critical part of your practice’s medical waste disposal procedure. Having clear instructions for your staff on what type of waste goes into the red bag can help. Download our free Quick Reference Medical Waste Handling Guide to help you and your staff properly segregate your waste.


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