Medical Waste Regulations in Hawaii (2026)

Generator registration, storage limits, approved treatment, transport rules, and penalties under Hawaii Department of Health, Solid and Hazardous Waste Branch, with the primary statute behind every line.

Last verified against primary sources.
Changelog
  • Initial publication. Confirmed against HAR 11-104.1 sections 1, 11, 21, 31, and 42 (Cornell LII rendering of the HI DOH rule) and HRS 321-21 and 321-18.

Hawaii medical waste rules at a glance

Regulated medical waste rules in Hawaii, at a glance
Governing agencyHawaii Department of Health, Solid and Hazardous Waste Branch
Primary statute / rule
  • HAR 11-104.1: Management and Disposal of Infectious Waste
  • HRS 321-21: Infectious wastes; management and disposal
Generator registrationHawaii does not require infectious waste generators to register or obtain a permit, but under HRS 321-21 every generator must, on request of the Department of Health, show proof that its infectious waste is being managed and disposed of in accordance with departmental rules. [source]
On-site storage time limitNo fixed storage time limit or refrigeration requirement is set in HAR 11-104.1. The handling, treatment, and disposal sections (11-104.1-11, 11-104.1-21, 11-104.1-32) impose containment and labeling duties but state no maximum holding period. [source]
Approved treatment methods
  • Incineration
  • Sterilization, including autoclaving (steam sterilization)
  • Chemical disinfection
[source]
Transport / manifest rulesHAR 11-104.1 requires untreated infectious waste moved off site (section 11-104.1-31) to be sealed in leakproof, biohazard-labeled containers inside fully enclosed, rigid, leakproof vehicle compartments bearing the Universal Biological Hazard symbol, and not mixed with noninfectious waste. The chapter sets no state manifest or tracking-document requirement of its own. [source]
On-site treatment allowed?Yes. Under HAR 11-104.1-21 a generating facility may treat its own infectious waste on site by incineration, sterilization, or chemical disinfection following CDC, EPA, OSHA, and CLSI guidance. Waste not treated on site must go to a medical waste treatment facility permitted under HAR 11-58.1. [source]
Penalty rangeUp to $1,000 per separate offense under HAR 11-104.1-42, with each day a violation continues constituting a separate offense. Violators are also subject to HRS 321-20, and a general violation of a Department of Health rule is a misdemeanor under HRS 321-18. [source]

What is unique about Hawaii

Hawaii regulates infectious waste under public-health law, not its solid-waste-pollution statute. The rules sit in HAR 11-104.1, adopted under HRS chapter 321 (sections 321-11, 321-20, and 321-21), administered by the Department of Health, rather than under HRS chapter 342H. There is no generator registration or permit step; instead HRS 321-21 makes generators show proof of compliant management on departmental request, and the chapter sets no numeric storage time limit, leaving figures cited by commercial haulers without a basis in the state code.

Frequently asked questions

Which agency regulates medical and infectious waste in Hawaii?

The Hawaii Department of Health, through its Solid and Hazardous Waste Branch, under HAR 11-104.1 adopted pursuant to HRS chapter 321.

Do Hawaii infectious waste generators need a permit or to register?

No. HAR 11-104.1 contains no generator registration or permit step. Under HRS 321-21, generators must instead show proof, on request of the Department of Health, that their waste is managed and disposed of per departmental rules.

How long can infectious waste be stored in Hawaii?

No fixed storage time limit is set in state code. HAR 11-104.1 requires segregation, leakproof biohazard containment, and labeling, but states no maximum holding period or refrigeration trigger.

What treatment methods are approved in Hawaii?

HAR 11-104.1-21 approves incineration, sterilization (including autoclaving), and chemical disinfection, applied per the waste type and consistent with CDC, EPA, OSHA, and CLSI guidance, to render the waste noninfectious.

How must infectious waste be transported off site in Hawaii?

Under HAR 11-104.1-31, untreated infectious waste moved off site must be sealed in leakproof, biohazard-labeled containers placed inside fully enclosed, rigid, leakproof vehicle compartments that bear the universal biological hazard symbol, and it may not be mixed with noninfectious waste. The chapter does not impose a state manifest or tracking-document form, so the containment and labeling rules, together with federal DOT requirements for shipping infectious substances, govern transport.

What happens if a Hawaii facility does not treat its waste on site?

If a generating facility does not treat its infectious waste on site, it must send the waste to a medical waste treatment facility permitted under HAR 11-58.1. Penalties for violating the infectious waste rules run up to $1,000 per separate offense under HAR 11-104.1-42, with each day a violation continues counting as a separate offense, and a general violation of a Department of Health rule is a misdemeanor under HRS 321-18. Generators must also show proof of compliant management on request under HRS 321-21.

Does Hawaii regulate infectious waste differently from regular solid waste?

Yes. Infectious waste is pulled out of the ordinary solid waste stream and governed by HAR 11-104.1 under public-health law, which requires segregation at the point of generation, leakproof biohazard-labeled containment, treatment to render it noninfectious, and disposal only after treatment or at a permitted medical waste treatment facility. Untreated infectious waste may not be managed as ordinary trash, and the Solid and Hazardous Waste Branch oversees both the infectious waste rule and the permitted facilities that receive treated waste.