Medical Waste Regulations in Maryland (2026)
Generator registration, storage limits, approved treatment, transport rules, and penalties under Maryland Department of the Environment (permits, generator IDs, enforcement) with the Maryland Department of Health (definitions and treatment standards), with the primary statute behind every line.
Maryland medical waste rules at a glance
| Governing agency | Maryland Department of the Environment (permits, generator IDs, enforcement) with the Maryland Department of Health (definitions and treatment standards) |
|---|---|
| Primary statute / rule |
|
| Generator registration | A generator may not treat, store, dispose of, transport, or offer special medical waste for transportation without first obtaining a Maryland identification number from the Department, and the Department of the Environment requires a generator to notify it when the generator produces 50 pounds or more of special medical waste in a calendar month or has more than 50 pounds on site at any time. [source] |
| On-site storage time limit | No maximum on-site storage time or refrigeration temperature is set in the primary special medical waste regulations. COMAR 26.13.11.03 instead ties regulation to quantity, providing that wastes are subject to the full generator and transporter rules once a person generates or accumulates 50 pounds or more in a calendar month. Day limits cited by some commercial haulers are not confirmed by a Maryland primary source. [source] |
| Approved treatment methods |
|
| Transport / manifest rules | A generator who transports or offers special medical waste for off-site treatment, storage, or disposal must prepare shipping papers in accordance with the federal hazardous materials shipping-paper rules at 49 CFR 172.200 to 172.204, and a transporter may not accept special medical waste from a generator unless the waste is accompanied by a shipping paper prepared by the generator under COMAR 26.13.12.04. [source] |
| On-site treatment allowed? | Yes. A generator may treat special medical waste on site only by the methods provided in COMAR 10.06.06, and may not landfill sharps unless the generator first incinerates them or sterilizes and then mechanically destroys them. [source] |
| Penalty range | Under Environment Article Section 9-269 (which governs solid and special medical waste), civil penalties run up to $10,000 plus an additional amount not exceeding $10,000 a day for each day a violation continues, capped at $50,000; administrative penalties run up to $1,000 per violation per day, not exceeding $50,000 total. The Maryland Department of the Environment is the enforcing agency. [source] |
What is unique about Maryland
Maryland splits authority between two agencies. The Department of Health (COMAR 10.06.06) defines special medical waste and sets the treatment standards, while the Department of the Environment (COMAR 26.13.11 through 26.13.13) issues generator identification numbers, certifies haulers and vehicles, and enforces the rules. Regulation turns on quantity rather than time: a person generating less than 50 pounds in a calendar month is excluded from the full generator and transporter requirements, but crossing 50 pounds generated or accumulated pulls the waste into full regulation (COMAR 26.13.11.03).
Frequently asked questions
Which agency regulates special medical waste in Maryland?
Both. The Maryland Department of Health defines special medical waste and sets treatment standards under COMAR 10.06.06, and the Maryland Department of the Environment handles generator identification numbers, hauler and vehicle certification, transport, permitting, and enforcement under COMAR 26.13.11 through 26.13.13.
Do I need to register or get an identification number as a generator?
Yes. Under COMAR 26.13.12.03 a generator may not treat, store, dispose of, transport, or offer special medical waste for transport without first obtaining a Maryland identification number, and the Department of the Environment requires notification once a generator produces or holds 50 pounds or more in a calendar month.
Is there a small-quantity exclusion?
Yes. Under COMAR 26.13.11.03, if a person generates less than 50 pounds of special medical waste in a calendar month, those wastes are not subject to the full generator and transporter standards; accumulating more than 50 pounds brings them back into regulation.
What treatment methods does Maryland allow?
Under COMAR 10.06.06.04, special medical waste other than sharps may be treated by autoclaving, chemical disinfection, disinfection, cremation, mechanical destruction after decontamination, incineration, or an approved alternative method. Sharps may not be landfilled unless first incinerated, or sterilized and then mechanically destroyed (COMAR 26.13.12.05).
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