The rules that govern this work

Two federal regimes govern this work almost everywhere in the United States. Neither licenses companies — one regulates how employers protect the people doing the work, and one regulates what happens to the waste.

The two that matter

• OSHA’s bloodborne pathogens standard, 29 CFR 1910.1030 — a written exposure control plan, universal precautions, employer-paid protective equipment, hepatitis B vaccination offered free within 10 working days, and annual training. This is where “OSHA certified” comes from, and why the phrase means nothing.

• Medical waste transport — trauma scene waste ships as UN 3291, Division 6.2, not UN 3373, and responsibility runs from collection to final treatment rather than ending when the truck leaves.

What is left to the states

Almost everything else. Whether the work needs registering, who may transport waste and above what weight, and what a treatment facility must be permitted for.

The result is a patchwork: California requires registration before work begins, Florida regulates only the transport, and most states appear to rely on general medical waste rules. What we have confirmed, state by state.