Disposal of toenail debris in podiatry practices

April 30, 1993

The Honorable Edward M. Kennedy
[Recipient address omitted]
Dear Senator Kennedy:

This is in response to your letter of April 2, which you wrote on behalf of your constituent, Dr. William J. Hartigan. Dr. Hartigan contacted you to obtain "definitive guidelines for the proper handling of Podiatric Medical debris such as toenail particles and nail dust."

Specifically, Dr. Hartigan asked if toenail particles are considered to be "biological hazardous debris that requires some type of containment or disposal." He also asked if there has ever been any investigation into the transmission of Human Immunodeficiency Virus (HIV) and hepatitis B virus (HBV) from the nail dust generated during podiatric procedures.

The Occupational Safety and Health Administration (OSHA) regulation 29 CFR 1910.1030, "Occupational Exposure to Bloodborne Pathogens," was issued to protect employees from transmission of these viruses in December of 1991. It requires that employers implement certain controls to protect occupationally exposed employees from the hazards of bloodborne pathogens. Occupational exposure is defined as the reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials (OPIM) that may result from the performance of an employee's duties. Toenail particles would be considered OPIM only if they are contaminated with blood or other blood components such as exudates from wounds.

The bloodborne pathogens standard also requires the correct disposal of regulated waste. However, toenail particles may not qualify as regulated waste. Regulated waste is defined as liquid or semi-liquid blood or OPIM; items contaminated with blood or OPIM and which would release these substances in a liquid or semi-liquid state if compressed; items that are caked with dried blood or OPIM and are capable of releasing these materials during handling; contaminated sharps; and pathological and micro-biological wastes containing blood or OPIM. When the toenail particles in Dr. Hartigan's practice do not meet this definition, he may dispose of them as ordinary trash without violating any OSHA regulations.

Dr. Hartigan also enclosed an article regarding the health hazards of nail dust inhalation and asked whether OSHA has evaluated the risks relative to nail dust inhalation. OSHA has not evaluated the specific risks associated with nail dust inhalation, and is not planning any specific action concerning the matter.

We hope this information is responsive to your constituent's concerns.

Sincerely,
Roger A. Clark, Director
Directorate of Compliance Programs