Medical Waste Bag Colors: What Red, Yellow, Black and Blue Mean

In the US, the color of a medical waste bag tells staff and haulers what is inside and how it must be treated. Red means biohazardous (regulated medical) waste. Yellow means trace chemotherapy waste. Black is used for RCRA hazardous pharmaceutical waste, and blue or blue-and-white for non-hazardous pharmaceutical waste. Only red is tied directly to federal OSHA rules; the other colors come from state law and industry practice, and other countries use different codes.

We make medical waste bags to order for distributors and importers, so we get asked the color question often, usually with “which color do I need to print?” Here is the US system, where it comes from, and a short note on the UK and EU.

US medical waste bag color codes

Color	Waste stream	Examples	Where the rule comes from
Red	Biohazardous / regulated medical waste	Items soaked or caked with blood or other potentially infectious materials, cultures and stocks, some pathological waste	OSHA Bloodborne Pathogens Standard (red bags may replace biohazard labels) and state medical waste rules
Red (rigid container)	Sharps	Needles, scalpels, broken glass with blood	OSHA: sharps go in closable, puncture-resistant, leakproof containers, labeled or color-coded. Not in bags.
Yellow	Trace chemotherapy waste	Empty chemo vials, IV bags and tubing, and gowns with only trace amounts (RCRA empty, under 3% of the original quantity)	State law in some states (for example California) and industry practice
Black	RCRA hazardous pharmaceutical waste	Bulk or partly used chemo drugs, P-listed drugs and their containers, chemo spill clean-up	Industry practice for waste managed under EPA hazardous waste rules (40 CFR 266 Subpart P)
Blue, or blue and white	Non-hazardous (non-RCRA) pharmaceutical waste	Expired or unused drugs that are not RCRA hazardous	Industry practice; sent for incineration rather than landfill
White	Pathology waste (in some states)	Human tissue and body parts kept separate from other red-bag waste	California allows white bags to separate pathology waste
Clear or black liner	General (non-regulated) trash	Packaging, paper, food waste, uncontaminated gloves and gowns	Facility policy

Two cautions. First, black means two very different things in a hospital: a black container in the pharmacy is hazardous drug waste, while a black liner in a hallway can is ordinary trash. Second, these colors are a convention, not a single national law. A hospital’s own waste plan and its state rules decide what goes where.

Red bags: biohazard and regulated medical waste

Red is the one color with a federal basis. The OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030) requires containers of regulated waste to carry the biohazard label, fluorescent orange or orange-red with contrasting lettering. It also says red bags or red containers may be used in place of the label.

Beyond OSHA, medical waste is regulated mainly by the states. EPA lost its specific authority over medical waste when the Medical Waste Tracking Act of 1988 expired in 1991, so each state sets its own rules for bag color, marking and strength.

What goes in a red bag

• Items that would release blood or other potentially infectious material if squeezed, or that are caked with dried blood.
• Microbiological cultures and stocks, and lab waste contaminated with them.
• Pathological waste, unless your state requires a separate color.

What does not go in a red bag: ordinary trash, packaging, and gloves or gowns that are not visibly contaminated. Putting general waste in red bags is one of the biggest cost problems hospitals have, because red bag waste costs much more to treat than regular trash.

Red bag strength rules

Many states set minimum film strength for biohazard bags. California is a good example. Its Medical Waste Management Act says biohazard bags must be red, except that yellow bags may be used for trace chemotherapy waste and white bags for pathology waste. Bags that line the US DOT shipping containers for transport off site must be certified by the manufacturer as passing:

• ASTM D1709 dart impact: at least 165 grams
• ASTM D1922 tear resistance: at least 480 grams, in both directions

Florida keeps an approved red bag list under its biomedical waste rule, and bags not on the list must have test results on file at the generator. Before you buy or import red bags, check the rules for each state you sell into.

Yellow bags: trace chemotherapy waste

Yellow is used for items contaminated with only trace amounts of chemotherapy drugs. “Trace” generally means the container is RCRA empty: all contents removed by normal means, with less than 3% of the original amount left. Typical contents are empty vials, empty IV bags and tubing, and gowns and gloves used during administration. Trace chemo waste is usually incinerated, not autoclaved.

Yellow does not mean “infectious” in the US system. That is a common mix-up, because in the UK and many other countries yellow is used for infectious waste.

Black containers: RCRA hazardous pharmaceutical waste

Black is used for pharmaceutical waste that is hazardous under RCRA, the federal hazardous waste law. That includes P-listed drugs such as warfarin and arsenic trioxide, unused and partly used chemo drugs, and chemo spill clean-up materials. Healthcare facilities manage this waste under EPA’s Subpart P rule, which requires the container to be labeled “Hazardous Waste Pharmaceuticals”. Subpart P does not set a color; black is the industry convention.

Blue and white: non-hazardous pharmaceutical waste

Most pharmaceutical waste is not RCRA hazardous, but it still should not go to landfill or down the drain. Hospitals collect it in blue or blue-and-white containers and send it for incineration. EPA’s Subpart P bans flushing hazardous waste pharmaceuticals down the sewer in every state.

UK and EU: different colors

Medical waste colors are not international. If you sell outside the US, use the local code.

UK color (HTM 07-01)	Waste stream
Orange	Infectious waste that can be treated by alternative methods, such as autoclaving
Yellow	Infectious waste that must be incinerated, such as waste contaminated with chemicals or non-cytotoxic medicines
Purple	Cytotoxic and cytostatic waste
Red	Anatomical waste
Blue	Non-cytotoxic waste medicines
Yellow and black stripes (“tiger” bags)	Offensive, non-infectious waste
Black or clear	Ordinary municipal waste

Note how the UK differs: yellow means infectious, orange is used for infectious waste that can be autoclaved, and cytotoxic waste is purple. Within the EU there is no single color code. Each member state sets its own, so check the national rules in Germany, the Netherlands, France and other markets before printing bags.

Buying tips for importers and distributors

• Specify the market and waste stream, not just a color. “Red biohazard bag for California, transport liner” tells us the strength and printing you need. “Red bag” does not.
• Name the tests you need. If your state requires ASTM D1709 and D1922 results, put the minimum values on your PO and plan for test reports on your production lot.
• Check approved lists. Some states, such as Florida, keep a list of approved red bags. Allow time for that process.
• Get the printing right. Biohazard symbol, “Biohazard” or “Infectious Waste” wording, and any state-required text. We print up to 8 colors on one or both sides and match Pantone colors, so the red, yellow or purple matches your existing range.
• Choose the bottom seal. Star seal bottoms spread the load and leak less than gusseted bags, which matters for wet clinical waste.

We make medical waste bags to order in red, yellow, blue, purple, orange and other colors, in HDPE, LDPE and LLDPE, flat packed or on rolls. Our plants follow Japan’s JIS standard and ISO 9001. Lead time is 4–6 weeks for a first printed order and 3–4 weeks for repeats. See our trash bag and liner range, our heavy duty can liners, and custom printing options. For sizes, use the trash bag size chart.

FAQ

What goes in a yellow medical waste bag?

In the US, trace chemotherapy waste: empty chemo vials, IV bags, tubing, and gowns and gloves with only trace amounts of drug. In the UK and many other countries, yellow is used for infectious waste that must be incinerated, so check the local system.

What is the difference between red and yellow medical waste bags?

In the US, red is for biohazardous waste contaminated with blood or other potentially infectious materials. Yellow is for trace chemotherapy waste. They go to different treatment: red bag waste is often autoclaved, while trace chemo waste is incinerated.

What goes in a black medical waste container?

RCRA hazardous pharmaceutical waste, such as P-listed drugs, bulk or partly used chemotherapy drugs, and chemo spill clean-up. It is managed as hazardous waste. A black liner in an ordinary trash can is different and holds general waste.

Are medical waste bag colors required by law?

Partly. OSHA requires regulated waste to be labeled with the biohazard symbol or placed in red bags or containers. Many states set bag colors and strength in their medical waste rules. The pharmaceutical colors (black, blue, yellow) are mostly industry practice, and they vary between facilities.

What color bag is used for pharmaceutical waste?

Black for RCRA hazardous pharmaceuticals and blue or blue-and-white for non-hazardous pharmaceuticals. Trace chemotherapy waste goes in yellow. In the UK, non-cytotoxic medicines go in blue and cytotoxic medicines in purple.

Send us the waste stream, color, size, thickness and the market where the bags will be used, plus any test values your state requires. We will come back with a spec and a quote. Contact us here.