New developments in medical waste management regulation: Uncertainties Analysis

Introduction. With the adoption of Federal Law No. 306-FZ of August 8, 2024, “On Amendments to Certain Legislative Acts of the Russian Federation,” hospital waste management was integrated into the federal waste management system. However, a closer analysis of certain provisions and their correlation with the practical work of medical institution has raised new questions.Objective. To analyze regulatory changes and identify new uncertainties that could impact on the practical work of medical institution and the environment.Material and methods. The provisions of the new law were analyzed in relation to issues related to the practical work of medical institutions, as well as ensuring the environmental and sanitary-epidemiological safety of waste management.Results. A number of uncertainties have been identified, relating to both specific waste management issues (responsibility for developing environmental documentation and its practical implementation) and broader issues, such as environmental safety (the possibility of further processing of Class A medical waste and the consequences of certain waste from medical institutions being classified as municipal solid waste, even though they are not, by definition, municipal solid waste) and sanitary and epidemiological safety (the lack of priority given to hardware-based treatment methods over physical impact methods). These uncertainties stem from insufficient legislative development of certain issues and provisions (the delineation of responsibilities for ensuring environmental requirements, the clarity of terminology, and the impossibility of legitimately defining hazard classes and issuing certificates by either a medical institution or a regional solid municipal waste management operator).Conclusion. The identified uncertainties lead to a lack of clear understanding of certain aspects of medical waste management. Their elimination requires a consolidated decision by several government agencies regulating both medical waste management and its production and consumption.Contribution: Balakaeva A.V. — the concept and design of the study, collection and processing of material, statistical processing, writing a text; Skopin A.Yu. — collection and processing of material, writing a text. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final versionConflict of interest. The authors declare no conflict of interest.Funding. The study had no sponsorship.Received: November 18, 2025 / Accepted: December 2, 2025 / Published: February 10, 2026