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Recommendations for Menstrual Hygiene Disposal Best Practices

Are Your Methods Outdated?


By Shallan Ramsey
July 15, 2019


Menstrual hygiene disposal may not be everyone’s favorite topic, but facilities everywhere are familiar with the challenges it presents. When toilet paper is all that is provided in a stall for the handling and covering of blood-saturated items, contaminated and overfilled receptacles are unavoidable. It doesn’t matter how well-trained and attentive custodial staff may be, it isinevitable that there will be visible blood on the inside and outside of menstrual receptacles if there are no other options but toilet paper.


Facilities may provide liners for their receptacles, but, unfortunately, these aren’t always effective. Menstrual waste can end up sliding into the receptacle and miss the bag altogether. Large wads of toilet paper covering menstrual items may crush the liner as well, ultimately pushing it to the bottom of the receptacle. Further, these wadsmay balance on top of rigid liners and become partially trapped by the lid causing receptacles to look full, even when they may not be.



In such situations, the alternative for people using the restroom becomes flushing their menstrual hygiene products down the toilet. Plumbing problems due to flushed menstrual items are a universal issue. This is partially because tampons expand significantly in water, although it is typically the string attached to the tampon that becomes stuck in buildup, debris, or a junction in the pipes. Once this happens, it isn’t long before there is a total blockage. Plumbers are expensive and overflowing toilets can wreak havoc on a facility.


Many facilities have become somewhat complacent when it comes to the typical struggles around menstrual hygiene disposal, assuming that there is not much that can be done. In this way, the most important issue around menstrual hygiene disposal is often completely overlooked; the health and safety of the custodial staff and the users of the restroom.


There is a major discrepancy in the way blood is handled in every other environment outside of public restrooms. In medical settings, blood is obviously taken very seriously. Furthermore, in all types of settings, if visible blood is seen on any surface outside of the restroom, universal precautions are taken and the bloodborne pathogen kit is quickly retrieved. Inside the kit is personal protective equipment, including gloves, goggles, masks, as well as disinfectants and red bags. These kits exist to protect whomever will be cleaning up the blood and whomever will be using the area afterwards.


According to the CDC, bloodborne pathogens can be transmitted in several ways, including direct contact with infected blood through “skin bearing minute scratches, abrasions, burns, or even minor rashes,” as well as “mucous membranes in the mouth, nose, or eyes.” Research has shown that diseases like Hepatitis B, Hepatitis C and MRSA can live outside the body even in dried blood. It has been reported that Hep B can survive for up to a week, Hep C for up to 3 weeks and MRSA can survive for even longer.


It is easy to turn a blind eye, but when you take a moment to acknowledge what is actually happening in public restrooms, it is evident that current practices need to evolve. People using the bathroom are handing blood during the removal process of a menstrual item. They proceed to open the lid of the receptacle to place items inside, flush the toilet and then open the stall door. They use the soap dispenser and turn on the water to wash their hands. Out of habit, many will turn off the water prior to retrieving a paper towel to protect themselves, potentially re-touching a contaminated surface. Today, many facilities are transitioning to as many touchless systems as possible, but even in the best-case scenario, there is still the stall door handle to think about.


Although OSHA excludes feminine hygiene items from regulated waste, their guidelines do state that bags holding menstrual waste should “prevent physical contact with the contents.” Additionally, guidelines include that custodians should be provided with gloves when handling menstrual waste as well. OSHA statesfurther that it is the employer’s responsibility to determine if there is an occupational exposure risk in an environment.


Unfortunately, custodians are not typically taking measures to protect their mucous membranes, as it is not required. If they were to inadvertently expose their eyes, nose or mouth to infected blood on their gloves, they could be at risk. It should also be noted that most custodians are not changing their gloves immediately after coming into contact with menstrual receptacles, which could result in further contamination on surfaces in the restroom.



The most alarming observation is that the people walking into use a public restroom are unprotected. Most of them are unaware that they could even be at risk for exposure to bloodborne pathogens. Therefore, they are not taking any precautions.


The lack of conversation around menstruation generally, and menstrual hygiene disposal specifically, has created a false separation between menstrual blood and blood. All the same, no matter the source, blood is blood. If it is important to take universal precautions everywhere else when handling blood, it is then not logical to essentially ignore such precautions in public restroom environments.


When considering how to most effectively manage menstrual hygiene disposal, facilities should take a step back and consider the entire process for someone changing out a menstrual item, beginning with the removal of the item, the process of its disposal, and the custodial staff’slater handling of the discarded waste.


Best practices for menstrual hygiene disposal should include single-usebags that can provide glove-like protection during the removal of a menstrual item,as well as allow users to seal the waste prior to the bag being placed into a receptacle. A solution like this can significantly reduce touchpoint contamination throughout the restroom and reduce exposure risks to bloodborne pathogens for custodians and other users of the restroom.


This type of single-use bag should prevent janitorial staff from needing to make physical contact with the contentsof the bag. If facilities do not provide this type of single-use solution in the restroom, they will fall short of addressing the problem in its entirety..


Best practices should further include well-fitting receptacle liners, as well as a regular schedule in place for disinfecting menstrual receptacles inside and out. Facilities should provide personal protective equipment as well, including gloves for custodial staff. Gloves should be changed promptly after coming into contact with menstrual receptacles, and regular hand washing policies should be enforced.


In summary, best practices for menstrual hygiene disposal in public restrooms should include the following:

  • Single-use bags that provide glove-like protection during the removal of menstrual items
  • Well-fitting liners for menstrual receptacles
  • A regular schedule for disinfecting both the inside and outside of menstrual receptacles
  • Personal protective equipment, including gloves
  • The consistent enforcement of regular hand washing policies


Shallan Ramsey is the CEO and Founder of MaskIT, a revolutionary and sustainable solution for menstrual hygiene disposal. She is an award-winning entrepreneur and frequently presents at conferences around the country on the importance of properly addressing menstrual hygiene disposal. As a mother of three daughters, she is passionate about proactively trying to change the culture around menstruation to eliminate unnecessary risk in public restrooms for everyone. To find out more visit