Skip to main content

Strategies for Waste Management and Decontamination

  • Chapter
  • First Online:
Bioemergency Planning

Abstract

Caring for patients with highly hazardous communicable diseases (HHCDs) presents unique challenges in clinical as well as nonclinical activities, including the safe management of waste contaminated with infectious pathogens and appropriate decontamination of patient care areas. Medical waste generated during the care of a patient with a HHCD pose an increased risk to healthcare, environmental service, and waste-handling workers due to characteristics of HHCDs which may include high morbidity and mortality, high communicability, and low infectious dose. While all medical waste is potentially hazardous and should be handled with safety processes that limit the risk of contact and aerosol exposures, there is no margin of error for waste that is contaminated with highly infectious lethal pathogens. Medical waste contaminated with or suspected of being contaminated with a HHCD pathogen should be collected, packaged, stored, and disposed of in a manner that utilizes optimal infection control practices. The development of protocols for both ongoing and terminal decontamination of patient care areas is also an essential part of the management of the care environment for patients with HHCD.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Herstein JJ, Biddinger PD, Kraft CS, Saiman L, et al. Current capabilities and capacity of Ebola Treatment Centers in the United States. Infect Control Hosp Epidemiol. 2016;37(03):313–8.

    Article  Google Scholar 

  2. Herstein JJ, Biddinger PD, Gibbs SG, Le AB, et al. High-level isolation unit infection control procedures. Health Security. 2017;15(5):519–26. https://doi.org/10.1089/hs.2017.0026

    Article  Google Scholar 

  3. Centers for Disease Control and Prevention (CDC). Ebola-associated waste management. 2015. Retrieved January 16, 2017, from https://www.cdc.gov/vhf/ebola/healthcare-us/cleaning/waste-management.html.

  4. United States Government. Hazardous Materials Regulations. 49 C.F.R. Parts 171–180. Available from: http://www.ecfr.gov/cgi-bin/text-idx?SID=eec3801875105d88488ca31976310098&mc=true&tpl=/ecfrbrowse/Title49/49CIsubchapC.tpl. Data current as of October 30, 2017. Accessed 16 January 16, 2017.

  5. United States Department of Transportation (DOT). Transporting infectious substances safely. 2006. Retrieved January 16, 2017, from http://www.phmsa.dot.gov/pv_obj_cache/pv_obj_id_54AC1BCBF0DFBE298024C4C700569893C2582700/filename/Transporting_Infectious_Substances_brochure.pdf.

  6. WHO. Guidance on regulations for the Transport of Infectious Substances 2007–2008. Available from: http://www.who.int/csr/resources/publications/biosafety/WHO_CDS_EPR_2007_2cc.pdf.

  7. United States Department of Transportation (DOT), Pipeline and Hazardous Materials Safety Administration. Safety advisory: Packaging and handling Ebola virus contaminated infectious waste for transportation to disposal sites. 2014. Docket no. PHMSA–2014–0134, notice no. 14–04. Federal Registrar, 79(210), 64646. Available from: https://www.gpo.gov/fdsys/pkg/FR-2014-10-30/pdf/2014-25778.pdf. Accessed January 17, 2017.

  8. United States Government. Definitions classification, packing group assignments and exceptions for hazardous materials other than class 1 and class 7. 49 C.F.R. Sect. 173.134. Available from: http://www.ecfr.gov/cgi-bin/text-idx?SID1/4e35d034b2154456059cd69b2893745df&node1/4se49.2.173_1134&rgn1/4div8. Accessed January 16, 2017.

  9. Lowe JJ, Gibbs SG, Schwedhelm SS, Nguyen J, Smith PW. Nebraska biocontainment unit perspective on disposal of Ebola medical waste. Am J Infect Control. 2014;42(12):1256–7. https://doi.org/10.1016/j.ajic.2014.10.006.

    Article  Google Scholar 

  10. Stephens DS, Ribner BS, Gartland BD, Feistritzer NR, Farley MM, Larsen CP, Fox JT. Ebola virus disease: experience and decision making for the first patients outside of Africa. PLoS Med. 2015;12(7):e1001857.

    Article  Google Scholar 

  11. Garibaldi BT, Reimers M, Ernst N, Bova G, et al. Validation of autoclave protocols for the successful decontamination of Category A medical waste generated from the care of patients with serious communicable diseases. J Clin Microbiol. 2016;55:545–51. JCM-02161

    Article  Google Scholar 

  12. Occupational Safety and Health Administration (OSHA), National Institute for Occupational Safety and Health (NIOSH), Environmental Protection Agency (EPA). Safe handling, treatment, transport and disposal of Ebola-contaminated waste. 2016. Retrieved January 16, 2017, from https://www.osha.gov/Publications/OSHA_FS-3766.pdf.

  13. CSULA Environmental Health and Safety Biosafety Office. Fact sheet: Using autoclaves safely. Retrieved January 16, 2017, from http://www.calstatela.edu/sites/default/files/groups/Environmental%20Health%20and%20Safety/autoclavefactsheet.pdf.

  14. University of Ottawa Environmental Health and Safety Service. A guideline for the safe use of autoclaves. 2003. Retrieved January 16, 2017, from https://uwaterloo.ca/safety-office/sites/ca.safety-office/files/uploads/files/guideline-for-safe-use-of-autoclaves.pdf.

  15. United States Department of Transportation (DOT). Procedural guidance on the proper packaging of Ebola suspected waste, DOT guidance for preparing packages of Ebola contaminated waste for transportation and disposal. Retrieved January 16, 2017, from http://phmsa.dot.gov/staticfiles/PHMSA/DownloadableFiles/Files/suspected_ebola_patient_packaging_guidance_final.pdf.

  16. Centers for Disease Control and Prevention (CDC). Interim guidance for environmental infection control in hospitals for Ebola virus. 2015. Retrieved January 16, 2017, from https://www.cdc.gov/vhf/ebola/healthcare-us/cleaning/hospitals.html#seven.

  17. Centers for Disease Control and Prevention (CDC). Procedures for safe handling and management of Ebola-associated waste. 2015. Retrieved January 16, 2017, from https://www.cdc.gov/vhf/ebola/healthcare-us/cleaning/handling-waste.html.

  18. National Ebola Training and Education Center (NETEC). Waste management. Retrieved January 16, 2017, from http://netec.org/wp-content/uploads/2015/09/10-NETEC-Waste-Management.pdf.

  19. National Ebola Training and Education Center (NETEC). Laboratory testing and safety. Retrieved January 16, 2017, from http://netec.org/wp-content/uploads/2015/09/14-NETEC-Laboratory.pdf.

  20. Centers for Disease Control and Prevention (CDC). Interim Guidance Regarding Compliance with Select Agent Regulations for Laboratories Handling Patient Specimens Under Investigation or Confirmed for Ebola Virus Disease (EVD). 2015. Retrieved January 18, 2017, from https://www.cdc.gov/vhf/ebola/healthcare-us/laboratories/select-agent-regulations.html.

  21. Lowe JJ, Olinger PL, Gibbs SG, Rengarajan K, et al. Environmental infection control considerations for Ebola. Am J Infect Control. 2015;43(7):747–9. https://doi.org/10.1016/j.ajic.2015.03.006.

    Article  PubMed  Google Scholar 

  22. Jelden KC, Gibbs SG, Smith PW, Schwedhelm MM, et al. Nebraska biocontainment unit patient discharge and environmental decontamination after Ebola care. Am J Infect Control, DOI. 2015;43(3):203–5. https://doi.org/10.1016/j.ajic.2014.12.005

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John J. Lowe .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lowe, J.J., Jelden, K. (2018). Strategies for Waste Management and Decontamination. In: Hewlett, A., K. Murthy, A. (eds) Bioemergency Planning. Springer, Cham. https://doi.org/10.1007/978-3-319-77032-1_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-77032-1_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-77031-4

  • Online ISBN: 978-3-319-77032-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics