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The Nebraska Biocontainment Unit, located at the Nebraska Medical Center, shares best practices for Ebola waste removal, in a commentary published in in the December issue of the American Journal of Infection Control.
One of the key areas of concern related to the treatment of Ebola patients in the United States is waste removal. According to the case study, Ebola patients treated by the Nebraska team produced about 23 cubic feet – more than 50 pounds – of solid waste per day, most of which was personal protective equipment (PPE) worn by healthcare workers. Additionally, the patients produced approximately 2.3 gallons of liquid waste per day.
According to the U.S. Department of Transportation, which regulates hazardous material, Ebola waste is considered category A – meaning the waste is known or expected to contain a pathogen that is capable of causing fatal disease. Waste in this category requires many steps, and even a special permit, to ensure safe disposal.
The Nebraska Biocontainment Unit developed a strategy to convert the category A waste into category B medical waste, to enable safe disposal. This was done by transferring all solid waste, including PPE, patient linens, scrubs, towels, etc., to a pass-through autoclave system. After it was sterilized by the autoclave, the waste was placed in biohazard bags and into rigid packaging to be disposed of as category B medical waste.
Liquid waste produced by the Ebola patient was disposed of into a toilet with hospital-grade disinfectant and held for 2.5 times the recommended time before flushing the waste. This method was fully vetted by numerous stakeholders and surpasses the CDC guidance regarding Ebola liquid waste removal.
This case study seeks to provide other hospitals and facilities with guidance on the best practices associated with Ebola waste removal.
Reference: Lowe J, Gibbs S, Schwedhelm S, Nguyen J and Smith P. Nebraska Biocontainment Unit perspective on disposal of Ebola medical waste. American Journal of Infection Control. Volume 42, Issue 12. December 2014.