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U.S. Hospitals Struggle With Ebola Waste Disposal

Medical waste haulers don’t want it

According to an exclusive report from Reuters, the U.S. is days away from settling the critical question of how hospitals should handle and dispose of medical waste from Ebola patients.

Experts have warned that conflicting U.S. regulations over how such waste should be transported could make it difficult for U.S. hospitals to safely care for patients with Ebola, a messy disease that causes diarrhea, vomiting, and, in some cases, bleeding from the eyes and ears.

Most U.S. hospitals are not equipped with incinerators or large sterilizers (autoclaves) that could accommodate the large amounts of soiled linens, contaminated syringes, and virus-spattered protective gear generated from the care of an Ebola patient, said Dr. Jeffrey Duchin, chair of the Infectious Diseases Society of America's Public Health Committee.

Sterilizing Ebola waste before it is transported is important not only to protect waste haulers but to guard against someone using the waste “for nefarious purposes,” said Sean Kaufman, president of an Atlanta-based biosafety firm. “It's not just a safety issue,” he said.

The matter, which was first reported by Reuters last month, may pose a significant challenge for Texas Health Presbyterian Hospital in Dallas, which is now treating the first Ebola patient to be diagnosed on U.S. soil.

Duchin told Reuters that he didn’t know whether the hospital has its own incinerator or large autoclave, but if it does not, “they are going to have to find a temporary solution for managing infectious waste. That puts the hospital in a very difficult situation.”

The Centers for Disease Control and Prevention (CDC) advises hospitals to treat items infected with the Ebola virus in leak-proof containers and to discard them as they would other biohazards that fall into the category of “regulated medical waste.”

But the U.S. Department of Transportation (DOT) deems Ebola a Category A infectious agent, meaning it is capable of killing people and animals, and not “regulated medical waste,” a category in which pathogens are not capable of causing harm.

Waste management contractors who normally handle hazardous hospital waste say they cannot legally haul the material, which leaves hospitals stuck without a way to dispose of the waste.

The issue has already created problems. When Emory University Hospital in Atlanta was preparing to care for two U.S. missionaries infected with Ebola in West Africa in its high-security biocontainment unit, their waste hauler, Stericycle, initially refused to handle it. Bags of Ebola waste quickly began piling up until the hospital worked out the issues with the help of the CDC.

A DOT official said that the CDC and DOT will likely issue joint guidance on Ebola waste disposal by next week.

Source: Reuters; September 2, 2014.

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