Just one Ebola patient treated in a U.S. hospital will generate eight 55-gallon barrels of medical waste each day.
Protective gloves, gowns, masks and booties are donned and doffed by all who approach the patient’s bedside and then discarded. Disposable medical tools, packaging, bed sheets, cups, plates, tissues, towels, pillowcases and anything which is utilized to clean up after the individual has to be thrown away.
Dealing with this assortment of pathogen-filled debris without triggering new illnesses is a legal and logistical challenge for each U.S. hospital currently preparing for a possible visit by the virus.
In California and other states, it is a much worse waste-management nightmare.
While the U.S. Centers for Disease Control and Prevention recommends autoclaving (a kind of sterilizing) or incinerating the waste as a surefire means of destroying the germs, burning waste is effectively banned in California, also banned in many different states.
“Storage, transport and disposal of the waste is going to be a significant issue,” California Hospital Association President C. Duane Dauner warned Sen. Barbara Boxer, D-Calif., in a letter last week.
Even a few states that normally permit incineration are throwing up barriers to Ebola waste.
In Missouri, the state attorney general has sought to pub Ebola-contaminated debris by a St. Louis incinerator operated by Stericycle Inc., the country’s biggest medical waste disposal firm.
as a result of restrictions on burning, California hospital representatives say their only alternative appears to be trucking the waste over public highways and incinerating it in a different state — a prospect which makes some environmental advocates embarrassing.
Prerequisites for transport
Under national transport guidelines, the material would be designated a Class A infectious substance, or one that’s capable of causing death or permanent disability, and might require special approval from the Department of Transportation, hospital representatives say. “Not to create any type of scare, but only given the makeup of the people and the hub we are. It is very possible” It can’t endure a 1,500-degree scorching within an incinerator, or even the prolonged, pressurized steam of an autoclave. “It is killed by bleach, by autoclaving, by an assortment of chemicals.”
But, CDC guidelines note that”chemical inactivation” has yet to be standardized and could trigger worker safety regulations.
California health officials lately tried to reassure residents that the nation’s private and public hospitals were around the job and were actively training for the possible coming of Ebola.
“Ebola doesn’t pose a significant public health risk to California communities in the present time,” said Dr. Gil Chavez, an epidemiologist and deputy director in the California Department of Public Health. “Allow me to tell you why: Present scientific proof specifies that people can’t access Ebola through the atmosphere, food or water. … The Ebola virus doesn’t survive over a couple of hours on impervious surfaces.”
It was uncertain whether California officials viewed the waste issue as a possible issue.
Although one third of the nation’s private hospitals and”several” of its public hospitals reported to Boxer’s office there would be problems complying with the CDC’s incineration recommendation, and others, a state public health officer told reporters he was not aware of any conflicts.
Dr. David Perrott, chief medical officer for the California Hospital Association, said there was also confusion about whether contaminated human waste could be flushed down the toilet.
“Here is what we’ve heard from the CDC: It is OK,” Perrott said. “But we’ve heard from some sources, that maybe we must sterilize it somehow and then flush it down the toilet or you have to consult local governments. It sounds maybe a bit gross, but there is a real question about what to do with this waste.”
Dr. Thomas Ksiazek, a professor of microbiology and immunology at the University of Texas Medical Branch, has said he believes there’s been a lot of overreaction about Ebola medical waste.
“There are different methods to deal with the waste; autoclaving would be chief among them,” Ksiazek mentioned. “The issue is, most physicians don’t use it for many disposable products. They’re quite pleased to bag them up and send them to a normal medical disposal firm.”
But Allen Hershkowitz, a senior scientist at the Natural Resources Defense Council, said incineration is simple and powerful, and should be available to hospitals to help eliminate the mountain of waste.
Hershkowitz said states began to crack down on medical waste incineration years back because substances which didn’t have to get burned were being sent to combustors and were emitting dangerous pollutants.
within this instance of Ebola medical waste, he said California should reconsider its limitations.
“There’s no pollutant that is going to come from a waste incinerator that is more dangerous than the Ebola virus,” Hershkowitz said. “When you’re dealing with pathogenic and biological hazards, sometimes the safest thing to do is combustion.”
“There are other ways to deal with the waste; autoclaving would be chief among them,” Ksiazek said. “The problem is, most hospitals don’t use it for most disposable items. They’re quite happy to bag them up and send them to a regular medical disposal company.”
But Allen Hershkowitz, a senior scientist at the Natural Resources Defense Council, said incineration is simple and effective, and should be available to hospitals to help dispose of the mountain of waste.
Hershkowitz said states began to crack down on medical waste incineration years ago because materials that didn’t need to be burned were being sent to combustors and were emitting dangerous pollutants.
In this case of Ebola medical waste, he said California should reconsider its restrictions.
“There’s no pollutant that’s going to come out of a waste incinerator that’s more dangerous than the Ebola virus,” Hershkowitz said. “When you’re dealing with pathogenic and biological hazards, sometimes the safest thing to do is combustion.”