U.S. hospitals may not be able to safely dispose of waste from patients with the Ebola virus that arrive in the country, according to biosafety experts.
Due to conflicting regulations from the U.S. Centers for Disease Control and Prevention and the Department of Transportation on how to dispose of waste materials from patients being treated for the Ebola virus, some waste management companies will not remove medical materials used to treat those patients.
This conflict in disposal mandates could not only prevent hospitals from successfully treating patients that show symptoms of Ebola, but also put the hospital's surrounding communities at risk.
Because of federal transportation guidelines that require these items to be taken away by people with special hazardous materials training, Reuters reported Sept. 24 that Stericycle, the waste management company for Atlanta's Emory University Hospital, would not initially handle the waste generated in treating the Ebola-infected patients. Emory was the first hospital to care for Ebola patients in the U.S. during the current outbreak.
The hospital had 40 bags of hazardous waste at the peak of its treatment of the Ebola-infected patients, according to Emory's Dr. Aneesh Mehta. At one point, the staff had to buy as many 32-gallon containers with lids as possible from Home Depot to contain the waste until Atlanta-based Centers for Disease Control and Prevention helped Emory make a deal with Stericycle.
The number of people infected with Ebola in the West African countries of Liberia and Sierra Leone could reach anywhere from 550,000 to 1.4 million by mid-January, the CDC recently reported. Four Americans since August have been flown from West Africa to the U.S. where they were treated for Ebola. With the Ebola outbreak continuing to spread in Africa, it is likely that more infected patients will be diagnosed in U.S. hospitals, experts say. As many as 10 patients have been tested in U.S. hospitals for showing possible signs of an Ebola infection.
The CDC and the U.S. Department of Transportation, which regulates the transportation of infectious waste, have different guidelines for removing Ebola waste.
The CDC tells hospitals to discard Ebola waste as they would other waste considered "regulated medical waste," while the DOT requires that Ebola waste be put in special packaging and removed by those with special training, according to Reuters. Since there may not be packaging approved for handling Ebola waste, many waste management companies don't think they are legally allowed to transport the waste, which is why hospitals may be having difficulty with its removal.
Emory has been able to sterilize the waste with one of the university's autoclaves before letting a waste management company take it away, but not every hospital has access to one of these machines on-site. "For this reason, it would be very difficult for a hospital to agree to care for Ebola cases - this desperately needs a fix," Dr. Jeffrey Duchin, chair of the Infectious Diseases Society of America's Public Health Committee, told Reuters.
The CDC is working with the DOT on the issue, Reuters reports.
