Stericycle, DOT and CDC help hospitals prepare for Ebola waste

医院如何通过基于科学的决策为潜在的埃博拉病毒废物流做准备，并以最佳管理方法开始？

虽然这是不断发展的实践的新兴话题，但最重要的资源是The Center for Disease Control and Prevention网页，用于针对保护设备，隔离，存储，包装和删除该类别的传染性材料的最佳方法指南。尽管对于大多数医院而言，这种废物流可能不会成为问题，但准备是关键。

Special process for waste disposal

Stericycle, a member of练习GreenHealth, began working with the CDC and the Department of Transportation in August when the first Ebola case entered the United States. As a result of the collaboration, DOT released a special permit process along with requirements for proper segregation, containment, packaging and removal of this Category A infectious waste to address the needs of Dallas Presbyterian Hospital while maintaining overall public safety.

Stericycle, DOT and CDC continue to work together to evaluate the process and prepare to address additional Ebola-related waste needs. At present, each incident is addressed on a case-by-case basis.

To prepare for waste disposal, hospital staffers should work with their waste hauler for specific packaging procedures and ensure appropriate supplies are on-hand in the hospital and that their hauler is prepared to manage waste removal and disposal. Additional special permits likely will be required from the Department of Transportation to remove the Category A infections waste（PDF）, a different category from traditional infectious material (Category B).

The CDC reports that Ebola requires standard, contact and droplet precautions. It is spread by contact with one or more of the following: infected animals; blood or body fluids (including urine, saliva, sweat, feces, vomit, breast milk and semen) of a person sick with Ebola or objects (such as needles and syringes) contaminated with the virus.

Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling灌木肉(wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitos or other insects can transmit Ebola virus. Only mammals (humans, bats, monkeys and apes) have shown the ability to become infected with and spread Ebola virus.

According to theCDC site为临床医生提供指导，埃博拉病毒通过粘膜进入患者，在皮肤或其他肠胃外断裂。它感染了许多细胞类型，包括单核细胞，巨噬细胞，树突状细胞，内皮细胞，成纤维细胞，肝细胞，肾上腺皮质细胞和上皮细胞。孵育期可能与感染途径有关（注射六天，接触10天）。埃博拉病毒从初始感染部位迁移到区域淋巴结，然后迁移到肝脏，脾脏和肾上腺。

The CDC reports on the details regarding personal protective equipment. For waste collection, environmental services staff are recommended to wear, at a minimum, disposable gloves, gown (fluid resistant/ impermeable), eye protection (goggles or face shield) and face mask to protect against direct skin and mucous membrane exposure of cleaning chemicals, contamination and splashes or spatters during environmental cleaning and disinfection activities.

Additional barriers (leg covers, shoe covers) should be used as needed. If reusable heavy-duty gloves are used for cleaning and disinfecting, they should be disinfected and kept in the room or anteroom. Be sure staff is instructed in the proper use of personal protective equipment including safe removal to prevent contaminating themselves or others in the process, and that contaminated equipment is disposed of appropriately (included in the Category A waste collection). Any mattresses or pillows that are not covered with an impermeable plastic covering should be treated as Category A infectious waste, as well.

经常检查CDC网站以获取任何更新。疾病预防控制中心还建议任何带有患者隔离埃博拉病毒的房间，都应没有布料材料，例如地毯，窗帘或家具。应在所有表面上使用具有标签的EPA注册的医院消毒剂，其标签索赔应使用，所有废物应作为A类受管制的医疗废物（包括可重复使用的亚麻布）的类别收集。

必威体育2018可持续性和感染控制

必威体育2018可持续性团队, led by infection control, work together to educate new and existing employees, develop posters, strategically place waste bins and monitor waste segregation practices.

According to the练习GreenHealth必威体育2018可持续性基准报告, award-winning hospitals average a 9 percent regulated medical waste generation with top performers at a 2.3 percent compared to total waste. With waste fees at least five times more than for solid waste, it's worth the effort, saving anywhere from tens of thousands to hundreds of thousands of dollars per year in waste removal and treatment fees.

Top image of biohazard symbol byMaxal Tamorvia Shutterstock. This article first appeared atCSRWIRE.