This is an update of the article originally published on March 19, 2020. Regulations change frequently. That’s why Sharps Compliance monitors updates and communicates any changes to its customers.
In these uncertain times, many of our current and prospective customers look to us, their regulated medical waste (RMW) management experts, for guidance in the proper handling of waste generated from confirmed and suspected COVID-19 cases, and rightfully so.
As a courtesy to anyone seeking out such guidance, we have created a list of recommendations for waste management in some of the industries most impacted by coronavirus. All guidance listed below reflects the most up-to-date recommendations issued by the Centers for Disease Control (CDC), the World Health Organization (WHO), and industry leaders, as of April 10, 2020. And though the general recommendation is to treat COVID-19 RMW the same as any other infectious waste, there are some specific tips below that may prove useful to your home or practice.
- Place all used disposable gloves, face masks, and other contaminated items in a lined container before disposing of them with other household waste.
- Clean your hands (with soap and water or an alcohol-based hand sanitizer) immediately after handling these
- CDC’s Guidelines for Caring for Patients:
- Management of medical waste should be performed in accordance with routine procedures.
- CDC’s Infection Control Recommendations:
- Medical waste (trash) coming from healthcare facilities treating COVID-2019 patients is no different than waste coming from facilities without COVID-19 patients.
- Facilities should provide no-touch receptacles for disposal, at healthcare facility entrances, waiting rooms, and patient check-ins.
- Healthcare professionals are advised to use dedicated or disposable noncritical patient-care equipment (e.g., blood pressure cuffs) and personal protective equipment (gloves, masks, gowns, etc.).
- Healthcare professionals must receive training on and demonstrate an understanding of how to properly dispose of or disinfect and maintain PPE.
- Waste generated in the care of persons under investigation or patients with confirmed COVID-19 does not present additional considerations for wastewater disinfection in the U.S.
- CDC’s guidance states that management of laundry, food service utensils, and medical waste should be performed in accordance with routine procedures.
- From OSHA’s “Guidance on Preparing Workplaces for COVID-19”:
- N95 respirator training should address proper disposal.
- Workers who dispose of PPE and other infectious waste must also be trained and provided with appropriate PPE.
- Per the American Association of Bronchology & Interventional Pulmonology:
- Disposable bronchoscopes should be used first line when available.
- Follow CDC instructions for proper donning and doffing of all protective equipment and disposable devices.
- This information is based on the latest Centers for Disease Control (CDC) recommendations and expert consensus of the AABIP COVID-19 Task Force.
Family Medicine Clinics:
- American Academy of Family Physicians’ Checklist to Prepare Physician Offices for COVID-19:
- No-touch containers with disposable liners should be placed in all reception, waiting, patient care, and restroom areas used to dispose of waste materials with respiratory secretions.
- Arrange to use the currently recommended routine procedures/methods/protocols for the disposal of dangerous/medical waste.
- Nursing Homes are guided to put a trash can near the exit inside the resident room to make it easy for staff to discard PPE prior to exiting the room, or before providing care for another resident in the same room.
- For SARS-CoV-2 laboratory waste, follow standard procedures associated with other respiratory pathogens, such as seasonal influenza and other human coronaviruses.
- For waste associated with testing clinical specimens from suspected COVID-19 persons under investigation:
- personnel should follow standard procedures associated with other respiratory pathogens, such as seasonal influenza and other human coronaviruses.
- Biohazardous waste containers should be leakproof and closed prior to removal from the laboratory for decontamination.
- If there is no autoclave onsite, then pack waste in accordance with institutional policy and procedures.
- CDC has also issued lengthy Waste Disposal Recommendations for Postmortem Specimens from Deceased Persons Under Investigation for COVID-19.
- CDC’s Interim Additional Guidance for Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed COVID-19 in Outpatient Hemodialysis Facilities:
- Provide patients and healthcare professionals with instructions (in appropriate languages) on how to dispose of tissues and contaminated items in waste receptacles.
- Facilities should no-touch disposal receptacles positioned close to dialysis chairs and nursing stations.
- Disposable gowns should be discarded in a dedicated container after use.
- CDC’s Interim Environmental Cleaning and Disinfection Recommendations for U.S. Community Facilities with Suspected/Confirmed Coronavirus Disease 2019 states “Employers must comply with OSHA’s standards on Bloodborne Pathogens (29 CFR 1910.1030), including proper disposal of regulated waste, and PPE (29 CFR 1910.132).”
- If no symptomatic passengers were identified during or immediately after the flight, follow routine operating procedures for cleaning aircraft, managing solid waste, and wearing PPE.
- If ill travelers were identified during flight, treat all body fluids (such as respiratory secretions, diarrhea, vomit, or blood) as infectious. Properly dispose of gloves and other disposable items that came in contact with the sick person or body fluids in a biohazard bag or a secured plastic bag labeled as “biohazard.”
- General recommendations during the enhanced cleaning process include following the airline’s routine procedures for disposal of PPE and other disposable items used in cleaning. Note that all waste from international flights will also fall under the jurisdiction of the U.S. Department of Agriculture/Animal and Plant Health Inspection Service (APHIS).
- PPE should be removed and placed with other disposable items in sturdy, leak-proof (plastic) bags that are tied shut and not reopened.
- The bags of used PPE and disposable items can then be placed into the solid waste stream according to routine procedures.
- Follow your standard operating procedures for waste removal and treatment.
- Disposable respirators should be removed and discarded after exiting the patient’s room or care area.
- Disposable eye protection should be discarded after use.
- Remove and discard soiled gowns in a dedicated container for waste or linen before leaving the patient room or care area.
- If close contact occurs during apprehension, follow standard operating procedures for the containment and disposal of used PPE.
- Ensure supplies are available such as tissues, hand soap, waste receptacles, and alcohol-based hand sanitizer in readily accessible areas.
- If someone is sick, wear disposable gloves and gowns for all tasks in the cleaning process, including handling trash.
- Employer considerations:
- Educate workers performing cleaning, laundry, and trash pickup to recognize the symptoms of COVID-19.
- Provide training on how to properly dispose of PPE to all cleaning staff on site prior to providing cleaning tasks.
- Comply with OSHA’s standards on Bloodborne Pathogens (29 CFR 1910.1030), including proper disposal of regulated waste, and PPE (29 CFR 1910.132).
- Provide tissues and no-touch disposal receptacles for use by employees.
Homes & Residential Communities:
- Throw used tissues in the trash.
- If possible, dedicate a lined trash can for a sick person. Use gloves when removing garbage bags and handling and disposing of trash.
- Consider consulting with your local health department about trash disposal guidance if available.
- Provide tissues and no-touch disposal receptacles for employees to use.
Non-traditional environments (converted hotels, mobile field medical units etc.) established by jurisdictions to deliver hospital-level, acute and non-acute care should implement the following infection prevention and control considerations to supplement existing pandemic planning efforts:
- Infrastructure to ensure dirty storage space for medical and non-medical waste and dirty equipment waiting to be reprocessed
- Sanitation and waste servicing for routine waste and medical waste (if required); refer to local regulations for handling of medical waste
- Daily removal of trash from individual patient rooms (e.g., hotel) plus environmental services staff perform terminal cleaning of rooms and patients ideally perform daily cleaning
Please refer to the EPA’s full listing of disinfectants for use against SARS-CoV-2 (COVID-19).
Additionally, since states govern regulated medical waste, please be sure to check with your state’s regulatory agency(s) to see if they have any additional guidance, requirements, or tips for handling waste specific to your state. Lastly, please contact Sharps Compliance at 800.772.5657 if you have any questions.
Is your medical office ready? Review our article on preparing your medical office for COVID-19 Coronavirus.
Stay healthy, everyone.