Waste and management of human waste

Waste

Patient with suspected VHF while waiting for results

Waste contaminated with blood or body fluids from a patient under investigation for VHF should have their waste managed in one of the following ways:

• left in the room until VHF has been excluded or confirmed (if there is sufficient space)
• stored (double bagged and in a rigid container) in a segregated area
• discarded immediately as clinical waste (for incineration), if there is insufficient room to store the waste.

If the patient is not producing secretions, clinical waste can be placed in sealed bags and disposed of as per the facility’s waste management policy, as there is minimal risk from this type of waste when patients are in the ‘dry’ or non-secretory phase.

Patient with confirmed VHF

All waste from patients with confirmed VHF is to be incinerated (or autoclaved), including:

• PPE
• linen
• medical supplies
• body fluids and contaminated items.

Facilities will need to determine how waste is to be safely removed from the patient room and where it is to be stored for final disposal.

A system should be developed for double-bagging all waste from the patient’s room. The first clinical waste bag from inside the patient’s room should be placed into a second clinical waste bag kept immediately outside the patient room. This may require a buddy system to be able to do this safely.

Clinical waste bags should be sealed before placing into a rigid outer container for transport.

If the waste includes a liquid component, use absorbent material to contain the fluid.

Fill bags to a maximum of three-quarters full to allow them to be adequately sealed.

The secure rigid outer container should be of sufficient dimensions to deposit and accommodate waste items likely to be generated in the routine care of the patient (for example, items of PPE).

Consideration could be given to using two types of waste bins – a lockable and sealable clinical waste bin for wet waste and an anatomical waste bin for other waste, as this can also be locked.

Organise with environmental services to deliver anatomical/clinical waste bins and facilitate ongoing supply of bins for the duration of the patient stay.

All used syringes, needles and sharps are to be placed into a designated sharps container, sealed and placed inside a clinical waste bin so it can be incinerated. Wipe the sealed sharps container, if visibly contaminated, with hospital-approved detergent/disinfectant wipes prior to removal from the patient’s room.

PPE

Staff handling VHF waste must wear Level 1 (Dry) PPE on Personal protective equipment (PPE), including:

• gloves
• long-sleeved gowns and aprons
• eye protection (goggles or face shields)
• a P2/N95 respirator
• closed shoes or boots.

In-hospital transport of waste

For in-hospital waste transport:

• use dedicated, closed containers for waste transport
• avoid transporting waste through public areas
• disinfect carts after each use with an approved detergent/disinfectant.

Storage of waste until collected

VHF waste should be stored in a safe and secure locked environment to prevent accidental or unauthorised access.

The secure rigid outer container must carry outer labelling consistent with UN2814/ADG Class 6.2 for transport and carry the text 'In the case of damage or leakage, immediately notify Public Health Authority.'

Treatment and disposal

Waste must be autoclaved, incinerated or otherwise inactivated before disposal.

Once properly treated, waste can be disposed of as regular medical waste.

Offsite transport and treatment

If untreated waste is transported offsite, it must comply with the Environmental Protection Regulations as a Category A Infectious substance, prescribed industrial waste.

The secure rigid outer container carrying this waste must be accompanied by a Transport Certificate setting out the prescribed waste as Hazard Category A waste/UN Number 2814. This includes the requirement for the waste generator to ensure that the waste transporter is aware of the transportation of VHF waste in permitted vehicles compliant with the Environment Protection Authority Victoria (EPA) special waste classification for VHF waste (R100).

Management of human waste

When managing human waste, remember:

• All human waste is potentially infectious.
• Although it is likely safe for human waste from patients with a VHF to be disposed of via the sewage system, it is recommended that all excreta be disposed of as clinical waste.
• All staff involved in the handling or disposal of human waste must wear the appropriate level of PPE (1 or 2) following a risk assessment (see Selection of PPE - risk assessment on Personal protective equipment).

Bedpans, urinals and commodes

Single-use bedpans and urinals are highly recommended. If reusable bedpans or urinals are all that is available, these must be discarded after use.

The method for disposal of excreta as clinical waste is as follows:

1. Solidify waste using high-absorbency granules or gel. If this is not available, place an incontinence pad in the receptacle to prevent leakage.
2. Place the bedpan or urinal, and contents, into a clinical waste bag and secure.
3. Consider double-bagging human waste disposed of via this method. Remove outer gloves, perform hand hygiene and reapply a second pair of gloves.

Nappies and incontinence pads

For nappies and incontinence pads:

• Place used items into a clinical waste bag and secure. Consider double-bagging human waste disposed of via this method.
• Remove outer gloves, perform hand hygiene and reapply a second pair of gloves.