A Category A infectious substance is an infectious substance in a form capable of causing permanent disability or life-threatening or fatal disease in otherwise healthy humans or animals when exposure to the substance occurs.
Category A waste refers to materials contaminated with Category A infectious substances. Proper transport and elimination of Category A waste are in accordance with the Hazardous Materials Regulations (HMR) put forth by the U.S. Department of Transportation (DOT)/Pipeline and Hazardous Materials Safety Administration (PHMSA). Compliance with proper guidelines is crucial in preventing disease spread and protecting our communities.
Healthcare facilities should have plans to address the entire waste lifecycle, from the initial generation of the waste to the final disposition of the waste including any of its byproducts. Waste management plans should consider jurisdiction- or facility-specific procedures and be made in collaboration with appropriate state, local, tribal, and/or territorial (SLTT) health and environmental departments. The safety of the people handling waste materials on-site, in transport, and off-site should be the focus of all protocols. Potential exposures to pathogens or other hazardous materials, including sharps, must also be considered. Finally, methods to communicate between people and facilities accurately and effectively regarding exposure risks should be in place.
Some facilities can treat or inactivate waste on-site, while others will need to package, store, and transport waste off-site for treatment, and respective plans will differ. Facility staff, emergency responders, remediation contractors, and others handling the waste should be made aware of how the waste was treated and the implications for what types of materials can be processed safely. No matter whether waste will be inactivated on-site or sent for off-site inactivation and disposal, staff should be conscious of the materials going into waste streams to reduce the risk of downstream exposures.
For the majority of facilities, protocols will address the following considerations:
- Planning for Category A waste
- Minimizing the amount of Category A waste
- Storing packaged Category A waste prior to inactivation or transport
- Moving Category A waste within a facility
- Treating Category A waste on-site
- Packaging Category A waste for off-site treatment
- Protecting worker health and safety
- Cleaning up spills
Check back next week as these considerations are discussed in more detail!
Alexandra McKenna Lewis is a 4th-year medical student at the University of Texas Medical Branch John Sealy School of Medicine.
Resources:
https://www.phmsa.dot.gov/sites/phmsa.dot.gov/files/2022-06/Cat%20A%20Waste%20Planning%20Guidance_Final_2022_06.pdf
https://www.phmsa.dot.gov/sites/phmsa.dot.gov/files/2020-04/Transporting-Infectious-Substances-Safely.pdf
https://www.phmsa.dot.gov/standards-rulemaking/hazmat/hazardous-materials-regulations