In this post, we will discuss the following considerations for managing Category A waste in a healthcare facility:
- Protecting healthcare worker and waste handler safety
- Spill cleanup procedures
Protecting worker health and safety: The first and best strategy for protecting workers is anticipation, assessment, identification, and planning for occupational exposure risk and appropriate protocol development before waste is generated. Safe work practices for employers and workers include:
- Limiting the number of workers who handle Category A waste throughout the waste lifecycle.
- Provide workers with appropriate PPE.
- Train and instruct workers on proper protocols for handling Category A waste per the Hazardous Materials Regulations (HMR). Train workers to notify a supervisor immediately if exposed to potentially infectious material, including waste.
- Whenever gloves are removed or changed, wash hands with soap and water for at least 20 seconds or use alcohol-based hand rubs followed by handwashing as soon as possible.
- Always wash hands with soap and water if hands are visibly soiled.
- Wear dedicated work clothing while on the job. Change clothing and shower as soon as possible if work clothing becomes soiled.
- Discard soiled work clothing and PPE with other Category A waste.
- Wear dedicated, washable footwear while working.
- Consider vaccination to protect workers from diseases for which a vaccine exists. (e.g., Hepatitis B, Hepatitis A; influenza; measles, mumps, rubella (MMR); COVID-19; and tetanus, diphtheria, and pertussis (Tdap)).
- Make chemoprophylaxis available to workers as part of post-exposure follow-up and care.
- Incinerate or autoclave entire, unopened waste containers to eliminate exposure associated with handling and opening containers.
- Handle inactivated, non-infectious waste as though it may continue to pose a hazard from sharps and other puncture injuries.
Cleaning up spills: Develop spill clean-up protocols and train staff to respond to and clean up spills of blood, body fluids, and other potentially infectious or contaminated materials within the facility.
- Assemble spill clean-up kits, which typically contain:
- Absorbent materials (such as clay cat litter or other absorbent granules, towels, or chux)
- Appropriate disinfectant
- Must have a label that claims against non-enveloped viruses.
- Tools for clean-up (broom, pans, bags/containers, cloths, tongs, hazardous material vacuums)
- Personal protective equipment (PPE)
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