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Waste Management Considerations for 2009 H1N1 Flu
The 2009 H1N1 flu (officially recognized as 2009 H1N1 Flu) is illness caused by an influenza virus. This new virus was first detected in the United States in April 2009 and has since spread worldwide. On June 11, 2009, the World Health Organization determined that a pandemic of 2009 H1N1 flu was underway. A flu pandemic occurs when a new influenza A virus emerges for which there is little or no immunity in the human population; the virus causes serious illness and spreads easily from person-to-person worldwide. The US Department of Health and Human Services (HHS)/Centers for Disease Control (CDC) and Prevention is the primary federal agency for conducting and supporting public health activities in the United States. The magnitude of the pandemic has resulted in an increased awareness of waste management considerations associated with this virus. However, the overall waste management approach remains the same as for other flu-related waste. The consistent use of current standard precautions when handling waste contaminated by 2009 H1N1 or seasonal flu will be effective in protecting employees and the public.
- How are influenza viruses thought to be spread from person to person?
- What 2009 H1N1 flu-related waste may be generated?
- Does EPA have any specific waste management protocols for 2009 H1N1 flu?
- In general, how should waste disposal be handled to prevent the spread of 2009 H1N1 flu in a healthcare, home, school or business setting?
- What guidance has CDC issued that discusses waste management considerations involving 2009 H1N1 flu?
- What disinfectants has EPA registered to use for 2009 H1N1 flu?
- How can I stay current with the latest EPA and other federal guidance issued involving 2009 H1N1 flu?
How are influenza viruses thought to be spread from person to person?
2009 H1N1 influenza virus appears to spread from person to person through close contact in ways similar to other influenza viruses. Although the relative contribution of different routes of transmission is uncertain, influenza virus can potentially be transmitted through:
- Droplet exposure of mucosal surfaces (e.g., nose, mouth, and eyes) by respiratory secretions from coughing or sneezing persons infected with influenza;
- Contact, usually of hands, with an infectious patient or a surface that is contaminated with influenza viruses followed by self-inoculation of virus onto mucosal surfaces such as those of the nose, mouth, and eyes; and
- Small particle aerosols near a person infected with influenza.
Transmission of influenza through the air over longer distances (e.g., from one patient room to another) is not a primary consideration. All respiratory secretions and bodily fluids, including diarrheal stools, of patients with 2009 H1N1 influenza are considered to be potentially infectious.
What 2009 H1N1 flu-related waste may be generated?
Waste is generated from the care of patients in health care facilities, cleaning and disinfection of contaminated surfaces, as well as from the use of personal tissues and/or masks to contain coughs and sneezes. Although the main ways that influenza is thought to be transmitted from person to person is via large droplets produced when someone coughs or sneezes, some transmission may also occur by a person touching a surface contaminated with influenza viruses and then touching their nose, eyes or mouth. To reduce the chances that flu may be transmitted after touching surfaces, CDC recommends routine disinfection of surfaces in workplace and community environments, as well as in residential situations where people are caring for individuals with influenza like illness.
Does EPA have any specific waste management protocols for 2009 H1N1 flu?
The HHS/CDC has developed guidance for the 2009-2010 H1N1 flu season in consultation with EPA and other federal agencies. The HHS/CDC guidance addresses, in part, waste handling, disinfection and disposal associated with 2009 H1N1 flu in different settings. The types of wastes associated with 2009 H1N1 flu (e.g., medical/infectious wastes) are solid wastes and therefore, these wastes are subject to state, local and tribal governments' rules and regulations. Much of the waste from 2009 H1N1 flu is being handled as medical waste through hospitals and labs, which is the same process as occurs for other types of flu. Just because a material has the potential to be contaminated with H1N1 influenza virus does not mean it is a regulated medical waste. As a result, it is important to consult with state, local and tribal waste management officials to determine how these wastes should be managed (e.g., municipal solid waste landfills, hazardous waste landfills or medical waste treatment facilities).
In general, how should waste disposal be handled to prevent the spread of 2009 H1N1 flu in a healthcare, home, school or business setting?
There is no evidence to suggest that either 2009 H1N1 flu or seasonal flu can be spread via contact with routine solid wastes or regulated medical wastes generated in a healthcare facility or in a home, school, or business. Routine cleaning and disinfection strategies used during influenza seasons can be applied to the environmental management of 2009 H1N1 influenza. Management of laundry, utensils, personal protective equipment and medical waste should also be performed in accordance with procedures followed for seasonal influenza. Current waste management strategies for any influenza viruses in circulation:
- Use standard precautions when working with solid waste that may be contaminated with 2009 H1N1 flu outside of patient isolation areas.
- Use personal protective equipment as is currently required by your state (e.g., gloves) when handling open waste containers.
- No changes in waste containment need to be made during periods of flu activity (e.g., single bag lining for routine clinic wastes, appropriate labeled containment for regulated medical wastes).
- Current medical waste procedures should be used to characterize, handle, and treat medical waste in accordance with state and federal regulations.
- Medical waste that has been treated can be safely disposed in municipal solid waste landfills as per normal procedures.
Homes, Schools, and Businesses:
- Disposable tissues and/or masks used to contain coughs, sneezes or nasal discharges should be placed in waste receptacles; no special precautions other than hand washing and hygiene are required.
- Disposable tissues and/or masks are considered routine solid waste that can be sent to municipal solid waste landfills without treatment, unless specific state, local, or tribal solid waste or medical waste regulations prohibit this practice.
- Hand washing or other hand hygiene practices should be followed after emptying waste receptacles.
What guidance has CDC issued that discusses waste management considerations involving 2009 H1N1 flu?
The HHS/CDC has developed several guidance documents that address waste handling, disinfection, and disposal associated with 2009 H1N1 flu in different settings. These guidance documents are written to be consistent with CDC's guidance on the Environmental Management of Pandemic Influenza Virus as well as CDC's Interim guidance on 2009 H1N1 Infection Control in Healthcare Settings. These documents and others that discuss treatment and/or disposal issues are included here for your information:
- CDC 2009 H1N1 Flu Biosafety Guidance (including lab waste and disinfectant use)
- CDC 2009 H1N1 Flu Interim Guidance on Taking Care of a Sick Person in Your Home
- CDC Hand Washing Guidance
- Links to Additional 2009 H1N1 Flu and General Pandemic Planning Guidance
What disinfectants has EPA registered to use for 2009 H1N1 flu?
EPA registers pesticide products, including disinfectants. Currently, over 500 disinfectant products are registered for use on hard, non-porous surfaces against influenza viruses. EPA believes, based on available scientific information, that the currently registered influenza products will be effective against the 2009 H1N1 flu strain and other flu strains on hard, non-porous surfaces. A list of these disinfectants can be found on EPA's Guidance for Testing and Labeling Claims against Pandemic 2009 H1N1 Influenza A Virus (Formerly called Swine Flu) Web page.
How can I stay current with the latest EPA and other federal guidance issued involving 2009 H1N1 flu?
You can find this information at the federal government's flu Web site, EPA's pandemic flu Web site or EPA's Office of Resource Conservation and Recovery's H1N1 Web page.