Stericycle Inc.

22/07/2024 | News release | Distributed by Public on 22/07/2024 13:57

Understanding, Managing, and Disposing of Category A Waste in Healthcare

July 22, 2024

Expert Guide on Handling Category A Infectious Substances in Healthcare

Healthcare facilities are tasked with the daily management of substantial amounts of medical waste, making it critical for healthcare professionals to identify and correctly dispose of it to protect staff and patients alike. Among the different types of waste, Category A infectious substances stand out due to their ability to cause severe health issues, including fatal disease. These pathogens, which include viruses like Ebola, can lead to permanent disability, life-threatening conditions, or even death in healthy individuals upon exposure. Given their high-risk nature, these infectious substances require meticulous handling procedures.

What is a Category A Infectious Substance?

A Category A infectious substance is officially classified under DOT 49 CFR 173.134(a)(1)(i) as an infectious agent that, upon exposure, has the potential to cause permanent disability, life-threatening conditions, or fatal diseases in otherwise healthy humans or animals. This category includes highly virulent pathogens such as the Ebola virus, various hemorrhagic fever viruses, and the variola virus, which is responsible for smallpox. Waste classified as Category A is comprised solely of these pathogens' cultures or may result from treating a patient infected with a Category A pathogen. The Planning Guidance for Handling Category A Solid Waste is an industry reference published through the Pipeline and Hazardous Materials Safety Administration (PHMSA). It is available to help generators understand which infectious substances are Category A as cultures only, or in all situations.

Distinguishing Category A Infectious Substances From Regulated Medical Waste

The definition of Regulated Medical Waste (RMW) may differ at the federal, state, and local levels. That said, RMW is generally waste known or reasonably expected to contain a pathogen potentially derived from the medical treatment of an animal or human, which includes diagnosis and immunization, or from biomedical research, which includes the production and testing of biological products. RMW may include items saturated with liquid or semi-liquid blood or other potentially infectious materials (OPIM). Some examples may include disposable gowns, used gauze, and procedural drapes that are saturated with blood or OPIM. Contaminated sharps, including used needles, scalpels, or syringes, may also qualify as RMW.

Unlike RMW, however, Category A infectious substances are subject to more rigorous handling and packaging requirements due to the hazards associated and higher risk level. Category A infectious substances require specialized handling and inactivation procedures to mitigate their potential to cause life threatening or fatal health outcomes.

How to Optimize the Management of Category A Infectious Substances

Managing Category A infectious substances safely is a critical task, particularly when dealing with pathogens like Ebola or hemorrhagic fever viruses (HFVs), which can generate large quantities of infectious waste. Such diseases, often associated with severe symptoms and extended hospitalizations, significantly increase the risk of transmitting life-threatening illnesses. However, with proper management strategies, it is feasible to handle these substances safely. It is essential for organizational leaders to establish comprehensive plans that cover the entire lifecycle of infectious waste-prior to its initial generation through the final treatment of residuals.

  • Segregation of Category A Waste: Effective management starts with onsite staff correctly identifying and segregating Category A waste from other types of solid waste. If Category A waste is inadvertently mixed with other waste, the entire mixture should be treated as Category A waste. Category A waste requires more resources, such as dedicated storage areas, specific personal protective equipment (PPE) and packaging materials, and packaging and transportation processes potentially including special permits. Due to the additional specifications for managing Category A waste, it typically has higher transportation and disposal costs. It is crucial to accurately classify waste to prevent the overclassification of non-Category A waste. Suspected Category A waste should be stored separately until a confirmed diagnosis.
  • Packaging of Category A Waste: Disposal of Category A waste requires adherence to stringent Department of Transportation (DOT) regulations for packaging. The hazardous nature of Category A infectious substances mandates that they meet higher packaging standards than RMW to prevent disease spread. Depending on the type of Category A infectious substance, there may be specific packaging requirements by substance type identified in special permits issued by the DOT.
  • Transportation of Category A Waste: After proper packaging, Category A waste must be transported in compliance with Hazardous Materials Regulations (HMR) or under a DOT special permit. The DOT typically requires a confirmed diagnosis of a Category A infection before granting a special permit for transport. The packaging and transportation of Category A infectious substances are subject to more rigorous requirements than other types of infectious wastes.

Navigating Category A Infectious Substances with a Reliable Partner

It's essential to align your organization's policies with the regulatory, industry, and supplier requirements when managing all waste streams, especially regulated waste streams. Navigating the complexities of Category A infectious substances doesn't have to be a solitary journey-Stericycle is here to guide you. Stericycle has served our customers during times of significant outbreaks, epidemics, and pandemics of contagious diseases, including outbreaks in 2003 of SARS, 2009 of H1N1, 2014 of Ebola, and 2020 of COVID-19. By collaborating with the Centers for Disease Control and Prevention (CDC) and the United States DOT, Stericycle understands that compliance and safety are at the forefront of handling and disposing of Category A waste. In the face of the 2014 Ebola outbreak, Stericycle quickly mobilized, becoming the first company to receive a special permit from the DOT for the transportation of infectious substances resulting from Ebola virus treatment.

Stericycle remains vigilant and prepared for any potential future health crises, staying true to our mission of protecting health and well-being in a safe, responsible, and sustainable way. With over three decades of experience in supporting hospitals and health systems during public health emergencies, including the Ebola Virus Disease and COVID-19, Stericycle is well-equipped to assist with your Category A waste management requirements.

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