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Interim Guidance for U.S. Residence Decontamination for Ebola and Removal of Contaminated Waste

It is unclear if this resource has been informed by a best practice guideline, systematic review, randomized controlled trial or published single study.  The evidence in this resource has not been assessed for quality.

This resource provides guidance for public health and contracted services to decontaminate a residence and remove contaminated waste from an EVD patient.

http://www.cdc.gov/vhf/ebola/prevention/cleaning-us-homes.html

 Guidance
Author: Centre for Disease Control and Prevention (CDC)
Resource Date: Mar 2, 2015
Categories: Waste management Waste Management Professionals Public Health Professionals Environmental Cleaning Professionals Information for the public Centre for Disease Control and Prevention International
View Count: 0

CDC’s interim guidance document provides information for public health, state and/or local authorities who may have to decontaminate or arrange for a contract company to decontaminate a residence and remove contaminated waste because someone who was living within a particular region was confirmed to have Ebola Virus disease (EVD). These recommendations discuss effective disinfectant products and provide guidance for contract companies to follow in dealing with contaminated waste and guidance on how to use personal protective equipment (PPE).

Key Points

Effective Disinfectant Products: Currently, no hospital disinfectant products registered by the Environmental Protection Agency (EPA) claim that they kill the Ebola virus. Use an EPA-registered hospital disinfectant product with claims against non-enveloped viruses (norovirus, rotavirus, adenovirus, polio virus). These products are capable of inactivating both enveloped and non-enveloped viruses, including Ebola virus. A link to EPA’s list of Disinfectants for Use Against the Ebola Virus is included in the CDC document.

Level of Cleaning and Decontamination: The way to decontaminate the residence of a person confirmed to have EVD depends on the symptoms demonstrated at the time while in the residence. If the person with EVD had fever only without diarrhea, vomiting or bleeding, then the residence requires cleaning and laundering as normal using detergent and/or disinfectant. If the person with EVD had fever and diarrhea, vomiting or bleeding, then the authorities may need to contract a company to assess the residence to determine the proper decontamination and disposal procedures.

Which contract companies can conduct the cleaning? Companies with experience in cleaning biohazard and crime scenes can conduct the cleaning. These companies must comply with their state’s Ebola policies and the guidelines of the Occupational Safety and Health Administration (OSHA).

Transport of Waste: Ebola-contaminated waste must be packaged and transported in accordance with hazardous materials regulations provided by the U.S. Department of Transportation. OSHA standards, including Bloodborne Pathogens, may also be required.

Definitions: This section includes definitions for a contract company, disinfection products and PPE.

Decontamination and Waste Disposal: Guidelines for decontamination and waste disposal are determined by the symptoms of the person with EVD while they were within the residence:

  • In residences where a person with Ebola only had fever, normal cleaning and laundering is required because the individual was not contaminating the environment with body fluids (blood, diarrhea or vomiting).
  • In residences where a person with EVD had diarrhea, vomiting and/or bleeding, the local public health or assigned authority for Ebola emergency response should be involved to manage the decontamination and waste disposal through a contract company.

Public health authorities can assist in finding a qualified contract company to manage decontamination and waste removal for a residence of an EVD-confirmed person while complying with the state’s Ebola policies.

Recommendations for Contract Companies: The contract company should follow the recommendations described in CDC’s Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus and OSHA fact sheet 3756 on Cleaning and Decontamination of Ebola on Surfaces – Guidance for Workers and Employers in Non-Healthcare/Non-Laboratory Settings. Recommendations include the following:

  • For non-porous surfaces, use an EPA-registered hospital disinfectant with claims against non-enveloped viruses.
  • Properly contain, store and dispose of porous materials according to state regulations.
  • Package and transport waste according to the U.S. Department of Transport hazardous materials guidelines.

Contract Company Requirements and PPE (biological and chemical):  Contract company employees must be properly trained. The contract company is responsible for selecting and providing PPE to protect employees from exposure to Ebola as well as to chemical hazards from cleaning and disinfecting agents. Fit testing and clearance with NIOSH-approved respirators must take place before potential exposure to aerosolized virus particles and chemicals used for cleaning and disinfection.

Table: Interim Guidance Summary for Decontamination and Waste Disposal in a U.S. Residence where a Person has EVD – summary table is included

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