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Guidance Note H1402
Packaging and Transport of waste from suspect
and confirmed cases of the Ebola Virus uid
Revision: 1.0
Date: 21/10/2014
Guidance Note: Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus
Revision 1.0 21/10/2014 Page 2 of 16
Contents
1 Purpose ........................................................................................................................................... 3
2 Introduction ...................................................................................................................................... 3
3 Regulations ..................................................................................................................................... 3
4 PROTEC620 packaging .................................................................................................................. 4
5 Alternative Packaging ..................................................................................................................... 7
5.1 General Provisions: ................................................................................................................. 7
5.2 Packaging type ........................................................................................................................ 8
5.3 Assembly of packaging ........................................................................................................... 9
5.4 Additional packaging and handling procedures .................................................................... 15
5.5 Labelling of packaging .......................................................................................................... 15
5.6 Storage .................................................................................................................................. 15
6 Collection ....................................................................................................................................... 16
Guidance Note: Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus
Revision 1.0 21/10/2014 Page 3 of 16
1 Purpose
This document is intended to provide hospitals and healthcare professionals with key information
about the safe handling and disposal of medical waste generated from the care of persons with
suspect and confirmed cases of the Ebola virus.
2 Introduction
Packaging used for the transport of waste from patients with Ebola must meet the requirements of
transport of dangerous goods by road regulations. There are two types of packaging available for
waste from persons diagnosed with or suspected of having the Ebola virus:
1. PROTEC620 packaging
This packaging is the Mauser WIVA PROTEC620 packaging. Guidance associated with this
packaging is outlined in section 4 of the report.
2. Alternative packaging
The Health and Safety Authority have granted an exemption whereby alternative packaging can
be used for the packaging of waste from suspect and confirmed cases of the Ebola virus.
Guidance associated with this packaging is outlined in section 5 of this report.
Note: Either type of the above packaging can be used in healthcare facilities for waste from persons
with suspect or confirmed cases of the Ebola virus.
Appropriate general and personal protective clothing and equipment must be provided and
used by staff involved in the handling of the waste and waste packaging.
3 Regulations
Category A – Ebola waste must be consigned nationally by road according to the following dangerous
goods transport regulations:
ADR European Agreement concerning the International Carriage of Dangerous Goods by
Road 2013.
European Communities (Carriage of Dangerous Goods by Road and Use of Transportable
Pressure Equipment), 2011, S.I. No. 349 of 2011.
European Communities (Carriage of Dangerous Goods by Road and Use of Transportable
Pressure Equipment) (Amendment) Regulations 2013, S.I. No. 238 of 2013.
To comply with the above regulations the waste from patients with the Ebola virus must be packaged
in line with this guidance document. If you have any queries regarding this guidance document,
please contact your Dangerous Goods Safety Advisor.
Guidance Note: Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus
Revision 1.0 21/10/2014 Page 4 of 16
4 PROTEC620 packaging
This section outlines instructions for the use of the Mauser WIVA PROTEC620 packaging for waste
from persons with suspect or confirmed cases of the Ebola Virus.
Step 1
The outer box should be opened and the drum removed
outside of the treatment room.
Open the Box by folding the flaps outwards.
Step 2
Remove the drum from the cardboard box and plastic
packaging.
Secure the cardboard box in a secure, safe, location outside
the treatment room.
Note: this cardboard box and outer plastic bag is not for
disposal. This packaging is required for the safe
transportation of the waste from the healthcare facility.
Step 3
Line the drum with the 2 inner bags and fold back around the
drum.
Place granule pouch provided in the bottom of the inner plastic
bag.
The drum is now ready for use and can be brought to the
treatment area.
Step 4
Once the drum is ¾ full, secure the 1st inner plastic bag with tie
provided. Please note there are 3 cable ties provided on the
lid of the drum.
Secure the 2nd
inner plastic bag with the second tie provided.
Guidance Note: Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus
Revision 1.0 21/10/2014 Page 5 of 16
Step 5
Fold both bags inwards.
Cover the bags with the polystyrene disc.
Step 6
Place the lid on top and secure with the ring clamp.
Step 7
Place the blue seal in opening on the clamp band. Please
note this seal is provided on the back of the lid.
Decontaminate external surface for the blue drum with
10,000ppm hypochlorite solution before it is removed
from the treatment room.
Step 8
Remove the drum from the treatment room.
Retrieve the cardboard box from the secure location.
Step 9
Place at the drum in the outer plastic bag and secure with the
third cable tie provided.
Guidance Note: Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus
Revision 1.0 21/10/2014 Page 6 of 16
Step 10
Place the sealed drum in the cardboard box and close flaps in
sequence 1 to 4 whilst removing adhesive strips.
Affix the infectious substance label to the box.
Remove the package to a secure facility pending collection.
Guidance Note: Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus
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5 Alternative Packaging
The Health and Safety Authority (HSA) has issued an exemption whereby alternative packaging can
be used for waste from persons with suspect or confirmed cases of the Ebola virus. The guidance in
this section must be strictly followed to ensure that the alternative packaging meets the requirements
of the HSA exemption.
5.1 General Provisions:
The following general provisions shall be complied with:
1. Medical or clinical wastes suspected of containing Ebola virus shall not be transported by
road unless diagnosis of the patient/source has been confirmed. Pending diagnosis, the
waste shall be packaged in accordance with section 5 of this document and stored in a
secure location at the healthcare facility.
2. If the diagnosis is proven to be negative, the waste shall be treated as Category B waste and
disposed of with standard clinical waste as appropriate.
3. If the diagnosis is proven to be positive, the waste shall be treated as Infectious Substances
Category A waste. Additional packaging procedures in addition to those outlined in section 5
will be required prior to transport. The waste disposal company will advise you of these
requirements.
Guidance Note: Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus
Revision 1.0 21/10/2014 Page 8 of 16
5.2 Packaging type
The following packaging is permitted under this exemption from the Health and Safety Authority.
.Soft waste (blood/ bandages, tubing)
Primary packaging Standard clinical waste bag.
Secondary
packaging
Standard clinical waste bag (double bagging).
Tertiary packaging
30/60 litre clinical waste rigid bin.
Sufficient absorbent material must be placed
in the bin to absorb the entire liquid contents.
Sharps Waste (e.g. needles, syringes)
Primary packaging Standard sharps bin.
Secondary
packaging
Two layers of clinical waste bags
Tertiary packaging
30/60 litre clinical waste rigid bin.
Sufficient absorbent material must be placed
in the bin to absorb the entire liquid contents.
Liquid waste (e.g. urine bags)
Primary packaging Standard clinical waste bag.
Secondary
packaging
Standard clinical waste bag. (double bagging)
Tertiary packaging
30 litre clinical waste rigid bin.
Sufficient absorbent material must be placed
in the bin to absorb twice the liquid content.
The maximum quantity of liquids per bin
should be 5 litres.
Guidance Note: Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus
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Notes:
Clinical waste bags must be in-situ within the clinical waste rigid bin prior to adding the waste.
Each clinical waste bag must be closed individually using the swan neck closure mechanism and
plastic tie.
A minimum of one 6 litre absorbent sheet or equivalent, should be placed in the 30/60 litre rigid
bin. For liquids a minimum of two 6 litre absorbent sheets or equivalent, should be placed in the
30 litre rigid bin.
The maximum quantity of liquids that can be disposed of in a 30 litre bin is 5 litres.
5.3 Assembly of packaging
The following is the step by step guide for the assembly of the alternative packaging for waste
contaminated or suspected of being contaminated with Ebola Virus.
Soft waste i.e. bandages, gloves, ppe, tubing.
Step 1
Insert absorption material into the bottom of the 30/60 litre
rigid bin. (Recommended: 6 litre absorbent sheet or
equivalent)
Step 2
Line the 30/60 litre rigid bin with the 2 inner clinical waste
bags and fold back around the bin.
Step 3
The bin is now ready for the disposal of soft clinical waste.
Guidance Note: Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus
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Step 4
When the bin is 2/3 full close the inner bag using the swan
neck closure method with a plastic tie.
Step 5:
Close the outer bag using the swan neck closure method
with a plastic tie.
Step 6:
Close the 30/60 litre rigid bin with a yellow lid.
Ensure that the clips on the lid match up prior to
closure.
Step 7:
When closed decontaminate external surface of the
30/60 litre rigid bin with 10,000ppm hypochlorite
solution before it is removed from the treatment room.
Remove the package to a secure storage room.
Guidance Note: Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus
Revision 1.0 21/10/2014 Page 11 of 16
Sharps waste i.e. needles, syringes, empty glass vials and bottles.
Step 1
Insert absorbent material into the bottom of the 30/60 litre
rigid bin. (Recommended: 6 litre absorbent sheet or
equivalent)
Step 2
Line the 30/60 litre rigid bin with the 2 inner clinical waste
bags and fold back around the bin.
Step 3
For sharps waste place the waste in the sharps bin.
Ensure the sharps bin selected will fit comfortably into a
30/60 litre clinical waste rigid bin.
Maintain sharps bins in the temporary closure position
when being used by staff.
When ¾ full or up to the manufacturer line lock the sharps
bin. Sign and date upon closure.
Step 4
Place the sharps bin into the 30/60 litre rigid bin.
Step 5
Close the inner bag using the swan neck closure method
with a plastic tie.
Guidance Note: Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus
Revision 1.0 21/10/2014 Page 12 of 16
Step 6
Close the outer bag using the swan neck closure method
with a plastic tie.
Step 7
Close the 30/60 litre rigid bin with a yellow lid.
Ensure that the clips on the lid match up prior to
closure.
Step 8
When closed decontaminate the external surface of the
30/60 litre rigid bin with 10,000ppm hypochlorite
solution before it is removed from the treatment room.
Remove the package to a secure storage room.
Note: Do not dispose of sharps bins in the same bin as soft waste.
Guidance Note: Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus
Revision 1.0 21/10/2014 Page 13 of 16
Liquid waste i.e. urine bags, blood bags.
Step 1
Insert absorbent material into the bottom of a 30 litre rigid
bin. (Recommended: two 6 litre absorbent sheets or
equivalent)
Note: The maximum quantity of liquid waste that
should be disposed of in the bin is 5 litres.
Step 2
Line the 30 litre rigid bin with the 2 inner clinical waste bags
and fold back around the bin.
Step 3
The bin is now ready for the disposal of liquid waste i.e.
blood bags, urine bags.
Step 4
When the bin is 2/3 full close the inner bag using the swan
neck closure method with a plastic tie.
Note: A maximum of 5 litres of liquid can be placed in
the 30 litre bin.
Step 5:
Close the outer bag using the swan neck closure method
with a plastic tie.
Guidance Note: Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus
Revision 1.0 21/10/2014 Page 14 of 16
Step 6:
Close the 30 litre rigid bin with a yellow lid.
Ensure that the clips on the lid match up prior to
closure.
Step 7:
When closed decontaminate the external surface of the
30 litre rigid bin with 10,000ppm hypochlorite solution
before it is removed from the treatment room.
Remove the package to a secure storage room.
Guidance Note: Packaging and Transport of waste from suspect and confirmed cases of the Ebola Virus
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5.4 Additional packaging and handling procedures
Other dangerous substances shall not be packaged in the same packaging unless necessary for
neutralising the hazardous nature of the infectious substances.
5.5 Labelling of packaging
Each 30/60 litre rigid bin once removed from the treatment room must have a label with the following
information:
“CATEGORY A EBOLA WASTE - QUERY CASE” (Minimum dimensions 12 mm).
Reference to the patient where the waste originated.
Signature and date of responsible person.
If the diagnosis is proven to be negative the 30/60 litre clinical waste rigid bin will have a label with the
following:
“NEGATIVE DIAGNOSIS - Standard Clinical Waste” (Minimum dimensions.12 mm).
Reference to the patient where the waste originated.
Signature and date of responsible person.
If the diagnosis is proven to be positive the 30/60 litre clinical waste rigid bin will have a label with the
following:
“CATEGORY A EBOLA WASTE - CONFIRMED CASE” (Minimum dimensions.12 mm).
Reference to the patient where the waste originated.
Signature and date of responsible person.
The 30 litre rigid bins containing liquid waste must have a label with the words
“Liquid waste” (Minimum dimensions: 12 mm)
5.6 Storage
The 30/60 litre clinical waste rigid bin must be stored in a locked and well ventilated covered facility
on-site pending diagnosis.
If the diagnosis is proven to be negative, the waste shall be removed from the storage facility and
disposed of with standard clinical waste as appropriate.
If the diagnosis is proven to be positive, the waste shall remain in the locked facility until the vehicle
from the waste disposal company arrives for collection.
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6 Collection
If the event of a suspect case of the Ebola virus the waste disposal company should be contacted
immediately.
The waste disposal company will advise on further packaging procedures to be adopted prior
to transporting the waste by road.