FactSheet
Safe Handling, Treatment, Transport and
Disposal of Ebola-Contaminated Waste
Workers involved in handling, treatment, transport and disposal of medical,
laboratory and other waste must be protected from exposure to Ebola virus—which
causes Ebola virus disease—and from physical and chemical hazards that may be
associated with waste management tasks.
Ebola is spread primarily through direct contact
with blood or other body fluids of a person who
is ill with Ebola and from contact with objects
contaminated with Ebola virus. Waste generated
from caring for or cleaning up after an Ebola
patient may pose a risk to workers if it is not
handled safely or treated and disposed of properly.
Safe handling, treatment, transport and disposal
of waste that is suspected or known to be
contaminated with Ebola virus begins at the
point the waste is generated (i.e., the point of
origin) and continues through final disposal.
Waste may be generated at the point of origin
during activities such as:
• Using and discarding sharps, dressings, and
other supplies while caring for a patient with
suspected or confirmed Ebola;
• Discarding supplies used for clinical
laboratory testing of samples from a patient
with suspected or confirmed Ebola;
• Cleaning hospital rooms; ambulances,
airplanes, and other vehicles; airport and other
transportation facilities; residences; or other
areas with suspected or confirmed Ebola-virus
contamination; and
• Removing and discarding disposable personal
protective equipment (PPE) after working in
an environment with suspected or confirmed
Ebola-virus contamination.
Waste management steps
at point of origin
• Take steps to minimize solid and liquid wastes.
• Identify a complete chain for waste handling,
collection, treatment, transport and disposal
before the waste is generated. Ensure that waste,
including incinerator ash or other completely
treated materials, has a final place for disposition.
• Create a waste management plan and secure
necessary contracts and permits ahead of
time in order to help avoid potential exposure
hazards, security risks, and storage problems.
Pre-identify waste management facilities
prior to waste generation; waste management
facilities may have their own requirements
that may need to be considered.
• Place materials in double, leakproof bags,
and store in a rigid, leakproof container to
reduce the risk of worker exposure: www.cdc.
gov/vhf/ebola/hcp/environmental-infection-
control-in-hospitals.html. If waste ultimately
will be transported, follow U.S. Department of
Transportation (DOT) guidance for packaging
from the outset to minimize repackaging or
additional handling: phmsa.dot.gov/hazmat/
packaging-of-ebola-contaminated-waste.
• Employers should follow manufacturer
instructions on product labels and Safety Data
Sheets for Environmental Protection Agency
(EPA)-registered disinfectants when selecting
PPE for their workers.
Sharps containers must be closable, puncture-resistant,
leakproof, and labeled or color-coded.
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• Use a puncture-proof container for sharps.
See www.cdc.gov/niosh/docs/97-111.
• Mark and label outer packaging according
to the Occupational Safety and Health
Administration (OSHA) Bloodborne Pathogens
standard (29 CFR 1910.1030) and DOT
general marking requirements for non-bulk
packagings (49 CFR 172.301).
• Ensure that the outsides of waste containers
are not contaminated. Use a combination of
administrative controls and work practices to
avoid contaminating a container when placing
waste into it.
• Implement protocols for effectively
decontaminating the outside of bags that go
into containers, and the containers themselves
if they come into contact with potentially
infectious waste.
• If porous containers (e.g., corrugated
cardboard boxes) become contaminated,
they should be placed into another container.
Disinfect the outsides of waste bags with
an EPA-registered disinfectant that meets
Centers for Disease Control and Prevention
(CDC) criteria (see page 3: “Disinfectants
for Ebola virus”) by wiping or spraying the
bags with an appropriate disinfectant. Follow
manufacturer instructions on product labels
for concentration, application method, and
contact time for the specific disinfectant.
• If practicable, consider autoclaving waste
on-site using an appropriate autoclave before it
is packaged and sent out of a facility for
disposal. Porous materials may require multiple
autoclave cycles to ensure sufficient penetration
of heat and steam. This approach may be more
effective than just using a longer cycle.
• Follow CDC guidelines and DOT Hazardous
Materials Regulations (HMR), at www.cdc.gov/vhf/
ebola/hcp/medical-waste-management.html and
phmsa.dot.gov/hazmat/transporting-infectious-
substances.
Use appropriate protective equipment
The Occupational Safety and Health Administration (OSHA) Personal Protective Equipment
(PPE) standard (29 CFR 1910.132) requires employers to assess the workplace to determine what
hazards are present and then choose the appropriate PPE to protect workers. Employers must
select PPE that will protect workers against Ebola virus and other hazards to which they may be
exposed. Workers with different job tasks—for instance, those who load waste containers onto
trucks compared to those who empty containers onto processing lines—may have very different
exposures and require different PPE. Workers must wear PPE to help minimize exposure to the
virus via mucous membranes and broken skin, or through inhalation of bio-aerosols. Examples of
PPE that may be needed during waste handling, treatment, transport and disposal include:
• Nitrile gloves (consider using double-gloves and/or puncture-resistant gloves for extra protection);
• Goggles or face shields;
• Fluid-resistant or impermeable gowns or coveralls, and aprons;
• Facemasks that cover the nose and mouth;
• Dedicated washable shoes with protective shoe coverings;
• N95 respirators, Powered Air Purifying Respirators (PAPRs), or other respiratory protection devices.
OSHA’s PPE Selection Matrix is intended to help employers select appropriate PPE for protecting
workers who may be exposed to Ebola virus on-the-job. The National Institute for Occupational
Safety and Health (NIOSH) also provides recommendations for the selection and use of
protective clothing and respirators for protection against biological agents: www.cdc.gov/niosh/
docs/2009-132.
Training, practice and observation of workers in correct donning and doffing of PPE are important
infection control measures. Workers should put on PPE in a way that minimizes the risk of skin
and mucous membrane contact with potentially infectious materials; and remove PPE in a way
that avoids self-contamination. This includes decontaminating PPE before and between removal
steps: www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html. The order of PPE removal may vary
depending on the type of PPE a worker uses, the nature of the work tasks being performed, and
which devices or garments are contaminated, among other factors.
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Collecting and transporting waste
• Under the Bloodborne Pathogens standard,
29 CFR 1910.1030, and other OSHA
requirements, employers already must
protect workers who collect and transport
waste from exposure to infectious agents,
such as the hepatitis B virus and human
immunodeficiency virus (HIV), in the waste
they handle on a daily basis. Although
exposure to these other agents may be more
likely, employers are also required to protect
workers from exposure to the Ebola virus.
• Following stringent packaging protocols,
including decontaminating waste containers,
at the point of origin (i.e., where the waste was
generated) may reduce the risk of exposure
to Ebola virus and other infectious agents for
workers involved in collecting packaged waste.
• Place containers of waste as low as possible
on dollies, hand trucks, or carts and in trucks
or other transport vehicles to prevent toppling
and spillage. Secure containers, especially
stacked ones, within vehicles using suitable
straps or tie-downs.
• Employers must take steps to protect workers
from exposure to contaminated waste
containers and to protect workers when they
must handle waste containers that are visibly
soiled or otherwise known or suspected of
having Ebola-virus contamination.
• Use proper protections, including additional
or more protective PPE, if handling waste
containers with visible contamination from
blood, body fluids, or other potentially
infectious or unknown material. Employers
may consider additional or more protective
PPE for waste collection and transport
workers if they determine another more
serious hazard(s) exists.
• Follow DOT HMR, at phmsa.dot.gov/hazmat/
transporting-infectious-substances.
Processing waste in a treatment/
disposal facility
• Under the Bloodborne Pathogens standard,
29 CFR 1910.1030, and other OSHA
requirements, employers already must
protect workers who process waste in
a treatment/disposal facility from exposure
to infectious agents, such as the hepatitis B
virus and HIV, in the waste they handle on
a daily basis. Although exposure to these
other agents may be more likely, employers
are also required to protect workers from
exposure to the Ebola virus.
• Workers who are exposed to waste before it
is completely treated and decontaminated,
including when opening containers to load
waste onto processing lines or into autoclaves
or incinerators, may be at higher risk for
exposure to Ebola virus and other infectious
agents than workers with job tasks such as
handling waste products that have already
been treated (e.g., incinerator ash or waste that
already was appropriately autoclaved at its point
of origin). Waste that has been properly treated
and decontaminated is no longer infectious.
• Place containers of waste as low as possible
on dollies, hand trucks, or carts and when
stacking to prevent toppling and spillage.
Secure stacked containers using suitable
shelves, straps or other equipment.
Disinfectants for Ebola virus
• Use an EPA-registered disinfectant
with label claims for use against non-
enveloped viruses (e.g., norovirus,
rotavirus, adenovirus, poliovirus)
to treat contamination/spills and to
disinfect non-porous surfaces after bulk
spill material has been removed.
• Non-enveloped viruses are typically
more difficult to destroy than enveloped
viruses, such as Ebola. Stronger
disinfectants used to destroy non-
enveloped viruses are also capable of
inactivating enveloped viruses.
• See EPA List L of selected registered
antimicrobial products that meet the
CDC criteria for use against the Ebola
virus: www.epa.gov/oppad001/list-l-
ebola-virus.html.
• Always follow the manufacturer’s
instructions (e.g., concentration,
application method and contact time)
for the specific disinfectant.
• Never mix chemicals (e.g.,
disinfectants/cleaners) together.
Certain combinations of chemicals
can be deadly or can reduce the
effectiveness of the disinfectant.
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• Employers must consider increasing levels
of PPE for waste processing and treatment/
disposal workers if they determine that a more
serious hazard exists.
• Follow applicable EPA, state, and local
regulations for hospital/medical/infectious
waste incinerators: www.epa.gov/
ttnatw01/129/hmiwi/rihmiwi.html.
• Workers tasked with processing reusable
collection and storage containers, conducting
housekeeping within processing facilities,
or cleaning transport vehicles may refer to
OSHA’s “Cleaning and Decontamination of
Ebola on Surfaces” Fact Sheet for additional
guidance: www.osha.gov/Publications/OSHA_
FS-3756.pdf.
Do not shred contaminated waste
• Do not use waste management processes that
involve shredding incoming waste materials
that have suspected or confirmed Ebola-virus
contamination.
• Shredding, particularly with equipment that
is not closed and ventilated out of the work
area, may result in generation of bio-aerosols
(aerosolized droplets containing infectious
particles that can be inhaled).
• Shredders may become clogged or jammed
by atypical, porous waste materials (e.g.,
linens, carpet, curtains, or other textiles) that
must be discarded when decontamination is
not possible.
• If at all possible, do not enter a clogged
shredding machine to resolve a jam. If a worker
must do so, always ensure that the machine is
powered off and follow proper lockout/tagout
procedures for controlling hazardous energy:
www.osha.gov/SLTC/controlhazardousenergy.
• Ensure that the worker has proper PPE to
protect against all health and safety hazards that
are possible from the waste and the machinery,
including bloodborne pathogens and other
infectious diseases, and mechanical, electrical,
and other physical hazards of the equipment.
Final disposal of treated waste
• Waste that has been properly treated and
disinfected using thermal/heat treatment
(e.g., microwaves), autoclaving, incineration,
or a combination of these or other generally
accepted methods is not considered to be
infectious.
• Depending on state regulations, such waste
can safely be disposed of following the
protocols normally used by a facility under the
jurisdiction of the state where it is located.
• As with any solid waste, other applicable
disposal requirements should be considered
(e.g., if non-infectious materials, such as toxic
metals, are present in regulated amounts).
Use appropriate respiratory protection
• In instances where workers may be exposed
to bio-aerosols (e.g., as a result of using high-
pressure air or water for cleaning) suspected
or known to contain Ebola virus, additional
respiratory protection is needed. In these
cases, medically qualified workers must use,
at a minimum, a NIOSH-approved, fit-tested
N95 respirator. See www.cdc.gov/niosh/npptl/
topics/respirators/disp_part/n95list1.html.
Safer waste processing techniques
• Select waste processing techniques that
minimize potential worker exposure to
Ebola virus or other pathogens.
• Incinerating entire, unopened waste
containers in incinerators eliminates
exposures associated with handling and
opening containers. Incinerator facilities
should be operated in compliance with
applicable federal, state, and local
regulations.
• If using autoclave or rotoclave
equipment, develop, validate and
regularly test protocols using biological
and non-biological indicators to ensure
that the autoclave temperature and
pressure are maintained for long
enough time periods to kill all organisms
throughout the waste content and that
heat/steam can penetrate packaging and
any porous materials.
• Weekly (or more frequent) testing with
biological or non-biological indicators
ensures that autoclave equipment is
functioning properly.
• Do not use open burning techniques,
which could expose workers and other
individuals to harmful air contaminants.
• Do not shred contaminated waste (see
related section at left).
5
• Wearing a respirator for extended periods
of time can be uncomfortable. Workers who
need respirators for long time periods may
find powered air-purifying respirators more
tolerable.
• Respirators used for protecting workers
against Ebola virus may not be effective
for also protecting them from exposure
to certain chemicals used for treating and
decontaminating waste, or for cleaning
and decontaminating equipment. To learn
more about the requirements for selecting
an appropriate respirator to protect against
chemical exposure (elastomeric respirator
with appropriate chemical or combination
cartridges or a supplied-air respirator), consult
OSHA’s Respiratory Protection standard,
29 CFR 1910.134, and the manufacturer’s
Safety Data Sheet (SDS) for the specific
chemical(s) that workers are using. See
OSHA’s Respiratory Protection web page:
www.osha.gov/SLTC/respiratoryprotection.
Infection control for all waste workers
• Limit the number of workers who handle
waste to essential staff. For example, instruct
and train healthcare workers generating waste
during care of an Ebola patient to properly
package the waste instead of requiring an
environmental services or waste collection
worker to also handle the waste.
• Whenever gloves are removed or changed,
wash hands with soap and water, or use
alcohol-based hand rubs if soap and water
are unavailable. Always wash with soap and
water if hands are visibly soiled.
• Avoid touching the face or other exposed
parts of the body while wearing gloves or
before washing/sanitizing bare hands.
• Change clothing and shower as soon as
possible if work clothing becomes soiled.
Discard soiled work clothing with other Ebola-
contaminated waste.
• Consider wearing dedicated, washable
footwear while on the job.
• Notify a supervisor immediately if exposed
to potentially infectious material or waste on
the job, including on work clothing or exposed
skin or through mucous membranes (e.g.,
eyes, nose, mouth).
Follow applicable OSHA standards
• Employers must ensure that they comply
with OSHA’s Bloodborne Pathogens standard,
29 CFR 1910.1030, to protect workers who
may be exposed to blood or other potentially
infectious materials.
• OSHA’s Personal Protective Equipment
(PPE) standard, 29 CFR 1910.132, provides
additional information about how to select
and use appropriate PPE, training and other
requirements.
• Employers must comply with OSHA’s Hazard
Communication standard, 29 CFR 1910.1200,
when their workers use certain chemicals for
cleaning and decontamination.
• OSHA’s Lockout/Tagout standard, 29 CFR
1910.147, contains requirements on controlling
hazardous energy when working with
machinery.
• In some cases where a specific OSHA
standard doesn’t apply, the General Duty
Clause (Sec. 5(a)(1)) of the Occupational Safety
and Health Act requires employers to furnish
to each employee a place of employment
Worker training is essential
Employers must train workers about
sources of exposure to Ebola and
appropriate precautions.
Where workers may be exposed to blood
or other potentially infectious materials,
such as in the waste handling, treatment,
transport and disposal industry, employers
must provide the training required by
OSHA’s Bloodborne Pathogens standard,
29 CFR 1910.1030. This includes information
about how to recognize tasks that may
involve exposure and the methods to
reduce exposure, including engineering
controls, work practices and PPE.
Employers must train workers required to
use PPE on what equipment is necessary,
how to put it on and take it off safely and
effectively, when and how they must use
it, and how to dispose of the equipment.
that is free from recognized hazards that are
causing or are likely to cause death or serious
physical harm to employees.
• Employers may also be required to follow
state regulations that cover potentially
infectious medical waste, sometimes referred
to as regulated medical waste: www.epa.gov/
osw/nonhaz/industrial/medical/programs.htm.
Assistance for Employers
OSHA’s On-site Consultation Program offers free
and confidential advice to small and medium-
sized businesses in all states across the country,
with priority given to high-hazard worksites.
On-site Consultation services are separate from
enforcement and do not result in penalties or
citations. Consultants from state agencies or
universities work with employers to identify
workplace hazards, provide advice on compliance
with OSHA standards, and assist in establishing
safety and health management systems. To
locate the OSHA On-site Consultation Program
nearest you, call 1-800-321-6742 (OSHA) or visit
www.osha.gov/consultation.
Additional resources
• About Ebola
{ www.osha.gov/SLTC/ebola
{ www.cdc.gov/niosh/topics/ebola
• About bloodborne pathogens and
needlesticks
{ www.osha.gov/SLTC/
bloodbornepathogens
{ www.cdc.gov/niosh/topics/bbp
• For selection and use of PPE, including
respirators
{ www.osha.gov/SLTC/
personalprotectiveequipment
{ www.cdc.gov/niosh/ppe
{ www.osha.gov/SLTC/
respiratoryprotection
{ www.cdc.gov/niosh/topics/
respirators
• About toxic and hazardous substances,
including chemical hazards
{ www.osha.gov/SLTC/
hazardoustoxicsubstances
{ www.cdc.gov/niosh/npg
• About Hazard Communication
{ www.osha.gov/dsg/hazcom
• About controlling hazardous energy
(Lockout/Tagout)
{ www.osha.gov/SLTC/
controlhazardousenergy
OSHA - DTSEM FS-3766 12/15/2014
U.S. Department of Labor
Disclaimer: This document is not a standard or regulation, and it creates no new legal obligations. It contains
recommendations as well as descriptions of mandatory safety and health standards. The recommendations are advisory
in nature, informational in content, and are intended to assist employers in providing a safe and healthful workplace.
The Occupational Safety and Health Act requires employers to comply with safety and health standards and regulations
promulgated by OSHA or by a state with an OSHA-approved state plan. In addition, the Act’s General Duty Clause,
Section 5(a)(1), requires employers to provide their employees with a workplace free from recognized hazards likely to
cause death or serious physical harm. State Plans adopt and enforce their own occupational safety and health standards
at www.osha.gov/dcsp/osp.
This information will be made available to sensory-impaired individuals upon request. The voice phone is (202) 693-1999;
teletypewriter (TTY) number: (877) 889-5627. For other requests or questions, contact OSHA at 1-800-321-OSHA (6742). To
receive NIOSH documents or more information about occupational safety and health topics, contact NIOSH at 1-800-CDC-
INFO (1-800-232-4636), TTY: 1-888-232-6348, web: www.cdc.gov/info, or visit the NIOSH website at www.cdc.gov/niosh.