Waste Management of Excess - PowerPoint Presentation

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Waste Management of Excess tOPV

Selecting Methods for the Destruction of Trivalent Oral Polio Vaccine (tOPV) during the switch

February 2016

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What is covered in this presentation?

At the end of

this

presentation, decision makers will be able to select the most appropriate methods to safely destroy tOPV after reviewing:

Inactivation

of

tOPV

3

Disposal of inactivated

tOPV

4

Volume of

tOPV

to be destroyed

1

Material of vials to be destroyed

2

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tOPV destruction involves inactivation and disposal

Disposal of tOPV after the switch should follow national legislation. If national legislation does not exist, then this presentation provides guidance on how to safely dispose of tOPVtOPV

MUST be inactivated* prior to disposalInactivate by: autoclaving, boiling, chemical inactivation,

encapsulation or incineration

Dispose by: transporting to waste facility or burying

* Inactivation of tOPV is defined as eliminating the infectious nature of poliovirus in

tOPV

or otherwise rendering the

tOPV

vials unusable and inaccessible (encapsulation)

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tOPV Inactivation Decision Tree

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STEP 1: Evaluate volumes of tOPV vials to be destroyed

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STEP 2: Determine materials of tOPV vials to be destroyed

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STEP

3: Choose appropriate method to inactivate tOPV

Autoclaving

Boiling

Chemical inactivation (e.g. with bleach)

Encapsulation

Incineration

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Ideal use and drawbacks of tOPV inactivation methods

Autoclaving

Boiling

Chemical Inactivation

Encapsulation

Incineration

Ideal

use

Autoclaving

should be done

in a large autoclave with integrated shredder.

Alternatively, vials can be opened and treated in any autoclave.

Boil unopen

ed vials

Chemically inactivate opened vials using bleach or other chlorine solution

at the recommended concentrations (0.5%).

Encapsulate unopened vials in containers filled with concrete.

Incinerate in a high-temperature incinerator capable of safely handling glass (such as a rotary kiln incinerator).

Drawback

Unopened/unshredded vials may not be fully inactivated in an autoclave, especially if the autoclave has been densely packed with other waste that could act as an insulator.Closed glass vials may explode under pressure if unopened.

Boiling may be impractical

for treating large quantities of vials.

Operators must be careful to avoid scalding

Expensive for processing large quantities

of vials and requires operators to be trained in using chlorine solution.

Chlorine solution must be safely disposed of

Concrete-filled containers must still be securely buried.

Melted glass can damage incinerators at

temperatures

<

1100°.

Closed glass vials can

explode under pressure if unopened

Plastic vial incineration is prohibited in many countries due to toxic emissions.

Please note:

Staff should handle open vials as hazardous infectious waste and take precautions (e.g. wearing personal protective equipment)

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Autoclaving

High-temperature steamMost environmentally friendly methodGlass vials full of liquid (i.e. not opened) should be “loosened” to avoid rupture, unless the autoclave has an integrated shredder

Plastic vials or glass vials that contain little liquid do not need to be open or punctured After autoclaving, vials will be sterile but must still be disposed of following national or local waste management guidelines for municipal waste

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Boiling

Immersing vials in boiling water for approximately 30 minutes destroys pathogenic micro-organisms*Both glass and plastic vials can be safely boiledGlass vials can be boiled without opening

After boiling, the inactivated vials should be disposed of following national or local waste management guidelines

*http://www.cdc.gov/hicpac/pdf/guidelines/disinfection_nov_2008.pdf

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Chemical Inactivation

Inactivate tOPV using 0.5% chlorine solutiontOPV

vials should be opened and immersed in the solution for at least 30 minutes9 parts clear water to 1 part household bleach

20 vials can be safely sterilized in 4 liters of solutionAfter treatment, vials and leftover chlorine solution must both be disposed of following national or local waste management guidelines

Koshmanova

T:

Stomatologia

(

Mosk

) 1998;77(1): 48-0

http://

www.biosafety.be/Polio/www729.pdfhttp://www.cdc.gov/hicpac/pdf/guidelines/disinfection_nov_2008.pdf11Slide12

Incineration

Open

pit burning of plastics can have a severe negative environmental impact

should not be used as an inactivation

method

Incinerators vary in temperatures reached in primary waste

chamber

Low temperature burning (

<800°

C) is

not recommended

because it is environmentally hazardous (e.g. single chamber cement or brick covered incinerators)Medium temperature burning (800-1100°C) using dual-chamber incinerators may cause glass vials to explode or partially melt, and it is not recommendedPlastic vial incineration may be prohibited in some countries due to toxic emissions but is possible at medium and higher temperatures (>800°C) if permitted by national emissions guidelines

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13

Incineration, cont.

>

1100°C is needed for safe destruction of glass vials with

tOPV

(e.g. rotary-kiln incinerators and industrial furnaces

)

Co-incineration

in industrial furnaces (e.g. cement kilns) will both inactivate and destroy

tOPV

vials and can be done in partnership with an industrial facility

Ash and any other post-incineration residue must be treated as toxic waste and disposed of according to national or local waste management guidelinesSlide14

Encapsulation

Disposes of

tOPV without immediate inactivation (and without opening the vials) but makes it inaccessible and puts it beyond useInvolves filling containers

¾ full with tOPV vials, adding an immobilizing material

(e.g. sand, cement, or clay) and sealing

and burying the containers

Encapsulated waste

must be disposed of following National or local waste management guidelines for municipal

waste

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STEP 4: Dispose of the inactivated

tOPV vials

Transport the waste materials to a waste facility (e.g. sanitary land fill, municipal dump, industrial waste site, or other facility meeting national and local waste guidelines)

Bury the waste materials on-site in a secured and fenced-off burial site

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Thank you!



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