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CDC Releases Interim Ebola Guidance for Wastewater Workers

CDCThe Centers for Disease Control (CDC) has released its "Interim Guidance for Managers and Workers Handling Untreated Sewage from Individuals with Ebola in the United States" to provide recommendations for workers who handle untreated sewage (wastewater) that comes from hospitals, medical facilities, and other facilities with confirmed individuals with Ebola.

Much of the Interim Guidance is based on World Health Organization (WHO) information, studies, and recommendations. WHO recommends that Ebola waste be disposed of through a sanitary sewer or buried in a pit toilet or latrine with no additional contact or treatment. In addition, WHO says wastewater handling processes in the U.S. are designed to inactivate and remove pathogens, such as Ebola. Since Ebola is an enveloped virus, the CDC says it is more fragile and susceptible to environmental stresses and chemical germicides than non-enveloped viruses such as hepatitis A, poliovirus, and norovirus.

The CDC says there is no evidence to date that Ebola can be transmitted via exposure to wastewater. However, the CDC says workers who come into contact with untreated wastewater before it enters a wastewater treatment facility could be at very low risk of exposure to the Ebola virus. These workers include plumbers in hospitals that are treating an Ebola patient; sewer maintenance workers working on the active sewer pipelines or pump systems that serve a hospital with an Ebola patient; and construction workers who repair or replace active sewer lines serving a hospital with an Ebola patient.

The Ebola virus is transmitted through:

  • Direct, unprotected contact with broken skin, eyes, nose, or mouth with blood or other body fluids (feces, vomit, urine, saliva, sweat, breast milk, tears, vaginal fluid, and semen) of an infected patient who is actively ill
  • Needle stick injuries from needles and syringes that have been contaminated with infected blood or other body fluids and tissue from an infected patient who is actively ill
  • Unprotected contact with medical equipment contaminated with blood or body fluids from an infected patient who is actively ill
  • Direct, unprotected contact with the body of someone who has died from Ebola

It is prudent for all utility employees to know safety and operations protocols to prevent exposure; properly put on and remove personal protective equipment (PPE); and remain vigilant about common sense hygiene practices. Scott Schaefer, PE, AE2S Wastewater Practice Leader says, “Ebola is a powerful reminder to practice good workplace hygiene, and it is also a good reason to reevaluate Standard Operating Procedures and make modifications to reduce the risk of exposure to Ebola or other infectious diseases.”

Recommended PPE:

  • Goggles or face shield protects eyes from splashes
  • Surgical mask protects nose and mouth from splashes
  • National Institute for Occupational Safety and Health (NIOSH)-approved N95 respirator when cleaning processes may generate aerosols
  • Impermeable/fluid-resistant coveralls
  • Waterproof gloves
  • Rubber boots

Basic hygiene practices:

  • Wash immediately with soap after handling wastewater or any materials that have been in contact with wastewater.
  • Avoid touching face, mouth, eyes, nose, open sores or cuts while handling wastewater or anything that has come into contact with wastewater.
  • Wash hands with soap and water before eating or drinking.
  • Remove wastewater contaminated clothing and launder at work or use a uniform laundry service. Do not launder at home.
  • Eat in designated areas away from untreated wastewater.
  • Do not smoke or chew tobacco or gum when handling human waste or wastewater, or any materials that have been in contact with wastewater.
  • Cover open sores, cuts, and wounds with clean, dry bandages.

The CDC's Interim Guidance also recommends that workers wash their hands with soap and water immediately after removing PPE, and discard used PPE in leak-proof infectious waste containers. You may access additional Ebola waste management information from the CDC by clicking here.

The Interim Guidance echoes the recommendations shared during an Ebola webinar put on by the Water Environment Federation (WEF) in early November. During the webinar, Naoko Munakata, WEF Disinfection and Public Health Committee Chair, listed some of the topics that warrant additional study, including the effectiveness of disinfectants against the virus; Ebola's survival in human waste and environmental matrices; as well as the risk of transmission. The Army Medical Research Institute of Infectious Diseases (USAMRIID) at Fort Detrick in Maryland is currently studying Ebola's survival in human waste, and the National Science Foundation's Rapid Response Research is offering grants for modeling and understanding the spread of Ebola.

The CDC is the lead federal agency for Ebola containment and prevention. Click on the following links to access the CDC's Interim Guidance or its general information about Ebola. If you have additional questions about how an outbreak could impact your wastewater facility, contact Scott Schaefer, AE2S Wastewater Practice Leader, at Scott.Schaefer@ae2s.com or 763-463-5036.


If you have any questions concerning the content of this newsletter,
please contact Heather Syverson at 701-364-9111 or Heather.Syverson@ae2s.com.
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