Transporting Ebola Waste a Daunting Task for Eight Approved US Hazmat Haulers

This story appears in the Nov. 10 print edition of Transport Topics.

The job of transporting an Ebola victim’s personal property and waste from the hospital to the landfill is frightening to the average person considering so little is known about the contagious deadly disease.

But to people such as Dana West, the painstakingly regimented and detailed process actually is less dangerous than cleaning up an ammonia or cyanide spill, where one breath can be fatal.

West is account manager for Advanced Environmental Options Inc., one of only eight hazmat companies in the United States that has been issued special permits by the Pipeline and Hazardous Materials Safety Administration to transport highly infectious Ebola medical waste from hospital room to disposal site.

Materials first must be decontaminated then placed in a red bag that is sealed and decontaminated. Next, the red bag is placed in a second bag that is sealed and decontaminated. That bag is then placed in a 55-gallon drum that is sealed and decontaminated.

“Then and only then can you put it on a truck,” West said. “Once it is sealed on the truck for transport, you lock it, and you stay with it, and you have to go directly to the disposal facility.”

All contaminated items belonging to the patient and caregivers have to be taken from the site — items ranging from sheets, pillow cases, bodily fluids, and almost anything a patient touches as well as gloves and other protective gear worn by hospital workers.

At the disposal facility, it will be burned and the ashes put in a landfill.

Spartanburg, South Carolina-based Advanced Environmental Options is one of eight hazmat haulers granted the federal government’s special permit to transport Ebola waste.

PHMSA allows many hazmat carriers to haul dangerous medical matter dubbed Class A infectious material — waste that can cause serious illness or death — in small quantities.

But the agency requires a special permit for hauling and disposing of Ebola medical waste.

“Our regulations were written before this epidemic came out,” the PHMSA spokesman said. “The transport of these types of Class A infectious materials was usually from laboratory to laboratory in small vials for research requirements that are triple-packed.”

The spokesman added: “But because of the volume of material that needs to be disposed of that is now infected with this Ebola pathogen, the special permit requirement is being required.”

Those eight companies allowed to transport Ebola waste were required to submit an application, meet safety requirements, submit to a fitness evaluation and have a clean record.

Truckers had to learn as quickly as the medical community.

Doctors at the Centers for Disease Control and Prevention, and hospitals were caught off guard by the Ebola virus when Thomas Duncan got off a plane in Dallas.

But since last month, nurses, doctors and other hospital staff throughout the United States have been preparing for Ebola victims to walk into their emergency rooms. Many U.S. health workers, journalists and volunteers have been returning from Liberia, where they assisted those with the disease.

Another company cleared for Ebola waste hauling, Stericycle Inc. of Lake Forest, Illinois, was the first to haul Ebola waste when Duncan, the second U.S. patient with the disease, died at a Dallas hospital last month.

A spokesman for PHMSA said that the company known as CG Environmental — Cleaning Guys — a Fort Worth, Texas, company disinfected Duncan’s apartment, while Stericycle employees took the waste to an undisclosed site for incineration and disposal.

“CG Environmental was not party to any special permit for this effort,” the spokesman said. “The disinfection of the apartment is not regulated by the U.S. Department of Transportation.”

CG and Stericycle did not respond last week to phone messages seeking comment.

Fear over Ebola may be why there aren’t more trucking companies seeking this hazmat work.

Already it is creating challenges for those transport companies trying to get the waste to a disposal site, said Joe Delloiacovo, executive vice president of MedAssure Services, a medical waste disposal company that has not sought a special Ebola permit.

He is aware of at least four states — Indiana, Kansas, Louisiana and Oklahoma — that want to take actions to ban the transport of any Ebola waste through their states or to dispose of the waste in their landfills.

“If you have to go from point A to point B to transport this material to a disposal facility, it could become rather complicated,” he said.

All the sites in the United States. are getting “a lot of blowback from state and local officials,” said West of Advanced Environmental Options.

In fact, she said she’s only aware of one incinerator facility that is accepting the waste in Texas.