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The 2014 Ebola epidemic raised concern that sewer and wastewater workers may be at risk of exposure to pathogens discharged in hospital wastewater. This project developed a Bayesian belief network model compiling available knowledge to quantify infection risks to wastewater and sewer workers under various scenarios of hospital handling of Ebola patient waste. In addition, this project held a workshop of 33 participants representing wastewater utilities (n=4), state and federal agencies (n=11), industries (n=4), and infectious disease experts (n=14) to develop a consensus protocol for managing liquid waste from Ebola patients prior to sewer disposal. The risk model shows that under a worst-case scenario in which a worker is immersed in sewage for one minute, the infection risk is one in 450. Under scenarios in which workers inhale but do not ingest wastewater droplets, the infection risk is less than one in a million, even under worst-case conditions. Disinfecting patient liquid waste with peracetic acid prior to sewer disposal eliminates the infection risk under all scenarios. To ensure sewer and wastewater workers are adequately protected, workshop participants recommended the disinfection of Ebola patient liquid wastes with peracetic acid for 15 minutes prior to flushing down hospital toilets or other drains.

Project Number: WERF3C15

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