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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:
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Volume of tOPV to be destroyed
Material of vials to be destroyed
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Inactivation of tOPV
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Disposal of inactivated tOPV
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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 tOPV
• tOPV MUST be inactivated* prior to disposal
• Inactivate 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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Small Volume
tOPV Inactivation Decision Tree
Local
inactivation
Autoclaving, Boiling, Chemical
inactivation
Plastic or glass vials
Encapsulation
Autoclaving, Boiling, Chemical
inactivation
Large Volume
Plastic vials
Encapsulation
Central or offsite inactivation
Autoclaving, Boiling, Chemical
inactivation
Glass vials
Encapsulation
High temperature (>1100°C) incineration
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STEP 1: Evaluate volumes of tOPV vials to be destroyed
Small volume
(<20 vials)
Volume of
tOPV to be
destroyed
Large volume
(>20 vials)
Allows for local level disposal at facility level
May require additional capacity for disposal of tOPV
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STEP 2: Determine materials of tOPV vials to be
destroyed
Glass
May shatter and harm incinerator operator or may melt and cause
damage
Plastic
Incineration or burning of plastics is prohibited in some countries1
Sealed
Not permeable for inactivation and may explode under pressure2
Opened
Open vials will allow for safe inactivation of tOPV by any method
tOPV Vial
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STEP 3: Choose appropriate method to inactivate tOPV
a)
Autoclaving
b)
Boiling
c)
Chemical inactivation (e.g. with bleach)
d)
Encapsulation
e)
Incineration
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Ideal use and drawbacks of tOPV inactivation methods
Autoclaving
Autoclaving should be
done in a large autoclave
with integrated shredder.
Ideal use
Drawback
Boiling
Closed glass vials may
explode under pressure if
unopened.
Encapsulation
Incineration
Boil unopened
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 hightemperature incinerator
capable of safely
handling glass (such as a
rotary kiln incinerator).
Boiling may be
impractical for
treating large
quantities of
vials.
Expensive for
processing large
quantities of vials and
requires operators to
be trained in using
chlorine solution.
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
Alternatively, vials can be
opened and treated in any
autoclave.
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.
Chemical
Inactivation
Operators must
be careful to
avoid scalding
Chlorine solution must
be safely disposed of
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 steam
• Most environmentally friendly method
• Glass 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 boiled
• Glass 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 solution
• tOPV vials should be opened and immersed
in the solution for at least 30 minutes
• 9 parts clear water to 1 part household
bleach
• 20 vials can be safely sterilized in 4 liters of
solution
• After 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.pdf
http://www.cdc.gov/hicpac/pdf/guidelines/disinfection_nov_2008.pdf
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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 dualchamber incinerators may cause glass vials to explode
or partially melt, and it is not recommended
• Plastic 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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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 guidelines
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Encapsulation
• Disposes of tOPV without immediate
inactivation (and without opening the
vials) but makes it inaccessible and
puts it beyond use
• Involves 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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