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Status of Regulatory Amendment

The Virginia Regulated Medical Waste (RMW) Management Regulations (9 VAC 20-120 et seq.) are currently being amended in order to modernize the standards for general handling and treatment of RMW based on industry best management practices. The goals of Amendment 3 are to clarify the requirements for generators and permitted facilities, improve permitting procedures, and streamline the regulations for ease of use while still protecting natural resources and human health.

Management of Ebola-Contaminated Wastes in Virginia

Through federal inter-agency coordination, a new policy, Managing Solid Waste Contaminated with a Category A Infectious Substance, was published in August 2019 to provide guidelines for effectively managing Category A waste associated with infectious disease incidents. This document is applicable to Ebola-contaminated wastes and provides information intended to assist governmental and non-governmental leaders, local emergency medical services, emergency managers, hospitals, healthcare providers, laboratories, environmental services workers, waste management companies and workers, and related stakeholders with safely managing Category A waste. The policy addresses guidelines pertaining to:

  • Category A Waste
  • Overarching Planning Considerations
  • Federal Government Roles & Responsibilities
  • Generator, Transporter, and Treatment Facility Responsibilities
  • Final Disposal of Treated Waste, and
  • Worker Health and Safety

Though no Ebola cases have been identified in Virginia and the Virginia Department of Health (VDH) has discontinued active monitoring of travelers  from Africa, DEQ remains prepared for the generation and appropriate management of Ebola-contaminated waste and wastewater. DEQ has worked with state, local and federal agencies to ensure thorough, effective actions that would protect public health and the Commonwealth’s land, water and air resources. These actions are based on Virginia programs and requirements for regulated medical waste, which cover waste generated, treated or otherwise managed in Virginia.

DEQ also coordinated with private organizations such as the Virginia Health Care Waste Management Cooperative, and facilities that are permitted to treat regulated medical waste, as well as the Virginia Water Environment Association and wastewater treatment operators.

According to the Centers for Disease Control and Prevention (CDC) and the Virginia Department of Health (VDH), the risk of contracting Ebola Virus Disease (EVD) is very low. Ebola is not spread through the air or by water or food. The virus is transmitted through direct contact with infected bodily fluids (e.g., blood, vomit, feces, urine). EVD is not spread by mosquitoes or other insects. However, proper sanitation and waste management are crucial to contain the virus. CDC has published information regarding the Survivability of Ebola Virus in Medical Waste.

Medical Waste Regulations in Virginia

To protect public health and public safety, all Ebola-contaminated waste generated and/or managed in Virginia is subject to the management requirements established in the Virginia Regulated Medical Waste (RMW) Regulations (9 VAC 20-120 et seq). The RMW regulations are currently being amended, and all information pertaining to Amendment 3 of the regulation can be found on the Virginia Regulatory Town Hall webpage.

DEQ coordinates with the healthcare facility, VDH, CDC, private contractors, and other local, state and federal agencies to ensure proper and immediate waste management.


Healthcare facility personnel managing Ebola-contaminated waste must comply with the Occupational Safety and Health Administration's (OSHA) Bloodborne Pathogen Standard to protect workers from exposure.  The CDC and OSHA have provided additional information on these standards and Ebola, which can be found here:



Segregation and Storage


If a healthcare facility believes a patient may be infected with Ebola, any and all waste generated  in the treatment of the patient must be segregated and stored separately from all other regulated medical waste until the presence of Ebola is confirmed.   See DEQ’s guidance for additional information on storage requirements.


Packaging and Transporting

Ebola-contaminated waste must be packaged and transported in accordance with the requirements for a Category A Infectious Substance under the U.S. Department of Transportation’s (US DOT) Hazardous Materials Regulations (HMR; 49 CFR, Parts 171-180).  A Category A Infectious Substance is a material known or reasonably expected to contain a pathogen, such as Ebola, that is in a form capable of causing permanent disability or life-threatening or fatal disease in otherwise healthy humans or animals when exposed to it. Category A Infectious Substance must be triple-packaged with leak-proof inner packaging and a rigid outer package, labeled and tracked -- among other requirements.  For the transport of Ebola-contaminated materials, US DOT has established a special permit (DOT SP-16279).  In order to transport Ebola-contaminated waste, a transporter must apply for and be granted party status to the special permit. Additional information is provided in US DOT’s Guidance for Transporting Ebola Contaminated Items.


The CDC has published a web-based document containing key information about the safe handling and disposal of medical waste generated from the care of persons diagnosed with or suspected of having Ebola. 

  • Ebola-contaminated waste should be treated by autoclave or incineration.  No incinerators in Virginia are approved for treatment of regulated medical waste.
  • A number of existing healthcare and commercial facilities in Virginia have received a permit-by-rule from DEQ for the treatment of regulated medical wastes by autoclave. These permits are governed by the regulated medical waste regulations. Facilities that have an existing permit may treat the Ebola-contaminated waste on-site by autoclave only. Any facility considering the use of an autoclave to treat this waste under its existing permit-by-rule should  update its operations plan to incorporate recommendations from the CDC or VDH for treating Ebola-contaminated waste. DEQ is providing these facilities with additional protocols and guidelines as necessary. 
  • All other facilities that generate or manage Ebola-contaminated waste must obtain from DEQ either:
    • An emergency permit to store the material prior to being shipped off-site; or
    • An emergency permit to store and treat the waste on-site using an appropriate treatment method.

Facilities that need an emergency permit or have questions on managing Ebola-contaminated waste should contact the Director of DEQ’s Office of Waste Permitting and Compliance.

Note: Any facility considering a treatment method other than autoclaving should consult with DEQ and VDH. Hospitals and medical facilities should contact their local wastewater treatment plant or service authority for specific guidance for wastewater.


Any facility seeking to accept Ebola-contaminated waste that has been properly treated by autoclave or the ashes from the incineration of the waste must seek approval from DEQ through a Special Waste Disposal Request.  This request must be submitted to the Director of DEQ’s Office of Waste Permitting and Compliance.

Ebola-associated waste that has been appropriately treated and inactivated is not infectious, does not pose a health risk, and is not considered to be regulated medical waste or a hazardous material under federal law. Such waste is no longer considered a Category A infectious substance and is not subject to US DOT’s requirements for hazardous materials regulation.


Wastewater Treatment Operations

Protection of Air Quality

Ebola is not transferred by air, only through human contact and human body fluids. The Clean Air Act requires EPA to adopt emission guidelines for solid waste incineration units, including hospital/medical/infectious waste incinerators. No incinerators are permitted in Virginia to treat regulated medical waste. DEQ issues all air quality permits in Virginia to ensure that emissions do not cause harm to the public or the environment.  

Additional Information

For specific questions or information regarding Ebola-contaminated waste management, contact: Justin Williams, Director, Division of Land Protection and Revitalization; (804) 698-4000.

For information regarding Amendment 3 of the RMW Regulations, please visit the Virginia Regulatory Town Hall webpage. To receive email notifications of all regulatory actions, register as a public user on Virginia Regulatory Town Hall. This is a free service.

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Virginia Department of
Environmental Quality
P.O. Box 1105
Richmond, VA 23218
(804) 698-4000

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