RSS Thinking

Technical Opinion on Masks and Gloves Disposal Management during COVID-19

by RSS Team in General

4th June 2020

Salah Abu Salah, Husam Alkilany, Rawia Abdullah, Ahmad Abu Safa and Musab Al-Hour

Environmental Studies Division, Water and Environment Centre

According to World Health Organization (WHO), studies of influenza, influenza-like illness, and human coronaviruses provide evidence that the use of medical mask can prevent the spread of infectious droplets from an infected person to someone else and potential contamination of the environment by these droplets. There is limited evidence that wearing a medical mask by healthy individuals in the households or among contacts of sick patient, or among attendees of mass gatherings may be beneficial as a preventive measure. However, there is currently no evidence that wearing a mask (whether medical or other types) by healthy persons in wider community setting, including universal community masking, can prevent them from infection with respiratory viruses, including COVID-19 ^[8]. Nevertheless, masks could protect the wearer from large-particle droplets, splashes, sprays, or splatter that may contain viruses and bacteria, keeping it from reaching the wearer’s mouth and nose ^[7].

In the currently pandemic conditions of Corona (COVID-19), wearing of masks and gloves in enclosed public areas (e.g. supermarkets, public transport, banks, etc.) becomes mandatory by law in Jordan and many other countries. Some new phenomena related to solid waste arose in local communities, where it became visible to any viewer to see scattering of masks and gloves and flying in the air in the streets and yards, which were supposed to reduce the speed of the spread of the disease, but it could speed up the spreading of the disease.

The Centers for Disease Control (CDC) in USA recommends the use of cloth face cover in public where the appropriate social distancing is not possible, such as in grocery que, as a measure to protect others during this COVID-19 pandemic ^[6].

In general, three types of masks are available, N95, surgical and cloth facemask, see Figure (1) and (2) below. In many countries, N95 and surgical masks are in shortage of supply so governments try to encourage public to keep for medical staff.

Figure (1): N95 mask (left) and surgical mask (right)

Figure (2): Cloth mask

For N95 mask, according to CDC, it could be decontaminated using UV light, 70% ethanol spray, 58F heat and vaporized hydrogen peroxide (VHP). National Institute of Health (NIH) recommended the use of VHP as the best method to retain the integrity of the mask for up to three wearing and decontamination sessions. Keeping in mind that N95 are meant for single use ^[6]. For surgical mask, disposal of masks is the best solution ^[3], ^[7].

For cloth facemask recommended for the public, washing in washing machine is recommended as long as temperature is hot or warm (at least 60 ⁰C). Hand wash hygiene is acceptable in case no washing machine is available at home, but still the water used should be hot or warm. Bleach and strong washing agents should be avoided ^[6].

Regarding the use of gloves, for the general public CDC recommends wearing gloves when cleaning or caring for someone who is sick. In most other situations, like running errands, wearing gloves is not necessary. Instead, practice everyday preventive actions like keeping social distance from others, washing hands with soap and water for 20 seconds (or using a hand sanitizer with at least 60% alcohol), and wearing a cloth face covering when going out in public ^[6]. However, it has become compulsory to wear gloves in public enclosed areas in Jordan. Many public enclosed areas are providing different types of disposable gloves, such as plastic disposable gloves and latex or latex free disposable gloves. Figure (3) below shows these different types.

Figure (3): Plastic (left) and latex (right) disposable gloves

In the following lines, a brief review of the methods of dealing with masks and gloves after their use by community members and not by members of the health care sector will be presented. The use of masks and gloves in the health sector is managed according to the regulations of the medical waste.

Until now, the used masks and gloves are disposed of improperly, since people are littering them. So, it seems that people learned how to wash their hands and forgot to learn how to put the waste in the trash bin. The disposable masks and gloves are lightweight and can be easily swept away with the wind.

If this issue is not managed properly and not supported by the needed legislation promptly, the containment of the spread of COVID-19 is questionable. The average number of masks and gloves used and disposed of per day in Jordan is estimated to be in the range of 1.1 million masks per day and 2.2 million gloves, assuming the use of disposable masks and gloves is only by 20% of the population in the age between 16 – 60 years old, and only one mask and one pair of gloves per person and day.

The following recommendations can help in the management of the used disposable masks and gloves disposal issue:

They should be placed in a securely tight garbage bag (tear-proof), knotted and be put out with the regular trash for collection. Throwing of loose masks or gloves in the waste bins should not be allowed ^[1].
It is important to emphasize that masks and gloves do not belong to recycling ^[5].
According to the Executive Director and CEO of the Solid Waste Association of North America (SWANA), even if the masks and gloves are manufactured from plastic origin, they are not treated as curbside recycling ^[5].
According to Federal Association of “Germans Disposal, Water and Raw Materials Management e.V. (BDE)”, the high percentage of rubber in some types of gloves makes the recycled raw materials unusable ^[2].
The used disposable masks should not be disposed of with the paper waste ^[4].
Unlawful littering should be punishable by legislations (fines).
Public should be encouraged to use only washable face mask and instructions should be provided in Arabic to fabricate them at home to avoid high expenses especially for limited income people. Washing instruction should be provided as well.
Shops and supermarkets should provide closed bin at their exits to collect used gloves and masks as well as hand sanitization opportunity should be available.
Some international references suggest reuse of the N95 and surgical masks after certain decontamination procedures, but for public it is not recommended.
It is not practical to consider the used gloves and masks by public as medical waste, since it will increase the disposal cost without a real need. It is more practical to control the landfills and prohibit any scavenging activities during the pandemic period in the landfills and to prohibit the scavenging activities from the waste containers in the streets.
Awareness material should be provided to public in Arabic about importance of the followings, which should be done by all persons ^[8]:
- Avoid groups of people and enclosed, crowded spaces.
- Maintain physical distance of at least 1.5 -2 m from other persons, in particular from those with respiratory symptoms (e.g. coughing, sneezing).
- Perform hand hygiene frequently, using an alcohol-based hand rub if hands are not visibly dirty or soap and water when hands are visibly dirty.
- Cover their nose and mouth with a bent elbow or paper tissue when coughing or sneezing, dispose of the tissue immediately after use, and perform hand hygiene.
- Refrain from touching the mouth, nose and eyes.
It is important to make people aware about false confidence built by using masks.

Finally, no instruction was issued until now in Jordan, for dealing with gloves and masks at public level. However, the Ministry of Environment announced the launch of a campaign to distribute medical waste bags to collect masks and gloves. Nevertheless, it is clear that this campaign is limited. In addition, this approach will not be feasible as mentioned before (to be treated as medical waste).

References

[1] District Office Landshut, 2020.

www.landkreis-landshut.de/Landratsamt.aspx (Accessed on 12.05.2020)

[2] Federal Association of German’s Disposal, Water and Raw Materials Management e.V. (BDE), 2020.

www.bde.de/covid-19/abfallschluessel/ (Accessed on 11.05.2020)

[3] German Robert Koch Institute (RKI), 2020.

www.rki.de (Accessed on 12.05.2020)

[4] Muenster Waste Companies (AWM), 2020.

www.awm.stadt-muenster.de/index.html (Accessed on 11.05.2020)

[5] Solid Waste Association of North America (SWANA), 2020.

www.swana.org (Accessed on 11.05.2020)

[6] U.S. Centers for Diseases Control and Prevention (CDC), 2020.