How do you dispose of a positive antigen test? Do you place the contents in the biohazard bag and carefully place it in a rubbish bin? What happens a positive test kit once it is discarded?
ith thousands of antigen tests being used across Kerry in recent weeks – and more set to be used in the future – it raises concerns about whether or not they are being disposed of in a safe and efficient manner.
On a recent walk in Tralee, I spotted fragments from an antigen test scattered on the street next to a pile of rubbish awaiting collection. This put me thinking about the volume of antigen tests being used at present and how they are being handled.
An antigen test contains three main elements: a swab, a mini testing panel, and the liquid capsule. When a positive test is detected, it means all three elements immediately pose a health hazard, or at least that’s how most would see it.
The use of antigen tests has risen exponentially since the rise of Omicron in late November. Tests are now widely used, often multiple times a week depending on an individual’s circumstances. This has driven demand to such an extent that a shortage of test kits was reported in parts of Kerry during the Christmas period.
Minister for Health Stephen Donnelly is currently examining proposals which would mean people with a positive antigen test will no longer need to have a PCR test, while Sinn Féin is calling on government to make antigen tests free. This is all good news in terms of efficiency but it’s also likely to mean a further spike in demand for antigen tests.
Earlier this month the HSE ordered an additional 15 million antigen tests to meet public demand. The HSE also estimates that roughly 300,000 tests a week have been sent out to homes since the beginning of January.
One pharmacy told The Kerryman this week that they are still finding it difficult to keep stocks up. So what does this mean for all the used tests?
It’s difficult to gauge the exact number of test kits that have passed through Kerry’s domestic waste network in recent weeks, even if it’s safe to assume it must now be in the thousands.
Many people, I’m sure, conscientiously use the biohazard bag when disposing of the test kit, but others most likely do not. A US contamination study in 2020 said it’s possible for COVID to remain infectious on plastic surfaces for up to 72 hours.
The bottom line here is that if antigen tests used in a hospital or pharmacy setting are treated as biohazard material, and destroyed under strict supervision, does this imply that practices around disposing of test kits in a household setting should be stricter?
The Kerryman contacted six domestic waste disposal operators in the county to find out what happens test kits in household rubbish. Only three of the operators were available to comment.
The main response of the three that did comment, is they did not know if there was an increase in test kits as domestic rubbish is exported to designated landfills in Cork and Limerick. They also declined to answer if staff were involved in separating this waste prior to export.
Kerry County Council (KCC) still operates a waste collection service in Killarney and facilitates the compacting and onward transportation of various waste from its five civic amenity sites at Killarney, Milltown, Kenmare, Cahersiveen, and Dingle. However, KCC does not have any input on where private waste disposal companies export rubbish.
When asked if it noticed an increase in antigen tests at these sites, KCC said it could not comment definitively on the matter as there is no way of checking or monitoring this short of opening bags of litter.
Under its policy on Wastewater and Waste Management, KCC requires that any hazardous waste be disposed in a safe manner in accordance with the National Hazardous Waste Management Plan (NHWMP).
This is the same NHWMP that works in tandem with the Government’s ‘Action Plan for Antimicrobial Resistance’; a strategy that consistently highlights the importance of avoiding putting medical waste in household waste.
The new ‘Health National Action Plan on Antimicrobial Resistance 2021-2025’ was updated in November 2021 to include a segment on the challenge presented by COVID but makes no reference to how antigen tests should be disposed of in the interest of public health.
The test kits purchased from shops and pharmacies instruct people to place the kit in a rubbish bin. This advice is consistent with the HSE’s own website. In the UK, the NHS advice is that test kits be put in a biohazard bag but be placed ‘into another plastic bag’.
A US-based medical website indicated that as the contents of a rapid antigen test is considered ‘hazard waste’ they should be separated from ‘other wastes located around the area and not dispose of them in the general waste or rubbish bin’.
I contacted the Environmental Protection Agency (EPA) to find out if there is a policy for the disposal of antigen tests, and if not, should there be. The EPA said it was a ‘policy-related’ query and a matter for the Department of Environment, Climate and Communications (DECC).
When contacted, the DECC, suggested I get in touch with the HSE, which I did but am still awaiting a reply. However, a spokesperson for the DECC did confirm that test components from an antigen test can be placed in a residual waste bin. It also directed me to mywaste.ie for further guidelines on handling COVID waste, but this did not contain specific information on antigen tests.
Lastly, while much of the debate on antigen tests at the moment is to do with cost, efficiency, and availability, are we ignoring another possible health factor around used antigen tests? Is there any, as yet, unrealised threat to public health from the way antigen tests are disposed? Is there an environmental risk?
The purpose of this piece is not to provide answers but to raise questions. In a county where fly tipping is already a problem, adding positive antigen tests to the mix over a prolonged period is the last thing we need. All expert opinion welcome.