Table 1.

Summary of the Recommended tOPV Inactivation and Disposal Methods

	Autoclaving	Boiling	Chemical Inactivation	Encapsulation	Incineration
Definition in the IMG guidelines	The use of high-pressure steam at 121°C–134°C to kill pathogens over a specified duration	Boiling tOPV vials at water boiling temperature (100°C) for 30 minutes	Immersing tOPV vials in 0.5% chlorine bleach solution for 30 minutes	Immobilization of tOPV vials using impervious material (such as cement) in a container	Controlled burning of tOPV vials in a furnace at temperatures >1100°C for complete combustion
Ideal use	Autoclaving should be done in a large autoclave with integrated shredder; alternatively, vials can be opened and treated in any autoclave	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 high-temperature incinerator capable of safely handling glass (such as a rotary kiln incinerator)
Drawback	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; closed glass vials may explode under pressure if unopened	Boiling may be impractical for treating large quantities of vials; operators must be careful to avoid scalding	Expensive for processing large quantities of vials, requires operators to be trained in using chlorine solution; chlorine solution must be safely disposed of	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; plastic vial incineration is prohibited in many countries due to toxic emissions
Disposal	Transport of the waste materials to a waste facility; burial of the waste in a secured and inaccessible pit or landfill