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To quantify these risks, we developed a Bayesian belief network model incorporating data on virus behavior and survival along with structural characteristics of hospitals and wastewater treatment systems. We applied the model to assess risks under several different scenarios of workers\u2019 exposure to wastewater for a wastewater system typical of a mid\u2010sized U.S. city. The model calculates a median daily risk of developing EVD of approximately 6.1\u00d710<jats:sup>\u221212<\/jats:sup> (90% confidence interval: 1.0\u00d710<jats:sup>\u221212<\/jats:sup> to 5.4\u00d710<jats:sup>\u22129<\/jats:sup>; mean 1.8\u00d710<jats:sup>\u22126<\/jats:sup>) when no prior exposure conditions are specified. Under a worst\u2010case scenario in which a worker stationed in the sewer adjacent to the hospital accidentally ingests several drops (0.35 mL) of wastewater, median risk is 5.8\u00d710<jats:sup>\u22124<\/jats:sup> (90% CI: 8.8\u00d710<jats:sup>\u22127<\/jats:sup> to 9.5\u00d710<jats:sup>\u22122<\/jats:sup>; mean 3.2\u00d710<jats:sup>\u22122<\/jats:sup>) . Disinfection of patient waste with peracetic acid for 15 minutes prior to flushing decreases the estimated median risk to 3.8\u00d710<jats:sup>\u22127<\/jats:sup> (90% CI: 4.1\u00d710<jats:sup>\u22129<\/jats:sup> to 8.6\u00d710<jats:sup>\u22125<\/jats:sup>; mean 2.9\u00d710<jats:sup>\u22125<\/jats:sup>). The results suggest that requiring hospitals to disinfect EVD patient waste prior to flushing may be advisable. The modeling framework can provide insight into managing patient waste during future outbreaks of highly virulent infectious pathogens.<\/jats:p>","DOI":"10.1111\/risa.12827","type":"journal-article","created":{"date-parts":[[2017,4,24]],"date-time":"2017-04-24T21:33:38Z","timestamp":1493069618000},"page":"376-391","source":"Crossref","is-referenced-by-count":23,"title":["A Bayesian Belief Network Model Assessing the Risk to Wastewater Workers of Contracting Ebola Virus Disease During an Outbreak"],"prefix":"10.1111","volume":"38","author":[{"given":"Joseph W.","family":"Zabinski","sequence":"first","affiliation":[{"name":"Department of Environmental Sciences and Engineering, Gillings School of Global Public Health University of North Carolina  Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey J.","family":"Pieper","sequence":"additional","affiliation":[{"name":"USDA NIFA Fellow Civil and Environmental Engineering  Virginia Tech"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline MacDonald","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Environmental Sciences and Engineering, Gillings School of Global Public Health University of North Carolina  Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1021\/ez5003715"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411100"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1071\/MA15053"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/wmh3.164"},{"key":"e_1_2_6_6_1","unstructured":"Infection Prevention and Control Recommendations for Hospitalized Patients Under Investigation (PUIs) for Ebola Virus Disease (EVD) in U.S.Hospitals [Internet]. 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