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PubMedDate not supplied

Durability and function of disposable versus reusable laparoscopic instrumentation.

The durability and function of reusable and disposable laparoscopic instruments are compared, and the relative advantages and disadvantages of each are illustrated. Familiarity with the relevant issues described should allow surgeons to make informed choices on the most suitable instruments for their specific situation.

Costs and Cost Analysis↗
PubMed2004

Healthcare waste management: a case study from the National Health Service in Cornwall, United Kingdom.

This paper looks at steps taken towards the development of a 10-year strategy for the management of healthcare waste from the National Health Service (NHS) in Cornwall, United Kingdom. The major issues and challenges that affect the management of waste by the NHS, including its organisational structure and collection infrastructure, are outlined. The waste flows of the main acute medical site are detailed, using waste audits of domestic and clinical bags, redundant equipment, bulky waste, and special waste. Some of the common barriers to change, such as staff habits and public perceptions, are also identified. Recommendations are made with respect to improvements in the overall organisational infrastructure and increased localised control. The recommendations also centre around the formation of strategic partnerships, within the site, between sites and at the broader level between the NHS and its surrounding community. An important challenge to be overcome is the need to progress from the concept of "waste management", to one of sustainable decision making regarding resource use, including methods of waste minimisation at the source and recycling. Staff training and awareness underpin several of the short and medium/long term solutions suggested to reduce the waste at the source and recover value from that produced. These measures could potentially reduce disposal quantities by as much as 20-30% (wt.) and costs by around 25-35%.

Decision Making↗
PubMed1995

Hospital waste--the current and future treatment and disposal trends.

Hospital wastes pose a serious public health problem. This is primarily caused by the diversity of the individual components of the waste which constitute a risk to health if inadequately handled. It is evident that economic and technical conditions for both a safe disposal, including environmentally sound manner incineration as well as efficient stem or microwave disinfection and a safe management practice based on legal regulations consequently will contribute to protections of both human health and the environment. There is no reason to assume there may be any universal, standard regulations to be used and accepted unianimously and consistently valid for all countries. It is necessary to honor the specific, social and economic background of every country. Nevertheless the European Community principles of hospital waste treatment and disposal will be eventually accepted by this country in principal, in the framework of a general economic and political integration of European countries.

Czech Republic↗
PubMed2004

[Special proposal].

Various kinds organs and tissues obtained from operations and autopsies are preserved for a certain period of time after obtaining samples for histopathological examination and are later disposed of. Some of these organs and tissues are occasionally used for research or educational purposes. Although consent is usually obtained from the patient or from the family of the deceased patient before performing an operation or autopsy, the use and disposal of residual organs and tissues have been performed by clinicians or pathologists without obtaining consent from the patient or from the family of the deceased patient. Now, however, consent must be obtained after sufficient explanation to the patient or to the family of the deceased patient for the storage, use and disposal of residual organs and tissues. It must be kept in mind that residual organs and tissues are parts of a human body and that these parts belong to the patient from which they were obtained or to the family of the deceased patient. These points are important and provide an ethical basis for use and disposal of residual organs and tissues.

Ethics, Medical↗
PubMed2001

Safety considerations for in vitro toxicology testing.

A range of hazards may be encountered in in vitro toxicology laboratory work. Such hazards are primarily chemical reagents for which the level of risk, particularly with long-term exposure, may be difficult to ascertain. Cells and tissues may also present biosafety concerns and it is important that risk assessments are prepared for each procedure before commencing project work. Ideally control measures should be simple and combine the use of appropriate equipment with documented procedures supported by risk assessments. In any laboratory staff and procedures change significantly over time, thus monitoring of procedures (including waste disposal) and a comprehensive training programme for all staff are essential components to assure both the quality and safety of laboratory work.

Animals↗
PubMed2001

[Survey of disinfectant usage in a polyclinic in Rome: preliminary results].

The authors describe the survey that was conducted in the largest hospital in Rome. The aim was to estimate the disinfectants and chemical sterilizers employed and asses possible hazards for patients and workers arising from the use of disinfectants, together with the problem of waste disposal. The study was conducted by means of a survey form that was distributed to 39 departments/institute in the whole hospital of which 24 (61%) responded. Overall 635 charts were collected listing 886 usage procedures and 110 formulations with 40 different active ingredients. The disinfection fields of use were: skin(52.4%) environment (28.8%) and hospital equipment (20.8%) This study shows that a modern hospital should select very few disinfectants and prepare a handbook that can explain disinfectant usage procedures and concentrations. In the guidelines the problem of waste disposal and employee safety should also be considered.

Containment of Biohazards↗
PubMedDate not supplied

Achieving safe sharps practice.

The use of sharps should be avoided where possible. However, when their use is essential, particular care is required in handling and disposal and, if possible, safer devices should be used.

Equipment Design↗
PubMed1993

[Collecting sharp instruments: useful or not?].

78 per cent of the exposure incident are needle punctures (40 per cent during recapping of the needle). Housekeeping personnel, laboratory personnel, nursing personnel, dentists and physicians experienced the highest incidence of needle stick injuries. Many needle stick injuries can be prevented by not recapping used needles and using a rigid punction resistant needle disposal system.

Dental Waste↗
PubMed2001

Infectious waste surveys in a Saudi Arabian hospital: an important quality improvement tool.

OBJECTIVES: To analyze the composition by weight of the infectious waste stream, better segregate waste, reduce disposal costs, reduce the load on the hospital incinerator, identify inappropriate items having significant cost or safety implications, and provide a safer work environment for housekeepers. METHODS: Four infectious waste surveys were conducted between 1991 and 1999 that involved opening a total of 7364 bags of infectious waste. The contents of each infectious waste bag were separated into 20 different components and weighed. Inappropriately discarded items were removed and tagged with the date and hospital unit of origin. SETTING: Dhahran Health Center, a 410-bed hospital operated by the Saudi Arabian Oil Company (Saudi Aramco) in Dhahran, Saudi Arabia. RESULTS: The surveys show a continuing trend in a higher percentage of plastics and a decrease in paper due to increased use of disposables. Much of the infectious waste consisted of plastic intravenous bottles, intravenous lines, and paper wrappers for sterile instrument sets that were not infectious. Dhahran Health Center was producing a total of 1163 kg of infectious waste per day before the first survey. This was reduced to 407 kg per day after implementation of a waste segregation program in 1991 (a reduction of 65%). Incineration operation was reduced from daily to 3 days per week, with a corresponding reduction in incinerator emissions. Infectious waste from inpatient, surgical, and obstetric areas was reduced by a total of 70% between 1991 and 1999, from 2.8 kg (6.1 lb) to 0.85 kg (1.9 lb) per patient per day. This is in the range of 2 to 4 lb per patient per day that is generally reported. Numerous inappropriately discarded items were discovered during the surveys with cost or safety implications. Each survey, including the latest one of November-December 1999, has shown that further improvements are possible in the hospital's waste management program. Specific educational efforts and changes in procedures are described. CONCLUSIONS: We believe this is the first report of such an extensive analysis of a hospital's infectious waste. Many hospitals do not have the resources to conduct such detailed surveys of their waste streams. However, regardless of the method of treatment and disposal, such surveys are valuable quality improvement tools because all health care facilities want to reduce disposal costs, identify high-value items mistakenly discarded, and improve safety.

Data Collection↗
PubMed2003

Emission of polycyclic aromatic hydrocarbons from animal carcass incinerators.

This study investigated two batch-type animal carcass waste incinerators, one in a hog farm (HOWI) and the other in a livestock disease control centre (LIWI). Additionally, a medical waste incinerator (MEWI) with a fixed grate for the disposal of biological medical waste was also examined. A GC/MS technique was applied to analyze the concentrations of 21 polycyclic aromatic hydrocarbons (PAHs) species in the stack flue gas, bottom ash and wet scrubber (WSB) effluent. The analytical results indicated that total-PAHs in the stack flue gas for HOWI, LIWI and MEWI were mainly in the gaseous phase. Moreover, the mean total-PAHs concentrations of the stack flue gas for HOWI and LIWI were 1.5 and 1.4 times higher than for MEWI (=391 microg/m(3)), respectively. At the most carcinogenic potencies, the results revealed that the mean BaP+BbF+DBA concentrations in the stack flue gas for HOWI and LIWI were 7.6 and 4.6 times higher than those of MEWI (=1.18 microg/m(3)), respectively. Moreover, during the outbreak of foot-and-mouth disease among pigs in southern Taiwan in 1997, emissions of total-PAHs and BaP+BbF+DBA exceeded 226.2 and 2.3 kg/day, respectively.

Abattoirs↗
PubMed1997

Waste abatement: recycling, disposal practices can cut costs.

On average, most healthcare facilities are doing less than they should in the areas of source reduction and recycling, and will likely do so until mandated by law. The main reasons for this are ever-tightening healthcare budgets, limited staffing, and the cost of operating recycling programs compared to the cost of general solid waste disposal. Poor record keeping also may also be hampering the final decision to recycle. This article, Part II on waste abatement practices in healthcare organizations, examines what factors facilities should consider in establishing a recycling program, and analyzes cost-effective collection and disposal practices.

Conservation of Natural Resources↗