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PubMedDate not supplied

Clinical waste generation from renal units: implications and solutions.

The treatment of end-stage renal disease (ESRD) makes extensive use of presterilized disposable items which, after use, are contaminated by blood. The preferred route of disposal of such items is by incineration. Disposal costs have risen and this increase in costs has not been matched by waste management programs in renal units. Many of the waste items generated also contain polyvinyl chloride (PVC) whose incineration is environmentally sensitive. Furthermore blood tubing sets contain plasticizers such as di(2-ethylhexyl) phthalate (DEHP), which is known to pose health risks to specific groups of patients. The generation of clinical waste in a dialysis unit is analyzed, issues associated with disposal are discussed, and approaches toward a cost-effective, environmentally sustainable clinical waste management program are reviewed.

Cost-Benefit Analysis↗
PubMed2003

The disposal of used sharps by diabetic patients living at home.

The disposal of sharps generated in the community has been identified as an area of public health and environmental health concern. While there is a large amount of literature on sharps disposal practices in healthcare settings, the sharps disposal practices of diabetic patients living at home has been poorly documented. This study describes the sharps disposal practices of diabetic patients in South Staffordshire, an English health district. A randomly selected sample of 1,348 adult (aged >or= 16 years) diabetic patients were obtained from the district population-based diabetes register. A self-administered questionnaire was posted to the sample. Non-responders received up to two reminders. A response rate of 91% was achieved. Household containers were used by: 34.1% of respondents for syringes; 35.1% for lancets; and 27.6% for needles. Sharps boxes were the least used method of sharps disposal. Many respondents indicated that they had received only verbal information on how to dispose of their sharps. Those who recalled receiving information were more likely to dispose of their sharps safely. The results of this study suggest that sharps are disposed of in the most convenient manner, into the household waste. This contributes to environmental pollution and places people at risk of physical and psychological trauma.

Adult↗
PubMed2004

New approaches in safe handling of hazardous drugs.

This session provided an overview of the health effects of occupational exposure to hazardous drugs and provided information about specific steps that can be taken to reduce accidental exposure, such as reducing surface contamination, use of personal protective equipment, and proper disposal guidelines, among other safe practices. Tips for developing or auditing safety procedures in the workplace were provided as well.

Antineoplastic Agents↗
PubMed2006

Preliminary study of physico-chemical treatment options for hospital wastewater.

Hospital effluents are loaded with pathogenic microorganisms, partially metabolized pharmaceutical substances, radioactive elements, and other toxic substances. Such effluents if not treated properly can damage the natural environment and create a biological imbalance. This paper points out the areas of concern for hospital wastewater disposal and reports the findings of a limited physico-chemical study of treatment options for hospital effluents conducted at Christian Medical College and Hospital, Vellore, Tamil Nadu. The effluent collected was checked for conventional parameters and subjected to coagulation experiments. The raw and settled effluents were coagulated with FeCl(3), filtered and disinfected. Physico-chemical treatment seems to be an attractive option for the cost-effective disposal of hospital effluents. The results of this study call for further detailed study in this area.

Biodegradation, Environmental↗
PubMed1996

Disposal of dialysate in HIV-positive patients: an update.

One of the concerns with the use of peritoneal dialysis in human immunodeficiency virus (HIV)-positive patients is disposal of the peritoneal effluents. This article reviews survival characteristics of HIV in dialysate effluents and current disinfectant strategies.

Dialysis Solutions↗
PubMed2006

Practice and opinion towards disposal of unused medication in Kuwait.

OBJECTIVES: The aim of this study was to measure the attitude and practice of Kuwaiti patients in Kuwait with regard to safe disposal of unwanted medicines. SUBJECTS AND METHODS: Three-hundred patients or their family members waiting for prescriptions at public general hospitals in Kuwait completed a questionnaire soliciting their practice with regard to medication use and disposal, and their opinion of the best way to dispose of unwanted medicines. RESULTS: Almost half of the respondents (45.4%) obtained medicines on prescription more than 3 times a year and almost all had unwanted medicines in the home. Reasons for possessing unused medication were mostly due to a change of medication by the doctor (48.9%), or self-discontinuation (25.8%). Their most common method of disposal was to throw unwanted medicines in the trash (76.5%) or flush them down the drain (11.2%). Half (54.0%) thought that a system of taking medicines to pharmacies for safe disposal would be favorable. CONCLUSION: The study indicates that the need for an appropriate method for disposal of unwanted medication exists in Kuwait. Hence, guidelines on safe disposal of unwanted medicines are required and an organized method of collecting unused medication needs to be introduced.

Adult↗
PubMed2005

Safe injection practice among health care workers, Gharbiya, Egypt.

A cross-sectional study was conducted in 25 health care facilities in Gharbiya governorate to assess safe injection practices among health care workers (HCWs). Two questionnaires, one to collect information about administrative issues related to safe injection and the other to collect data about giving injections, exposure to needle stick injuries, hepatitis B vaccination status and safe injection training. Practices of injections were observed using a standardized checklist. The study revealed that there was lack of both national and local infection control policies and lack of most of the supplies needed for safe injection practices. Many safe practices were infrequent as proper needle manipulation before disposal (41%), safe needle disposal (47.5%), reuse of used syringe & needle (13.2%) and safe syringe disposal (0%). Exposure to needle stick injuries were common among the interviewed HCWs (66.2%) and hand washing was the common post exposure prophylaxis measure (63.4%). Only 11.3% of HCWs had full course hepatitis B vaccination. Infection control -including safe injections- training programs should be afforded to all HCWs.

Child↗
PubMed1994

Solid waste disposal in district health facilities.

Hospital waste is not necessarily difficult to dispose of. In most cases it can be safely dumped in a properly designed waste pit. Waste management problems at district hospitals in developing countries are usually caused more by lack of information than by financial or technical difficulties.

Developing Countries↗
PubMed1998

Operation Red Box: a pilot project of needle and syringe drop boxes for injection drug users in East Baltimore.

We assessed the acceptability and the use of a community-based needle and syringe disposal project designed to serve injection drug users. In June 1996, three surplus U.S. mail collection boxes were painted red and used as syringe and needle drop boxes in locations with high drug use in East Baltimore. Acceptance of the drop boxes was measured by focus groups of residents, drug users, and police, held before and after project implementation. Use was measured by weekly counts of needles recovered from the red boxes. A sample of all deposited needles was randomly chosen for needle washing and subsequent HIV antibody testing. Community impact was measured by systematic surveys of needles discarded on public sidewalks, in areas with and areas without drop boxes. Before implementation, members of focus groups expressed concerns that drop boxes could convey mixed messages to youth (e.g., seeming to condone drug use), might result in increased loitering, and could further community stigmatization. After project implementation, all focus groups expressed support of project expansion. In the first 10 months, 2971 needles were collected. Of 156 needles tested, 10.9% were positive for HIV antibody. Needle counts on the street showed no significant change in red box areas compared with control areas. In this pilot project, red boxes were accepted by the community and drug users. Police officers also used the boxes to dispose of confiscated needles. Although limited in the number of drop boxes and follow-up time, this pilot project shows promise as a community-based method of safe needle disposal.

Adolescent↗
PubMed2005

Injection safety and Indian Academy of Pediatrics.

A major proportion of injections administered in India are unsafe. Unsafety is due to (1) steps that are associated with increased risk of spread of blood borne viruses and (2) errors related to technique of injection and faulty habits. Recommendations of Indian Academy of Pediatrics revolve round the following points: Equipment related, safe injection practices, best injection techniques, rational injection practices, prevention of needle stick injuries and reducing disease transmission recommendation for HIV-PEP (postexposure prophylaxis), HBV-PEP, disposal of syringes and sharps. The points have been discussed elaborately.

Academies and Institutes↗
PubMed1999

Sharps disposal in the ED: simple techniques and equipment.

Disposal of sharp instruments and needles ("sharps") is an ongoing problem in the emergency department (ED). Cleanup and disposal of needles and other sharps after a procedure is the responsibility of all ED personnel, including physicians. Simple cleanup techniques are explained and illustrated. All techniques are designed to be done (1) without exposing physician to a needle stick, (2) with equipment readily available in the ED, and (3) with containers readily seen by those disposing of the sharps and other materials. Adherence to these cleanup procedures should help lessen the problem of sharps and disease exposure in the ED.

Accidents, Occupational↗
PubMed2006

Legal regulation of clinical waste in the community.

The European Union has led the way in regulating the management of waste and has compelled member states, including the United Kingdom, to introduce legislation to ensure that risks to public health and the environment from waste is minimized. Waste management is now highly regulated and it is essential that district nurses comply with the regulations when disposing of waste produced in the course of treating patients. This article describes how the health and safety, waste and carriage legislation governs how district nurses handle clinical and hazardous waste in the community.

Community Health Nursing↗
PubMed2002

Dissemination of vancomycin-resistant enterococci harboring vanA through disposal of waste derived from industrial production of vancomycin.

We demonstrated the occurrence of vancomycin-resistant enterococci (VRE) in waste derived from the industrial production of vancomycin and their dissemination through disposal of such waste into a sewage treatment plant. Bacteriological counts on a medium selective for enterococci (Slanetz-Bartley agar) revealed the presence of high numbers of presumptive VRE (approximately 10(6) CFU/ml) in the waste originating from the fermentation biomass used for vancomycin production. The waste was also found to contain active residues of vancomycin (64-1,024 microg/ml) by bioassays using a vancomycin-susceptible enterococcal strain. Randomly amplified polymorphic DNA (RAPD) analysis of 65 presumptive VRE isolates from the waste allowed distinction of four genotypes, two of which (A and D) belonged to the genus Enterococcus, most likely E. faecium, and harbored the vanA gene conferring high-level vancomycin resistance. The same VRE strains found in the waste occurred also in the biological tanks and the final effluent of the sewage treatment plant receiving the waste, as demonstrated by the detection of undistinguishable pulsed-field gel electrophoresis (PFGE) patterns in VRE isolated from these sources. These results indicate the need to assess the possible dissemination of VRE and other antibiotic-resistant bacteria through disposal of waste derived from antibiotic production.

Anti-Bacterial Agents↗
PubMed1999

[Clinical waste disposal].

Public health centers and private practitioners are responsible for the disposal of waste generated by their activities. In spite of the quantities being small, it may be hazardous for patients, clinicians, technician's safety and the environment. This issue is not driven by the lack of appropriate rules. There are plenty of terminology. Evaluation of the risks allows the appropriate protective measures to be put in place. A dedicated organization for handling each type of waste is required. Because not all waste may be hazardous, a health scientist must identify and categorize the risk factors associated with the waste. Waste disposal is handled in two ways. One according to the level of hazard, the other as domestic waste. The waste handling is managed in three phases: diagnostic, data collection and decision making. The supervisory staff must advise and train all people who may come into contact with such waste.

Europe↗
PubMedDate not supplied

Management of infectious waste in the home care setting.

Adaptation of infection control into practical protocol for the home care setting continues to present a challenge for home care nurses. Most information published on the management of infectious waste in home care is based on hospital protocols, and does not apply to home practice. Reasonable practices for disposal of infectious waste are not addressed by any authoritative resources. This presentation will identify principles of infection control, requirements, laws of regulating bodies, and steps that are measured chronologically to write administrative waste control policies.

Centers for Disease Control and Prevention, U.S.↗
PubMed2006

Safe syringe disposal is related to safe syringe access among HIV-positive injection drug users.

We evaluated the effect of syringe acquisition on syringe disposal among HIV-positive injection drug users (IDUs) in Baltimore, New York City, and San Francisco (N = 680; mean age 42 years, 62% male, 59% African-American, 21% Hispanic, 12% White). Independent predictors of safe disposal were acquiring syringes through a safe source and ever visiting a syringe exchange program. Weaker predictors included living in San Francisco, living in the area longer, less frequent binge drinking, injecting with an HIV+ partner, peer norms supporting safe injection, and self-empowerment. Independent predictors of safe "handling"-both acquiring and disposing of syringes safely-also included being from New York and being older. HIV-positive IDUs who obtain syringes from a safe source are more likely to safely dispose; peer norms contribute to both acquisition and disposal. Interventions to improve disposal should include expanding sites of safe syringe acquisition while enhancing disposal messages, alternatives, and convenience.

Adult↗
PubMed2005

Biomedical waste in laboratory medicine: audit and management.

Pathology, microbiology, blood bank and other diagnostic laboratories generate sizable amount of biomedical waste (BMW). The audit of the BMW is required for planning proper strategies. The audit in our laboratory revealed 8 kgs anatomical waste, 600 kgs microbiology waste, 220 kgs waste sharps, 15 kgs soiled waste, 111 kgs solid waste, 480 litres liquid waste along with 33,000 litres per month liquid waste generated from labware washing and laboratory cleaning and 162 litres of chemical waste per month. Section wise details are described in the text. Needle sharps are collected in puncture proof containers and the needles autoclaved before sending to needle pit. The glass forms the major sharp category and is disinfected with hypochlorite before washing/recycling. All microbiology waste along with containers/plates/tubes are autoclaved before recycling/disposal. The problem of formalin fixed anatomical waste as histology specimens is pointed out. The formalin containing tissues cannot be sent for incineration for the fear of toxic gas release and the guidelines by the Biomedical waste rule makers need to be amended for the issue. The discarded/infected blood units in blood bank need to be autoclaved before disposal since chemical treatments are difficult or inefficient. The liquid waste management needs more attention and effluent treatment facility needs to be viewed seriously for hospital in general. The segregation of waste at source is the key step and reduction, reuse and recycling should be considered in proper perspectives.

Hospitals↗