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PubMed2004

Effects of the humic substances of de-inking paper sludge on the antagonism between two compost bacteria and Pythium ultimum.

We investigated the in vitro influence of humic substances (HS) extracted from de-inking paper sludge compost on the inhibition of Pythium ultimum by two compost bacteria, Rhizobium radiobacter (Agrobacterium radiobacter) and Pseudomonas aeruginosa. When low concentrations (5 or 50 mg l(-1)) of HS were added to the culture medium, fungal inhibition by R. radiobacter significantly increased (P<0.01) by 2-3%. In contrast, these low levels of HS had no effect on P. ultimum inhibition by P. aeruginosa. The Fe, chelated by HS, was in part responsible for the decrease of P. ultimum inhibition by the bacteria when increasing amounts of HS were added in the culture medium. The addition of 500 mg l(-1) of humic acids isolated from de-inking paper sludge compost or from fossil origin completely eliminated the inhibition of P. ultimum by R. radiobacter. This Fe effect also stimulated growth of R. radiobacter and reduced its siderophore production in a minimal medium supplemented with HS as sole source of Fe. The results showed that HS influence microbial antagonism when added to a culture medium. However, this effect varies with different factors such as the type of bacteria, concentration of HS, molecular weight and Fe content.

Bacteria↗

PubMed2004

Release of patients after therapy with unsealed radionuclides.

After some therapeutic nuclear medicine procedures with unsealed radionuclides, precautions may be needed to limit doses to other people, but this is rarely the case after diagnostic procedures. Iodine-131 results in the largest dose to medical staff, the public caregivers, and relatives. Other radionuclides used in therapy are usually simple beta emitters (e.g. phosphorus-32, strontium-89, and yttrium-90) that pose much less risk. Dose limits apply to exposure of the public and medical staff from patients. Previously, the ICRP has recommended that a source-related dose constraint for optimisation of a few mSv/episode applies to relatives, visitors, and caregivers at home, rather than a dose limit. The present report recommends that young children and infants, as well as visitors not engaged in direct care or comforting, should be treated a s members of the public (i.e. be subject to the public dose limit.) The modes of exposure to other people are: external exposure; internal exposure due to contamination; and environmental pathways. Dose to adults from patients is mainly due to external exposure. Contamination of infants and children with saliva from a patient could result in significant doses to the child's thyroid. It is important to avoid contamination of children and pregnant women. After radioiodine therapy, mothers must cease breastfeeding immediately. Many types of therapy with unsealed radionuclides are contraindicated in pregnant females. Women should not become pregnant for some time after radioisotope therapy. Technetium-99m dominates discharges to the environment from excreta of nuclear medicine patients, but its short half-life limits its importance. The second largest discharges, iodine-131, can be detected in the environment after medical uses but with no measurable environmental impact. Storing patient's urine after therapy appears to have minimal benefit. Radionuclides released into modern sewage systems are likely to result in doses to sewer workers and the public that are well below public dose limits. The decision to hospitalise or release a patient should be determined on an individual basis. In addition to residual activity in the patient, the decision should take many other factors into account. Hospitalisation often involves a significant psychological burden as well as monetary and other costs that should be analysed and justified. Patients travelling after radioiodine therapy rarely present a hazard to other passengers if travel times are limited to a few hours. Environmental or other radiation-detection devices are able to detect patients who have had radioiodine therapy for several weeks after treatment. Personnel operating such detectors should be specifically trained to identify and deal with nuclear medicine patients. Records of the specifics of therapy with unsealed radionuclides should be maintained at the hospital and given to the patient along with written precautionary instructions. In the case of death of a patient who has had radiotherapy with unsealed radionuclides in the last few months, special precautions may be required.

Environmental Exposure↗

PubMed2006

Process engineering design of pathological waste incinerator with an integrated combustion gases treatment unit.

Management of medical wastes generated at different hospitals in Egypt is considered a highly serious problem. The sources and quantities of regulated medical wastes have been thoroughly surveyed and estimated (75t/day from governmental hospitals in Cairo). From the collected data it was concluded that the most appropriate incinerator capacity is 150kg/h. The objective of this work is to develop the process engineering design of an integrated unit, which is technically and economically capable for incinerating medical wastes and treatment of combustion gases. Such unit consists of (i) an incineration unit (INC-1) having an operating temperature of 1100 degrees C at 300% excess air, (ii) combustion-gases cooler (HE-1) generating 35m(3)/h hot water at 75 degrees C, (iii) dust filter (DF-1) capable of reducing particulates to 10-20mg/Nm(3), (iv) gas scrubbers (GS-1,2) for removing acidic gases, (v) a multi-tube fixed bed catalytic converter (CC-1) to maintain the level of dioxins and furans below 0.1ng/Nm(3), and (vi) an induced-draft suction fan system (SF-1) that can handle 6500Nm(3)/h at 250 degrees C. The residence time of combustion gases in the ignition, mixing and combustion chambers was found to be 2s, 0.25s and 0.75s, respectively. This will ensure both thorough homogenization of combustion gases and complete destruction of harmful constituents of the refuse. The adequate engineering design of individual process equipment results in competitive fixed and operating investments. The incineration unit has proved its high operating efficiency through the measurements of different pollutant-levels vented to the open atmosphere, which was found to be in conformity with the maximum allowable limits as specified in the law number 4/1994 issued by the Egyptian Environmental Affairs Agency (EEAA) and the European standards.

Air Pollution↗

PubMed2005

Does incineration turn infectious waste aseptic?

Incineration of infectious waste is considered to be biologically safe. We performed basic experiments to confirm that bacillus spores are killed by incineration in a muffle furnace. Biological samples containing 10(6) spores of Bacillus stearothermophilus were placed in stainless steel Petri dishes and then into hot furnaces. The furnace temperature and duration of incineration were 300 degrees C for 15 min, 300 degrees C for 30 min, 500 degrees C for 15 min, 500 degrees C for 30 min and 1100 degrees C for 3 min. We confirmed that all spores of B. stearothermophilus were killed at each of these settings. The effect of incineration seems to be equivalent to that of sterilization, based on the satisfactory sterilization assurance level of 10(-6).

Geobacillus stearothermophilus↗

PubMed2005

Standards of clinical waste management in UK hospitals.

The arrangements for bulk clinical waste handling were observed in 26 UK hospitals. Storage of waste carts in areas freely accessible to the public, and failure to lock individual carts was common. Many clinical waste carts and areas dedicated to their storage were in a poor state of repair. Substantial improvement is required in the management of clinical waste in hospitals in order: (1) to eliminate the possibility of acquired infection through unauthorized, inappropriate access to clinical waste and to minimize adverse effects resulting from contact with waste pharmaceuticals; (2) to comply with the Duty of Care imposed by UK Health & Safety legislation; and (3) to satisfy concerns regarding the general standard of hospital hygiene.

Cross Infection↗

PubMed2006

Lowering standards of clinical waste management: do the hazardous waste regulations conflict with the CDC's universal/standard precautions?

Clinical waste is a costly and troublesome commodity. Comprising the detritus of medical care, the foremost hazard is the risk of infection from micro-organisms present in these wastes. Infection commonly occurs through penetrating injury, the so-called 'sharps' or 'needlestick' injury, although contamination of non-intact skin or splashes to the eye may transmit infection. Bloodborne viruses (hepatitis B, hepatitis C, human immunodeficiency virus) are the most serious threat, although respiratory, soft tissue and enteric infections are not unknown. The European Hazardous Waste Directive, that harmonizes the categorization and control of wastes, permits downregulation of clinical wastes where the risk of infection may be low. Although strengthened by the requirement for risk assessment in waste classification, UK regulatory guidance promoting classification of some clinical wastes as non-hazardous completely ignores the Centers for Disease Control and Prevention's Universal Precautions for the prevention of transmission of human immunodeficiency virus, hepatitis B virus and other bloodborne pathogens in healthcare settings, which seek to prevent bloodborne virus infection in healthcare workers and others, and the more extensive Standard Precautions that extend these principles to the prevention of healthcare-associated infections and the environmental spread of nosocomial pathogens. By creating a potent cost driver encouraging downregulation of some clinical wastes, UK legislation based on the European Hazardous Waste Directive conflicts with the CDC's Universal/Standard Precautions.

Animals↗

PubMed2006

Potential compromise of hospital hygiene by clinical waste carts.

Bulk waste storage carts are common in hospitals and undoubtedly assist in the day-to-day management of clinical wastes. They are used for the transport and interim storage of primary clinical waste containers and are often located close to or within hospital buildings to receive such wastes from clinical departments. Examination of a random selection of bulk clinical waste carts at nine acute hospitals across Greater London revealed external soiling in all of 23 carts. Eight of 13 carts were also soiled on the inner surfaces, with evidence of bloodstains and free fluids in the base of five carts. Staphylococcus aureus and enterococci were recovered in low numbers from the lids (N=7) and wheels (N=10) of carts and Escherichia coli, Enterobacter spp. and Pseudomonas aeruginosa were recovered from the wheels of a further five carts. Two carts were heavily contaminated with Aspergillus spp. Pathogens originating from clinical wastes may be transferred from contaminated bulk waste carts to the wider hospital environment. It may be advisable to keep bulk carts outside clinical areas, and preferably outside all hospital buildings. This becomes particularly important in circumstances where carts supplied by contractors are not dedicated to a single hospital or National Health Service trust.

Blood-Borne Pathogens↗

PubMedDate not supplied

[Occupational risk for blood exposure and staff behaviour: a cross-sectional study in 3 Moroccan healthcare centers].

OBJECTIVE: As in other countries, Moroccan health-care workers are exposed to occupational blood exposure (OBE) hazards. The purpose of this study was to estimate the occupational safety and hygiene conditions determining the OBE risk for health-care workers. WORKERS AND METHODS: In March 2000, a multicentric study was carried out in Morocco on 420 health-care workers, with an anonymous questionnaire. The study included health-care workers in the Taza and Temara hospitals and health centers, as well as in a Rabat public medical analysis laboratory. RESULTS: The participation rate was 67.8% (285/420). The population was mainly female (61%) with a mean age of 41.4 years (+/-7 years). Health-care workers answered that: occupational hygiene and safety were inadequate (55.1%); wearing single-use gloves was rare (34.5%); resheathing used needles was frequent (74.5%); safe containers were often missing (67%). In 1999, the annual average incidence of OBE was 1.5 (+/-4.3) per capita. If we consider the whole career of health-care workers, the incidence reached about 14.3+/-28.1 per capita. The absence of post-exposure chemoprophylaxis was the rule. CONCLUSION: The study shows that there is a need to improve occupational hygiene and safety conditions for Moroccan health-care workers in order to reduce OBE hazards.

Adult↗

PubMed2005

Is bioaugmentation a feasible strategy for pollutant removal and site remediation?

Microorganisms can degrade numerous organic pollutants owing to their metabolic machinery and to their capacity to adapt to inhospitable environments. Thus, microorganisms are major players in site remediation. However, their efficiency depends on many factors, including the chemical nature and the concentration of pollutants, their availability to microorganisms, and the physicochemical characteristics of the environment. The capacity of a microbial population to degrade pollutants within an environmental matrix (e.g. soil, sediment, sludge or wastewater) can be enhanced either by stimulation of the indigenous microorganisms by addition of nutrients or electron acceptors (biostimulation) or by the introduction of specific microorganisms to the local population (bioaugmentation). Although it has been practiced in agriculture and in wastewater treatment for years, bioaugmentation is still experimental. Many factors (e.g. predation, competition or sorption) conspire against it. However, several strategies are currently being explored to make bioaugmentation a successful technology in sites that lack significant populations of biodegrading microorganisms. Under optimal local conditions, the rate of pollutant degradation might increase upon addition of an inoculant to remediate a chemical spill; however, the most successful cases of bioaugmentation occur in confined systems, such as bioreactors in which the conditions can be controlled to favour survival and prolonged activity of the exogenous microbial population.

Biodegradation, Environmental↗

PubMed2005

[Hospital practice and prion risks].

Procedures applicable in France for the prevention of prion diseases were first implemented in 1995, resulting from the threat of an epidemic extension of Creutzfeldt-Jakob Disease (CJD) following contamination resulting from the use of extracted growth hormone. It was found later that the bovine disease could infect humans via foodstuffs, and the human variant of the disease (v-CJD) transmissible through lymphoid formations was described in 1996. This led to generalizing precautions to a larger number of medical interventions, taking into account the risk for a population more broadly exposed to contamination. The principles for managing these new risks are described, as well for the use of medical devices or in patient as pathology laboratories.

Animals↗

PubMed2006

Safety in the sleep laboratory.

The importance of workplace safety cannot be understated. The safety of employees affects morale, attendance, and workman's compensation. Federal organizations and agencies have provided guidelines to help ensure the health and safety of the technician and the patients who visit the sleep center. This article discusses commonly encountered hazards and ways to address them.

Accidents, Occupational↗

PubMed2005

Microbial ecology of the closed artificial ecosystem MELiSSA (Micro-Ecological Life Support System Alternative): reinventing and compartmentalizing the Earth's food and oxygen regeneration system for long-haul space exploration missions.

MELiSSA is a bioregenerative life support system designed by the European Space Agency (ESA) for the complete recycling of gas, liquid and solid wastes during long distance space exploration. The system uses the combined activity of different living organisms: microbial cultures in bioreactors, a plant compartment and a human crew. In this minireview, the development of a short-cut ecological system for the biotransformation of organic waste is discussed from a microorganism's perspective. The artificial ecological model--still in full development--that is inspired by Earth's own geomicrobiological ecosystem serves as an ideal study object on microbial ecology and will become an indispensable travel companion in manned space exploration.

Bacteria↗

PubMed2005

High mercury emissions from dental clinics despite amalgam separators.

Mercury (Hg) as amalgam has been used as a dental filling material for more than 150 years. Thereby, dentists and their patients have been directly exposed to Hg, and the public and the environment indirectly exposed via Hg emissions from incinerators and Hg in waste water from households and dental clinics. Due to the toxic properties of Hg and bioaccumulation in biota of Hg emitted via dental clinic waste water, amalgam separators were introduced in Sweden in the 1980s. Although these amalgam separators in the certification process are required to remove at least 95% of incoming Hg in a standardized laboratory test, their efficiency in practical use has not been properly investigated. Here we present actual Hg emissions via waste water from 12 dental clinics equipped with the same type of amalgam separator based on sedimentation. All waste water was collected for four consecutive working days, initially at ordinary operating conditions and a second time after a thorough revision and cleaning of the discharge system. The results indicate that mercury emissions from dental clinics can be reduced by an improved design of the discharge system, a sensible use of high pressure water cleaning, and regular maintenance, including replacement of amalgam separators and filters at certain intervals. The study also indicates that banning Hg in dentistry is the one long-term way to stop Hg emissions from dental amalgam.

Dental Amalgam↗

PubMed2005

Impact of medical waste incineration in the atmospheric PCDD/F levels of Porto, Portugal.

As a consequence of a monitoring program of a new municipal waste incinerator initiated in 1998, a large data-base of dioxin and furan concentrations in the atmosphere of the metropolitan area of Porto, in northern Portugal, has been collected. The existence of this data coincides with the shutdown in January 2001 of two medical waste incinerators that were under operation in the inner city of Porto. Dioxin emissions from these facilities were measured indicating emissions 100 to 1000 times larger than recent European Union directive limits. Data show that the shutdown of these two units had a clear effect on the improvement of air quality in the region that was observed either on the overall level of dioxins and furans or as in subtle alterations of the homolog pattern of these compounds in the atmosphere.

Air Pollutants↗

PubMed2004

Technologies that make administration of vaccines safer.

There is an ever-expanding technology that is aimed at making the administration of vaccines safer. Conventional ways of administering vaccines are being upgraded, modified or replaced by a wide variety of innovations. The paradigm of liquid vaccines, needles and syringes is slow to change, but already developments are occurring that will change for ever the way vaccines are administered and will improve the safety record of immunization. The oral route of vaccine administration has generally been thought of as safe, but until now only the polio vaccine has been widely used in this way. The conventional method of vaccine administration is by injection. Many ingenious devices have become available that now make injecting safer. Inventors are now looking imaginatively to alternative routes and technologies for delivering vaccines. Vaccines are generally manufactured to extremely high standards and rarely are shown to be the cause of safety issues. People remain the weakest safety link is vaccine administration. Technologies that bypasses the ability of man to make bad decisions or to behave incorrectly are of tremendous value. The vaccine world is in the middle of a radical re-think about how vaccines might best be administered. The presentation of the vaccine can be altered to fit new technologies such as powder jet guns, or skin patches. Even the conventional needle and syringe have evolved to much safer versions, and are set to continue this evolution. All this means even safer vaccines and their delivery.

Drug Compounding↗

PubMed2004

A study of the dental solid waste produced in a school of dentistry in Turkey.

Dental wastes are regulated under medical waste control regulations in most countries. Even though the quantity of hazardous wastes in dental solid wastes is a small proportion, there is still cross infection risk and potential danger for environment associated with mismanaged wastes. For this reason, knowledge of waste composition and development of proper management alternatives are necessary. In this study, the composition of solid wastes coming from eight clinics of the dental school of a University hospital in Turkey is examined. Although the waste has some variations between the two samplings, the general picture is such that the major components remain pretty much the same (in terms of %) for a fixed clinic. The composition of waste changes from one clinic to the other as expected. However, one can deduce from the data obtained that at about 35%, rubber gloves constitute close to the half of the total solid waste in almost all the clinics. Other major component is paper forming approximately 30% of the solid waste. In general, total waste coming from the clinics is related with the number of procedures conducted on patients at the clinics. Only a small fraction of the waste is hazardous indicating that at Hacettepe University School of Dentistry, hazardous waste collection rules are obeyed in most of the times.

Dental Waste↗

PubMed2004

Results of a hospital waste survey in private hospitals in Fars province, Iran.

Hospital waste is considered dangerous because it may possess pathogenic agents and can cause undesirable effects on human health and the environment. In Iran, neither rules have been compiled nor does exact information exist regarding hospital waste management. The survey presented in this article was carried out in all 15 private hospitals of Fars province (Iran) from the total numbers of 50 governmental and private hospitals located in this province, in order to determine the amount of different kinds of waste produced and the present situation of waste management. The results indicated that the waste generation rate is 4.45 kg/bed/day, which includes 1830 kg (71.44%) of domestic waste, 712 kg (27.8%) of infectious waste, and 19.6 kg (0.76%) of sharps. Segregation of the different types of waste is not carried out perfectly. Two (13.3%) of the hospitals use containers without lids for on-site transport of wastes. Nine (60%) of the hospitals are equipped with an incinerator and six of them (40%) have operational problems with the incinerators. In all hospitals municipal workers transport waste outside the hospital premises daily or at the most on alternative days. In the hospitals under study, there aren't any training courses about hospital waste management and the hazards associated with them. The training courses that are provided are either ineffective or unsuitable. Performing extensive studies all over the country, compiling and enacting rules, establishing standards and providing effective personnel training are the main challenges for the concerned authorities and specialists in this field.

Data Collection↗

PubMed2004

Incineration of healthcare wastes: management of atmospheric emissions through waste segregation.

The amount of atmospheric pollutants emitted through the incineration of healthcare wastes can be estimated using emission factors. Emission factors have been published without including sufficient information about the types of wastes incinerated. This paper reports the first emission factors estimated for the incineration of wastes segregated into different types according to the Portuguese legislation. One controlled-air incinerator without air pollution control devices was used in the research. The main objectives of the study were: (i) to estimate the emission factors for particulate matter, dioxins, heavy metals and gaseous pollutants, according to the type of waste incinerated; (ii) to evaluate the quality of atmospheric emissions; and (iii) to define a methodology for the management of atmospheric emissions, evaluating the influence of type of waste incinerated and of the segregation method used on the emitted amounts. It was concluded that: (i) when emission factors are not associated with the type of incinerated mixture, the utility of the emission factors is highly doubtful; (ii) without appropriate equipment to control atmospheric pollution, incineration emissions exceed legal limits, neglecting the protection of human health (the legal limit for pollutant concentrations could only be met for NO(x), all other concentrations were higher than the maximum allowed: dioxins, 93-710 times; Hg, 1.3-226 times; CO, 11-24 times; SO(2), 2-5 times; and HCl, 9-200 times); (iii) rigorous segregation methodologies must be used to minimize atmospheric emissions, and incinerate only those wastes that should be incinerated according to the law. A rigorous segregation program can result in a reduction of the amount of waste that should be incinerated by 80%. A reduction in the quantity of waste incinerated results in a reduction on the amounts of pollutants emitted: particulate matter, 98%; dioxins, 99.5%; As, Cd, Cr, Mn and Ni, respectively, 90%, 92%, 84%, 77% and 92%; Hg and Pb, practically eliminated; SO(2) and NO(x), 93%; and CO and HCl, more than 99%.

Air Pollution↗