Disposal Containers Research Articles

Relationship between sharps disposal containers and Clostridium difficile infections in acute care hospitals

Sharps disposal containers are ubiquitous in health care facilities; however, there is paucity of data on their potential role in pathogen transmission. This study assessed the relationship between use of single-use versus reusable sharps containers and rates of Clostridium difficile infections in a national sample of hospitals. A 2013 survey of 1,990 hospitals collected data on the use of sharps containers. Responses were linked to the 2012 Medicare Provider Analysis and Review dataset. Bivariate and multivariable negative binomial regression were conducted to examine differences in C difficile rates between hospitals using single-use versus reusable containers. There were 604 hospitals who completed the survey; of these, 539 provided data on use of sharps containers in 2012 (27% response rate). Hospitals had, on average, 289 beds (SD±203) and were predominantly non-for-profit (67%) and nonteaching (63%). Most used reusable sharps containers (72%). In bivariate regression, hospitals using single-use containers had significantly lower rates of C difficile versus hospitals using reusable containers (incidence rate ratio [IRR]=0.846, P=.001). This relationship persisted in multivariable regression (IRR=0.870, P=.003) after controlling for other hospital characteristics. This is the first study to show a link between use of single-use sharps containers and lower C difficile rates. Future research should investigate the potential for environmental contamination of reusable containers and the role they may play in pathogen transmission.

Pharmacy-randomized intervention delivering HIV prevention services during the syringe sale to people who inject drugs in New York City

BackgroundPharmacy syringe access may be an opportunity to provide HIV prevention resources to persons who inject drugs (PWID). We examined the impact of a pharmacy-randomized intervention to reduce injection risk among PWID in New York City. MethodsPharmacies (n=88) were randomized into intervention, primary control, and secondary control arms. Intervention pharmacies received in-depth harm reduction training, recruited syringe customers who inject drugs into the study, and provided additional services (i.e., HIV prevention/medical/social service referrals, syringe disposal containers, and harm reduction print materials). Primary control pharmacies recruited syringe customers who inject drugs and did not offer additional services, and secondary control pharmacies did not recruit syringe customers (and are not included in this analysis) but participated in a pharmacy staff survey to evaluate intervention impact on pharmacy staff. Recruited syringe customers underwent a baseline and 3-month follow-up ACASI. The intervention effect on injection risk/protective behavior of PWID was examined. ResultsA total of 482 PWID completed baseline and follow-up surveys. PWID were mostly Hispanic/Latino, male, and mean age of 43.6 years. After adjustment, PWID in the intervention arm were more likely to report always using a sterile syringe vs. not (PR=1.24; 95% CI: 1.04–1.48) at 3-month follow-up. ConclusionsThese findings present evidence that expanded pharmacy services for PWID can encourage sterile syringe use which may decrease injection risk in high HIV burdened Black and Latino communities.

Prevention of Needlestick and Sharp Injuries among Hospitals in Thailand

Purpose: Epworth HealthCare amalgamated the renal dialysis and day oncology units in 2012 in a purpose built area within a 700 bed acute hospital. Infection Prevention has monitored the patient infection rates and outcomes before and after the amalgamation to understand the impact of co horting the specialties. Methods: The planning to combine the two areas began in 2010 with major research investigation and networking review to identify previous infection related outcomes from similar specialty amalgamations. Nil evidence was identified. Epworth planned and built this model of care around a zoned separation using four chair areas. The remainder of the unit is a shared space including waiting areas, clean and dirty utility rooms, medication and pantry areas. The unit has share staff services for cleaning, food delivery, laundry and waste management. The area consists of twelve dedicated dialysis chairs and twenty oncology chairs with a four chair that can be used for either specialty with in excess of 280 patient attendances per week. All infections are reviewed including bacteraemias and multi resistant organisms using definitions accepted for hospital surveillance to define either community acquired or hospital acquired. The method used is daily pathology results review, daily area rounding and an automated weekly readmission with infection report. There has been twice yearly ad hoc microbiology plating undertaken in the area. Results: The review of all patient infections resulted in none that was attributable to the patient placement in the unit. Prior to the unit amalgamation there were two line related infections identified in twelve months. There was no clinical practice change in the three years. Conclusions: Although we cannot say there is no risk, there is no evidence to date to recommend the cohabitation should not continue.

Understanding sharps injuries in home healthcare: The Safe Home Care qualitative methods study to identify pathways for injury prevention.

BackgroundHome healthcare is one of the fastest growing sectors in the United States. Percutaneous injuries from sharp medical devices (sharps) are a source of bloodborne pathogen infections among home healthcare workers and community members. Sharps use and disposal practices in the home are highly variable and there is no comprehensive analysis of the system of sharps procurement, use and disposal in home healthcare. This gap is a barrier to effective public health interventions. The objectives of this study were to i) identify the full range of pathways by which sharps enter and exit the home, stakeholders involved, and barriers for using sharps with injury prevention features; and ii) assess the leverage points for preventive interventions.MethodsThis study employed qualitative research methods to develop two systems maps of the use of sharps and prevention of sharps injuries in home healthcare. Twenty-six in-depth interview sessions were conducted including home healthcare agency clinicians, public health practitioners, sharps device manufacturers, injury prevention advocates, pharmacists and others. Interview transcripts were audio-recorded and analyzed thematically using NVIVO qualitative research analysis software. Analysis of supporting archival material also was conducted. All findings guided development of the two maps.ResultsSharps enter the home via multiple complex pathways involving home healthcare providers and home users. The providers reported using sharps with injury prevention features. However, home users’ sharps seldom had injury prevention features and sharps were commonly re-used for convenience and cost-savings. Improperly discarded sharps present hazards to caregivers, waste handlers, and community members. The most effective intervention potential exists at the beginning of the sharps systems maps where interventions can eliminate or minimize sharps injuries, in particular with needleless treatment methods and sharps with injury prevention features. Manufacturers and insurance providers can improve safety with more affordable and accessible sharps with injury prevention features for home users. Sharps disposal campaigns, free-of-charge disposal containers, and convenient disposal options remain essential.ConclusionsSharps injuries are preventable through public health actions that promote needleless treatment methods, sharps with injury prevention features, and safe disposal practices. Communication about hazards regarding sharps is needed for all home healthcare stakeholders.

Synthesis of Carbon Nanoparticles from Polystyrene Wastes

There are various methods for the synthesis of carbon nanoparticles. Each laboratory uses one of them depending on its abilities and available tools. Adding nanoparticles, especially Nano carbons, to some materials changes their behaviours. For example, adding carbon to iron matrix leads to an increase in its compressive strength and adding carbon to plastics results in a remarkable increase in their thermal resistance. Therefore, synthesis of such compounds from the wastes is a good achievement. The purpose of this study is the synthesis of carbon nanoparticles from the wastes (disposable containers made of polystyrene) using the designed reactor and heat system. In the used reactor, as high pressures and temperatures above 700 oC are used along with appropriate catalysts for different periods, all of the materials lose their macro structures and fragment into Nano-size particles. Each of the mentioned conditions is optimized with each other and type of initial materials. The effects of different parameters such as time, catalyst quantities, and the ration of polystyrene to catalyst available on the obtained particle sizes have been investigated. Time and catalyst ratio are the fundamental parameters in this method. The carbon nanoparticles that we have extracted from disposable containers also helps the environment and reduces the recycling costs of polystyrene wastes.

Modified Auger for Pit Latrine Desludging in Developing Countries

A modified auger was developed in response to the need for a hygienic and low-cost pit emptying technology. An auger is housed inside a 4” pipe and powered by a hydraulic motor. As the auger turns, sludge is conveyed up and out of the pit into containers for disposal. Development and lab testing of prototypes was followed by field-testing on pit latrines in South Africa. Flow rates up to 40 LPM were achieved in field-testing, which are high enough to empty a typical pit in 1 to 2hours. Field testing also revealed new challenges and progress has continued in order to solve these problems, including improved manoeuvrability and management of trash often found in latrines. The addition of a dolly frame improved the movement of the auger inside and outside of the pits. Trash removal technologies that could be coupled with the auger are currently in development. Further field-testing of the auger and trash management techniques will be carried out.

Epidemiology of Sharp Injuries and Hepatitis B Vaccination among Sudanese Dental House Officers

Occupational sharps injuries have been investigated among dental healthcare personnel but none have reported findings from Sudan. Data on hepatitis B vaccination is scanty among dental practitioners. The aim of the survey is to describe the epidemiology of sharps injuries and hepatitis B vaccination among dental house officers. A cross-sectional survey using an anonymous questionnaire was used to collect data from 161 dental house officers at a tertiary dental care facility in Khartoum. The response rate was 95%. Sharps injuries were experienced by 37.3% of house officers. Most injuries were caused by hollow bore needles (73.3%). The one hand scoop technique was practiced by 87.6% and 60.2% used sharps disposal containers. The surgery department was the major source of incident reporting (65.5%). Most of the injured house officers did not report their injury (90%). Only 32.9% were aware of a post exposure prophylaxis protocol at the hospital. Full vaccination against hepatitis B was reported by 43.5% of respondents and 6.7% received prophylaxis for hepatitis B. Adequate education and training; provision of hepatitis B vaccination and up-scaling of dental facilities to meet safer dental practices will help to reduce sharps injuries and improve hepatitis B vaccination.

Development of Nanomaterials for Nuclear Energetics

Structure and properties peculiarities of the nanocrystalline powders give the opportunity to design new and to develop a modernization of nuclear energy industry materials. It was shown experimentally, that addition of 5-10% uranium dioxide nanocrystalline powder to traditional coarse powder allows to decrease the sintering temperature or to increase the fuel tablets size of grain. Similar perspectives for the technology of neutron absorbing tablets of control-rod modernization are shown by nanopowder of dysprosium hafnate changing instead now using boron carbide. It is powders in nanocrystalline state get an opportunity to sinter them and to receive compact tablet with 8,2-8,4g/cm2 density for automatic defence system of nuclear reactor. Resource of dysprosium hafnate ceramics can be 18-20 years instead 4-5 years for boron carbide. To step up the radiation-damage stability of fuel element jacket material was suggested to strengthen a heat-resistant ferrite-martensite steel by Y2O3 nanocrystalline powder addition. Nanopowder with size of particles 560nm and crystallite size 9nm was prepeared by chemical coprecipitation method. To make lighter the container for transport and provisional disposal of exposed fuel from nuclear reactor a new boron-aluminium alloy called as boral was developed. This composite armed with nanopowders of boron-containing materials and heavy metals oxides can replace succesburnt-up corrosion-resistant steels.

Use of a daily disinfectant cleaner instead of a daily cleaner reduced hospital-acquired infection rates

Documenting effective approaches to eliminate environmental reservoirs and reduce the spread of hospital-acquired infections (HAIs) has been difficult. This was a prospective study to determine if hospital-wide implementation of a disinfectant cleaner in a disposable wipe system to replace a cleaner alone could reduce HAIs over 1 year when housekeeping compliance was ≥80%. In this interrupted time series study, a ready-to-use accelerated hydrogen peroxide disinfectant cleaner in a disposable wipe container system (DCW) was used once per day for all high-touch surfaces in patient care rooms (including isolation rooms) to replace a cleaner only. The HAI rates for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile were stratified by housekeeping cleaning compliance (assessed using ultraviolet-visible marker monitoring). When cleaning compliance was ≥80%, there was a significant reduction in cases/10,000 patient days for MRSA (P = .0071), VRE (P < .0001), and C difficile (P = .0005). For any cleaning compliance level there was still a significant reduction in the cases/10,000 patient days for VRE (P = .0358). Our study data showed that daily use of the DCW applied to patient care high-touch environmental surfaces with a minimum of 80% cleaning compliance was superior to a cleaner alone because it resulted in significantly reduced rates of HAIs caused by C difficile, MRSA, and VRE.

Reducing the incidence of needlestick injuries due to insulin pen injectors among self-users in the outpatient clinic setting

The rising number of people practicing insulin self-injection at home has led to increasing numbers of needlestick injuries due to inadequate self-injection skills among these patients. To reduce needlestick injuries at home, patients should not recap needles and should adopt proper needle disposal practices. A random survey of 80 outpatients currently using insulin pen injectors at home conducted between February and April 2012 found that 70% self-reported suffering needlestick incidents. Data analysis indicated the principal causes of these incidents were the lack of standard operating procedures, the absence of educational training, the shortage of educational instruction sheets for patients, and the inadequate skills and tools available to patients for disposing of needles safely at home. The aim of this project was to decrease the needlestick incidence rate for outpatients that use insulin pen injectors in order to increase overall patient safety. The project team established a pen injector standard operation procedure (SOP), conducted an educational training program, developed nursing instruction sheets for patients, designed and distributed needle disposal containers to patients, and taught patients the correct techniques for the disposing of needles at home. The needlestick incidence rate decreased from 70% pretest to 2.6% following implementation of the abovementioned measures. This project effectively reduced the needlestick rate attributable to insulin pen injectors. The authors hope that other departments will adopt this approach in order to improve patient safety.

Sharps injury reduction: a six-year, three-phase study comparing use of a small patient-room sharps disposal container with a larger engineered container.

A 350-bed Sydney hospital noted excessive container-associated sharps injuries (CASI) using small sharps containers and compared the effect from 2004 to 2010 of using a larger container engineered to reduce CASI. In Phase 1 (Ph1), disposable 1.4L containers (BD Australia) were carried to/from patients' rooms. In Phase 2 (Ph2), this stopped and a safety-engineered 32L reusable container (the Device; Sharpsmart, SteriHealth) was mounted in medication stations only and sharps were carried to and from patient rooms using kidney dishes. In Phase 3 (Ph3), the Device was wall-mounted in patient rooms. Sharps injuries were categorised as 'during-procedure', 'after-procedure but before disposal', 'CASI', and 'improper disposal SI'. Disposal-related SI comprised CASI plus improper-disposal SI. Injuries per 100 full-time-equivalent staff were analysed using Chi2; p ≤ 0.05; and relative risk and 95% confidence limits were calculated. In Ph1 (small containers) 19.4% of SI were CASI and transport injuries were zero. In Ph2 (Device in medication station) CASI fell 94.9% (p <0.001); Disposal-related SI fell 71.1% (p=0.002) but transport injuries rose significantly. In Ph3 (Device in patient room) zero CASI occurred (p<0.001); Disposal-related SI fell 83.1% (p=0.001). Recapping SI fell 85.1% (p=0.01) with the Device. The Device's volume, large aperture, passive overfill-protection and close-at-hand siting are postulated as SI reduction factors.

Corrosion behaviour of waste disposal container in sub-surface disposal system

This study was conducted in order to clarify the long term corrosion behaviour of containers made of carbon steel. Natural immersion crevice corrosion tests were carried out for 360 days in an alkaline and reducing environment using a combination of materials including carbon steel and welding materials or bolts. In addition, potentiostatic crevice corrosion tests were carried out for 90 days. In both tests, there was no evidence to suggest localised corrosion in the different kinds of metal contact parts, including carbon steel, welding materials and bolts. It was also recognised that crevice corrosion was less likely to be generated on disposal container materials. From these experimental results, it is believed that the possibility of localised corrosion is extremely low if the environment around the carbon steel container is maintained under highly alkaline and reducing conditions.

Consumption, health attitudes and perception toward fast food among Arab consumers in Kuwait: gender differences.

This study aimed to investigate gender differences in the fast food intake, health attitudes, and perceptions of fast food among adult Arab consumers aged 19 to 65 years in Kuwait. A total of 499 consumers (252 males, 247 females) were selected at convenience from three shopping malls in Kuwait City. The consumers were interviewed using a specially designed questionnaire. The findings revealed that men were more frequently consumed fast food than women (p < 0.001). Men were significantly more likely to consume “double” burgers (52%) than women (29.9%) (P < 0.001). The great majority of consumers (95%) considered fast food harmful to health. However, the consumers were continued to intake fast food (92%), indicating that health information on fast food not necessarly affects their consumption. Local foods were more likely to be considered fast food if eaten as a sandwich or without a disposal container. It can be concluded that fast food perceptions are influenced by gender, media and socio-cultural factors. Nutrition education programmes should focus on nutritive values of the foods rather than on their “fast food” classification.

Coupled analysis of mechanical- and corrosion-related degradation of carbon steel spent fuel container

Failure of high level waste/spent fuel containers is most likely to occur as a result of mechanical overload following a period of corrosion that results in a reduction of the wall thickness and/or the degradation of the material properties. There can be significant interaction between the mechanical loads and the corrosion processes to which a disposal container is subjected which, in turn, can influence the mode and time of failure. Here, these interactions are illustrated for a single shell, carbon steel spent fuel container during its entire life cycle, from the time of manufacture through to the long term behaviour in a bentonite backfilled geological disposal facility. The evolution of the structural integrity of the container is illustrated through the use of failure assessment diagrams.

Blending powdered antineoplastic medicine in disposable ointment container

On dispensing powdered antineoplastic medicines, it is important to prevent cross-contamination and environmental exposure. Recently, we developed a method for blending powdered medicine in a disposable ointment container using a planetary centrifugal mixer. The disposable container prevents cross-contamination. In addition, environmental exposure associated with washing the apparatus does not arise because no blending blade is used. In this study, we aimed to confirm the uniformity of the mixture and weight loss of medicine in the blending procedure. We blended colored lactose powder with Leukerin(®) or Mablin(®) powders using the new method and the ordinary pestle and mortar method. Then, the blending state was monitored using image analysis. Blending variables, such as the blending ratio (1:9-9:1), container size (35-125 mL), and charging rate (20-50%) in the container were also investigated under the operational conditions of 500 rpm and 50 s. At a 20% charging rate in a 35 mL container, the blending precision of the mixtures was not influenced by the blending ratio, and was less than 6.08%, indicating homogeneity. With an increase in the charging rate, however, the blending precision decreased. The possible amount of both mixtures rose to about 17 g with a 20% charging rate in a 125 mL container. Furthermore, weight loss of medicines with this method was smaller than that with the pestle and mortar method, suggesting that this method is safer for pharmacists. In conclusion, we have established a precise and safe method for blending powdered medicines in pharmacies.

Prevalence of needle stick injuries among healthcare workers at the Federal Medical Centre, Owerri, south-east Nigeria

Background: A needle-stick is a sharp-pointed instrument used for puncturing tissues or passing a ligature around or through a vessel, but possibly also it could be a sharp instruments or objects for other purposes. Healthcare workers (HCW) can easily contact infections with blood-borne pathogens such infections are hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV), when health workers are exposed to occupational blood diseases through the use of sharp instruments and needle sticks. Objective: This research investigated the prevalence, causes and prevention of needle stick injury among healthcare workers at the Federal Medical Centre (FMC), Owerri. Materials and Methods: The sample size was fifty respondents while the major instrument for data collection was a well constructed, validated and reliable tested questionnaire, including observations made. Data obtained was analysed using frequency distribution, and chi-square. Results: Results of the a study indicated majority of the injuries occur during injection procedure (34%), recapping (14%), and improper disposal of used syringes and needle (6%), stress had (6%), overfilled disposal boxes also recorded (2%) and lack of experience among workers had (0%). Sex of respondents recorded 86% for female and 14% for male. Conclusion: A standard and understandable programmes to avert NSI should be encouraged.. Examples of such measures are as follows: recapping should be avoided, the use of disposal containers should be encouraged, surgical gloves and other safety devices can also be used to reduce a high cause of developing chronic blood-diseases like hepatitis, cirrhosis and liver cancer. Keywords: Needle- stick injury, hepatitis, healthcare workers, occupational hazard, disposal containers

Awareness And Preventive Measures Against Hepatitis B Virus Infection Among Dental Surgeons In Lagos State

Objectives: The aim of this study was to assess the awareness of Hepatitis B Virus(HBV) infection among Dental Surgeons in Lagos state and to identify preventive measures adopted against HBV infection.Materials and Methods: 220 structured self-administered questionnaires about knowledge of HBV and infection control measures were distributed to Dentists in Lagos University Teaching Hospital; Lagos State University Teaching Hospital; Military Hospital, Yaba, Lagos; Military Hospital, Bonny Camp, Victoria Island, Lagos; Randle General Hospital, Surulere, Lagos; General Hospital Lagos and 12 Private Dental Clinics. The response rate was 85 percent.Results: A high level of awareness and knowledge of HBV infection was demonstrated in this study compared to previous studies.22 15 This however did not translate into a commensurate increase in crossinfection control practices. 71 percent of Dentists usually took a detailed medical history of their patients. 66.3 percent had been vaccinated against Hepatitis B Virus; 94.5 percent wore and changed gloves during treatment and 100 percent in between patients; 36 percent wore and changed face masks during treatment and in between patients. 66.9 percent used autoclaves for sterilization, 62 percent had special containers for sharps disposal while 50% always used sterilization wrappers. Only 26 percent always disinfected working surfaces in between patients. Based on these responses, only a small percentage of Dentists in this sample were considered to be compliantwith an inventory of standard infection control procedures.Conclusions: There is a great need in Lagos, perhaps in Nigeria as a whole for the adoption and implementation of standard infection procedures and the provision of formal and obligatory infection control courses and guidelines for Dental Surgeons by the Ministry of Health and the Dental Association, in addition to distribution of standard infection control manuals that incorporate current infection control recommendations.Keywords: Hepatitis B Virus (HBV), Occupational Hazard, Cross Infection, Post Exposure prophylaxis (PEP), Dental Surgeons.

Assessment and Comparative Analysis of a Reusable Versus Disposable To-Go System

Disposable to-go containers, especially those made from polystyrene foam, are typically thought to have a negative impact on the environment compared to reusable containers. This study tested this assumption and provides new insight into the reusable versus disposable debate. GaBi 4 software was used to conduct the inventory and compara tive analysis. The software works by modeling product elements from a life-cycle perspective and provides access to a live database of the environmental impacts associated with sourcing and refining the raw materials and processed components of a product. For the inventory and analysis of the present study, the software provided a number of databases that reflect the materials (polypropylene and polystyrene) and processes (molded plastics) involved. The inventory’s scope included raw material extraction, production, transportation, cleaning, and disposal of the EcoClamshell to-go containers in order to compare it with disposable polystyrene containers. This study explored two impact categories: greenhouse gases and embodied energy. It was found that the Eco-Clamshell emits 12 times the greenhouse gases and 21 times the embodied energy when compared on a one-to-one basis with a disposable product. It was also determined that a reusable Eco-Clamshell must be used more than 29 times to be the environmentally preferable product in the category of embodied energy and approximately 15 times in terms of greenhouse gas emissions. The number of reuses necessary will vary according to the environmental impact category and the type of dishwasher used. The results of this study show that reusable to-go containers minimize environmental impact if they are used a certain number of times, and manufactured using lighter materials as opposed to heavy duty plastic. A reliable system of accountability should be used to ensure the proper life span and cost effectiveness of the product.

Experience in the Management of Disused Lightning Rods Containing 241Am in a Research Institute in Brazil

Radioactive lightning rods (RLR) were manufactured and installed in Brazil for almost two decades, before they were prohibited in 1989. Structures protected by this type of lightning preventers included residential buildings, schools, commercial and industrial facilities, among others. It is estimated that about 3.4 TBq of 241Am were used by manufacturers, and a total of 75,000 pieces with a mean activity of about 46 MBq were in the market. While only a fraction of the total has been recovered, the almost twenty thousand pieces already collected at the Nuclear and Energy Research Institute (IPEN) had their sources successfully separated from the remaining recyclable metal scrap and are now encapsulated in lead containers for final disposal.

Helicase‐Dependent Amplification of Nucleic Acids

Helicase-dependent amplification (HDA) is a novel method for the isothermal in vitro amplification of nucleic acids. The HDA reaction selectively amplifies a target sequence by extension of two oligonucleotide primers. Unlike the polymerase chain reaction (PCR), HDA uses a helicase enzyme to separate the deoxyribonucleic acid (DNA) strands, rather than heat denaturation. This allows DNA amplification without the need for thermal cycling. The helicase used in HDA is a helicase super family II protein obtained from a thermophilic organism, Thermoanaerobacter tengcongensis (TteUvrD). This thermostable helicase is capable of unwinding blunt-end nucleic acid substrates at elevated temperatures (60° to 65°C). The HDA reaction can also be coupled with reverse transcription for ribonucleic acid (RNA) amplification. The products of this reaction can be detected during the reaction using fluorescent probes when incubations are conducted in a fluorimeter. Alternatively, products can be detected after amplification using a disposable amplicon containment device that contains an embedded lateral flow strip.