Sharps Disposal Practices Research Articles

Localization of the questionnaire about sharps disposal at home among diabetes based on knowledge, attitude, and practice theory, and a cross-sectional survey of current conditions.

Diabetes Mellitus is a long duration disease, and if a person with diabetes is infected with a blood-borne infectious disease and proper syringe disposal practices are not followed, they run the danger of transmitting the infection to others for a very long period. Whereas fewer research has been done in China on the handing of sharp objects at home. Therefore, there is a need to translate and localize the Knowledge-Attitude-Practice Questionnaire regarding sharp disposal for diabetic patients to assess the current level of patient knowledge, attitudes, and practices and to improve the basis for promoting safe sharps handling practices. This investigation was a cross-sectional study. The Knowledge-Attitude-Practice Questionnaire regarding sharp disposal was localized and debugged and tested for reliability and validity, and then 334 patients were investigated by General Characteristics Questionnaire, Knowledge- Attitude-Practice Questionnaire regarding sharp disposal, and the influencing factors of practice level regarding sharp disposal of patients were analyzed. The Cronbach's α value of the attitude section was 0.864 and the content validity index was 0.923. The knowledge and practice sections are in line with continental language conventions and are easy to understand without any ambiguity. The majority (52%) of the participants had poor knowledge and a neutral attitude toward disposing of sharp objects. Sharps disposal practices among diabetes mellitus patients were poor since about 90% of patients dispose of their used sharps directly into the household waste. Furthermore, we found that level of education, knowledge and attitude were the major predictors of practices regarding sharps disposal among diabetic patients (R 2 = 0.573, p < 0.001). The Chinese version of the Knowledge-Attitude-Practice Questionnaire regarding sharp disposal has applicability in China. In China, current practice of disposing used sharps is improper. Additionally, the majority of the subjects had low levels of knowledge and attitudes. To raise awareness and encourage diabetic patients to follow appropriate sharps disposal practices, there needs to be ongoing education and a locally tailored safe sharp disposal alternative accessible.

At-home disposal practices of used insulin needles among patients with diabetes in China: A single-center, cross-sectional study.

Most insulin injections for people with diabetes are administered at home, thus generating many used needles. Unsafe disposal of these at-home needles can lead to needle stick injuries, blood-borne disease transmission, and environmental contamination. Previous studies have shown varying results on the prevalence of and factors associated with safe sharps disposal practices of people with diabetes. To assess the prevalence of and the factors associated with the safe disposal of used insulin needles among patients with diabetes. We collected data from 271 insulin-using patients at a tertiary care hospital in China. A self-designed instrument was used to assess sociodemographic data, disease- and treatment-related characteristics, sharps disposal practices, education on diabetes self-management and sharps disposal, and awareness of the potential risks associated with unsafe sharps disposal. Multivariate logistic regression analysis was used to explore factors associated with safe sharps disposal practices. Only 10.3% (28/271) of participants disposed of used at-home insulin needles in a safe manner, and 14.8% (45/271) of participants had received previous instruction on sharps disposal. Previous sharps disposal instruction (AOR = 4.143, 95% CI = 1.642-10.450) and awareness of the risk of blood-borne pathogen transmission (AOR = 3.064, 95% CI = 1.332-7.046) were associated with safe disposal of used insulin needles. In our study, the prevalence of safe sharps disposal practices was low, and a minority of respondents had received previous instruction on sharps disposal. Participants who had previously received instruction and were aware of the risk of blood-borne pathogen transmission were more likely to handle sharps safely. Our study findings suggest that health care professionals should pay attention to sharps disposal practices of patients with diabetes and conduct diabetes education programs that include information on safe sharps disposal methods and potential hazards of unsafe sharps disposal.

Medical sharps in Portugal: a cross-sectional survey of disposal practices among the diabetic population

ObjectiveWe aim to determine the disposal site for biohazardous materials resulting from diabetes surveillance and therapy.DesignCross-sectional study.SettingFive Portuguese primary care facilities.ParticipantsWe randomly sampled diabetic patients representative of five primary care...

Sharps Disposal Practices Among People With Diabetes in a Community Care Clinic.

The primary objective of this study was to determine sharps disposal practices among people with diabetes in a community care clinic. Secondary objectives were to identify patterns of sharps use and barriers to proper use. Surveys were distributed to patients at a community care clinic in person and via mail. Survey questions focused on how sharps are used and disposed of, the frequency of sharps changes, sharps disposal training, sharps identification, and confidence in sharps disposal. Participant demographics and diabetes profiles were also collected. Among 89 respondents, mean age was 60 years (range 29-93 years), 61.8% were Caucasian, 88.8% had type 2 diabetes, and 60.7% had had a diabetes diagnosis for ≤10 years, with diverse diabetes management methods; 57.3% did not receive or were unsure of sharps training, 25.8% discarded used sharps without a designated sharps container, and 37.1% properly disposed of sharps containers at sharps disposal facilities. Barriers to proper sharps practices included perceived safety of reusing sharps and waste with single use, cost, and the hassle of disposal. Those with prior sharps training were more likely to properly use and discard sharps; however, gaps in knowledge were still evident in this population. Results indicate gaps in proper sharps use and disposal knowledge among people with diabetes. Responses revealed sharps practices that are inconsistent with current federal and state regulations and are potentially dangerous for those handling improperly discarded sharps. Targeted sharps usage and disposal education resources are needed for individuals with and without prior sharps training.

517-P: The Prevalence and Predictors of Improper Sharps Disposal among People with Diabetes in Saudi Arabia

Background: Diabetes often requires the use of sharp objects (e.g. needles, lancets, etc) to maintain optimal glycemic control. Improper disposal of sharps poses substantial threats to the environment and public health. Objectives: To estimate the prevalence, and identify predictors, of improper sharps disposal among people with diabetes (PWD) in Saudi Arabia. Method: We surveyed PWD, visiting a diabetes center in Riyadh, Saudi Arabia in Sep- Oct, 2021. We asked questions about sociodemographics, type and duration of diabetes, methods of sharps disposal, and whether the study participants had received instructions on proper sharps disposal. We defined “proper sharps disposal” as: dispensing sharps into a designated sharps disposal container or home-made sealed container. Results: Of the 293 PWD surveyed, 60% were women, 54% were ≥35 years old, and 53% had type 1 diabetes. Majority (80% and 72%) reported improper disposal of needles and lancets, respectively. Approximately, 56% of needle users and 61% of lancet users reported that they had never received instructions on safe sharps disposal. Receiving education on safe sharps disposal was associated with a 66% reduction in the risk of improper sharps disposal practice[OR (95% CI) : 0.34 (0.16-0.68) ] after adjusting for age, gender, type and duration of diabetes, income, education, and nationality of the study participants. Among those who improperly dispose their needles, 67% thought their way of sharps disposal was appropriate and 47% did not know what type of infections can be transmitted via needlestick injuries. Conclusion: Our findings highlight the high prevalence of unsafe sharps disposal practices among PWD, and how providing education on safe sharps disposal can help address this environmental and public health threat. Policies to reduce diabetes-related waste, unify the approach to proper sharps disposal, and educate PWD on how to safely dispose sharps are needed to achieve a sustainable and safe waste management system. Disclosure G.Alsuwailem: None. M.Barakeh: None. G.A.Almarshoud: None. A.Zawawi: None. R.A.Bakader: None. M.Al-sofiani: None.

An exploratory study on the knowledge, attitude and practice of sharp disposal among type 2 diabetes mellitus patients in Northern Peninsular Malaysia

The use of exogenous insulin exposes the patients to sharps (insulin pen needles and lancets). Improper sharps disposal increases the risk of transmitting diseases such as hepatitis B, hepatitis C, Human Immunodeficiency Virus and other blood borne diseases. To assess the knowledge, attitude and practices of sharp disposal among type 2 diabetes mellitus patients in the Northern Peninsular of Malaysia. A self-administered, questionnaire-based, cross-sectional study was conducted at nine health clinics in the three Northern Peninsular Malaysia states. This study (NMRR-20-1757-56045 IIR) was approved by Medical Research and Ethics Committee, Malaysia. A total of 312 subjects were recruited in this study. The majority (46.15%) of the subjects had moderate knowledge regarding sharps disposal ranging from 60% to 70% of the knowledge score. The majority (59.60%) of the subjects had a positive attitude towards proper sharps disposal and 13.30% of the subjects had a strongly positive attitude. Sharps disposal practices among type 2 diabetes mellitus patients were poor since only two subjects reported correctly disposing of their used sharps. The study showed that the majority of the subjects had moderate knowledge, a positive attitude and poor sharp disposal practice.

Practical guidance on insulin injection practice in diabetes self-management in the Indian setting: an expert consensus statement

This consensus statement aimed to provide a simple and easily implementable practical educational guide- line for healthcare professionals (HCPs) and patients regarding insulin injection practice in diabetes self- management in the Indian setting. A group of experts analysed published data from guidelines, clinical trials and real world evidence to reach consensus recommendations on optimal insulin injection practices in terms of a) the injection sites (preparation of site of injection, choosing the injec- tion site, site rotation), b) choice of device and storage of insulins, and c) safety precautions, sharp disposal practice and complications. Findings from Global and Indian arm of 2014-2015 ITQ Study were considered to emphasize a need for improved practice by HCPs covering all the vital topics essential to proper injection habits. The consensus statement provides a simple and easily implementable practical educational guideline for HCPs and patients to optimize insulin injection practices in accordance with recent advances in device manufac- turing, newer research findings, and updated interna- tional guidelines as well as widespread concerns about neglected safety precautions such as single-patient use of pens and appropriate sharp disposal practices.

MON-021 Patterns of Sharps Handling and Disposal Among Insulin Using Patients with Diabetes

Background: Nearly 7 million patients with diabetes mellitus (DM) in the U.S. use insulin. Both Insulin therapy and self-monitoring of blood glucose (SMBG) have the potential to generate a large volume of biohazardous waste via use of “sharps” (needles and lancets). Unless safely disposed of these sharps could present a public health risk, placing unaware individuals at risk of needle sticks. However, there is a paucity of data on whether patients safely handle and dispose of used insulin needles and lancets. Objective: Assess patterns of sharps use and disposal among a clinic and hospital based population of DM patients on insulin therapy. Method: A survey was administered to a convenience sample of adult insulin treated DM patients recruited from an outpatient endocrinology clinic and an inpatient hospital setting. Patients were asked about patterns of sharps use (frequency of daily SMBG and insulin injections), how often sharps were used prior to disposal, sharp disposal technique, and education received regarding safe sharp disposal. Results: The survey was completed by 142 patients (94 outpatients and 48 inpatients). Mean age was 56 years, self-reported DM duration 20 years, hemoglobin A1c was 8.4%, and BMI 30.2 kg/m2; 57% were men and 75% were white. No differences in characteristics (p>0.1) were seen between outpatient and inpatient respondents. The average number of insulin injections was 3/day, and frequency of SMBG was 3.5/day. A minority (22%) used an insulin needle 2 or more times, and 32% threw the needles directly into the garbage as opposed to a sealable or red sharps container. Most (56%) respondents used a lancet 2 or more times, sometimes changing the lancet once only every few months. Around a third (35%) threw used lancets directly into the garbage; one patient flushed them down the toilet. No differences were seen between outpatients and inpatients (p> 0.3) in patterns of needle use, lancet use, or disposal method. The majority (63%) of respondents indicated they had never received instruction on safe disposal of sharps. Conclusion: In this population of both outpatients and inpatients, repeated use of the same insulin needle and lancet was noted. Moreover, nearly a third of respondents disposed of their sharps in an unsafe manner. If similar data are confirmed in broader studies, this could translate into a large number of insulin using patients improperly disposing of their sharps waste—a potentially important public health hazard. With the rising prevalence of DM and need for insulin, further study is needed to determine sharps disposal practices of these patients. Improved education is needed on both a population and patient level regarding proper handling of these biohazardous materials.

Practices related to sharps disposal among diabetic patients in Sri Lanka

BackgroundPatients with diabetes on insulin therapy use sharps (e.g., needles) on a regular basis and a considerable proportion of them, within their home environments. These sharps and other bloodstained materials, if not disposed of appropriately has the potential to be a public health hazard.ObjectiveOur objective was to explore the practices related to sharps disposal among patients with diabetes from North Colombo Teaching Hospital (CNTH), Ragama, Sri Lanka.MethodsWe conducted a cross-sectional study on 158 patients with diabetes from the CNTH. Patients had to use sharps for the daily management of their disease for inclusion into the study group. Data were collected on sharps disposal practices using an interviewer-administered questionnaire. Clinic records were also used as a secondary data source.ResultsMost patients, 153/158 (96.8%) used syringes to inject insulin. Forty-three patients (27%) involved others (e.g., family) when disposing of sharps. Used sharps were commonly disposed to the household garbage bin by 66 participants (41.7%). Other methods used for sharps disposal were: sharps container, toilet pit, household garbage dump and indiscriminate measures. Importantly most patients, 147 (93%) had received no information on how to dispose of sharps after usage.ConclusionPatients commonly used unsafe practices in home-based sharps disposal. These included disposing of in the household garbage bin, burning sharps in the household garbage dump and disposing of into the common garbage dump of the community. Being male and being > 60 years of age was associated with a higher dependence on family members for sharps disposal. Patient education and public resources for sharps handling can help improve this situation.

Factors Contributing to Appropriate Sharps Disposal in the Community Among Patients With Diabetes.

Background.Proper disposal of sharps has been well studied in hospital settings but not often addressed in the home setting. This lack of attention has resulted in erratic use of proper sharps disposal techniques and thus increased risk of needle-stick injuries and infections. This study aimed to evaluate methods of disposal and patient demographic factors associated with correct disposal of diabetes-related sharps in the community.Methods.A survey was administered to diabetes patients at an endocrinology clinic of an academic tertiary care center. Correct disposal of sharps was defined as use of designated sharps or other leak-proof containers. Numerous patient factors were evaluated for a clinically significant association with correct disposal of sharps via χ2 testing.Results.Fifty-nine percent of patients reported disposing of their sharps correctly. Those with diabetes for >30 years had the lowest rate of correct disposal (36%). Age, sex, education level, type of diabetes, and type of diabetes regimen were not associated with correct disposal. Patients who received formal training on proper sharps disposal from a nurse or from other sources were more likely to dispose of sharps correctly (odds ratio [OR] 3.95, 95% CI 1.37–11.34, and OR 4.55, 95% CI 1.5–13.85, respectively). Married patients were less likely to correctly dispose of sharps (OR 0.36, 95% CI 0.14–0.92, P = 0.033).Conclusion/Clinical Relevance.This study was the first to examine disposal practices and associated risk factors for poor disposal methods among patients in a U.S. tertiary medical center. A large portion of patients was found to have improper sharps disposal practices. Prior formal training in sharps disposal was associated with higher rates of correct practices, suggesting that increased emphasis on provider-patient education can lead to significant improvement in disposal habits.

Knowledge and Self-Reported Practice of Insulin Injection Device Disposal among Diabetes Patients in Gondar Town, Ethiopia: A Cross-Sectional Study.

Background. Incorrect sharp disposal practices may expose the public to needle-stick injuries. The present study aimed at assessing the knowledge and practice of diabetic patients towards insulin injection device disposal in Gondar town, Ethiopia. Methods. A cross-sectional study was employed on insulin requiring diabetes patients who visited the diabetes clinic at Gondar University Referral Hospital (GURH) from February 1 to March 28, 2016. Frequencies, percentages, and ANOVA (analysis of variance) and Student's t-test were used to analyze variables. Results. About half of the participants (49.5%) had poor knowledge towards safe insulin injection waste disposal. More than two-thirds (80.7%) of respondents had poor practice and 64.3% of respondents did not put insulin needle and lancets into the household garbage. 31% of respondents threw sharps on street when they travel outside. Respondents living in urban areas had a higher mean of knowledge and practice score than those who live in rural area. Conclusions. This study revealed that knowledge and practice of diabetic patients were low towards safe insulin injection waste disposal in study area. Healthcare providers should also be aware of safe disposing system and counsel patients on appropriate disposal of used syringes.

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.

Improper sharp disposal practices among diabetes patients in home care settings: Need for concern?

In the recent years, outbreaks of blood-borne infections have been reported from assisted living facilities, which were traced back to improper blood glucose monitoring practices. Needle-stick injuries have been implicated in many such cases. This directly raises concerns over sharp disposal practices of diabetic patients self-managing their condition in home care settings. With India being home to a huge diabetic population, this issue, if neglected, can cause substantial damage to the health of the population and a marked economic loss. This article discusses the sharp disposal practices prevalent among diabetes patients, the importance of proper sharp disposal, barriers to safe disposal of sharps, and the options available for doing the same. For adopting an environmentally safe wholesome approach, disposal of plastics generated as a result of diabetes self-care at home is important as well. The article also looks at the possible long-term solutions to these issues that are sustainable in an Indian context.

Knowledge, Attitudes and Practices on the Disposal of Sharps in Patients of the UP-Philippine General Hospital Diabetes Clinic

Introduction. Diabetics using insulin are the largest group of patients that use syringes and needles outside of the hospital. Despite this, few studies have been done regarding the disposal of sharps of these patients in the community setting. Objectives. The objective of phase 1 was to create a validated, self-administered questionnaire to assess the knowledge, attitude and practices of diabetic patients with regard to the disposal of sharps in the community setting. The objectives of phase 2 were to assess the knowledge, attitude and practices of these patients and identify which factors influence these characteristics. Methodology. Literature review and a focus group discussion were conducted. A conceptual framework based on the Health Belief Model was created. Questionnaire items were reviewed by an expert panel, translated into Filipino and pre-tested. The final questionnaire was administered to 130 patients. Results. Majority of patients (82%) disposed of their sharps through the community garbage collection and most (76%) used a sharps container. Less than one-fourth (23.7%) had acceptable disposal techniques. Respondents had moderate knowledge (mean score of 62.2%) and positive attitude (mean score of 3.95 out of 5) towards sharps disposal. A longer duration of diabetes mellitus (DM) and insulin use negatively influenced disposal practices. Attitude was positively influenced by needle stick injury to self and college education, but being married exerted a negative influence. Conclusion. The majority of patients at the UP-PGH DM clinic have improper sharps disposal practices, and need to be better educated about proper techniques.

The Sticking Point: Diabetic Sharps Disposal Practices in the Community

The Sticking Point: Diabetic Sharps Disposal Practices in the Community

Sharps disposal practices among diabetic patients using insulin

Insulin-dependent diabetic patients are not educated on safe sharps disposal methods, so leading to unsafe disposal of needles. Appropriate education on the correct disposal of sharps should be an integral part of their diabetic counseling. Doctors, nurses and pharmacists should all take responsibility for educating and reinforcing information about correct sharps disposal methods. Patients should be advised to either discard sharps into puncture resistant containers placed into their household refuse, or return them in secure containers for disposal by the dispensing institutions. Patients should also be educated regarding health risks associated with used needles. The South African Metabolic and Endocrine (SEMDSA) Guidelines and the South African Standard Treatment Guidelines (STG) should also give clear guidance on the safe disposal of needles.

Disposal of sharps medical waste in the United States: Impact of recommendations and regulations, 1987-2007

To gauge the impact of regulatory-driven improvements in sharps disposal practices in the United States over the last 2 decades, we analyzed percutaneous injury (PI) data from a national surveillance network from 2 periods, 1993-1994 and 2006-2007, to see whether changes in disposal-related injury patterns could be detected. Data were derived from the EPINet Sharps Injury Surveillance Research Group, established in 1993 and coordinated by the International Healthcare Worker Safety Center at the University of Virginia. For the period 1993-1994, 69 hospitals contributed data; the combined average daily census for the 2 years was 24,495, and the total number of PIs reported was 7,854. For the period 2006-2007, 33 hospitals contributed data; the combined average daily census was 6,800, and the total number of PIs reported was 1901. In 1992-1993, 36.8% of PIs reported were related to disposal of sharp devices. In 2006-2007, this proportion was 19.3%, a 53% decline. This comparison provides evidence that implementation of point-of-use, puncture-resistant sharps disposal containers, combined with large-scale use of safety-engineered sharp devices, has resulted in a marked decline in sharps disposal-related injury rates in the United States. The protocol for removing and replacing full sharps disposal containers remains a critical part of disposal safety.

Knowledge, Attitude and Practices (KAP) on Disposal of Sharp Waste, Used for Home Management of Type-2 Diabetes Mellitus, in New Delhi, India

This was a cross-sectional study to explore the factors influencing practices about household sharp waste management among type 2 diabetics in Delhi, India. The study used self-administered questionnaires to find socio-demographic characteristics, diabetes management characteristics, and knowledge, attitude and practices (KAP) towards household sharp waste management. While there is a large amount of literature on sharp disposal practices in the healthcare setting, to the best of our knowledge sharp disposal at home and associated factors has not been studied in India before. A total of 303 type 2 diabetics, who were above 18 years of age and gave informed consent, were asked to fill a self-administered questionnaire stating their socio-demographic, diabetes management characteristics, and KAP on household sharp management. Information or education on sharp use and disposal by healthcare provider, pharmacist and sharp manufacturer was collected as influencing factors. Any past injury to self, family member or to pet was also collected as one of the potential influencing factors. The study did not find any association of socio-demographic factors, diabetes management characteristics (like duration of type 2 diabetes, duration and frequency of insulin use, number of needles and lancets used, reuse of sharps, frequency of blood glucose monitoring, frequency of physician visit etc.), knowledge and attitude with sharp disposal practices of respondents. Household waste bins were frequently used by majority (84.1%) of respondents to discard their sharps, whereas only a few (16.9%) had informed their garbage handlers about presence of sharps in their waste. In contrast, influencing factors like education form healthcare provider, pharmacist and friends were significantly associated with good sharp disposal practices.

Sharp disposal practices in urban dispensaries

Sir, Bio-medical waste means waste generated during the process of diagnosis, treatment and/or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biological. Injections are among the most frequently used medical procedure with an estimated 12 to 16 billion injections administered each year worldwide. (1) According to IPEN study, 03-06 billion injections are administered annually in India. (2) A large majority of them are administered for curative purpose and rest for immunization. An injection is considered to be safe when it does no harm to the recipient, does not expose the health care worker to any risk and does not result in waste that is dangerous to the community. (3) Although sharps waste constitutes a small proportion of all health care waste, its inadequate management can cause direct negative impact on health personnel and community and in addition, pollute the environment. A study was conducted to assess injection [immunization] waste disposal practices in urban dispensaries of Delhi, India. Primary data were collected by a single investigator using observation checklist based on Government of India guidelines (4) during the period October 2005 to March 2006. All [32] government dispensaries operational in a randomly selected municipal zone of Delhi, India were covered after obtaining permission from competent authorities. Owing to limited resources, only one visit was made to each health facility and best of five injections were observed to comment on disposal practices and method of terminal waste disposal from the dispensary was also observed and/or recorded. Results are thus presented according to health facility. All the health facilities were using AD [auto-disable] syringes for primary immunization of children. Correct needle disposal practices [needle shredding/chemical disinfection] and incorrect practices [needle bent/recapped with both hands] were observed in equal number (16 [50.00%]) of health facilities respectively. It was noticed that dedicated bio-medical waste transport service was available in 18 [56.25%] health facilities only as per regulatory stipulation for transfer of biomedical including immunization waste to common biomedical treatment facility. Rest of the health facilities i.e. 14 (43.75%) were either disposing off their entire immunization waste into nearby general municipal waste containers [dhalao] or were burning in uncontrolled manner [Figure 1]. An interesting observation was made that incorrect needle practices were more prevalent in those health facilities that had provision of dedicated BMW transport service suggestive of carelessness/need for attitudinal change [Table 1]. Table 1 Sharp disposal practices according to health facilities Figure 1 Uncontrolled burning of AD syringes in a dispensary BMW labeled colored coded bags were used in 29 [90.62%] health facilities for disposing immunization waste; however, varying color bags were in use. All the injection-related waste was also thrown in respective available bags. Red-colored bags were used in 16 [50.0%], blue bags in 11 [34.37%], and yellow bags in 2 [6.25%] health facilities, respectively. The reason cited was logistic issues. The cut-needle that was collected using hub cutter was emptied back directly into plastic/cardboard container at the end of immunization day or was being preserved in the hub cutter itself till it got completely filled. It was heartening to note that there was no littering of injection waste in or around any of the health facilities. IPEN study on ‘Assessment of Injection Practices in India’ reported satisfactory immunization waste disposal in 50.0% of health facilities only. There are multiple government health agencies in Delhi that are providing health services including immunization to community. Some of these agencies had outsource to vendors the practice of transporting biomedical including immunization waste to common biomedical treatment facility in accordance with Bio Medical Waste Management and Handling Rules, 1998 while in rest this was not made available. To conclude, corrective interventions are required at two levels i.e. one at individual/health facility and another at health agency level. It is the organizational responsibility to coordinate and make available dedicated bio-medical waste transport services including other logistics, which is also binding on them as per statutory requirement. Re-orientation training/sensitization of health personnel at periodic interval may instill in safe BMW management practices. Similarly, close monitoring and supervision is required by medical officers at individual level to ensure correct waste disposal practices by health workers.

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 ⩾̸ 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.