*SAFE INJECTION GLOBAL NETWORK* SIGNPOST *SAFE INJECTION GLOBAL NETWORK* Post00505 Waste Handlers Protection? + Abstracts + News 22 July 2009 CONTENTS 1. Sanitation Workers and Protective gear - Sharps injuries in healthcare waste handlers. - Needle and Syringe Use & Sharps Disposal by a Rural Population - Summary of the Agency for Toxic Substances and Disease Registry report to the Congress: the public health implications of medical waste. - At the U.S. Environmental Protection Agency: Medical Waste Home: - World at work: Refuse collectors - The microbiological hazards of municipal and clinical wastes - Waste disposal and infection transmission in health care institutions - Health And Safety Risks Amongst The Municipal Solid Waste Collectors In Port Harcourt Metropolis Of The Niger Delta Region Of Nigeria - Safe management of wastes from healthcare activities. - Vaccinations for waste-handling workers. A review of the literature - Preliminary Risk Analysis Applied To The Handling Of Health-Care Waste - Solid Waste Management Health and Safety Risks: Epidemiology and Assessment to Support Risk Reduction - Hepatitis B morbidity in municipal and hospital waste collection workers in the city of Rio de Janeiro - This is an extract from a paper from the ICDDRB on medical waste management - cites US data: - No Abstract: Hepatitis B virus and hepatitis C virus in medical waste handlers in Tripoli, Libya - Safe Management of Bio-medical Sharps Waste in India - A Report on Alternative Treatment and Non-Burn Disposal Practices 2. Abstract: Needlestick Injuries Among Health Care Workers: A Literature Review - Brief Article 3. Abstract: Unsafe injection practices in Gujarat, India 4. Abstract: Phylogenetic analysis of hepatitis B virus full-length genomes reveals evidence for a large nosocomial outbreak in Belgium 5. Abstract: Hepatitis B virus infection in US correctional facilities: a review of diagnosis, management, and public health implications 6. Abstract: Bundling occupational safety with harm reduction information as a feasible method for improving police receptiveness to syringe access programs: evidence from three U.S. cities 7. Abstract: Prevalence rates and risk factors for hepatitis C among drug users not intreatment in Malaysia 8. Abstract: Factors associated with Hepatitis C infection in patients with chronic hemodyalisis 9. Abstract: Contaminated Product Water as the Source of Phialemonium curvatum Bloodstream Infection among Patients Undergoing Hemodialysis 10. No Abstract: Reporting healthcare associated infections should be mandatory, says audit office 11. No Abstract: Teamwork achieves high-quality medical devices 12. No Abstract: Microbiologic assessment of multidose Restylane for facial augmentation 13. NIH and Wikimedia Foundation Collaborate to Improve Online Health Information 14. News - China: Hemophiliacs sue Shanghai firm over HIV infections - UK: Fears as women use unlicensed drug in search of all-over tan - Canada: No evidence Alta. hospital's syringe reuse spread HIV: minister - USA: Clinics linked to hepatitis outbreak file for bankruptcy - UK: RCN Calls For EU Agreement On Sharps Injuries To Be Implemented Quickly - Pakistan: Govt to act against quacks, says Jakhrani - EU: European agreement on injuries to health workers caused by 'sharps' - USA: More than 500 Tested and Cleared for Hepatitis C in Springs - Pakistan: Overuse of injections fuelling hepatitis epidemic - USA: Cathedral City's Innovative Program for Safe Syringe Disposal Wins Award - Africa: Poor syringe hygiene can be fatal This edition of SIGNpost is located at: http://uqconnect.net/signfiles/Archives/SIGN-POST00505.txt and is printer friendly. 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Subscribe or un-subscribe by email to: sign@uq.net.au, sign@who.int More information follows at the end of this SIGNpost! __________________________________________________________________________ __________________________________________________________________________ * Visit the WHO injection safety website and the SIGN Alliance Secretariat at: http://www.who.int/injection_safety/en/ Revised injection safety assessment tool: TOOL C [pdf 1.78Mb] http://www.who.int/injection_safety/Injection_safety_final-web.pdf Download the latest injection safety Best Practices review at: http://www.uqconnect.net/signfiles/Files/BestPracticesJul2003.pdf * Use the Toolbox at: http://www.who.int/injection_safety/toolbox/en/ * Get SIGN files on the web at: http://www.uqconnect.net/signfiles/Files/ * SIGNpost archives: http://www.uqconnect.net/signfiles/Archives/?M=D Get the final report of the SIGN Meeting 2008, Moscow, Russian Federation [2.36Mb] at: http://www.who.int/injection_safety/2008MeetingReport.pdf __________________________________________________________________________ _____________________________________*____________________________________ 1. Sanitation Workers and Protective gear A question came in asking about studies that show the efficacy of increased use by sanitation workers of personal protective gear (gloves), HBV vaccination, and pre & post-exposure prophylaxis as protection against sharps injury and bloodborne pathogen transmission. The moderator did a wide but not exhaustive search and found very a limited number of studies of sharps injuries among sanitation workers and waste handlers. In this field there are many press releases for protective gear and multiple guidelines for operators and contractors. The efficacy of protective equipment in use remains an open question. A few references follow: - Sharps injuries in healthcare waste handlers. - Needle and Syringe Use & Sharps Disposal by a Rural Population - Summary of the Agency for Toxic Substances and Disease Registry report to the Congress: the public health implications of medical waste. - At the U.S. Environmental Protection Agency: Medical Waste Home: - World at work: Refuse collectors - The microbiological hazards of municipal and clinical wastes - Waste disposal and infection transmission in health care institutions - Health And Safety Risks Amongst The Municipal Solid Waste Collectors In - Port Harcourt Metropolis Of The Niger Delta Region Of Nigeria - Safe management of wastes from healthcare activities. - Vaccinations for waste-handling workers. A review of the literature - Preliminary Risk Analysis Applied To The Handling Of Health-Care Waste - Solid Waste Management Health and Safety Risks: Epidemiology and Assessment to Support Risk Reduction - Hepatitis B morbidity in municipal and hospital waste collection workers in the city of Rio de Janeiro - This is an extract from a paper from the ICDDRB on medical waste management - cites US data: - No Abstract: Hepatitis B virus and hepatitis C virus in medical waste handlers in Tripoli, Libya - Safe Management of Bio-medical Sharps Waste in India - A Report on Alternative Treatment and Non-Burn Disposal Practices .......................................................................... __________________________________________________________________________ Ann Occup Hyg. 2008 Jun;52(4):281-6. Sharps injuries in healthcare waste handlers. Blenkharn JI, Odd C. Blenkharn Environmental, 18 South Road, Ealing, London W5 4RY, UK. blenkharn@ianblenkharn.com Clinical waste disposal carries with it a risk of serious and possibly life-threatening infection. Combining confidential questionnaires and structured interviews with discrete observation, the attitudes and approach to safe handling of bulk clinical wastes by staff in a specialist waste treatment facility were assessed. With particular attention to glove use and hand hygiene, observations were supplemented by review of group- wide accident and incident records, with emphasis on sharps injuries and related blood and bloodstained body fluid exposures. Deficiencies in glove selection and use, and in hand hygiene, were noted despite extensive and on-going training and supervision of waste handlers. Though ballistic puncture-resistant gloves protect against sharps injury, these were uncomfortable in use and were sometimes rejected by waste handlers who preferred thin-walled nitrile gloves that were more comfortable in use though provide no resistance to penetrating injury. Among the waste handlers working for a single specialist waste disposal company, sharps injuries (n = 40) occurred at a rate of approximately 1 per 29 000 man hours. Injuries were caused by hypodermic needles from improperly closed or overfilled sharps boxes (n = 6) or from sharps incorrectly discarded into thin-walled plastic sacks intended only for soft wastes (n = 34). Most injuries occurred to the fingers or hands. No seroconversions occurred, though two individuals suffered anxiety/stress disorder necessitating prolonged leave of absence with professional counselling and support. Glove use and hand hygiene must feature prominently in the on- going training of waste handlers. Though ballistic gloves afford protection against sharps injury, the initial segregation and safe disposal of clinical wastes by healthcare professionals must provide the primary control measure. Despite robust and unambiguous legislation and good practice guidelines, serious errors by healthcare staff that result in the disposal of hypodermic needles and other sharps to thin-walled plastic waste sacks places waste handlers at risk of bloodborne virus infection. Further improvement in the standards of waste segregation and disposal by healthcare professionals are still required to protect ancillary and support staff and waste handlers working in the disposal sector. .......................................................................... __________________________________________________________________________ Journal of Environmental Health, Vol. 58, 1995 Needle and Syringe Use & Sharps Disposal by a Rural Population by M.L. Russell , G.F. Ross , D. Richen Journal Article Excerpt Introduction The sharps hazards arising from hospital and medical clinic waste are well recognized, and much attention has been paid to the development of safe methods for handling and disposing of such waste (1,2). A published case report had illustrated that garbage handlers in the community may be at risk of needle injuries (3). One report indicated that at least 14% of the medical waste injuries from sharps sustained by refuse workers are from sharps in residential waste (4). Needles are used for veterinary as well as for human treatment. However, little is known about the prevalence of their use or the methods used to dispose of them. The purpose of this paper is to describe the prevalence of use of needles and syringes for human and veterinary purposes, and the methods used for disposal of these sharps by a rural Alberta, Canada, population. Methods Data were collected by trained interviewers in a telephone survey of the health-related knowledge, attitudes, and practices of residents of the Drumheller Health Unit (DHU) conducted for the purpose of program planning and evaluation. The DHU, located in central Alberta, is a rural health unit serving a population of 31,000. The largest community within the DHU has a population of about 7,000. Directory seeded random digit dialling was used to contact eligible households. This method, thought to increase the efficiency of random digit dialling, was also chosen because reverse directories, which are recommended to be used in the development of the sampling frame for studies using random digit dialling, are not available for rural Alberta. Within the DHU, the ... .......................................................................... __________________________________________________________________________ Summary of the Agency for Toxic Substances and Disease Registry report to the Congress: the public health implications of medical waste. Morb Mortal Wkly Rep 1990;39:822-4. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1519619 The findings of the Agency for Toxic Substances and Disease Registry Medical Waste Tracking Act report. M Y Lichtveld, S E Rodenbeck, and J A Lybarger Agency for Toxic Substances and Disease Registry, Atlanta, GA 30333. Abstract The Agency for Toxic Substances and Disease Registry (ATSDR) report "The Public Health Implications of Medical Waste: A Report to Congress" has been finalized and submitted to Congress. The report is a comprehensive review of all available data and information on the subject. Based on the data developed in the report, ATSDR concludes that the general public is not likely to be adversely affected by medical waste generated in the traditional health setting. However, the increase of in- home health care and other sources of nonregulated medical waste (e.g., intravenous drug users) provides opportunities for the general public to contact medical waste. In addition, ATSDR concludes that public health concerns exist for selected occupations involved with medical waste. These populations include janitorial and laundry workers, nurses, emergency medical personnel, and refuse workers. The ATSDR report also defines what material should be managed as medical waste and identifies research needs related to medical waste. The scanned full report is available at: http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1519619&blobtype=pdf .......................................................................... __________________________________________________________________________ At the U.S. Environmental Protection Agency Medical Waste Home: http://www.epa.gov/waste/nonhaz/industrial/medical/index.htm Medical Waste Publications: http://www.epa.gov/waste/nonhaz/industrial/medical/publications.htm .......................................................................... __________________________________________________________________________ Occupational and Environmental Medicine 2004;61:282-286; doi:10.1136/oem.2002.001172 WORLD AT WORK: Hazards of the job World at work: Refuse collectors P P F M Kuijer and M H W Frings-Dresen Coronel Institute for Occupational and Environmental Health, AmCOGG: Center for Research into Health and Health Care, Academic Medical Center/University of Amsterdam, Netherlands Correspondence to: Dr P Kuijer Coronel Institute for Occupational and Environmental Health, Academic Medical Centre/University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, Netherlands; p.p.kuijer@amc.uva.nl A discussion of risks of the job and measures to protect the workers Keywords: health risks; preventive measures; safety hazards; waste; workload The first 150 words of the full text of this article appear below. Refuse is collected all around the world. The following collecting methods are mentioned in the literature:1 bags (plastic and paper), bins (110–150 l), drums (110–210 l), two-wheeled containers (80–360 l), and four-wheeled containers (300–1800 l). Over all, the job of a refuse collector can be characterised by frequent lifting, carrying, pushing, and/or pulling of heavy objects. In the Netherlands, most production systems to collect domestic refuse make use of a closed refuse truck with an automatic lifting device to empty two-wheeled containers (fig 1) or four-wheeled containers (fig 2).2,3 Only in a few parts of the Netherlands, especially in city areas where households have no space to place a container, are bags collected.4 In general, the wheeled containers are collected by a team of a truck driver and one or two refuse collectors. Table 1 presents the time spent on the different tasks and . . . Copyright © 2004 by the BMJ Publishing Group Ltd. .......................................................................... __________________________________________________________________________ The microbiological hazards of municipal and clinical wastes C.H. Collins 1 D.A. Kennedy 1 1 1 Department of Microbiology, National Heart and Lung Institute, Dovehouse Street, London, UK and 1The Medical Devices Directorate, Department of Health, Russell Square, London, UK Correspondence to: Dr C.H. Collins, The Ashes, Hadlow, Kent TN11 0AS, UK. No Abstract .......................................................................... __________________________________________________________________________ Health Policy and Planning; 9(1): 86-90 © 1994 brief-report Waste disposal and infection transmission in health care institutions VINIT SHARMA1,3, RAJKUMAR BANSAL1, ANURAGINI SHARMA1 and CR RAMACHANDRAN2 1 P. S. Medical College, Karamsad, Gujarat, India 2 Non-communicable Diseases Section, ICMR, New Delhi, India. 3Correspondence: Dr Vinit Sharma, Department of Community Medicine, Pramukh Swami Medical College, Karamsad 388 325, Gujarat, India In the present study waste disposal patterns of 10 purposely selected health care institutions from two states of India have been examined. Data were collected by pre-structured interviews of hospital administrators and on-the-spot observations, and were evaluated with reference to the possibility of transmission of various diseases, including HIV infection. It was observed that none of these institutions had a documented waste management and disposal policy. All categories of waste were disposed by being thrown on the open ground or in open municipal cans without any pre- treatment, rendering them accessible to rag-pickers. Both the internal and external transportation of hospital wastes were faulty and hazardous. A physical examination of 40 rag-pickers and 70 hospital workers who were directly involved in the disposal of hospital wastes, revealed that almost 40% (n= 47) of them suffered from skin infections and/or had cuts or abrasions on their palms, hands, or feet. None of them ever used hand gloves while working and only a limited few (n = 23) were found to be wearing shoes while coming in contact with hospital wastes. This study stresses the importance of periodic in-service orientation programmes for all categories of health care personnel and suggests some acceptable and affordable alternative measures for disposal of hospital wastes. .......................................................................... __________________________________________________________________________ There is some data on waste handler injuries in this one: http://www.srdit.si/gzo07/papers/12MPInyang_FinalPaperGzO07.pdf Health And Safety Risks Amongst The Municipal Solid Waste Collectors In Port Harcourt Metropolis Of The Niger Delta Region Of Nigeria Mfrekemfon P. INYANG University of Ibadan, Dept. of Human Kinetics and Health Education Faculty of Education, Ibadan, Oyo state, NIGERIA. mfrekemfon@yahoo.com International Conference “Waste Management, Environmental Geotechnology and Global Sustainable Development (ICWMEGGSD'07 - GzO'07)” Ljubljana, SLOVENIA, August 28. - 30., 2007 ABSTRACT Refuse collectors are those that pick up garbage for deposit at transfer stations or recyclable materials for deposit at existing recycling sites. This task is executed through the use of a truck on assigned routes. In developed countries automated trucks are used using hydraulic lift to pick up and dump trash containers. In developing countries such as Nigeria, the reverse is the case. Refuse collectors in this study area manually lift and dump containers into the operational trucks. Refuse collection is laden with health hazards. They are exposed to foul odours, dust, ants, flies and they get dirty easily even when they wear protective clothing if any (Appendix1B). Other hazards include chemical burns, injuries from disposable needles, broken glasses, falling objects from overloaded containers and the diseases that accompany solid waste. It is a very common sight to see refuse collectors on truck filled to overflowing with solid wastes sitting unsupported on top of the refuse while the truck is moving. The aim of this paper was to explore the work practices, injuries, illnesses, working conditions and other hazards faced by Port Harcourt municipal solid waste collectors in the course of discharging their duties. The sample for the study constituted of two hundred and seventy nine (279) solid waste collectors selected through convenient sampling technique. Their supervisors also formed part of the sample population. Data for the study was collected through structured questionnaire on Port Harcourt Metropolis solid waste (MSW) workers and oral interview with the aid of trained research assistants. Responses were analyzed using descriptive statistics of frequency counts, percentages and tables. Results revealed that out of the total respondents of two hundred and seventy – nine (279), 73(26.2 %) agreed that their protective equipments were of the right quality and suitable to the task, 31(11.1 %) were undecided while 175(62.5 %) disagreed. This implied that their protective equipments were not of the right quality and also not suitable to the tasks. Qualitative data revealed that not all the workers were given the protective equipments. Physical observation of the waste components revealed broken glasses and bottles, empty tins with serrated edges, broken plates, hypodermic needles and other sharp objects amidst several other forms of wastes. Two hundred and thirteen respondents representing 76.3 % of the total population agreed that they had sustained injuries from sharp objects in the course of packing refuse with bare hands. Only 57(20.4 %) disagreed while 9(3.2 %) were undecided. The study therefore concluded that Solid waste collectors in Port Harcourt municipality experienced different types of preventable hazards inherent in their jobs due to their work practice. The hazards they experienced ranged from injuries of all kinds, musculoskeletal and hearing disorders to respiratory and gastro intestinal tract infections. It was therefore recommended that the workers should be provided with the right protective equipments suitable to the tasks and also monitored to ensure their usage at work. Amongst other recommendations was also the need for periodic health surveillance to detect early signs of disease and also monitor their work ability. Key words: health, safety risks, solid waste collectors, Port Harcourt Metropolis, Niger Delta Region, Nigeria. .......................................................................... __________________________________________________________________________ Pruss A, Giroult E, Rushbrook P. Safe management of wastes from healthcare activities. Geneva: World Health Organization,1999. .......................................................................... __________________________________________________________________________ Waste Management & Research, Vol. 23, No. 1, 79-86 (2005) DOI: 10.1177/0734242X05048037 Vaccinations for waste-handling workers. A review of the literature Rebecca Tooher Tabatha Griffin Elen Shute ASERNIP-S, Royal Australasian College of Surgeons, Adelaide, South Australia Guy Maddern University of Adelaide, Department of Surgery, The Queen Elizabeth Hospital, Woodville, South Australia. A review of the literature relating to the need for vaccination against infectious disease in the solid waste industry was conducted, focusing on hepatitis A, hepatitis B and tetanus. Databases (Medline, PreMedline, EMBASE, CINAHL, Current Contents, Cochrane Database, HTA Database, DARE, OSHROM) were searched up to and including August 2003. Articles were included in the review if they reported the prevalence of immunity to hepatitis A, hepatitis B or tetanus in solid waste workers or the incidence of clinical infection with any of these diseases. Papers about hazardous or medical waste, incineration or other infectious diseases were excluded. Fortyfour papers constituted the evidence database. Only one paper studied the prevalence of antibodies to hepatitis A and hepatitis B in solid waste workers compared with sewage plant workers and office workers, and no difference was found between these groups of workers. There was some evidence to support a theoretical risk of infection with hepatitis A, B and tetanus; however, no studies could be found of the risk of these diseases in solid waste workers. No single cases of these diseases being acquired occupationally in solid waste management were identified in the literature. Workers in the solid waste industry may theoretically be at increased risk of acquiring infectious diseases occupationally. However, at present no studies could be found which have documented this risk. Key Words: Waste management • infection • vaccination • solid waste: wmr 746–1 .......................................................................... __________________________________________________________________________ Brazilian Journal of Chemical Engineering Print version ISSN 0104-6632 Braz. J. Chem. Eng. vol.19 no.4 São Paulo Oct./Dec. 2002 doi: 10.1590/S0104-66322002000400004 Preliminary Risk Analysis Applied To The Handling Of Health-Care Waste S.M.L.Carvalho1 and M.G.C.Silva2* 1Department of Chemical Engineering, Federal University of Pará, UFPA, Zip Code 66075-900, Belém, PA - Brazil. E-mail: sleao@feq.unicamp.br 2School of Chemical Engineering, State University of Campinas, P.O. Box 6066, Zip Code 13083-970, Campinas - SP, Brazil. E-mail: meuris@bla.feq.unicamp.br (Received: March 5, 2002 ; Accepted: August 6, 2002) Abstract - Between 75% and 90% of the waste produced by health-care providers no risk or is "general" health-care waste, comparable to domestic waste. The remaining 10-25% of health-care waste is regarded as hazardous due to one or more of the following characteristics: it may contain infectious agents, sharps, toxic or hazardous chemicals or it may be radioactive. Infectious health-care waste, particularly sharps, has been responsible for most of the accidents reported in the literature. In this work the preliminary risks analysis (PRA) technique was used to evaluate practices in the handling of infectious health-care waste. Currently the PRA technique is being used to identify and to evaluate the potential for hazard of the activities, products, and services from facilities and industries. The system studied was a health-care establishment which has handling practices for infectious waste. Thirty- six procedures related to segregation, containment, internal collection, and storage operation were analyzed. The severity of the consequences of the failure (risk) that can occur from careless management of infectious health-care waste was classified into four categories: negligible, marginal, critical, and catastrophic. The results obtained in this study showed that events with critics consequences, about 80%, may occur during the implementation of the containment operation, suggesting the need to prioritize this operation. As a result of the methodology applied in this work, a flowchart the risk series was also obtained. In the flowchart the events that can occur as a consequence of a improper handling of infectious health-care waste, which can cause critical risks such as injuries from sharps and contamination (infection) from pathogenic microorganisms, are shown. Keywords: health-care waste, solid waste, risk analysis, PRA. complete article at: http://www.scielo.br/scielo.php?pid=S0104-66322002000400004&script= sci_arttext&tlng=en .......................................................................... __________________________________________________________________________ Solid Waste Management Health and Safety Risks: Epidemiology and Assessment to Support Risk Reduction March 2000 James D. Englehardt Lora E. Fleming Judy A. Bean Huren AN Nicolette John Jeff Rogers Melissa Danits University of Miami, State University System of Florida Florida Center for Solid and Hazardous Waste Management http://www.eng.miami.edu/~mswrisk/report.pdf Extract: Punctures, lacerations and abrasions from glass, metal, plastic and wooden objects are frequently reported by refuse collectors (Gellin, 1985). Needlestick punctures have also been reported among this group. The improper disposal of medical waste, from both residential and medical facility sources, is most likely responsible for the reports of needlestick injuries by waste collectors. In a study by Turnberg and Frost (1990), among waste workers who responded 21% reported having ever been stuck or scratched by a waste hypodermic needle; 6% of these respondents reported the needle contact within the last year. Needles evoke fear of contamination by hepatitis viruses, AIDS or other potentially fatal infections (Campbell, 1993). However, documentation of these diseases as occupational health effects is lacking. Solid waste workers in the United States are currently estimated to have a risk of contaminated puncture that is 1/1000th the risk level of hospital nurses (World Health Organization, 1996). .......................................................................... __________________________________________________________________________ Infect Control Hosp Epidemiol 1999;20:591–592 DOI: 10.1086/503147 Letter Hepatitis B morbidity in municipal and hospital waste collection workers in the city of Rio de Janeiro J. A. Ferreira A. T. Tambellini C. L. da Silva M. A. Guimaraes .......................................................................... __________________________________________________________________________ This is an extract from a paper from the ICDDRB on medical waste management cites US data: http://www.icddrb.org/images/wp144.pdf A report on medical wastes by the U.S. Environmental Protection Agency to the Congress estimated the annual number of HBV infections resulting from sharp injuries among medical personnel and waste-management workers (Table 1). Of an overall yearly total of 300,000 cases, the annual number of HBV- related infections in the USA resulting from exposure to healthcare wastes is between 162 and 321 (12). The Centers for Disease Control and Prevention (CDC) estimates that 5,100 healthcare workers with frequent occupational blood contact are infected each year with HBV (Miriam Altar, unpublished data). Occupational exposure from needles or other sharp objects remains an issue of great concern to healthcare workers (29-32). The risk of hepatitis B or HIV transmission from such exposure has added to this concern (33- 35). The CDC reported that 37 healthcare workers were infected with HIV through occupational exposure. The majority of this exposure was due to sharp objects (36). It has been reported that 7-31% of sharp injuries are related to the disposal of needles, excluding recapping (37-40). Needle-stick injuries (NSIs) are among the greatest occupational hazards of hospital personnel (41), posing a risk for transmission of hepatitis B (42), hepatitis C (43,44), and HIV (33,45). Some studies suggest that injuries during the practice of recapping needles account for 12-18% of such injuries; and errors that occur during or after needle disposal account for up to 40% (32,46). Another survey found that recapping, the most common mechanism of injury, accounted for 30% of NSIs, whereas 13% resulted during or after needle disposal (38). A study performed at the University of Wisconsin found that although 60% of all NSIs occurred in nursing personnel, with an annual rate of 92.6 NSIs per 1,000 employees, house- keeping personnel had the highest incidence of NSIs (127 NSIs per 1,000 employees) (32). It has been reported that, in France, by 1992, eight cases of HIV infection were recognized as occupational infections. Two of these cases, involving transmission through wounds, occurred in waste handlers (12). It has also been reported that, in the USA, by June 1994, 39 cases of HIV infection were recognized by the CDC as occupational infections. By June 1996, the cumulative recognized cases of occupational HIV infection had risen to 51. All cases were nurses, medical doctors, and laboratory assistants. HIV has extremely limited viability outside a living host, although the live virus-survival time may depend upon the environment and the concentration of virus. Therefore, except for those persons within healthcare establishments, the potential to develop HIV infection from medical waste contact is remote. Because HBV remains viable for an extended time in the environment, the potential for HBV- associated infection following contact with medical wastes is likely to be higher than that associated with HIV (47). It has been showed that, in Japan, the risk of infection after hypodermic needle puncture is as follows: HIV is 0.3%, HBV is 3%, and HCV is 3-5% (12). A report on medical wastes by the U.S. Environmental Protection Agency to the Congress estimated the annual number of HBV infections resulting from sharp injuries among medical personnel and waste-management workers (Table 1). Of an overall yearly total of 300,000 cases, the annual number of HBV- related infections in the USA resulting from exposure to healthcare wastes is between 162 and 321 (12). .......................................................................... __________________________________________________________________________ No Abstract: Hepatitis B virus and hepatitis C virus in medical waste handlers in Tripoli, Libya Journal of Hospital Infection, Volume 72, Issue 3, Pages 258-261 E. Franka, A. El-Zoka, A. Hussein, M. Elbakosh, A. Arafa, K. Ghenghesh .......................................................................... __________________________________________________________________________ While not entirely relevant - this may be of interest http://www.searo.who.int/LinkFiles/SDE_mgmt-bio-medical.pdf Safe Management of Bio-medical Sharps Waste in India A Report on Alternative Treatment and Non-Burn Disposal Practices World Health Organization, Regional Office for South East Asia New Delhi, 2005 SEA-EH-548 __________________________________________________________________________ _____________________________________*____________________________________ 2. Abstract: Needlestick Injuries Among Health Care Workers: A Literature Review - Brief Article __________________________________________________________________________ Needlestick Injuries Among Health Care Workers: A Literature Review - Brief Article EDWINA A. McCONNELL "Needlestick Injuries Among Health Care Workers: A Literature Review - Brief Article". AORN Journal. FindArticles.com. 22 Jul, 2009. http://findarticles.com/p/articles/mi_m0FSL/is_1_71/ai_59035041/ NEEDLESTICK INJURIES AMONG HEALTH CARE WORKERS: A LITERATURE REVIEW C Porta, E Handelman, P McGovern American Association of Occupational Health Nurses Vol 47 no 6 (1999) 237-243 This article offers the results of an extensive literature review about needle-stick injuries. Addressed are needlestick injury rates and trends, along with current scientific findings pertaining to safer needle devices and their effectiveness in decreasing needle-stick incidents. Needle-stick injury rates and trends. The US Centers for Disease Control and Prevention estimates that 800,000 exposure incidents occur annually. Determining the scope of needlestick injuries in the United States, however, is difficult for several reasons. First, national databases do not exist to track or tabulate data about needle-stick injuries. Second, the literature reviewed pertains to hospital sites and may not be representative of other health care settings. Third, researchers have used a variety of methods to evaluate needle-stick injury rates, making it difficult to compare individual findings and determine a standard needle- stick injury rate. Finally, many injuries are not reported. Research regarding underreporting indicates needlestick injury rates ranging from 21% to 95%. Safer needle devices. More than 1,000 US patents in the area of needle- stick prevention devices have been issued since the early 1980s. Many studies report that use of safer devices is associated with radical improvements in safety and decreases in reported needle-stick injuries. Some literature, however, reports little or no improvement. Despite the limitations of these studies, they do offer generalizations about the use of safer devices. First, devices with passive mechanisms of action are recommended over those with active mechanisms of action. Devices with passive mechanisms require no action from the user; thus, they do not add a step to the user's work procedure. Second, most of the studies focus on three basic devices: IV equipment, suture needles, and hollow bore needles. Of particular interest to perioperative nurses is the fact that suture needles harbor great potential for disease transmission. The good news is that blunt suture needles are associated with significant decreases in needle-stick injuries. The use of these needles, however, is limited to certain surgical procedures. Third, some studies have attempted to determine the cost-efficiency of using safer needle devices. The studies found that the direct purchasing costs related to safer needle devices are greater than those of traditional devices; however, a comparison of study findings requires the use of standard economic frameworks. Finally, the user's satisfaction is critical to the success of safer needle devices. Dissatisfaction with the devices frequently results in users resorting to traditional devices. This is least likely to happen when satisfaction among users is high. Greater satisfaction is related to the use of training periods that enable users to practice and gain confidence in using the new products. Conclusion. Needle-stick injuries continue to pose a serious threat to perioperative nurses, as well as to other health care workers. Needleless IV needles and blunt suture needles have been developed. Product substitution, however, is not sufficient to address the problem. The literature supports comprehensive injury prevention and control strategies, in addition to the use of safer devices. Critical to the success of these strategies and the introduction and use of safer devices is the involvement of the users. Edwina A. Mcconnell RN, Phd, Frcna Nursing Research Committee COPYRIGHT 2000 Association of Operating Room Nurses, Inc. COPYRIGHT 2001 Gale Group __________________________________________________________________________ _____________________________________*____________________________________ 3. Abstract: Unsafe injection practices in Gujarat, India __________________________________________________________________________ Singapore Med J. 2008 Nov;49(11):936-9. Unsafe injection practices in Gujarat, India. Pandit NB, Choudhary SK. Department of Community Medicine, CU Shah Medical College, Surendranagar, Gujarat, India. drniraj74@gmail.com INTRODUCTION: The objective of this study was to obtain comprehensive data on injection practices, especially about safety issues, among health services providers and residents in the Anand district of Gujarat, India. METHODS: The study was a cross-sectional study. Stratified random sampling method was used to select primary healthcare facilities, and the field method of randomisation was used to select families in the general population in the catchment areas of the selected health facilities. Thus, 182 health facilities and 510 families (2,080 population) were covered in the study. RESULTS: Almost 77 percent of service providers had unsafe injection practices, including the use of a boiling pan for sterilisation, recapping of needles and exposure to body fluids. The proportion of unsafe injection practices was higher among Government health service providers. The prevalence of needle stick injuries (NSI) among service providers was 52.2 percent and the annual incidence of NSI was 19 percent. 21.6 percent of the population studied had received one or more injections in the past one year, and the average number of injections per head per year in the present study was 0.2. CONCLUSION: The study revealed a high proportion of unsafe injection practices in the district studied, but a low average number of injections per head per year in the community. Serious issues regarding injection safety need to be addressed urgently. There is a need to develop local guidelines for injection usage and implement a community- based educational programme for the people. __________________________________________________________________________ _____________________________________*____________________________________ 4. Abstract: Phylogenetic analysis of hepatitis B virus full-length genomes reveals evidence for a large nosocomial outbreak in Belgium __________________________________________________________________________ J Clin Virol. 2009 Jul 15. Phylogenetic analysis of hepatitis B virus full-length genomes reveals evidence for a large nosocomial outbreak in Belgium. Pourkarim MR, Verbeeck J, Rahman M, Amini-Bavil-Olyaee S, Forier AM, Lemey P, Maes P, Van Ranst M. Laboratory of Clinical Virology, Rega Institute for Medical Research, Leuven, Belgium; Research Center, Iranian Blood Transfusion Organization (IBTO), Tehran, Iran. BACKGROUND: Hepatitis B virus (HBV) is primarily transmitted from mother to child, by sexual contact, intravenous drug abuse, or unsafe health care-related injection practices. Despite increased safety efforts, nosocomial acquired hepatitis B infection remains problematic. OBJECTIVES: A large HBV outbreak was investigated comprising 36 patients with acute HBV infection in a primary care physician's practice. STUDY DESIGN: In a retrospective study (2003-2008), 36 serum samples from patients with acute HBV infection were collected. They had received several injections by the same physician at least 3 months before the onset of clinical symptoms. As a control group, sera were collected from HBV patients from other physicians from the same province. Full-length HBV genomes were amplified and were phylogenetically analysed. RESULTS: HBV complete genomes of 32 patients were successfully amplified and sequenced, and clustered together with the reference genotype A, subgenotype A2 strains. We also analysed 26 control HBV genotype A samples. All 32 HBV strains from the patient group clustered in a monophyletic branch with a bootstrap value of 100, whereas the control samples branched separately in another clade. The genetic distance value showed small differences within the patients group, whereas the rate within the control group was seven times higher. These observations confirm that the source of transmission was clearly different in both groups. CONCLUSION: Maximum likelihood analysis and genetic distance calculations based on the full-length genomes of HBV strains isolated from patients and controls provided strong evidence for a common nosocomial source of infection for all 32 patient cases. __________________________________________________________________________ _____________________________________*____________________________________ 5. Abstract: Hepatitis B virus infection in US correctional facilities: a review of diagnosis, management, and public health implications __________________________________________________________________________ J Urban Health. 2009 Mar;86(2):263-79. Hepatitis B virus infection in US correctional facilities: a review of diagnosis, management, and public health implications. Gupta S, Altice FL. Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT 06510-2283, USA. shailigupta@gmail.com Among the blood-borne chronic viral infections, hepatitis B virus (HBV) infection is one that is not only treatable but also preventable by provision of vaccination. Despite the availability of HBV vaccine for the last 15 years, more than 1.25 million individuals in the USA have chronic HBV infection, and about 5,000 die each year from HBV-related complications. From a societal perspective, access to treatment of chronic viral infections, like HIV and viral hepatitis, is highly cost-effective and has lasting benefits by reducing risk behaviors, morbidity, mortality, as well as disease transmission in the community. Individuals in correctional facilities are specially predisposed to such chronic viral infections because of their high-risk behaviors. The explosion of incarceration in the USA over the last few decades and the disproportionate burden of morbidity and mortality from chronic infections among the incarcerated have put incredible strains on an overcrowded system that was not originally designed to provide comprehensive medical care for chronic illnesses. Recently, there has been a call to address medical care for individuals with chronic medical conditions in correctional settings, including those with infectious diseases. The economic and public health burden of chronic hepatitis B and its sequelae, including cirrhosis and hepatocellular carcinoma, is felt most prominently in managed care settings with limited budgets, like correctional facilities. Prevalence of HBV infection among the incarcerated in the USA is fivefold that of the general population. We present a review of diagnosis, prevention, and the recently streamlined treatment guidelines for management of HBV infection in correctional settings, and discuss the implications and public health impact of these measures. __________________________________________________________________________ _____________________________________*____________________________________ 6. Abstract: Bundling occupational safety with harm reduction information as a feasible method for improving police receptiveness to syringe access programs: evidence from three U.S. cities __________________________________________________________________________ Harm Reduct J. 2009 Jul 14;6(1):16. Bundling occupational safety with harm reduction information as a feasible method for improving police receptiveness to syringe access programs: evidence from three U.S. cities. Davis CS, Beletsky L. In light of overwhelming evidence that access to sterile injection equipment reduces incidence of injection-attributable bloodborne disease without encouraging drug use, many localities have authorized sterile syringe access programs (SAPs), including syringe exchange and pharmacy- based initiatives. Even where such interventions are clearly legal, many law enforcement officers are unaware of the public health benefits and legal status of these programs and may continue to treat the possession of injection equipment as illegal and program participation as a marker of illegal behavior. Law enforcement practice can impede SAP utilization and may increase the risk of needlestick injury (NSI) among law enforcement personnel. Many SAPs conduct little or no outreach to law enforcement, in part because they perceive law enforcement actors as unreceptive to health-promotion programs targeting drug users. Case description: We report on a brief training intervention for law enforcement personnel designed to increase officer knowledge of and positive attitudes towards SAPs by bundling content that addresses officer concerns about infectious disease and occupational safety with information about the legality and public health benefits of these programs. Pilot trainings using this bundled curriculum were conducted with approximately 600 officers in three US cities. Discussion and Evaluation: Law enforcement officers were generally receptive to receiving information about SAPs through the bundled curriculum. The trainings led to better communication and collaboration between SAP and law enforcement personnel, providing a valuable platform for better harmonization of law enforcement and public health activities targeting injection drug users. CONCLUSION: The experience in these three cities suggests that a harm reduction training curriculum that bundles strategies for increasing officer occupational safety with information about the legality and public health benefits of SAPs can be well received by law enforcement personnel and can lead to better communication and collaboration between law enforcement and harm reduction actors. Further study is indicated to assess whether such a bundled curriculum is effective in changing officer attitudes and beliefs and reducing health risks to officers and injection drug users, as well as broader benefits to the community at large. __________________________________________________________________________ _____________________________________*____________________________________ 7. Abstract: Prevalence rates and risk factors for hepatitis C among drug users not intreatment in Malaysia __________________________________________________________________________ Drug Alcohol Rev. 2009 Jul;28(4):447-54. Prevalence rates and risk factors for hepatitis C among drug users not in treatment in Malaysia. Vicknasingam B, Narayanan S, Navaratnam V. Centre for Drug Research, Universiti Sains Malaysia, Penang, Malaysia. vickna@usm.my INTRODUCTION AND AIMS: The prevalence of hepatitis C virus (HCV) among heroin dependants in treatment was estimated at 89.9%; however, virtually no information exists on the prevalence or risk behaviour among the larger population of drug users not in treatment. This study assessed the prevalence of HCV and associated risk factors among this group with a view to designing more effective intervention programs. DESIGN AND METHODS: A cross-sectional survey of 552 not-in-treatment drug users recruited from five key urban centres across peninsular Malaysia with on-site serological testing for HCV and HIV seropositivity was conducted. RESULTS: HCV prevalence was 65.4% for the overall sample, but higher among injecting drug users (67.1%) relative to non-injecting drug users (30.8%). Bivariate analysis suggested seven risk factors though only sharing injecting paraphernalia and lifetime homosexual/bisexual behaviour remained significant in multivariate analysis. DISCUSSION AND CONCLUSIONS: With the majority (65.9%) sharing injecting equipment and about the same proportion (65.4%) being HCV positive, the risk of further transmission to new drug users is high. It is imperative that the nascent needle and syringe exchange and condom distribution program and its ancillary services-- launched in 2005 to fight HIV--be fine tuned, as a first step, to control HCV. With its greater infectivity and non-symptomatic character, HCV is more insidious. Given the shared risk factors of HCV and HIV, routine screening of drug users for HCV-- currently non-existent--should be instituted. This, with other intervention measures, will help detect and control HCV at an earlier stage while also checking the spread of HIV. __________________________________________________________________________ _____________________________________*____________________________________ 8. Abstract: Factors associated with Hepatitis C infection in patients with chronic hemodyalisis __________________________________________________________________________ Rev Gastroenterol Peru. 2009 Jan-Mar;29(1):11-6. [Factors associated with Hepatitis C infection in patients with chronic hemodyalisis] [Article in Spanish] Valencia Yábar M, Cieza Zevallos J. Centro de Hemodialisis - EsSalud, Peru. BACKGROUND: Hepatitis C Infection (HCV) is a significant problem in patients treated with chronic hemodialysis in Peru. In prior studies, it has been reported that blood transfusions and time on hemodialysis have been identified as risk factors. Purpose: Study other probable factors associated with the Hepatitis C virus in a large hemodyalisis center in Lima, Peru. MATERIALS AND METHOD: The study consisted of a case model and controls for incident population. A negative case was studied in relation to each case with positive results for HCV antibodies paired by age, sex and origin. Odds ratio (OR) and its confidence interval (CI 95%) were used to assess the degree of association between variables. RESULTS: Time on hemodialysis (OR 7.13, CI 95%), 3.04-17.02), more than two hospitalizations (OR 4.49, CI 95%), 1.28-17.28), treatment in multiple dialysis centers (p<0.5), having undergone a transplant (p<0.01) and having received a blood transfusion (OR 2.61 CI 95% 1.04-6.68) were factors associated with HCV. Conclusion: Permanence on hemodialysis, hospitalizations, receiving dialysis at multiple centers, transplantation and blood transfusions were variables associated with HCV infection in the studied population. __________________________________________________________________________ _____________________________________*____________________________________ 9. Abstract: Contaminated Product Water as the Source of Phialemonium curvatum Bloodstream Infection among Patients Undergoing Hemodialysis __________________________________________________________________________ Infect Control Hosp Epidemiol. 2009 Jul 17. Contaminated Product Water as the Source of Phialemonium curvatum Bloodstream Infection among Patients Undergoing Hemodialysis. Rao CY, Pachucki C, Cali S, Santhiraj M, Krankoski KL, Noble-Wang JA, Leehey D, Popli S, Brandt ME, Lindsley MD, Fridkin SK, Arduino MJ. From the Divisions of Healthcare Quality Promotion (C.Y.R., J.A.N.-W., S.K.F., M.J.A.) and of Foodborne, Bacterial, and Mycotic Diseases (M.E.B., M.D.L.), Centers for Disease Control and Prevention, Atlanta, Georgia; and Edward Hines, Jr. Veterans Affairs Hospital, Hines (C.P., M.S., K.L.K.K., D.L., S.P.), and the University of Illinois at Chicago School of Public Health, Chicago (S.C.), Illinois. Objective. We investigated a cluster of cases of bloodstream infection (BSI) due to the mold Phialemonium at a hemodialysis center in Illinois and conducted a cohort study to identify risk factors. Design. Environmental assessment and cohort study. Setting. A hemodialysis center in a tertiary care hospital. Methods. A case patient was defined as a person who underwent dialysis at the center and had a blood sample that tested positive for Phialemonium curvatum on culture. We reviewed microbiology and medical records and tested water, surface, and dialysate samples by culture. Molds isolated from environmental and clinical specimens were identified by their morphological features and confirmed by sequencing DNA. Results. We identified 2 case patients with BSI due to P. curvatum. Both became febrile and hypotensive while undergoing dialysis on the same machine at the same treatment station, although on different days. Dialysis machines were equipped with waste handling option ports that are used to discard dialyzer priming fluid. We isolated P. curvatum from the product water (ie, water used for dialysis purposes) at 2 of 19 treatment stations, one of which was the implicated station. Conclusion. The source of P. curvatum was likely the water distribution system. To our knowledge, this is the first report of patients acquiring a mold BSI from contaminated product water. The route of exposure in these cases of BSI due to P. curvatum may be related to the malfunction and improper maintenance of the waste handling option ports. Waste handling option ports have been previously implicated as the source of bacterial BSI due to the backflow of waste fluid into a patient's blood line. No additional cases of infection were noted after remediation of the water distribution system and after discontinuing use of waste handling option ports at the facility. __________________________________________________________________________ _____________________________________*____________________________________ 10. No Abstract: Reporting healthcare associated infections should be mandatory, says audit office __________________________________________________________________________ BMJ. 2009 Jun 12;338:b2419. doi: 10.1136/bmj.b2419. Reporting healthcare associated infections should be mandatory, says audit office. Gulland A. __________________________________________________________________________ _____________________________________*____________________________________ 11. No Abstract: Teamwork achieves high-quality medical devices __________________________________________________________________________ Biomed Instrum Technol. 2009 Mar-Apr;43(2):153, 155. Teamwork achieves high-quality medical devices. Klacik S. St. Elizabeth Health Center, Youngstown, OH, USA. __________________________________________________________________________ _____________________________________*____________________________________ 12. No Abstract: Microbiologic assessment of multidose Restylane for facial augmentation __________________________________________________________________________ Arch Facial Plast Surg. 2009 Jul-Aug;11(4):271-3. Microbiologic assessment of multidose Restylane for facial augmentation. "The sterile needle cap was removed from the syringe and held by an assistant wearing ... An additional report 7 investigating bacterial contamination among ..." Brandt MG, Al Gilani M, Balderston J, Davidson R, Moore CC, Taylor M. __________________________________________________________________________ _____________________________________*____________________________________ 13. NIH and Wikimedia Foundation Collaborate to Improve Online Health Information __________________________________________________________________________ NIH and Wikimedia Foundation Collaborate to Improve Online Health Information National Institutes of Health (press release) - USA (14.07.09) The National Institutes of Health and the Wikimedia Foundation, the nonprofit organization that operates the Wikipedia® online encyclopedia, are joining forces to make health and science information more accessible and reliable. This collaboration is the first of its kind for both organizations. "NIH works to ensure that the information it provides on science and health is of the highest quality and reaches the widest audience," said John Burklow, NIH associate director for communications and public liaison. "We look forward to this opportunity to collaborate with the Wikimedia Foundation and participate in a resource that is used by millions of people around the world." On July 16, NIH will host Wikimedia staff and volunteers working in the sciences for an all-day event on its Bethesda campus. Participants will learn about the philosophy and mechanics of Wikipedia and will begin what is hoped to be a long-term dialogue aimed at improving public knowledge about health, science, and medicine. The international foundation has never before worked with a federal agency or a health sciences institution. "Wikipedia Academies are public outreach events, usually lasting one or two days, aimed at engaging academics and other subject-matter experts who are not familiar with wiki culture or online communities," said Frank Schulenburg, head of public outreach for the Wikimedia Foundation. "In presentations and workshops, experienced Wikipedia authors teach the participants how to contribute to Wikipedia and orient the audience to Wikipedia’s structures and community policies." "We're incredibly excited about our first official Wikipedia Academy in the United States," said Sue Gardner, executive director of the Wikimedia Foundation. "With the broad range of experts from the National Institutes of Health, we see a great opportunity for increasing the quality of all health-related information on Wikipedia, benefitting users of Wikipedia from all over the world." Wikipedia contains nearly 13.5 million articles written in over 250 languages. In May, it served over 315 million unique visitors. The site manages, on average, more than 14 million page views per hour. To satisfy the public’s growing need for reliable health information, NIH and the Wikimedia Foundation want to increase the availability of accurate medical and health information available to the public. At the same time, they hope to establish strategies to interlace the distinct cultures of Wikipedia and the research community. After the Wikipedia Academy, NIH subject matter experts will be able to contribute to Wikipedia and also help develop best practices for future sessions. Instructions about how to contribute, including video of the Wikipedia Academy at NIH, will be available on the NIH and the Wikipedia websites for scientists across the country. Wikipedia is an international online encyclopedia written collaboratively by volunteers. For more information about Wikipedia, visit www.wikipedia.org. The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov. __________________________________________________________________________ _____________________________________*____________________________________ 14. News - China: Hemophiliacs sue Shanghai firm over HIV infections - UK: Fears as women use unlicensed drug in search of all-over tan - Canada: No evidence Alta. hospital's syringe reuse spread HIV: minister - USA: Clinics linked to hepatitis outbreak file for bankruptcy - UK: RCN Calls For EU Agreement On Sharps Injuries To Be Implemented Quickly - Pakistan: Govt to act against quacks, says Jakhrani - EU: European agreement on injuries to health workers caused by 'sharps' - USA: More than 500 Tested and Cleared for Hepatitis C in Springs - Pakistan: Overuse of injections fuelling hepatitis epidemic - USA: Cathedral City's Innovative Program for Safe Syringe Disposal Wins Award - Africa: Poor syringe hygiene can be fatal Selected news items reprinted under the fair use doctrine of international copyright law: http://www4.law.cornell.edu/uscode/17/107.html __________________________________________________________________________ China: Hemophiliacs sue Shanghai firm over HIV infections By Jane Chen, Shanghai Daily - Shanghai,China (21.07.09) THREE hemophiliacs in south China who claim they have contracted the HIV virus from a blood product have launched a 6 million yuan (US$878,436) compensation battle in three separate lawsuits. The patients said they were infected with the HIV virus after using factor VIII, a blood product for hemophilia made by Shanghai Institute of Biological Products. Chancheng District People's Court in Guangdong Province's Foshan City has accepted the lawsuits, Southern Metropolis Daily reported today. SIBP, part of China National Biotec Corporation, is a large state-owned enterprise specializing in the research and development, production and marketing of biological products. According to Ministry of Health regulations, SIBP stopped producing factor VIII in 1995 due to health fears. But they did not stop selling the product until 1996, said Zhao Wei, father of one of the Foshan patients. Zhao told the newspaper he kept two bottles of HIV contaminated factor VIII as evidence, one produced in 1993 and the other in 1995. The three Foshan patients had used factor VIII from 1990 to 1996, the Southern Metropolis Daily report said. They were diagnosed with HIV and the hepatitis C virus, a liver disease, from 2001 to 2005. Though they have received 100,000 yuan (US$14,636) each in financial aid from SIBP, they said the amount was not enough to cover their high medical costs. They demanded the same compensation package given to Shanghai patients, who receive a monthly living allowance of 1,000 yuan to 3,000 yuan and free medical treatment, on top of the 100,000 yuan already provided, the report said. Zhao said his son has entered the active period of the infected disease and it costs 200,000 yuan each year for treatment. He said an SIBP official disclosed to him that more than 50,000 patients had used SIBP's factor VIII and over 300 of them had contracted HIV nationwide. Starting in 2004, patients launched lawsuits against SBIP over HIV infections. According to earlier reports, Henan Province has been one of the most important blood collection bases for many enterprises such as SIBP. Many farmers in Henan were infected with HIV in the blood donation process because of poor equipment and management. Contaminated supplies were unwittingly taken on by enterprises such as SIBP and then the related blood products were distributed around the country. .......................................................................... __________________________________________________________________________ UK: Fears as women use unlicensed drug in search of all-over tan By Carolyn Churchill, The Herald - Glasgow,Scotland,UK (21.07.09) Women are injecting an unlicensed drug that promises to give an all-over tan in the latest DIY beauty treatment. People from all social backgrounds have contacted pharmacies across the NHS Greater Glasgow and Clyde area asking for needles to help them inject Melanotan I or II, both of which stimulate the production of melanin, the dark pigment in the skin. Clinical trials into the drug are still under way in Australia but side- effects reported so far include headaches, nausea and vomiting. Melanotan II has been linked to appetite suppression and an increase in libido. One report published in the British Medical Journal also raised concerns that the drug can cause rapid changes in moles and this could lead to skin cancer being wrongly diagnosed or missed. Health officials said there were further fears that those injecting the drug, which is illegal to sell in the UK but can be bought over the internet, may be putting themselves at risk of contracting infections such as Hepatitis C and HIV. Mary Clare Madden, pharmacist at NHS Greater Glasgow and Clyde's Addiction Partnership, said: "We don't know what the possible side-effects of these products are and how serious they could be. "When people are ordering these products over the internet we don't know their origin, so there are serious concerns over their contents, contaminants and sterility. There is an issue about the correct dosage and people are at risk of overdosing. "There is also a risk of contracting blood-borne viruses if users are reusing or sharing injecting equipment." Melanotan, which has been dubbed the "Barbie drug", is a synthetic hormone that was originally being developed to help protect certain groups of people from developing skin cancer. The drug, also known as afamelanotide, is illegal to sell but not illegal to buy in the UK and can be found on websites for less than £30 for 10mg. It has also reportedly been found for sale in tanning salons and body building gyms. The Medicines and Healthcare products Regulatory Agency has previously warned people not to use Melanotan after reports of people injecting the drug south of the border. But this is the first evidence of the use of the drug in Scotland. Carole Hunter, lead pharmacist for NHS Greater Glasgow and Clyde's Addiction Partnership, said those who had requested injecting equipment for Melanotan were not typical of the intravenous drug users who normally access the health board's addiction services. "Generally, for the people who turn up at addiction services their appearance is probably the last thing on their mind," she said. "This is women across all social groups who want a tan for cosmetic reasons." The drug, which comes in powder form, should be mixed with bacteriostatic water, which is available on prescription, before it is injected into the abdomen and there are fears that there could be a further risk of infection if people are not using sterile water. Ms Madden said there was a "lack of awareness" about the process of injecting, with one example of a woman requesting a long needle which is for injection into the muscle rather than the stomach. .......................................................................... __________________________________________________________________________ Canada: No evidence Alta. hospital's syringe reuse spread HIV: minister Darcy Henton, John Lucas, Canwest News Service (21.07.09) EDMONTON -- Alberta Health Minister Ron Liepert says there is no evidence that the reuse of syringes in some procedures at a northern Alberta hospital caused the spread of HIV and hepatitis in the community. Mr. Liepert, commenting Tuesday on a report into the incident by the Alberta Health Quality Council, said the medical advice his department has received suggests the levels of those diseases in High Prairie, Alta., located about 350 kilometres northwest of Edmonton, are not our of line with the norm. "The real good news is, pretty much all of the testing has been completed in High Prairie, and although there are instances of individuals that have tested positive for HIV and hepatitis, there has been no ability to link any of those diseases with the issue around the reuse of syringes," he said. "I think we can rest assured that that issue is behind us. "It's one of those things that you can't ever be 100% certain, but I am confident that due diligence was done." Health officials had to test nearly 3,000 patients late last year for HIV and hepatitis after a manager at the High Prairie hospital discovered some staff were routinely reusing syringes in patient IV lines -- in some cases, for the last 18 years. The needles had medication vials attached to them that were filled with enough medication to cover several people undergoing endoscopy or dental procedures in a given day. They weren't put directly into patients' arms, but into intravenous lines to sedate people while scopes were snaked down their throats, or to relieve pain after dental surgery. When the needle was withdrawn, there was a chance some blood and contaminated medication could come up the IV line into the syringe, then infect the next patient needing the medication. The correct practice -- and the one put in place at the High Prairie Health Complex after the problem was discovered Oct. 2, 2008 -- is to have separate syringes with separate medication vials for every patient. On Tuesday, the health minister refused to blame doctors or nurses for not following the protocols, but said the lesson learned is there should be better monitoring to ensure that, when new standards and policies are prescribed by his department, they are followed. "Obviously, the review the Health Quality Council has completed found that was not the case, and, going forward, we're going to do a better job of ensuring that the monitoring takes place and that new standards are followed," he said. Edmonton Journal © 2009 The National Post Company. .......................................................................... __________________________________________________________________________ USA: Clinics linked to hepatitis outbreak file for bankruptcy Las Vegas Review - Journal - Las Vegas,NV,USA (20.07.09) The three medical clinics at the center of last year’s hepatitis outbreak filed for bankruptcy Friday, a move that threatens to delay the first civil trial involving a patient infected with hepatitis C. The Endoscopy Center of Southern Nevada, Gastro enterology Center of Nevada, and Desert Shadow Endoscopy Center all filed for Chapter 7 bankruptcy, which calls for liquidation of any corporate assets. The Southern Nevada Health District has genetically linked nine cases of hepatitis C to unsafe injection practices at the endoscopy centers. Another 105 cases are possibly related. The centers are named in lawsuits from patients who say they contracted hepatitis C and other blood-borne diseases because of unsafe injection practices at the clinics. The bankruptcies automatically postpone any lawsuits involving the clinics, and a bankruptcy judge must lift the postponement before the civil suits can proceed. The first trial in the mountain of litigation surrounding the hepatitis outbreak is scheduled to begin Oct. 19 in District Court. The plaintiff, Michael Washington, is a patient whose hepatitis C has been genetically linked to the Endoscopy Center of Southern Nevada. His lawyer, Ed Bernstein, said the bankruptcy filings are the latest delaying tactic by lawyers representing the clinics and doctors. “It’s another way to stop testimony, and stop the process, and tie things up again,” Bernstein said. “It’s been their course of conduct the entire case.” How quickly the issue is resolved depends on whether the clinics’ lawyers agree to drop the postponement or fight to keep it, he said. One lawyer representing the clinics, Bruce Thomas Beesley with the firm Lewis and Roca, was unavailable for comment Monday. Nancy B. Rapoport, a Boyd Law School professor, said the clinics have “the Cadillac of bankruptcy firms.” The bankruptcy papers were signed by Dr. Kusum Desai, acting as the attorney for her husband, Dipak Desai, the businesses’ general partner. Trustee Brian D. Shapiro, who will act as a middleman in the bankruptcy cases, said he would likely want to question Dipak Desai about the companies’ assets at an Aug. 24 creditors meeting because of his ownership stake. But that might not happen because of questions about his mental capacity following a stroke a year ago. The issue of his competence to handle legal matters has already arisen before the Nevada State Board of Medical Examiners. The board has ordered testing to determine if he can assist his defense against possible action against his medical license. All three clinics shut down shortly after the health district’s February 2008 announcement that 40,000 patients might have been exposed to hepatitis C, HIV and other blood-borne diseases because of unsafe injection practices. Two months later, another 10,000 patients received the same notification. Health officials blamed the outbreak on nurse anesthetists reusing single- dose medicine vials between patients. The vials, they say, became contaminated when nurses would use a syringe more than once on the same patient. A city of Las Vegas report said Desai ordered his nurses to reuse the medicine to save money. Will Kemp, a lawyer for former clinic patients, said the bankruptcies shouldn’t affect the money available to them. “I don’t think this will have any long-term impact because no one thought they had any assets to pay anyway,” he said. The Endoscopy Center of Southern Nevada listed $35,079 in assets and $303,256 in liabilities. It saw its gross income fall from $6.9 million in 2007 to $68,993 this year. The gastroenterology center listed $4.6 million in assets, of which $4.4 million was un collected patient and insurance bills. It listed $667,073 in liabilities. Notable debts included $18,000 to public relations firm R&R Partners and more than $258,000 in loans from its sister clinics. The gastroenterology center’s gross income fell from $11.1 million in 2007 to nothing this year. The Desert Shadow clinic listed $176,237 in assets and $279,947 in liabilities. Its gross income fell from $3.6 million in 2007 to $23,550 this year. Together, the three companies have paid Lewis and Roca more than $408,000 in legal fees since August. All three companies were also involved in pending lawsuits for breaking rental agreements and leaving more than $725,000 in unpaid rent. An Aug. 6 hearing was set for a motion to rule in favor of the landlords, DesMed LLC and Gold Shadow Properties LLC. Rapoport, the law professor at the University of Nevada, Las Vegas, said the lack of assets reminded her of the lyrics of an old Stevie Wonder song, “Nothing from nothing leaves nothing.” “It’s a very sad affair,” she said. “People are harmed from what happened at these places, but there’s no money from them to help these people out.” Find this article at: http://www.lvrj.com/news/breaking_news/51260237.html .......................................................................... __________________________________________________________________________ UK: RCN Calls For EU Agreement On Sharps Injuries To Be Implemented Quickly Medical News Today (press release) - UK (19.07.09) The Royal College of Nursing welcomed the signing of a joint agreement by European Federation of Public Service Unions (EPSU) and the European Hospital and Healthcare Employers Association (HOSPEEM). This is an EU- wide agreement which the RCN has played a key role in bringing about to prevent one million medical sharps injuries per year. Dr Peter Carter, Chief Executive of the Royal College of Nursing (RCN), said: "Around half of nurses in the UK have been injured by a needle or sharp and we are delighted that the voice of our members has been heard in Europe on this issue. Nurses work in fear of needlestick injuries and, while the deal is welcome, we are concerned that it might take a number of years to be implemented in the UK. We are calling for speedy implementation of these measures in order to end the stress, trauma and serious medical consequences of these preventable accidents. It is vital that more people are not injured while we wait for safer practices to reach the workplace. "It is very clear - needle policies, training and investment in safer needles can help prevent these accidents from happening in the first place. Nurses must also receive proper support from their employers when they sustain an injury to prevent the feelings of stress and isolation that often accompany such trauma. By making these changes and safeguarding the health of all staff, we can improve patient care in the UK and throughout Europe." Notes In the UK, a small but significant number of healthcare workers have developed potentially life-threatening diseases. Since the late 1990s, 11 health staff have contracted hepatitis C from needle jabs and five HIV transmissions have also been confirmed. While the majority of needlestick injuries are not life threatening, the possibility of developing infectious diseases such as hepatitis B, hepatitis C or HIV can cause immense distress, anxiety and anguish for nurses and other healthcare workers. Needlestick injury - the key facts An RCN survey of 4407 nurses, carried out in November 2008, found that: - Almost half of all nurses (48%) had been stuck by a needle or sharp that had previously been used on a patient; - Over half of nurses (52%) fear needlestick injuries either 'a great deal' or 'a fair amount'; - Nearly half (45%) of nurses reported they have not received training from their employer on safe needle use; - 95% of nurses consider that the availability of safer needle devices is either 'essential' or 'preferable', yet only a half report that they currently have access to any such device. The European Agency of Occupational Safety and Health estimates that one million needlestick injuries occur every year. As the largest occupational group of healthcare workers, nurses deliver the largest proportion of patient care and, not surprisingly, report the highest number of sharps and needlestick related injuries. Yet the majority of these injuries are preventable. The RCN made action on this issue a key point in the 2009 manifesto for the European elections - "The RCN calls on MEP candidates to ensure that the current negotiations between employers and trade unions to prevent needlestick injuries produces a Framework Agreement by autumn 2009. If it does not, then the European Parliament should demand EU legislation." Source Royal College of Nursing (RCN) Article URL: http://www.medicalnewstoday.com/articles/157988.php .......................................................................... __________________________________________________________________________ Pakistan: Govt to act against quacks, says Jakhrani By: Fozia Azam, The Nation, Pakistan - Karachi,Pakistan (17.07.09) ISLAMABAD - Ministry of Health is poised to take strict action against the flourishing quackery system in the country, which is a major source of spreading Hepatitis. The Minister for Health Mir Aijaz Hussain Jakhrani stated this while addressing a seminar organised by Shifa International to mark the World Hospital Day here on Thursday. “The Ministry of Health is working to devise a law to curb quackery”, he noted. The Minister termed used syringes, un-screened blood transfusion, contaminated medial equipment and piercing as major causes of hepatitis spread. “Taking note of the serious public health threats associated with the high prevalence of viral hepatitis, the Prime Minister has prioritised the subject in the National Health Policy” the minister added. The ongoing Hepatitis Control Programme is an ample proof of his commitment”, he remarked. He stressed the need of educating public and the healthcare providers on this particular issue. He lauded Shifa International Hospital for the initiative and efforts carried out regarding public awareness about hepatitis. Addressing the gathering consultant gastroenterologist Dr Nasir Khokhar informed that hepatitis is the 9th deadly disease in the world and mentioned that viral hepatitis has become a global epidemic”. He said 350 million people are long-term hepatitis carrier worldwide and 25 percent of these may die due to hepatitis or related complications. He informed that hepatitis A virus effects through close personal contact, contaminated water and food and rarely blood exposure. He said in 90 percent cases, hepatitis vaccination is reported to be effective. He stressed the importance of screened blood testing and transfusion, preventive measures to stop re-use of syringes, and the use of new blades for shaving and haircuts. He was of the view that hepatitis was spreading fast because of ignorance among the patients and a lack of proper preventive measures. It is wroth mentioning here that there are five types of hepatitis - A, B, C, D and E - of which A and E are caused through oral infection, contaminated water and unhygienic food. Hepatitis B, C and D are caused through un-sterilised syringes, sexual relation, and blood transfusion and from mother to newborn baby. .......................................................................... __________________________________________________________________________ EU: European agreement on injuries to health workers caused by 'sharps' News-Medical.Net (17.07.09) Unions and hospital employers have signed a Europe-wide agreement to set minimum standards for preventing injuries to health workers caused by 'sharps', including needles. The agreement, between the European Federation of Public Service Unions (EPSU) and European Hospital and Healthcare Employers' Association (HOSPEEM), sets common standards on risk assessments, prevention and protection, training, reporting and follow-ups. UNISON head of health Karen Jennings signed the agreement in Brussels as president of the EPSU health committee. She said the agreement "represents tremendous progress for the European hospital social dialogue process, but most importantly it makes a clear and positive contribution to the working lives of Europe's healthcare workers." EPSU and HOSPEEM will now ask the EU Commission to present the agreement to the council of ministers to implement it through an EU directive. http://www.unison.org.uk .......................................................................... __________________________________________________________________________ USA: More than 500 Tested and Cleared for Hepatitis C in Springs Brian Newsome, The Gazette, Colorado Springs, Colorado USA (07.17.09) So far, 544 people have tested negative for hepatitis C at Audubon Surgery Center in Colorado Springs, where a surgical technician with the virus is alleged to have stolen syringes filled with the painkiller Fentanyl and replaced them with used syringes filled with saline solution. The facility identified 1,200 patients who were potentially at risk of infection; almost 900 have been tested so far. One patient was found to have hepatitis C, but that case was determined to be unrelated to the technician. At Rose Medical Center in Denver, where the woman worked before coming to Audubon, 11 people linked with the her have tested positive for hepatitis C, as have four people unrelated to the investigation, and 1,250 have tested negative. .......................................................................... __________________________________________________________________________ Pakistan: Overuse of injections fuelling hepatitis epidemic Shahina Maqbool, The News International - Karachi,Pakistan (17.07.09) Islamabad: Unsafe injection practices, coupled with gross overuse of injections, which are perceived as being more effective and faster-acting than oral medication, have fuelled the transmission of hepatitis B and C in Pakistan. This trend has got to be curtailed by virtue of a public-private partnership involving effective utilisation of the skills and knowledge of the private medical sector, and resources of the government. Views to this effect echoed Thursday in the auditorium of Shifa International Hospital, where a seminar on hepatitis was organised with Minister for Health Mir Aijaz Hussain Jakhrani, as the chief guest. Addressing the seminar, Jakhrani invited Shifa to take the lead by sitting with the Ministry of Health and devising a joint strategy to rid Pakistan of Hepatitis, which is emerging as one of the fastest-growing public health challenges in the country. “A programme on hepatitis control has already been initiated by the prime minister. Let me assure you that any effort from any corner for the control of Hepatitis in Pakistan will be supported by the government,” Jakhrani said. Jakhrani said, since Hepatitis is mostly diagnosed at an advanced stage, but its management becomes difficult and expensive. He said that an aggressive health education campaign focusing on the symptoms and causes of the disease, needs to be launched to promote prevention. According to WHO estimates, 5 to 6 billion people worldwide and 12 million people in Pakistan are infected with hepatitis, and the number is constantly swelling. “A continuous effort should be made to educate both the public, as well as the healthcare providers, about the reasons responsible for the spread of hepatitis,” Jakhrani said. Explaining the inordinate delay in release of the National Health Policy, Jakhrani said that the government wants to bring the provinces on board, because it is eventually the provinces that will be responsible for its implementation. “The policy, which is comprehensive and a huge gift for the nation, will be presented to the cabinet in August,” Jakhrani said, announcing a new deadline. The minister’s speech was preceded by two presentations delivered by consultant gastroenterologist Dr. Nasir Khokhar, and consultant psychiatrist Dr Amin. Dr. Nasir defined Hepatitis as inflammation of the liver, which is the largest organ of the body weighing 1.5 kilogrammes. He said Pakistan is at the forefront of the global viral hepatitis epidemic. Dr. Nasir shared basic information about the five viruses that cause different types of hepatitis. He said, Hepatitis B virus is transmitted through contact with blood or body fluids of an infected person in the same way as Human Immunodeficiency Virus (HIV), the virus that causes AIDS. Worldwide, most infections occur from infected mother to child, from child-to-child contact in household settings, and from reuse of un- sterilised needles and syringes. Dr. Nasir said hepatitis B can be prevented in non-infected individuals through vaccination, which also reduces the chances of carcinoma. He lauded the government’s initiative of integrating Hepatitis B vaccination into the national immunisation schedule, and stressed that since most people are unaware of this development, it needs to be made more visible through the media. The gastroenterologist informed that Southeast Asia alone has 32.2 million patients of Hepatitis C, which leads to liver cirrhosis and eventually to liver cancer. Liver cancer is almost always fatal. In developing countries, most people with liver cancer die within months of diagnosis. Dr. Amin focused on the psychological costs, which patients suffering with hepatitis have to endure. He said that the disease prevents a person from reaching his full potential. Dr. Amin advised the government to prevent further transmission of the infection by making it mandatory for restaurant owners to employ only those persons as chefs, waiters, etc., who have been screened for hepatitis. “Each restaurant should paste a notice, informing their clients that all their staff members have been duly protected from hepatitis,” he said. He also advised households to also ensure that all their domestic servants have been screened. “This is the only way to halt transmission,” he said. Earlier, Dr. Manzoor Qazi, one of the founding members of Shifa International, termed simple measures such as frequent hand washing and use of clean needles and syringes, as holding the key to containment. He exhorted the medical community to play its role in the domain of public education so that people are not incapacitated by diseases like Hepatitis in the prime of their lives. In a related development, a Hepatitis Clinic will be functional in the gastroenterology OPD of the Pakistan Institute of Medical Sciences (PIMS) from today (Friday). The hospital will also be in a position to offer PCR — a basic test in the diagnosis and treatment of Hepatitis B and C — from next month onwards, following recent approval of funds by the PM for establishment of the facility in the pathology department of PIMS. According to Dr. Waseem Khawaja, PIMS, in collaboration with the Islamabad Traffic Police, will soon launch a school health education programme to familiarise students with ways to prevent hepatitis, and to spread awareness about traffic laws. .......................................................................... __________________________________________________________________________ USA: Cathedral City's Innovative Program for Safe Syringe Disposal Wins Award Trading Markets (press release) Edited - Los Angeles,CA,USA (16.07.09) HOUSTON, Jul 16, 2009 (GlobeNewswire via COMTEX) -- Sharps Compliance Corp. ("Sharps" or the "Company"), a leading provider of cost-effective disposal solutions for medical and pharmaceutical waste generated outside the hospital setting, today announced Cathedral City's special award by the California Resource Recovery Association ("CRRA") for its innovative program and partnership with Sharps Compliance. In partnership with Sharps, Cathedral City became the first city in the nation to offer a free and confidential program to help residents safely dispose of used hypodermic needles, syringes and lancets. The program, now in its fourth year, will be recognized with the award on August 4, 2009 at the 33rd annual CRRA Statewide Conference & Tradeshow in Rancho Mirage, California. The program uses the Company's flagship Sharps Disposal by Mail System(r), the first complete system for the proper disposal of the used needles and syringes commonly known as "sharps." By participating in the free and confidential program, it is estimated that approximately 1,400 Cathedral City residents who legally self-administer injections to treat diabetes, allergies, HIV and other medical conditions have prevented more than 480,000 used needles and syringes from potentially unsafe disposal in local landfills. "We believe the Cathedral City initiative is a model program that should be implemented throughout the country. This program is designed to cost- effectively facilitate the proper and safe disposal of used syringes for the estimated nine million people in the United States who are required for medical reasons to self-administer injectable medications in their homes or wherever their travels may take them," said David P. Tusa, Executive Vice President and Chief Financial Officer for the Company. "The broad variety of injectable medications needed to cope with health conditions produce a staggering three billion syringes annually that, when improperly discarded in household trash or recyclables, can present the risk of injury and disease to all communities. Cathedral City took action to deal with this problem, and Sharps is proud to have its system as an integral component of the successful program." Since the program began in 2005, Cathedral City regularly distributes informative postcards about the Sharps Disposal by Mail System(r) program to over 23,000 households in the community. Interested individuals can bring the postcard to one of four participating local pharmacies to enroll in the mail-back system. They receive the Sharps Disposal by Mail System(r), including up to three disposal containers per year for mailing to Sharps. When containers are received, Sharps responsibly destroys the used needles and syringes at its owned and fully-permitted medical waste facility. "Although there is not yet a national requirement regarding sharps disposal, the Sharps Disposal by Mail System(r) is recognized by both federal and state regulatory agencies as one of the safest and most effective ways to manage this health and safety issue," Mr. Tusa stated. "Seven states now have some form of law restricting consumer disposal of syringes, with California having by far the strongest, so we are particularly pleased that the CRRA has recognized the successful Cathedral City program. We believe that the success of the Cathedral City program at reducing the risk of injury and infection to employees at landfills, recycling centers and trash-sorting facilities who handle used sharps, and at controlling the potential release of toxins from used sharps into the soil, air and water, points the way for many other communities nationwide to take similar action." Those interested in learning more about protecting their communities should contact Sharps at 1-800-772-5657 or visit the Company's website at www.sharpsinc.com. About Sharps Compliance Corp. Headquartered in Houston, Texas, Sharps Compliance is a leading provider of cost-effective disposal solutions for medical and pharmaceutical waste generated outside the hospital setting. The Company's flagship product, the Sharps Disposal by Mail System(r), is a cost-effective and easy-to-use solution to dispose of medical waste such as hypodermic needles, lancets and any other medical device or objects used to puncture or lacerate the skin (referred to as "sharps"). The Sharps(r)MWMS(tm), a Medical Waste Management System, is a comprehensive medical waste solution which includes an array of services and products necessary to effectively collect, store and dispose of medical waste outside of the hospital setting. The System, which is designed for rapid deployment, features the Sharps Disposal by Mail System(r) products combined with warehousing, inventory management, training, data and other services necessary to provide a comprehensive solution. The Sharps(r)MWMS(tm) is designed to be an integral part of governmental and commercial emergency preparedness programs. The Company also offers a number of products specifically designed for the home healthcare market and products for the safe disposal of unused pharmaceuticals, RxTakeAway(tm). Sharps Compliance focuses on targeted growth markets such as the pharmaceutical, retail, commercial, and hospitality markets, as well as serving a variety of additional markets. Sharps is a leading proponent and participant in the development of public awareness and solutions for the safe disposal of needles, syringes and other sharps as well as unused pharmaceuticals in the community setting. As a fully integrated manufacturer providing customer solutions and services, Sharps Compliance's solid business model, with strong margins and significant operating leverage, and early penetration into emerging markets, uniquely positions the company for strong future growth. More information on Sharps Compliance can be found on its website at: www.sharpsinc.com Safe Harbor Statement The information made available in this press release contains certain forward-looking statements which reflect Sharps Compliance Corp.'s current view of future events and financial performance. Wherever used, the words "estimate", "expect", "plan", "anticipate", "believe", "may" and similar expressions identify forward-looking statements. Any such forward-looking statements are subject to risks and uncertainties and the company's future results of operations could differ materially from historical results or current expectations. Some of these risks include, without limitation, the company's ability to educate its customers, development of public awareness programs to educate the identified consumer, customer preferences, the Company's ability to scale the business and manage its growth, the degree of success the Company has at gaining more large customer contracts, managing regulatory compliance and/or other factors that may be described in the company's annual report on Form 10-K, quarterly reports on Form 10-Q and/or other filings with the Securities and Exchange Commission. Future economic and industry trends that could potentially impact revenues and profitability are difficult to predict. The company assumes no obligation to publicly update or revise its forward-looking statements even if experience or future changes make it clear that any projected results express or implied therein will not be realized. This news release was distributed by GlobeNewswire, www.globenewswire.com SOURCE: Sharps Compliance, Inc. .......................................................................... __________________________________________________________________________ Africa: Poor syringe hygiene can be fatal IRINNews.org South Africa (14.07.09) NAIROBI, 14 July 2009 (PlusNews) - Injections and needles are still not being used properly in African health facilities, putting millions of patients at risk of infectious diseases such as HIV and hepatitis C, health experts warned at the Africa Health Conference in Kenya's capital, Nairobi. "Injections are being misused by quacks and even professionals, who use them as means of making money from patients, especially in poor countries where people perceive the syringe as a symbol of cure. In this kind of injection mania there is a need to put measures in place to ensure safety," said Susan Agunda, the Deputy Chief Nursing Officer in Kenya's Ministry of Health. According to the United Nations Children's Fund (UNICEF), in developing countries alone, 16 billion injections are administered each year, of which 90 percent are for curative purposes; 50 percent of the total number of injections are unsafe. Disturbingly, about half the syringes used in Africa are re-used. Agunda called for health care workers to be adequately trained in the safe handling of needles and other injection equipment. "Just providing injection devices and not training health care workers on their proper use and disposal is not enough," she said. "Most health care workers still resort to recapping of needles, which is very dangerous and leads to numerous accidental injuries, and puts health workers at risk of getting infections, including HIV and AIDS." In this kind of injection mania there is a need to put measures in place to ensure safetyConference delegates called on African governments to put in place national guidelines on injection and needle use. Staff shortages were also cited as a possible cause for unsafe injections in poor countries. The World Health Organization estimates that about 5 percent of new HIV infections could be due to syringe re-use, and that 58 percent of health care workers report needle-stick injuries, in which they are accidentally pricked or scratched by an infected needle. A study on injection safety in Kenya by the University of Nairobi found that 61 percent of nurses in the health facilities surveyed reported needle-stick injuries during a period of three months. Syringes used by diabetic patients to inject insulin were finding their way onto the streets and were being used by injecting drug users, a major driver of new HIV infections. Agunda warned that quacks in rural areas and urban slums were jeopardizing people's lives through poor syringe disposal and re-use. "In a bid to reduce their costs ... [they] could turn to syringe and needle re-use and infect a big number of people in such settings, and it is the reason there must adequate surveillance by governments in Africa to stem it." ko/kn/he Themes: (IRIN) Health & Nutrition, (IRIN) HIV/AIDS (PlusNews) [ENDS] Report can be found online at: http://www.irinnews.org/Report.aspx?ReportId=85278 __________________________________________________________________________ _____________________________________*____________________________________ __________________________________________________________________________ * SAFETY OF INJECTIONS brief yourself at: www.injectionsafety.org A fact sheet on injection safety is available at: http://www.who.int/mediacentre/factsheets/fs231/en/index.html * Visit the WHO injection safety website and the SIGN Alliance Secretariat at: http://www.who.int/injection_safety/en/ Download the latest injection safety Best Practices review at: http://www.uqconnect.net/signfiles/Files/BestPracticesJul2003.pdf Use the Toolbox at: http://www.who.int/injection_safety/toolbox/en/ Subscribe or un-subscribe by email to: sign@uq.net.au, sign@who.int or on subscribe online at: http://www.who.int/injection_safety/sign/en/ Get SIGN files on the web at: http://www.uqconnect.net/signfiles/Files/ get SIGNpost archives at: http://www.uqconnect.net/signfiles/Archives/?M=D The SIGN Secretariat, the Department of Essential Health Technologies, WHO, Avenue Appia 20, CH-1211 Geneva 27, Switzerland. Telephone: +41 22 791 3680, Facsimile: +41 22 791 4836, E- mail: sign@who.int _____________________________________*____________________________________ __________________________________________________________________________ SIGN meets annually to aid collaboration and synergy among SIGN network participants worldwide. The 2009 SIGN annual meeting will be held from 30 November to Wednesday 2 December 2009 at WHO Headquarters in Geneva Switzerland. The PQS (performance Quality and Safety) consultative meeting with the industry, back to back with the SIGN meeting on 3rd and 4th December 2009. Get the final report of the SIGN Meeting 2008, Moscow, Russian Federation [2.36Mb] at: http://www.who.int/injection_safety/2008MeetingReport.pdf Many SIGN files can be opened in Acrobat Reader. To access all the features in Adobe Acrobat documents download the Acrobat Reader at: http://www.adobe.com/products/acrobat/readstep2.html Translation tools are available at: http://www.google.com/language_tools or http://www.freetranslation.com __________________________________________________________________________ All members of the SIGN Forum are invited to submit messages, comment on any posting, or to use the forum to request technical information in relation to injection safety. The comments made in this forum are the sole responsibility of the writers and does not in any way mean that they are endorsed by any of the organizations and agencies to which the authors may belong. Use of trade names and commercial sources is for identification only and does not imply endorsement. Contributions to: sign@uq.net.au or use your reply button! The SIGN Forum welcomes new subscribers who are involved in injection safety. Please subscribe by sending an email to: sign@who.int _____________________________________*____________________________________ The SIGN Internet Forum was established at the initiative of the World Health Organization's Department of Essential Health Technologies. The SIGN Forum is moderated by Allan Bass and is hosted on the University of Queensland computer network. http://www.uq.edu.au __________________________________________________________________________