POST 00902E : NEEDLE REMOVERS REVIEW
Follow-up on Posts 00891E and 00897E
24 March 2006
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Yves Chartier (mailto:[email protected]) responds to Satish comments and
concerns (Post 00897E) by explaining the present WHO perspective on the
issue..
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Dear Satish,
Thank you very much for your email and reaction.
I know that PATH and particularly PATH in India has done a lot around
needle remover.
The project that I had the great opportunity to visit in India was in my
point of view very good.
There is also no question on the added value of needle removers in waste
management, but also in term of safety for waste handlers and communities,
this without mentioning options to reprocess the plastic from syringes
into other plastic products. In a word, at the waste management stage it
brings safety and is an environmentally-friendly option.
The question remains on occupational safety.
The present policy on sharps from injection activities is: injection -
safety box.
The use of a needle remover adds an extra step in the process and extra
manipulation of the sharp itself.
This step requires clear evidence in term of safety.
Does the use of needle removers increase the risk of needle-stick injury
to injection providers and exposure to blood spray?
There is insufficient evidence so far, and the report you refer to
mentions it clearly.
What are the coming developments:
1. An extra study on routine activities is planned in Bangladesh.
The WHO protocol on routine will be used.
Reported needle-stick injuries will be documented.
The results of this study, if scientifically proven and well in respect
with the WHO protocol should bring enough evidence to take a position.
2. I agree with you that many countries are now introducing needle removers.
No proper technical specifications may lead to the use of poorly designed
devices with the risk of increased needle stick injuries. This would be of
course counter-productive as needle removers will be then regarded as
unsafe devices.
Specifications on needle remover have been developed in 2005. IT Power
India led the Waste Working Group for PQS and also developed draft
specifications for Needle removers. This has been revised by a good number
of people from PATH, WHO and others. Knowing the dynamic to introduce
needle removers in many countries, these specifications will be made
available very shortly for information.
3. My objective is that by the next SIGN meeting WHO comes with a clearer
position on needle removers.
As mentioned above evidence that the needle remover does not increase risk
for injection providers is the main issue.
One of the WHO's recommendation is that, if needle removers are introduced
or are already in use, these activities be documented and studied with the
support of the WHO protocol to bring evidence in a shorter period of time.
I believe that all together we can ensure, through extra studies, that at
the next SIGN meeting, a position is taken regarding the use of needle
removers.
I hope these few lines clarify where WHO wants to go. Be sure that this
Yes and No position is unstable and that we are trying our best to come
with a clear WHO position on this issue.
Once again thank you very much for your email. It is always great to hear
from you.
Best greetings,
Yves
Yves CHARTIER
Public health engineer
Water, Sanitation and Health
Public Health and Environment
World Health Organization
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