Post0230 INJECTION SAFETY & WASTE DISPOSAL 9 March 2000
CONTENTS
- SMALL SCALE INCINERATOR TRIALS - SOUTH AFRICA
- LOW-COST MEDICAL WASTE INCINERATOR MANUAL AND PLANS ARE NOW AVAILABLE
- SHARPS INCINERATION EMISSIONS CONTROL - NEW TECHNOLOGY DEVELOPMENT HELP?
- COMMENT RE: POST0216 INJECTION SAFETY + REPORT
- NEW ARTICLE: IMMUNIZATION INJECTION SAFETY IN AFRICA
- POTENTIAL INTERIM APPROPRIATE TECHNOLOGY SOLUTION TO INJECTION SAFETY
- NEW! SIGN HOME PAGE + SIGN RESOURCE CENTRE ON THE WEB
- SUBSCRIPTION TO SIGNpost
- CDC WEBSITE ON NEEDLE-FREE INJECTION TECHNOLOGY
- NEWS ITEM: MACEDONIAN CAPITAL LITTERED WITH MEDICAL WASTE
- SMALL SCALE INCINERATOR TRIALS - SOUTH AFRICA
Ticky Raubenheimer, CCCCM, has kindly made available to TECHNET
Subscribers, the long awaited results and findings of the very major trial
of small scale incinerators for medical waste at health facilities.
Contributions, comments and suggestions please: [email protected]
or use your reply button
From:
"Ticky Raubenheimer"
To: "Moderator - TECHNET"
Subject:
Small Scale Incinerator Trials - South Africa
Date:
Thu, 17 Feb 2000 09:59:00 +0200
Organization:
Collaborative Centre for Cold Chain Management
Dear Allan,
Finally we have completed the project in South Africa and all the
documentation has been submitted to the Department of Health for further
action. We wish to inform our colleagues in TECHNET accordingly and make
the documentation available to all.
The trials were very successful in many respects and showed us the way
forward in this regard. The major indicators were:
- Small scale incineration is a possible method to assist in medical waste
management in rural primary health care clinics
- Small scale incinerators can only be used under strictly controlled
loading limits in respect of quality of waste and quantity of waste.
- Small scale incinerators pose significant occupational health and safety
hazards and strict compliance with operational requirements, including
safety measures, must be adhered to
- Operators of small scale incinerators must be trained adequately and
monitored regularly for compliance
- Small scale incinerators have limited use within the total system of
medical waste management
- The trials confirmed that if these small scale incinerators are used
within the loading and geographical placement constraints, environmental
impact assessment studies may not be necessary for licensing of individual
units.
- The loading capacities of these small scale incinerators will allow for
the handling of medical waste during mass immunisation campaigns in South
Africa.
The documentation covering the total trial is quite extensive and some of
the report files are very big in size. We have therefore loaded them onto
an FTP server on the Internet in zipped format.
To obtain the files:
On the Internet, go to
ftp://ftp.csir.co.za/pub/public/WHO
Here you will find various files in Winzip format for downloading. The
titles are self explanatory. All these files are zipped with a password
i.e. Geneva - in other words, to unzip them please enter the password
Geneva when prompted by Winzip. The file sizes are as follows:
- First Steering Committee Meeting minutes (winzip size:116KB)
- Phase 2 - Laboratory trials report(winzip size:7,447KB)
- Second Steering Committee Meeting minutes(winzip size:120KB)
- Phase 3 - Field trials report(winzip size:2,838KB)
- Third Steering Committee Meeting minutes(winzip size:119KB)
- Phase 4 - Recommendations to the Dept. of Health on outcomes of
trials(winzip size:146KB)
- Final Combined Report Summary(winzip size:336KB)
We hope and trust that this information can be of interest to your readers
Best regards
Tickly Raubenheimer
Collaborative Centre for Cold Chain Management - South Africa
*
- LOW-COST MEDICAL WASTE INCINERATOR MANUAL AND PLANS ARE NOW AVAILABLE
The incinerator described in the manual was developed by the Innovative
Technology Group at De Montfort University, UK. Jim Picken at De Montford,
has kindly posted the manual and plans to both TECHNET and to SIGNpost
Forums. Thanks!
Contributions, comments and suggestions please: [email protected]
or use your reply button
- The file is available for download at:
ftp://ftp.acithn.uq.edu.au/Technet/1-ClickHereForTECHNETfiles/Waste/
Click on the file:
DeMontfordIncineratorJan2000.zip 2,347 KB
This file contains these files:
DeMontfordIncinerator.PDF 2381243
INCIN191099.dwg 322615
Karldraw3INCIN191099.TCW 304128
Note:
The last 2 files are in TurboCAD and AutoCAD respectively and
require those programs to open and view. If anyone in the TECHNET can help
with conversions to other formats it would be appreciated.
- You can also get the files via email.
Send an email to:
with the message: get technet DeMontfordIncineratorJan2000.zip
Moderators note:
You can only get files by email if you are a TECHNET
subscriber. To subscribe to TECHNET Internet Forum.
Send an email to:
with the message: subscribe
From:
"Jim Picken"
To: technet moderator
Intermediate Technology Development Group Ltd., Company Reg No. 871954,
England, Charity No. 247257.
Extract:
Page 1
" The medical waste incinerator is a simple two-chamber natural-draught
incinerator designed to be operated at temperatures of 800'C and higher.
The performance of the incinerator will vary depending on the moisture
content of the medical waste but a throughput of up to 15kg/hour can be
achieved.
The incinerator has been designed so that it can be built on site, using
standard building bricks or blocks and lined with refractory bricks. All
the steel components, such as the loading door, the ash removal
door and air inlet apertures can be made using basic workshop equipment.
Wood, wood and dry waste soaked in kerosene or diesel is required initially
to start the combustion process. Once the correct temperature is reached,
the medical waste is loaded into the incinerator. Much of the medical waste
will have value as a fuel and will contribute towards combustion but
additional wood or kerosene may be required to ensure that adequate
combustion temperatures are maintained.
The initial combustion occurs in the primary chamber and then the hot gases
pass into the secondary chamber where the combustion process is completed.
The two-chamber design helps to ensure that the combustion time is
sufficient to destroy the products of combustion and minimise any harmful
emissions.
The incinerator should be situated under a simple open-sided roofed
structure, such as a lean-to, away from tall buildings and in an area free
from air turbulence. Although it can be operated in the open, a roof will
help to protect the incinerator from rain and provides shelter for the
operator.
The incinerator is capable of incinerating most types of medical waste
including textiles, plastics and packaging. It can also incinerate most
types of drugs, medicines, vaccines and sharps ? as long as they are mixed
with other wastes. However, as grease-based products, such as ointments,
creams and Vaseline create large quantities of dense black smoke when
burned , they are best disposed of by other means."
*
- SHARPS INCINERATION EMISSIONS CONTROL - NEW TECHNOLOGY DEVELOPMENT HELP?
In the posting below, Janine Jagger, International Health Care Worker
Safety Center at the University of Virginia Medical School, provides a hint
of the new technologies for incineration construction and the control of
emissions that the group is working on.
- Janine is looking for funding for a fellowship to enable the further
development of the technology by the inventor of a brick kiln with a novel
emissions filter made from clay.
Replies to Janine at:
Contributions, comments and suggestions please: [email protected]
or use your reply button
TECHNET Forum subscribers will recall that Janine posted an update on the
activities in safe injection carried out at the Center in TECHNET Post0050,
2 October 1998.
Technet postings are available on the web at:
ftp://ftp.acithn.uq.edu.au/Technet/1-ClickHereForTECHNETfiles/Posts/
From:
"Jagger, Janine"
To: Technet Moderator
Subject:
Sharps Incineration Emissions Control Development Request
Date:
Fri, 21 Jan 2000 12:56:39 -0500
To the TECHNET moderator:
For the past two years our group has been working on injection safety
issues focusing on the areas that have received less attention than
injection equipment use and reuse; namely the secure containment of
injection waste at the point of use, and the destruction or elimination of
injection waste (by incineration or other means). We have been looking for
new technologies or existing technologies that have yet to be applied to
this problem. We have identified a very interesting technology that might
be used for the incineration of injection/medical waste, but needs to be
tested for that purpose. The raw materials needed to build this
incinerator are free, it has no moving parts, it filters 90% to 99% of
particulate emissions and it produces a salable product. It is a brick
kiln with a novel emissions filter made from clay and invented by Robert O.
Marquez a graduate student at New Mexico State University.
Robert is more than just a graduate student; he worked as an engineer for
Hewlett Packard for ten years. He is now devoted to developing
technologies to improve the lives of the poorest people. We are recruiting
Robert to the University of Virginia for a two-year post-doctoral
fellowship to do further research on the application of this technology to
medical waste incineration. He will be working with Professor James Smith,
an international expert in the properties of clays in the Engineering
School at U.Va. Upon completion of his fellowship at U.Va., Robert will
return to New Mexico State University where he has been offered a faculty
position.
We are searching for financial support for Robert's two-year post-doctoral
fellowship. Since this research falls outside of my area of expertise, I
need to be directed to the appropriate resources. Robert is a Native
American of the Navaho Tribe, which should qualify him for programs
targeting minorities in the U.S. Any advice that TECHNET members could
provide would be greatly appreciated.
Thank you for any help you can provide,
Janine Jagger, M.P.H., Ph.D.
Director, International Health Care Worker Safety Center
University of Virginia School of Medicine
---
From:
"Jagger, Janine"
To: Sign Moderator ,
Technet Moderator
Subject:
RE: posting
Date:
Sun, 23 Jan 2000 14:01:51 -0500
Allan,
Thank you for posting the message. Robert Marquez is a very special person
and if I can play a small role in helping his work come to fruition I will
be very pleased. When I first heard about his work with the brick makers
of Mexico (I heard about it on a national radio program) I immediately
thought about its application to the incineration of medical waste.
I "hunted him down" to find out if he had considered this application of
his technology. He said he had not and that he was looking for additional
applications. So my phone call was of great interest to him. He is
finishing his Ph.D. this Spring and then is required to work "somewhere
else" for 2 years before accepting a faculty position at NMSU. It's a rule
in American universities that faculty cannot be hired directly out of one's
own academic program. So I thought it would be ideal if we could get
Robert to U.Va. for a 2-year post-doc. After some searching I found out
that we had this major clay expert right here at U.Va. I put Robert in
touch with him and the two immediately fell deeply into "clay love." Robert
is convinced that this is the place for him to continue his research, so he
made a leap of faith, committing to do his post-doc here, in the belief
that somehow financial support will follow. So that is the point we are at
now.
I didn't know much about clay before, and I still don't know much. But
what I have learned is that the simple combination of dirt and water can
yield amazing results; and it is abundant and it is cheap. So I am hoping
that through the network of SIGN and TECHNET colleagues we can help Robert
to do the necessary research to test the application of clay filters to the
incineration of medical waste in developing countries.
Yes, please put me on the SIGN list - I thought I was on it!
Best regards,
Janine
*
- COMMENT RE: POST0216 INJECTION SAFETY + REPORT
Hala Azzam, USAID/E&E/EEUD/HRHA, comments on the problem of medical waste
disposal with reference to TECHNET Post0216 Injection Safety on 12 January
2000.
Hala also provides a web link to a think report analysing the effects
associated with activities undertaken and influenced by the health care
service sector.
"Environmental Implications of the Health Care Service Sector"
http://www.RFF.org/disc_papers/PDF_files/0001.pdf
Date:
Tue, 18 Jan 2000 13:51:38 EST
To:
From:
"Hala Azzam"
Subject:
re: Post0216 INJECTION SAFETY
Dear Allan,
I hope the issue of preserving vaccines at low temperature will be kept
alive this time[after Technet'99]. I read Posts0217 and 0218 and see that
there is some effort in this direction.
I have finally been able to locate one article in the US that has looked at
the impact of medical waste on the environment in a comprehensive manner!
It was published in October 1999, by RFF (Resource For the Future), a
think tank. It is more of a reconnaissance document, since the authors
are basically saying that there wasn't sufficient data in this area and
that more needs to be done. I thought it very telling however, that the
authors chose medical waste as their case study.
The thrust of the article was to look at the impact of the service sector
on the environment, an area that has fallen through the cracks. The topics
covered range from infection control and needle-stick injuries, to dioxin
emissions and ground water contamination. The article also talks about
about the vision for the future and mention that health is a sector that
has considerable influence both "upstream" on its suppliers, and
"downstream" on its end-users, and therefore alternatives with less impact
on the environment must be encouraged. I have attached the reference for
this article below:
http://www.RFF.org/disc_papers/PDF_files/0001.pdf
Sincerely
Hala
Hala Azzam, PhD
AAAS Fellow
USAID/E&E/EEUD/HRHA
tel 202- 712 1585
fax 202- 216 3409
email: [email protected]
*
- NEW ARTICLE: IMMUNIZATION INJECTION SAFETY IN AFRICA
[Crossposted from SIGNpost]
Modibo Dicko, WHO/AFRO, and colleagues have recently published an article,
in the Bulletin of WHO, looking at the problem of injection safety in
selected national immunization programs in Africa, in the context of a
recent logistics project.
Safety of immunization injections in Africa:
not simply a problem of
logistics by M. Dicko, A.-Q. O. Oni, S. Ganivet, S. Kone, L. Pierre, & B.
Jacquet:
vol.78, no.2, 163-169.
The article is available at:
http://www.who.int/bulletin/pdf/2000/issue2/bu0269.pdf
Or on the SIGN website at:
http://www.injectionsafety.org/html/resources_center.html
Or get the file by email:
Send a message to:
with the message: get technet Bul78-2-2000-Dicko.pdf
Additional Bulletin articles discuss immunization safety. Please see the
Table of Contents below.
- Kay Bond, WHO/ V&B, kindly posted the announcement of the publication of
the article and has drawn our attention to the Immunization Safety Priority
Project (Department of Vaccines and Biologicals, WHO Geneva). For more
information please contact Kay at: [email protected]
Action, comments and additions please: [email protected]
or use your reply button
From:
Date:
Mon, 06 Mar 2000 13:53:04 +0100
To:
Subject:
New Article:
Injection Safety In Africa
The Immunization Safety Priority Project of the WHO Dept. of Vaccines and
Biologicals is pleased to inform SIGNpost readers that the theme of the
February 2000 issue of the WHO Bulletin is "Immunization Safety". One
article by M. Dicko et al. looks specifically at the safety of immunization
injections in Africa.
On-line version:
http://www.who.int/bulletin/pdf/2000/issue2/bu0269.pdf
Do not hesitate to contact us with any questions or further information on
the Immunization Safety Priority Project.
Thanks and regards.
Kay Bond
Administrative Officer
Immunization Safety Priority Project
Department of Vaccines and Biologicals
WHO, Geneva
Tel: +41 22 791 2262
Fax: +41 22 791 4210
E-mail:
All articles in this Special Theme issue of the Bulletin of the World
Health Organization are available from this website:
http://www.who.int/bulletin/tableofcontents/2000/vol.78no.2.html
TABLE OF CONTENTS
Bulletin of the World Health Organization
The International Journal of Public Health
Volume 78, Number 2, Bulletin 2000, 153-280.
SPECIAL THEME - IMMUNIZATION SAFETY
EDITORIAL
Immunization safety:
a global priority by M. Scholtz & P. Duclos: vol.78,
no.2, 153-154. [Full text] [Full text PDF]
THEME PAPERS
New challenges in assuring vaccine quality by N. Dellepiane, E. Griffiths,
& J.B. Milstien: vol.78, no.2, 155-162. [Full text PDF]
Safety of immunization injections in Africa:
not simply a problem of
logistics by M. Dicko, A.-Q. O. Oni, S. Ganivet, S. Kone, L. Pierre, & B.
Jacquet:
vol.78, no.2, 163-169. [Full text PDF]
Developing a national system for dealing with adverse events following
immunization by U. Mehta, J.B. Milstien, P. Duclos, & P.I. Folb: vol.78,
no.2, 170-177. [Full text PDF]
Monitoring signals for vaccine safety:
the assessment of individual adverse
event reports by an expert advisory committee by J.-P. Collet, N.
MacDonald, N. Cashman, R. Pless, & the Advisory Committee on Causality
Assessment:
vol.78, no.2, 178-185. [Full text PDF]
The Vaccine Safety Datalink:
immunization research in health maintenance
organizations in the USA by R. T. Chen, F. DeStefano, R.L. Davis, L.A.
Jackson, R.S. Thompson, J.P. Mullooly, S.B. Black, H.R. Shinefield, C.M.
Vadheim, J.I. Ward, S.M. Marcy, & the Vaccine Safety Datalink Team: vol.78,
no.2, 186-194. [Full text PDF]
Simian virus 40, poliovirus vaccines, and human cancer: research progress
versus media and public interests by J.S. Butel: vol.78, no.2, 195-198.
[Full text PDF]
Clinical safety issues of measles, mumps and rubella vaccines by M.A.
Afzal, P.D. Minor, & G.C. Schild: vol.78, no.2, 199-204. [Full text PDF]
ROUND TABLE
Vaccine adverse events in the new millennium:
is there reason for concern?
by B. J. Ward: vol.78, no.2, 205-215. [Full text PDF]
Discussion by Ahmed A. Darwish; Phyllida Brown; John Clemens; Robert Pless;
Alan R. Hinman; Adrian J. Ivinson: vol.78, no.2, 216-223. [Full text PDF]
BULLETIN 2000 FEEDBACK
Health inequalities and social inequalities in health by Paula Braveman,
Nancy Krieger, & John Lynch: vol.78, no.2, 232-233. [Full text PDF]
Response to P. Braveman et al. by C.J.L. Murray, E.E. Gakidou, & J. Frenk:
vol.78, no.2, 234-235. [Full text PDF]
EDITORIAL
Reducing HIV/AIDS risk, impact and vulnerability by D. Tarantola: vol.78,
no.2, 236-237. [Full text] [Full text PDF]
CRITICAL REFLECTION
Directly observed treatment, short-course strategy and multidrug-resistant
tuberculosis: are any modifications required? by I. Bastian, L. Rigouts, A.
Van Deun, & F. Portaels: vol.78, no.2, 238-251.
[Full text PDF]
RESEARCH
Prevalence of use of complementary/alternative medicine:
a systematic
review by E. Ernst: vol.78, no.2, 252-257.
[Full text PDF]
Preventing trachoma through environmental sanitation:
a review of the
evidence base by A. Pr?mp; S.P. Mariotti:
vol.78, no.2, 258-266. [Full text PDF]
POLICY AND PRACTICE
Biomedical and development paradigms in AIDS prevention by I. Wolffers:
vol.78, no.2, 267-273. [Full text PDF]
BOOKS & ELECTRONIC MEDIA:
[SIGN and SIGNpost reviews]
vol.78, no.2, 276-277. [Full text PDF]
Letters:
vol.78, no.2, 278. [Full text PDF]
? World Health Organization / Organisation mondiale de la Santé¬ 2000
*
- POTENTIAL INTERIM APPROPRIATE TECHNOLOGY SOLUTION TO INJECTION SAFETY
Bob Chen, CDC/Atlanta, contributed these thoughts on an appropriate needle
technology to the TECHNET Forum.
Bob proposes fiber reinforced plastic needles - as more appropriate for the
usual purpose of needles and to simplify safe disposal.
Bob challenges needle designers and manufacturers to make this a reality!
Action, comments and additions please: [email protected]
or use your reply button
Moderators Notes:
The thermal processing of sharps was discussed in TECHNET Post0125,
Alternatives To Incineration, on 17 March 1999.
Go to the website
for the file: Post0125-AltIncineration.txt
The UK Consumers Association reported some success on using low level heat
(~200'C) to turn used syringes and needles into an apparently low risk,
disinfected plastic cake which successfully trapped all sharps.
The method the UK Consumers Association was working with was proposed by Dr
Imam Zagloul Imam, formerly Director general of VACSERA, Egypt, uses an
adapted domestic oven for the reduction and decontamination of injection
waste. This was described and discussed in TECHNET Post0125, along with
other methods of thermal processing of sharps.
From:
"Chen, Robert (Bob) (NIP)"
To: "'Technet Moderator'"
Subject:
RE: Post0216 INJECTION SAFETY
Date:
Thu, 13 Jan 2000 13:53:54 -0500
Dear Allan,
With the new millennium, I'd like to initiate/stimulate some discussion on
one potential interim(appropriate technology) solution to injection safety:
- developing and substituting plastic needles for steel needles as a first
step in helping to solve the waste disposal problem.
- combining a plastic needle with autodisabling pouch and needle delivery
system (e.g., an improved Uniject) as the second step.
Rationale:
- While alternative methods for administering medicines and vaccines are
under development, parenteral injections will still be the principal
delivery method in developed and developing countries for a long time.
- The main solution for unsafe injections developed to date by the
"developed" world is the single use disposable plastic syringe & needle.
The use of this "solution" requires 1) constant adequate supply at points
of use, and 2) adequate medical waste disposal system. Both of which are
clearly not available in much of the less developed world - highlighting
the need for an alternative solution.
- Pondering the uses of needle and syringe, one quickly realizes how
"overengineered" the typical plastic syringe and metal needle is for its
mission: a low pressure medical procedure that takes a few seconds to
complete.
The resulting waste has a large bulk of plastic and a metal needle that
requires thousands of degree to adequately incinerate (i.e., not doable in
most outlying clinics at point of use). The current syringe and needle is
always available for the tasks where such bulk of plastic and needle is
needed. The question is to come up with a simpler alternative for the main
mission of injections.
- Further reflection on the history of syringe and needle since its
invention in the 1800's, suggest that the major change is in the material
(from metal, to glass, and now plastic), rather than how the design can be
optimized to meet our current needs (until some of the recent
autodisabling/sheathing features).
- Plastic can be melted down into relatively less harmful and more easily
managed blocks at hundreds of degrees - something doable at almost all
outlying clinics. Therefore the current proposal to explore developing
plastic needles as a substitute for current metal needles, and then to
decrease volume of waste, link such needles to autodisabling pouch and
needle systems.
- While a plastic needle may not be able to be made as sharp as a metal
needle (perhaps plastic technology has now advanced to the point where this
is now debatable), since it is designed to be used just once, the
advantages of ease of disposal may outweigh a slight increase in pain. In
fact dulling after use without the ability to be resharpend may be a good
deterrent to reuse.
- Similarly, the plastic required to provide the necessary strength may be
more expensive than stainless steel initially, but the other benefits and
hopefully the market will make price less of an issue.
- While plastic may be more likely to break than metal, again, it would
seem to me that some simple weaving of plastic fibers would make this a
non-issue in routine use.
- While the above proposed solution(s) may not be the final or even a good
answer, I'd like to challenge the syringe and needle designers and
manufacturers, as well as others to critique and improve on this starting
point for discussion - and hopefully some solutions.
Best regards,
Bob
Robert T. Chen, MD MA
Chief, MS-E61
Vaccine Safety and Development Branch
National Immunization Program
CDC, Atlanta, GA 30333
*
- NEW! SIGN HOME PAGE + SIGN RESOURCE CENTRE ON THE WEB
www.injectionsafety.org
The Safe Injection Global Network has a home page:
Set your bookmark!
The Safe Injection Global Network website has been updated. New features
include a resource centre and a photo gallery. A list of documents
available on the site is posted below.
http://www.injectionsafety.org/html/resources_center.html
http://www.injectionsafety.org/html/gallery.html
Our thanks and congratulations to the EpiConcept Team for designing and
maintaining the site!
From:
Date:
Tue, 01 Feb 2000 18:50:23 +0100
To: "SIGNpost"
Subject:
SIGN Home Page
SIGN now has its WEB page at www.injectionsafety.org . For the moment, we
have just the fact sheets up there, but I would welcome comments and
suggestions regarding how we could make use of this extraordinary
communication tool.
Regards,
Yvan Hutin
SIGN coordination/WHO
E-mail:
---
From:
"Etienne"
To: "SIGN Moderator"
Date:
Fri, 03 Mar 2000 21:19:14 +0100
Subject:
the SIGN web site was updated on 03/02/2000
New in the SIGN site:
a resource center + a photo gallery
regards,
EpiConcept Team
SIGN RESOURCE CENTRE
http://www.injectionsafety.org/html/resources_center.html
The documents below can all be downloaded directly from this Internet site.
Alternatively, hardcopies can be ordered from the SIGN secretariat by
email or by writing or faxing the SIGN Secretariate at:
SIGN Secretariat
Department of Blood Safety and Clinical Technology
World Health Organisation
20 Avenue Appia
CH-1211, Geneva 27
Switzerland
E-mail:
[email protected] Fax: +41 22 791 4836
The documents available on 03 March 2000 are.
- Aide-memoire for a national strategy for the safe and appropriate use of
injections
This two-page document designed for policy makers at country level
summarises the key elements of a national strategy for the safe and
appropriate use of injections.
http://www.injectionsafety.org/documents/Memoire.pdf
*SIGN slide presentation
This powerpoint presentation reviews the evidence documenting the public
health problem associated with unsafe injections and presents the safe
injection global network.
http://www.injectionsafety.org/documents/sign.ppt
- SIGN Initial meeting report
The report of the SIGN initial meeting summarises the proceedings of the
initial SIGN meeting on October 4-5th, 1999, at the World Health
Organisation Headquarters in Geneva, Switzerland. It contains the SIGN
terms of association and the proposed SIGN strategic framework.
http://www.injectionsafety.org/documents/report.doc
- Consensus statement on use of auto-disable syringes for immunisation
This consensus statement signed by the World Health Organisation (WHO), the
United Nations Children Fund (UNICEF), the International Federation of Red
Cross and Red Crescent Societies (IFRCS), and the United Nations Population
Fund (UNFPA) addresses the need to generalise the use of auto-disable
syringes for immunisation by the end of 2003.
http://www.injectionsafety.org/documents/policy.doc
ARTICLES FROM THE BULLETIN OF THE WORLD HEALTH ORGANISATION ON INJECTION
SAFETY
- Injection safety: a global challenge
This editorial summarises key injection safety issues and announces the
launch of SIGN
http://www.injectionsafety.org/documents/hutin.pdf
- Unsafe injection in the developing world and transmission of bloodborne
pathogens: A review
This literature review summarises studies that assessed injection safety
and injection frequency, as well as studies estimating the strength of the
association between unsafe injections and infections with bloodborne
pathogens. It concludes that in many countries, unsafe injections are a
major source of infections with bloodborne pathogens.
http://www.injectionsafety.org/documents/simonsen.pdf
- Transmission of hepatitis B, hepatitis C, and HIV through unsafe
injections in the developing world: Model-based regional estimates
This mathematical model provides an estimate of the incidence of
injection-associated infections with hepatitis B virus (HBV), hepatitis C
virus (HCV), and human immunodeficiency virus (HIV). It suggests that each
year, in the world, overuse of injections and unsafe injection practices
combine to cause an estimated 8 to 16 million HBV infections, 2.3- 4.7
million HCV infections, and 80,000 to 160,000 HIV infections.
http://www.injectionsafety.org/documents/kane.pdf
- The cost of unsafe injections
This article provides an estimation of the cost of unsafe injections
annually world-wide.
http://www.injectionsafety.org/documents/miller.pdf
- Sterilisable syringes: Excessive risk or cost-effective option?
This article reviews reasons that would support the choice of sterilisable
syringes to administer injections.
http://www.injectionsafety.org/documents/battersby.pdf
- Auto-disable syringes for immunisation: Issues in technology transfer
This article reviews issues in technology transfer for the use of
auto-disable syringes for immunisation.
http://www.injectionsafety.org/documents/lloyd.pdf
- Safety of immunisation injections in Africa: Not simply a problem of
logistics
This article reviews difficulties in reaching immunisation injection safety
in Africa and proposes a holistic approach to injection safety that goes
beyond the problem of logistics.
http://www.injectionsafety.org/documents/dicko.pdf
- Anthropological perspectives on injections: A review
This article reviews anthropological studies conducted on the social and
individual determinants of poor injection practices.
http://www.injectionsafety.org/documents/reeler.pdf
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- SUBSCRIPTION TO SIGNpost [Crosspost from SIGNpost]
Are you subscribed? Send an email to: [email protected]
or to: [email protected]
From:
Sent:
Tuesday, February 08, 2000 9:59 AM
To: Sign Moderator
Subject:
!! SUBSCRIPTION to SIGNpost !!
I have come to realize that a number of persons are not subscribed to
SIGNpost, the weekly, moderated injection safety email forum run by Allan
Bass, while they think they are. In addition, some people have not
subscribed thinking that SIGN and technet have similar injection safety
posting, which is not exactly true.
In order not to send unsolicited emails, we have NOT subscribed people
automatically but we sent an invitation to which A REPLY WAS NECESSARY
to be SIGNposted.
If you wish to be signposted and receive weekly injection safety news,
you can
1- Reply to this email
2- Send an email to [email protected]
3- Send an email to Allan Bass
(Disregard this email if you are in fact already SIGNposted)
Best regards
Yvan Hutin
SIGN coordination/WHO
E-mail:
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- CDC WEBSITE ON NEEDLE-FREE INJECTION TECHNOLOGY
In case you missed it elsewhere! [Crosspost from SIGNpost]
From:
"Damon, Scott"
To: "'SIGN Moderator'"
Subject:
RE: Post0012 TOOLS + ARTICLE + SYMPOSIUM + INCINERATOR +
Date:
Wed, 9 Feb 2000 12:38:46 -0500
The Centers for Disease Control and Prevention (CDC) has developed a
website on needle-free injection technology. The site includes a
bibliography of related scientific literature; a listing of the needle-free
injection policies of the World Health Organization (WHO), CDC, and the
U.S. Department of Defense; and information about manufacturers and
devices.
To visit CDC's website on needle-free injection technology,
go to: http://www.cdc.gov/nip/dev/jetinject.htm
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- NEWS ITEM: MACEDONIAN CAPITAL LITTERED WITH MEDICAL WASTE
Contributions, comments and suggestions please: [email protected]
or use your reply button
Macedonian Capital Littered with Medical Waste
By Natasa Dokovska
SKOPJE, Macedonia, March 6, 2000 (ENS) - One month after a brand new
medical waste incinerator was placed in the Drisla waste collection
facility, medical waste is still scattered in the streets of Skopje. The
incinerator was donated to the former Yugoslav Republic of Macedonia by the
United Kingdom.
On Friday, the center of the Macedonian capital city of Skopje was littered
with the medical waste. Near the Town's Hospital, blood soaked materials,
syringes, dirty gauze and bandages were in plain view. Street dogs are
prowling amongst the waste, feeding and scattering the litter.
The UK government decided to donate the medical waste incinerator to the
Macedonian government after an incident six months ago when United Nations
peacekeepers, KFOR soldiers, left bags containing body parts from Kosovo in
the center of Skopje.
Skopje, Macedonia (Photo courtesy City of Skopje)
But now that the incinerator is in Skopje, nobody is interested in using
it. The hospital staff has been through extensive training in the use of
the incinerator, but they cannot using the instructions they received
because the incinerator remains closed.
Boris Zmejkovski, director of the Drisla waste collection depot, says he
cannot get the incinerator started for the lack of 100,000 German marks. He
must find a solution for financing of the work on the incinerator, because
it will be too expensive for the depot to cover alone.
Zmejkovski says another problem is that he does not yet have agreement from
all hospitals in Skopje to use the incinerator. And in addition, Zmejkovski
says once agreement is reached they must find trucks to transport the
waste.
During this period, the World Health Organization has been financing a
project to provide 250,000 plastic bags for medical waste for the period of
three months. They have asked the medical stuff to separate the waste in
three parts, but now nobody wants to do this work.
Environmentalists in Macedonia are worried that the new incinerator will
not be used and medical waste will continue to contaminate Skopje.
? Environment News Service (ENS) 2000. All Rights Reserved.
Copyright ? 2000 Lycos, Inc. All Rights Reserved. Lycos? is a
registered trademark of Carnegie Mellon University.
http://www.ens-news.com/
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