Some great posters available for download from Worcestershire Health Services NHS. Dealing with a variety of topics, including sharps bin use, needlestick protocol, spill management etc, they will be particularly helpful as a starting point for those wanting to create their own information posters and warning notices.

Spillages

Well done Worcestershire.

 

Needle with drop of bloodA family has an anxious year ahead after their little girl stood on a hypodermic needle on a Gold Coast beach.

A day enjoying the sun and surf at Currumbin on Tuesday came to a horrifying end for the McDermid family of Southport when four-year-old Tigerlily screamed in pain.

Graham and Carmen McDermid turned to see a hypodermic needle sticking out of Tigerlily’s right foot.

The family of four were just 100m north of the flagged area at Currumbin Vikings Surf Life Saving Club.

Shocked at the sight, the distressed parents had to pull the dirty needle out of the child’s foot.

“She was screaming in agony, lifting her leg up,” Mr McDermid said.

http://www.heraldsun.com.au/news/national/southport-family-faces-anxious-wait-after-fouryearold-had-hypodermic-needle-pulled-from-her-foot/news-story/724b05f8e0f347ef1e4a8c6c85d92db3

This should remind us of the dangers associated with discarded needles, that have a high risk of bloodborne virus infection. If infection does not occur, and of course we hope that will be the outcome in this case, severe, prolonged and sometimes debilitating anxiety can be devastating, for the individual and for family members.

It also reminds us that the most dangerous are those needles that become hidden in soft sand or long grass, especially in circumstances where individuals might reasonably expect to walk in safety while barefoot. At other times, discarded sharps can be covered in a snowfall, though walking barefoot might then be a rather foolhardy action.  And don’t forget all of those sharps “lost” within plastic waste sacks.

Good luck Tigerlily!

 

Needle with drop of bloodA member of the public performed CPR on the man who died in Dorking’s KFC on Monday, but he was injured by a needle as he did so.

Surrey Police officers, along with firefighters and paramedics, were called to the High Street eatery at around 9.50pm following reports of a concern for safety.

A man is his fifties was pronounced dead at the scene after having a cardiac arrest.

A customer in the restaurant had carried out CPR on the man. Paramedics and police officers took over care when they arrived but attempts to revive the him were unsuccessful.

Neighbourhood Inspector Richard Hamlin was quick to praise the man who tried to help.

He said: “We were very grateful to him for the efforts he made. He went way beyond the call of duty and further than most members of the public would have gone.

“He attempted to administer CPR. He received a needle stick injury in the process which he was taken to hospital for.

“Obviously any type of needle injury is very worrying for anyone to receive in any circumstances so really I would only like to reiterate our thanks to him.

“I phoned him to give my thanks to him for his actions personally. I think the family of the dead man would also have liked to thank him if they had seen the efforts he made.”

A spokeswoman for the Surrey Ambulance service confirmed that a man had died at Dorking KFC after collapsing at the premises and suffering a cardiac arrest.

A Surrey Police spokeswoman said: “The death is being treated as unexplained but at this stage there is nothing to suggest any third party involvement.

“A file is being prepared and will be passed to the Surrey Coroner’s Office in due course.”

 

Read more: http://www.dorkingandleatherheadadvertiser.co.uk/Member-public-injured-needle-tried-save-man-died/story-28475757-detail/story.html#ixzz3wqZJZjAE

 

 

Somerville, MA-based Triumvirate Environmental is turning medical and pharmaceutical waste into plastic lumber called “BestPlus.” According to Plastics News, the hazardous and medical waste management company acquired two companies in 2014: Medical Waste Recovery Inc. of Jeannette, PA and Northern Plastic Lumber Inc. of Lindsay, Ontario. Triumvirate moved equipment from Northern Plastic to the Jeannette facility, which sterilizes the waste, separates metals, and processes the remaining plastic and paper to make the finished plastic lumber.

While the stream contains mixed plastics, paper, and cardboard, most of the material is high-density polyethylene – about 70% to 80%, according to Triumvirate CEO John McQuillan.

The Jeannette site generated $600,000 per month in sales in less than two years, and Triumvirate does about $120 million in business a year overall, according to Plastics News. The company plans to add five similar facilities in the U.S.

http://www.wastedive.com/news/triumvirate-environmental-is-transforming-medical-waste-into-plastic-lumber/411452/

Not the first time this has been tried, including at least one trial in the UK, but the plastics composition have proven difficult to separate cleanly after even rather coarse shredding. There is still a high proportion of PVC that makes re-use difficult, and removing fragments of nitrile, vinyl and rubber gloves is a really difficult process. Moreover, unless syringe waste can be diverted from incineration and recovered, minus the metal fragment of sharps, then the net amount of recoverable plastic is still small.

Other, perhaps less, realistic concerns have been the possibility of drug residues in the plastic frame of park benches manufactures from these recovered plastics.

Even worse, the possibility of DNA residues from bloodstained hospital waste surviving the initial sterilisation process, then the plastics recovery and melt process, to be formed into a park bench.  Hardly a problem, though the question that was put to me to investigate was, could that DNA link an innocent hospital patient to a violent attack if a piece of that park bench was broken off and used in a criminal assault?

And my answer – no risk whatsoever.

 

 

More than £500,000 has been paid out in compensation to NHS Tayside staff in the past five years as a result of accidents or injury.

The incidents included almost 200 injuries involving scalpels and razor blades between 2010 and 2015.

NHS chiefs have said they take the “health and safety of staff very seriously” and have pledged to continue with a programme of incident reviews carried out within the organisation.

The 2014/2015 year saw a total of £49,611 being paid out. That figure was up nearly £15,000 on the previous year’s total of £34,775 – the lowest amount paid out in the last five years. Read the rest of this entry »

Needle with drop of bloodNHS trusts are still not complying with “safer sharps” rules, research has argued, which is potentially putting NHS employees at unnecessary risk of needlestick injuries and blood-borne infections such as hepatitis and HIV.

The study from research organisation MindMetre has suggested that many NHS trusts are flouting the Health and Safety Executive’s (HSE) Health and Safety (Sharps Instruments in Healthcare) Regulations 2013, which explicitly recommend that trusts should adopt sharps that incorporate safety mechanisms “where it is reasonably practicable to do so”.

The study examined purchasing volumes of safer sharps across the UK NHS acute sector, with data collected through Freedom of Information requests, between January to May 2015 and August to September 2015.

The results showed that, while progress had been made, the proportion of safer sharps devices was still nowhere near what would reasonably be expected in order to be fully compliant, MindMetre argued.

Greatest compliance levels with sharps Regulations was shown in the purchase of cannulation devices, with 79% of devices purchased in the first six months of 2015 incorporating a safety mechanism, it argued.

Blood collection was the next most compliant category, with 68% of devices purchased incorporating a safety mechanism in the same time period.

Compliance was lowest in the injection category. Here, only 44% of devices purchased in the period incorporated a safety device, despite the fact that the most common device to be involved in needlestick injuries is the syringe and needle, argued MindMetre.

Paul Lindsell, MindMetre’s managing director, said of the findings: “These levels of compliance are clearly unacceptable. The original EU Directive, enacted through the HSE Regulation, explicitly expects healthcare and care institutions to use safety devices in the vast majority of cases, and here we have clear evidence that this is not yet happening.

“Sharps injuries and resulting infections can not only cause immense personal distress, but can also ruin careers. That applies to everyone in the healthcare setting, from ancillary workers, through care professionals, to top clinicians. Failure to comply is quite simply an abnegation of the basic duty to look after staff safety at all levels,” he added.

So, no surprise there, is there?

 

 

Panda_00_00_38_17_Still002In yet another twist to sharps injury, a two-year-old panda has accidentally swallowed a syringe needle during a regular blood sampling process in a zoo in Taipei, Taiwan.

Yuanzai, the first panda ever born in the Chinese island region, unexpectedly seized the needle with her teeth on Thursday when it was already in her left forearm. Caretakers tried to take the needle out of her mouth but failed. The panda was then anesthetised and taken to the animal hospital for treatment.

Veterinarians checked Yuanzai with X-rays and located the needle in her digestive tract. They took various measures to ensure sure that her esophagus was not hurt. A second check found that the needle had already reached the small intestine.

Due to giant pandas’ fast intestinal tract movement, the vets decided to wait for the needle to be excreted out of Yuanzai’s body, mixed in the bamboo residues six to eight hours after being taken, said Eric Tsao, a spokesperson of Taipai Zoo.

Good luck, Yuanzai

 

 

Needle with drop of bloodThe Health Safety and Wellbeing Partnership Group (HSWPG) have created several guidance documents for the NHS, using partnership working to create valuable guidance. The latest resource is new guidance on managing the risks of sharps injuries.

Each year thousands of NHS workers are subjected to sharps injuries and NHS Employers estimate that this involves around 40,000 individuals per year.

Whilst, UNISON, the Royal College of Nurses and European Bio-safety Network have each produced their own guidance on tackling sharps injuries, this HSWPG guide is the first to be produced in partnership with the agreement of both employers and unions. It is based around a series of case studies of NHS providers who have worked in collaboration with trade unions.

To coincide with the launch of this guidance, Robert Baughan, assistant national officer for the trade union UNISON and a member of the HSWPG, has written a blog about why managing sharps injuries is important.

Employers should use this guide to review their risk assessments, policies, and procedures. It explains, step by step, what employers need to do when:

  • identifying the hazards and assessing the risks
  • deciding on and implementing the appropriate preventive measures (including advice on hierarchy of controls)
  • measuring and reviewing performance to ensure risks are being managed and that their preventive plan is effective
  • ensuring all sharps injuries are reported by establishing the right policies and procedures.

 

More information and lots of useful information here, albeit about 3 years late!

 

Blenkharn Environmental, accident, clinical waste discussion forum, clinical waste, clinical waste disposal, danger, health and safety, infection, injury, needle, needle disposal, needlestick, safety, sharps disposal, sharps injury, syringe disposal

Aids and hepatitis B tests for boy, 4, pricked by needle on busNeedle with drop of blood

A mother is facing a “horrible” wait after her young child underwent tests for Aids and hepatitis B due to being pricked by a needle on a bus.

The four-year-old boy was being pricked by a hypodermic needle when he reached behind a seat.

He then showed his horrified mother the needle and his bleeding finger.

He is now undergoing checks for and diseases such as Aids.

The child has had to have hepatitis B injections and the mother has been told it will be months before he is given the all-clear for even more worrying infectious diseases, such as Aids.

The mum, who wishes her son to remain anonymous to protect him from bullying, was told by medics to go straight to Torbay Hospital’s emergency department after the incident took place on the number 77 bus in Newton Abbot.

This which runs between the Sherborne Road bus station and Drake Road on the Buckland estate on September 9.

She said: “He had treatments and underwent tests, but it will be months until we get the results.

“He isn’t back at school yet and the wait is horrible”.

Read more: http://www.northdevonjournal.co.uk/Aids-hepatitis-B-tests-boy-4-pricked-needle-bus/story-27855944-detail/story.html#ixzz3mljjUnkD

 

 

 

 

 

A toddler has been stabbed by a “dirty heroin needle” on a Dublin Bus.Needle with drop of blood

A young girl has been pricked by a heroin-filled needle on a bus in Dublin – in another sickening incident involving drug paraphernalia in the city.

Yesterday, little Alysha Zambra got on a Dublin Bus vehicle with her mother, Stacie, where she was jabbed by the needle – writes Conor Feehan for www.herald.ie.

Tony Duffin, of the Ana Liffey Drug Project centre, said discarded used needles posed a massive risk to the public.

She was brought to Crumlin Children’s Hospital and tested for HIV and other blood-borne diseases. Now her shocked family face an agonising wait to see if she has contracted anything.

“We always go and sit at the back. I go in the middle and the kids sit either side of me,” Stacie, from Crumlin, said.

“I just glanced out the window and then when I turned around Alysha’s finger was pumping with blood and I saw the needle on the floor,” she added.

Mr Duffin has long campaigned for medically-supervised injection centres so addicts can take drugs in a place safe for them and the public.

Read more at http://www.mirror.co.uk/news/world-news/toddler-stabbed-heroin-filled-needle-6504351

Needle with drop of bloodThe Health and Safety Executive are not presently blessed with a reputation for efficiency, cherry-picking a few targets and concentrating on what might be considered the low hanging fruit in order to maximise Fee for Intervention.

But taking a look through their prosecutions database does show a list, perhaps a complete list, of those healthcare providers being one care home and the remainder hospitals, who have received an Improvement Notice due to failure to comply with Safer Sharps legislation.

It is truly a Hall of Shame.

 

Uxbridge Lister Hospital Stevenage Dec 2011
Furness General Hospital Cumbria Nov 2013
Pinderfields General Hospital Wakefield Jan 2014
Worthing & Southlands Hospital Worthing Jan 2014
Akari Care Limited Wallsend Jul 2014
The Princess Royal Hospital Telford Dec 2014
Dewi Sant Hospital Pontypridd Jan 2015
Russells Hall Hospital Dudley Mar 2015
Hillingdon Hospital Uxbridge May 2015
John Radcliffe Hospital Oxford May 2015
Poole General Hospital Poole Jul 2015
North Middlesex Hospital  Edmonton Jul 2015

 

The list is all the more notable by the big names that have been caught, and the recent dates listed against each Notice which testifies to a tawdry attitude to the safety of staff and others.

Most breaches been been recorded as “Failure to ensure safer sharps are used where necessary so far as is reasonably practicable or Failure to provide employees working with safer sharps training” or some variant thereof.

The presence of these failures is appalling. Those who have suffered sharps injury while working while their employer was failing in its duties to sharps safety should see a solicitor without delay.

But what about others, including those in the waste sector and cleaning contractors, laundry workers etc?  Waste handlers are at constant risk of sharps injury for inadequately packaged and carelessly disposed sharps. When handling wastes from centres not meeting its obligations to safer sharps then the risk must be heightened.

And if only HSE would work to ensure there were no others who are failing to adhere to the obligations of the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013, AND accede to demands to introduce sharps injury to fall within RIDDOR, things might really improve.

Be very careful.

 

 

Bellamy -v- Nottingham City Council

Nottingham County Court, 19th December 2014

C was employed as a Public Realm Operative. As he was working on grounds maintenance at a primary School, he was picking up a pile of ‘brash’ and sustained a needle stick injury to his right hand. He was wearing gloves but the hypodermic needle hidden amongst the material that he picked up with his hands, which he did not see, penetrated the gloves.

The school’s grounds were open at night because there is was a public footpath and so the Council had to ensure that litter and needle sticks were removed every morning before the school opened.

We argued a breach of Regulations 4, 6 and 10 of the PPE regulations, that the gloves were not suitable, the risk assessment was not adequate and the employer had not ensured that the PPE was properly used.

D argued that they had put a safe system in place to deal with the risk and that employees had been instructed that needles were not to be picked up by hand

The judge followed  Threfall v Hull City Council [2011] PIQR P3 (CA) and held that there was no safe system of work which was adequately enforced.  There was no real evidence to suggest that it was disseminated to the workforce or enforced.  The gloves provided were not suitable.  There was no contributory negligence; C could not have reasonably been expected to have  known that he was doing anything wrong.

 

Baker -v- Birmingham City Council

Birmingham County Court,  26TH January 2015

C’s  was a test case, one of four linked cases all involving needlestick injuries for bin men working for Birmingham City Council. All sustained injuries from needles concealed in black bin bags when they went to pick them up. All were  wearing standard gloves with the lowest puncture resistance of 1 (out of 4) under BS EN388.  The issue was solely whether under the PPE Regs  D should have provided specific anti-needlestick gloves to their bin men.

The Defendant’s denied liability on the basis of practicability. They indicated that anti-needlestick gloves were invariably stiffer and less dextrous than standard gloves and led to increased risk of RSI. They indicated that bin men wouldn’t wear gloves that increased stiffness in any way. They relied on a staff survey they had carried out several years before the accident trying out various gloves on the job.

The survey covered some gloves with increased puncture resistance (up to 2 out of 4 on the EN388 scale) and there were adverse comments from bin men about even that slight increase rendering the gloves too stiff to wear. They also indicated that any gloves would need to be fully waterproof and that many anti-needlestick gloves are not.

Both sides had expert engineers. D’s essential points were that the anti-needlestick gloves were not suitable because they were generally too stiff and could cause RSI.  However, he was not able to point to a single published study linking over use of anti-needlestick gloves to RSI.

We relied on a consulting engineer, Steven Rawden, who tested over 20 gloves with 4 different types of needles. He concluded that the AN gloves provided significantly better protection. He also tried them all on and found that although there was a slight increase in stiffness it would not be a material increase that would cause injury. He recommended ways of achieving  waterproofness.

In giving judgment the judge approached the case as Smith LJ had in Threlfall , considering how Regulation 4 should be applied:

  • What is the risk?  A needlestick injury
  • Was PPE provided to combat risk?  – Yes, gloves with lowest puncture resistance.
  • Was it effective in preventing injury?  No  (and the evidence was that there had been 10 similar injuries that year)
  • Was it impractical to provide effective PPE?

Judge found for us on the final point 4 on two grounds:

The Defendant had the burden of proof on practicability but had not properly pleaded their defence. Although they had listed all the objections to our suggestion that AN gloves should have been provided they had not specifically stated in unequivocal terms that it wasn’t practical to provide alternative gloves. Very harshly the judge indicated that they could not therefore begin to mount a defence of the kind they had run.

However, he also went on to decide that even that had not been the case.

It was not impractical to provide the gloves in any event. Judge preferred the evidence of Mr Rawden over D’s expert on that issue.

Finally, on causation he accepted that AN gloves do not totally avoid the risk but it was sufficient that they significantly reduce it.

SI sites

These are important cases.

Too often, NHS and contract cleaning companies whose staff are engaged in waste management on healthcare premises, waste disposal contractor whose staff are engaged in the collection and treatment of those wastes, and of local authority cleansing staff and other cleaners engaged elsewhere, are poorly provided with suitable equipment and appropriate PPE.

Sharps safety gloves are expensive and waste handlers have complained to me on many occasions that their employers are reluctant to issue replacements too quickly solely on the basis of excess cost.

Elsewhere, employees handling wastes in hospital premises and those engaged in litter picking or drug litter and needle retrieval in the community might be offered a pair of builder’s-type reinforced gloves that are not really suitable, a pair of Marigolds, or disposable nitrile gloves.  That is not acceptable.

In the only study of its kind, we found 40 sharps injuries suffered by waste handlers at a single treatment facility. Though the most common site for injury was the hands – where were the gloves? – sharps injury to legs also featured prominently.

Do your staff have good quality sharps protection gloves, preferably gauntlets, and trousers with ballistic panels?  Have they been properly trained?  Is that training assessed and periodically reinforced?  Are they properly supervised?

If you now answer no to any of these questions, you may have insurmountable and costly problems defending a case brought under PPE regulations.

There is no scope in blaming the waste producer who was responsible for placing that uncapped needle in the thin-walled waste sack that injured your employee. You know this happens and segregation errors are not uncommon. Failing to manage that will be costly.

 

 

 

Some time ago, University College Hospital London initiated a scheme whereby early discharge of patients saw them transferred to a nearby hotel to facilitate on-going care.

It’s a sensible cost-saving measure that is used elsewhere in the UK. It is particularly common in the US where bed costs for hospitalisation can be astronomical and it is there that the medical insurance companies had first developed this approach.

But there are problems. It is reported from the US that at the Wyndham hotel, close by Massachusetts General Hospital and where many patients are transferred for continuing care, are finding worrying large amounts of clinical wastes in guest/patient bedrooms.

Detail of exactly what is found are limited, though the report say they’re being exposed to used syringes, blood, vomit and other bodily fluids while cleaning rooms.  That is of concern, and it would be interesting to know if this is noted more frequently in rooms of ex-hospital guests/patients than in others. Read the rest of this entry »

Thinking about the impact of sharps injury?  Concerned about sharps safety? Learning of the psychological trauma that goes hand-in-hand with sharps injury?

Read this!

“While providing clinical care in the confirmed ward of the Ebola Treatment Unit (ETU) at the Kenema Government Hospital (KGH) in Kenema, Sierra Leone, I accidentally stuck an 18-gauge hollow-bore needle deep into my left thumb. I could immediately feel some blood oozing under my gloves, and I squeezed the area of penetration to try to promote additional bleeding. I rinsed the outside of my gloves with the only available option—0.5% bleach. In an ETU, one cannot simply remove one’s gloves and clean one’s hands with soap and water as one would with a needle stick in other clinical environments. After the momentary shock and embarrassment subsided, I notified my clinical partner about what transpired and then called by radio to have an urgent egress from the ETU.”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347316/pdf/tropmed-92-225.pdf

 

 

 

Sharps injury or needlestick is a constant fear, with the focus being on the possible transmission of HIV or of Hepatitis B or C, and the associated psychological trauma that goes along with the fear of infection.

But there is more than just HIV and Hep B/C to fear, as we have noted previously on the Clinical Waste Discussion Forum.

In the laboratory, handling of a wide variety of pathogenic virus, fungi, bacteria, and others, the unavoidable use of sharps in the laboratory can result in a wide range of sometimes exotic infections.

The US CDC has reported a rare vaccinia virus infection following needlestick injury to a vaccinated lab worker.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6416a2.htm

 

 

tablets and capsulesOn the Clinical Waste Discussion Forum we have for some years now been pushing for community-wide hazardous waste take-back arrangements, organised perhaps by local authorities who might make available better if temporary community collection points for drop-offs and collections.

It happens in America, where the local police and fire departments arrange community drop-off or collections every 6 to 12 months. This gives residents the change to get VOC-rich DIY chemicals and paints out of the shed, unused prescription and non-prescription drugs from the bathroom cabinet for more appropriate disposal.

For drug waste, the collection prevents well-intentioned disposal to a black sack or worse, down the toilet, of accumulation in the home to create a risk of accidental poisoning.

Does it work?  Well, yes, it does, and a search of the Forum will identify many examples.  One latest report catches the eye, when Sheriffs collect more than 11 tons of drugs during state-wide ‘take-back’.

Read the rest of this entry »

South Tyneside council is to scrap domiciliary clinical waste collections.

Announced on their website, the move is no doubt predicated on concerns regarding cost.

As an alternative, households producing sharps wastes are advised to “contact the District Nurse or other healthcare professional who will be able to advise on their correct disposal”.

“Any other medical waste such as dressings, bandages nappies etc. may be placed in your normal refuse bin, but please bag securely beforehand”.

This move will undoubtedly save money, and that is no bad thing. But I wonder what might be the cost of incorrectly disposed wastes, spilling from black bags or slipped into household recyclables that cause health and safety concerns and/or bring picking lines at the recycling hall to a standstill as a sharps bin bobs along the conveyor?

Time will tell if this change in approach will really save money, when viewed as a bigger picture, or just push costs from one budget holder to another?  And in the middle of this there is firstly, that patient who must struggle that little bit harder to manage their wastes – not a problem for many but a likely challenge for the housebound and chronically ill. Can social services – also funded by the local authority – cope with this additional burden?

Secondly, I foresee problems for waste handlers and others working for the local authority refuse services who no longer have the protection of a clear colour-coded warning of the possible hazards associated with these wastes.  The line of reasoning may follow the naïve ideas of the Environment Agency who in its earlier guidance could not foresee ‘any risk of infection associated with clinical wastes from an orthopaedic ward as these patients have a generally low incidence of infection’, ignoring of course the inevitability that individuals with Hepatitis B or C or HIV infection break bones too.  Astounding incompetence from their technical adviser and others who draft this nonsense, that was  quietly withdrawn and redrafted after this was drawn to their attention.

Time will indeed tell if this policy change by South Tyneside will work safely, since that must be the key determinant.  Other local authorities may well follow suit, while the Environment Agency sit quietly and do nothing at this possible risk and potential ‘violation’ of their guidance.

Let us hope there are no serious accidents.

 

 

 

A 16-year-old girl is anxiously awaiting blood test results after sitting on a needle on a bus.

She was on the top deck of the number 24 Brighton and Hove Bus Company vehicle when she was pricked by the needle.

The worried student, from Brighton, East Sussex spent the next four hours in hospital where she was given a hepatitis jab and had blood tests.

Speaking about the incident, she said: ‘My friend and I had got on the bus to go home and we were sat on the top.

‘I suddenly had this shooting pain in the back of my leg. I reached down and pulled out a needle that had snapped in half.

‘Then I looked down the side of the bus seat and there were packets and a syringe on the floor and the rest of the needle.’

 

 

http://www.dailymail.co.uk/news/article-3015915/Teenage-girl-rushed-hospital-HIV-hepatitis-tests-sat-NEEDLE-bus.html

 

 

 

East Kent Hospitals University NHS Foundation Trust has informed staff of no less than 40 incidents in the last 3 months when clinical waste was being sent to the laundry, some in clinical waste bags only but mostly in linen bags.

The Trust notes that “this is clearly not trust policy and poses significant health and safety risks to staff involved with laundry processing.

“It is difficult to pin down the wards and departments where this is happening as laundry is not traced beyond the hospital site.

These things happen, when policy is not sufficient and training inadequate. We do not know why it took 40 incidents before action was taken, but at least informing staff to raise awareness if a good first step. However, a robust root and branch review of clinical and other waste management processes and procedures seems overdue.

http://www.trustnewsonline.org/notices/2015/03/clinical-waste-being-put-in-laundry-bags/

 

 

Viridor brings cyclist safety to London waste fleet

The company has fitted its London-based waste collection vehicles with sideguards and sensors, to help prevent collisions on the road with cyclists.

Viridor has fitted a number of cyclist safety features on the inside and outside of its London waste vehiclesOver 50 rigid vehicles from the Canning Town and Iver South depots have been fitted with a range of measures aimed at minimising potential hazards to road users.

These include side guard bars to protect cyclists from becoming trapped in the space underneath the vehicle, and side scanners that alert drivers to any road users that may be present alongside them.

The ‘ultra-sonic’ scanners issue a bleeping noise inside the cab, helping collection crews ascertain if any cyclists are in the blind spot of one of the six mirrors installed in the vehicles.

External warning devices have also been installed on the vehicles to warn of a planned left hand turn. When the driver activates the left hand turn signal, a verbal warning announcement is repeatedly broadcast outside of the cab to alert cyclists of their intentions.

The investment has cost over £1,000 per vehicle across the Viridor fleet. It follows the past installation of safety features including side-view cameras, cycle safety vision windows and awareness stickers.

Viridor is also trialling 360 degree cameras on two of its vehicles to assess whether this leads to a significant reduction in potential incidents.

more

 

By no means exclusive to our central theme of clinical waste management and safety, but nobody can have missed the news of many cyclist deaths crushed under the wheels of trucks, especially in London

Well done Viridor, for making a valuable contribution to cycle safety.

Are your fleet vehicles cycle-safe?

 

 

 

 

 

 

 

 

A single mum whose daughter pricked her finger on a blood-stained needle discarded on a bus has spoken of the two month ordeal her family endured before finally getting the all clear.

Terri Hessing’s four-year-old daughter Jessica found the used needle down the side of a seat while travelling on an Arriva SB2 bus in January from Stevenage town centre to her home in Exeter Close.

Terri rushed Jessica to her GP who then referred her to Lister Hospital where she had a blood test four weeks later.

The results checking whether Jessica may have picked up some sort of infection from the needle took more than a month to come back.

“The worrying was awful,” she said. “Not knowing was the real issue. The doctors were satisfied she was low risk but that wasn’t much comfort to me. The stress was complete torture.”

During the tests it was established that the needle was probably use for insulin, which is vital for diabetics to help them regulate the glucose levels in their blood.

But as it was smeared with blood doctors believed it may have been used by a drug addict because they tend to draw blood when they inject.

Terri has three other children and said in addition to the mental strain it has put her family under their finances have had to cope as well.

more

 

Not wishing to pour misery on the family’s predicament, I am a little disturbed by the new report that specifies only a 2 month waiting period for an all clear, that realistically might extend for up to 6 months.

Fingers crossed

 

 

Needle with drop of bloodDublin City Council paid out some €8.32 million last year in staff and public injury claims.

According to figures released to Councillor Jim O’Callaghan, a total of €11 million has been paid out by the council on compensation claims since 2012, with the bulk of it spent last year.

Most of the money last year was spent paying compensation for claims from the public, with €7.7 million in settlements being paid. The main types of injuries were broken limbs, facial injuries and shoulder and back injuries.

Most of the claims were for broken limbs, facial injuries and shoulder and back injuries. However, the figures also showed an increase in injuries from syringe needles.

32 syringes a day are picked up from Dublin’s streets between the council and a number of groups.

The high numbers of needlestick injuries are of particular concern and bring focus on the provision of personal protection equipment and appropriate training for staff.

http://www.thejournal.ie/state-claims-agency-payouts-hse-1370954-Mar2014/

https://uk.news.yahoo.com/council-pays-thousands-compensation-staff-needle-stick-injuries-101951209.html#8vVRMmw

 

 

8-year-old stuck by hypodermic needle found on school playground

Needle with drop of bloodEthan Gurr likes to collect “treasures,” according to his mom, but the 8-year-old’s latest find has doctors testing Ethan’s blood to make sure he hasn’t been exposed to HIV, hepatitis and other blood-borne diseases.

“I don’t want to say this to be mean, but he’s kind of a packrat,” Katrina Gurr said. “He finds something, discovers it, and he’s got maybe a box or a bag and he’s got his little treasures in there.”

Typically, it’s “cool rocks and things like that,” she added.

“It’s not uncommon to get surprises in the washer,” Ethan’s dad, Mike Gurr, said.

Ethan was walking around the perimeter of the playground Tuesday at East Elementary School when he found something unusual for his collection — a hypodermic needle. The second-grader said he stashed his discovery in his lunchbox for safekeeping.

When Ethan reached into his lunchbox a short time later, the needle poked his finger.

“Then I looked at my finger and it was on my finger,” he said Thursday.

Ethan’s younger sister told their mom after school that Ethan had the needle, Katrina Gurr said, and her son initially tried to get rid of it. She retrieved the needle, though, and began to press her son for information.

“I said, ‘Honey, it’s important that you tell me if you have been poked,'” Katrina Gurr said.

Ethan eventually showed his mom the spot where the needle had pricked his finger, and she took him to the hospital for blood tests. She also contacted the school with her concerns.

“If it is a drug needle, why is it there at the school?” Katrina Gurr said, noting that there appeared to be dried blood around the base of the needle.

Custodians are now required to walk the grounds at East Elementary to check for needles and other hazards, according to Dean Wilson, director of student services for the Duchesne County School District. The practice will soon be in place district-wide, he said.

“We have a secondary and elementary principals training (where) we will go over this as a district, not just leave it to the one school,” Wilson said.

District administrators have asked Roosevelt police to increase patrols around East Elementary, and an assembly will be held Friday to talk to students about safety, Wilson said.

“We’re going to do the best we can to keep our kids safe,” he said.

The Gurrs hope the district’s policy changes — and their decision to share Ethan’s story — will prevent other children from coming into contact with used needles at school and in other public places.

“As safe as you think your children are in a small-town school or anywhere, it’s possible they are being exposed to more than you know,” Katrina Gurr said.

The first round of test results show that Ethan is OK, but doctors won’t know if he is truly in the clear until another round of blood test are run in six months.

“You try not to think about it,” Mike Gurr said, referring to the possibility that his son may have accidentally become infected with a lethal disease, “but it’s hard not to.”

Good luck Ethan

 

http://www.ubmedia.biz/ubstandard/news/article_a36ef7ca-b62a-11e4-8468-f39de7871acd.html?mode=story

 

 

 

Needle with drop of bloodThe number of young men in London injecting steroids is rising on a “regular basis” a drugs charity has warned.

South Westminster Drug and Alcohol Service said an increasing number of young male clients were seeking support for anabolic steroid use. A similar trend is likely in other UK towns and cities.

Home Office figures show 60,000 people used steroids in the UK in 2014

The National Institute for Health and Care Excellence said it was the “tip of the iceberg” and advised gyms to supply sharps bins for needles.

Roy Jones, from the South Westminster service, said: “Our numbers are increasing on a regular basis.

“I’ve been working with steroid users for 16 years and when I first started, the guys taking them were body builders in their 30s.

Easygym have installed sharps bins in all their gyms, while Fitness First, Virgin Active and David Lloyd said some of their clubs also have them.

All the gyms said they had a zero tolerance approach to steroids and the bins were a health and safety measure for diabetic members and the disposal of razors.

We on the Clinical Waste Discussion Forum have been raising awareness of this problem for some considerable time now. Read the rest of this entry »

Needle with drop of bloodPublic Health England says yet another healthcare worker who may have had contact with the Ebola virus in Sierra Leone has been transferred to the Royal Free Hospital in London after returning to the UK.

Public Health England (PHE) said the worker, who may have had contact with the deadly virus in Sierra Leone, does not currently have any symptoms.

After arriving back in the UK on Wednesday, the worker was transferred to the Royal Free Hospital in London for assessment and they will continue to be monitored for signs of the disease.

Professor Paul Cosford, PHE’s director for health protection, said: “The overall risk to the general public from Ebola remains very low.

“We are confident all appropriate public health actions have been, and will continue to be, taken to support this individual and to protect the public’s health.

http://www.telegraph.co.uk/news/worldnews/ebola/11434966/British-health-worker-monitored-for-Ebola-after-Sierra-Leone-needle-stick-injury.html

Of course, we keep our fingers tightly crossed that all will be well for this individual.

More so, we continue to hope that these UK healthcare workers Ebola sharps incidents and similar events affecting workers from other countries stimulate much more the multifaceted work toward the prevention of sharps injuries in other healthcare situations.

We can only hope.

 

 

A dozen NHS Grampian workers have successfully sued their employers after being injured by needles at work.

Staff faced months not knowing whether they had been hit with infections such as HIV and Hepatitis C following their injury.

NHS Grampian confirmed that payments were paid to the 12 staff after legal claims were lodged on grounds of stress suffered during the “agonising” wait.

While all of the workers received the all-clear following testing, undisclosed sums were agreed given their ordeal.

Exclusive figures show needlestick injuries were one of the most common personal injury claims made against the health board by staff over the last three years.

Litigation expert Julie Clark-Spence, a partner at Balfour and Manson in Aberdeen, said clients often faced months of uncertainty following such injuries.

She said: “We act for a number of individuals who have suffered needle stick injuries.

“Clients are often faced with an agonising wait for test results following injury because of potential exposure to blood-borne viruses. Many are under a great deal of stress and anxiety whilst tests are being carried out.

“Clients are subject to regular blood tests and immunisation which can take many months to conclude.”

Martin McKay, health spokesman at Unison in Aberdeen, said much work had been done to reduce the number of needlestick injuries.

However, he added that staffing shortages at the board may have contributed to the claims.

He said: “There have been vast improvements made in the past decade to reduce these injuries but incidents still occur.

“We believe the protocols put in place have vastly improved the safety of staff.”

“We have had a difficult few years at NHS Grampian and there have been well documented staffing and recruitment issues.

“Sometimes these issues may be factors in some cases.”

Strict rules govern the safe disposal of needles but the kit can become misplaced, with cleaners and laundry workers amongst those at risk.

A spokesman for the board said, if a needled had already been used on a patient, the patient would be traced and blood tests carried out on them.

The injured worker would then be offered appropriate immunisations with their blood stored for future testing, depending on the outcome of the patient’s screening.

The spokeswoman added: “We take the safety of our staff very seriously. Staff are encouraged to report all incidents and we use this information to improve safety all the time.

“We are by no means complacent and we continue to study accident reports in order to learn lessons.”

https://www.pressandjournal.co.uk/fp/news/aberdeen/501354/12-staff-sue-nhs-grampian-stress-injured-used-needles/

 

The mandatory introduction of engineered sharps safety devices was intended to reduce the rate of sharps injury.

Indeed, that has occurred but as we predicted several years ago safety sharps introduction has introduced a degree of complacency among users, particularly at the point of disposal. Data are not available to ascertain whether or not this has resulted in a consequential increase in the number of sharps injuries among ancillary staff and waste handlers. However, that increase does seem quite likely.

There are many situations during blood taking and injections where sharps injury might occur despite safety engineered devices. When a patient jumps or recoils suddenly, with agitated patients, and perhaps just being unlucky can lead to a sharps injury despite good practice.

There is evidence that a few trusts have reduced sharps training for some groups of staff presumably due to time and cost constraints, maybe through the arrogance of senior staff who will not attend training sessions, and in the expectation that safety devices have reduced the need. There may be issues also with the quality of this training, that properly focusses as much on disposal as use of sharps, this being an aspect of least concern for busy healthcare staff.

There remains an issue of staff being unfamiliar with a different type of safety sharps device when moving between employers resulting in a transient increase in sharps injury rate.

Even worse, some trusts are reported still to implement safety sharps use, apparently for reasons of costs.

Despite pressure for safety sharps starting among users, healthcare professionals and their professional bodies and later by the learned bodies and trades union groups, and through specific legislation, universal protection has not been achieved. The impetus is beginning to wane, perhaps only slightly, but that downward trend does not help.

Mandatory reporting of sharps injury incidents and near misses under RIDDOR has not been accepted by HSE, presumably because it would simply be too much work. Thus, HSE sits on its hands and the UK sharps injury legislation remains more or less on the shelf.

Perhaps the reality of costly legal action, or simply the threat of legal action, will reinvigorate sharps injury prevention among healthcare professionals, ancillary staff and waste handlers, and all of those others who might come into contact with sharps. We can but hope.

 

see also Sharps in the Clinical Waste Discussion Forum

 

 

The information given by suppliers, in their catalogues or on-line, can guide users or lead them far up the garden path.

So it is with this medical equipment and supplies provider advertising orange, located on the web today, Saturday 21 February 2015.

MedSecure

 

The small print associated with this offering assures the purchaser that the sack is:

  • Unique colour indicates that contents can be recycled, autoclaved or sent to landfill
  • Clearly printed with UN markings to signify clinical waste
  • Available in medium and heavy duty gauges and in a number of sizes
  • Supplied on rolls for convenient dispensing
  • Ideal for use with clinical waste bins MSC0270, MSC0271 and MSC0272.
  • Ideal for use in a first aid rooms – helps comply with HSE guidance document L74

 

Of course, if one of these filled sacks appeared at a recycling facility or a landfill site alarm bells would ring, klaxons sound, and lights flash as everything grinds to a standstill for clean-up and investigation. Someone, somewhere, would be for the high jump.

Going further, the supplier claims that it’s use would be ideal for use in a first aid room, where a Tiger bag could be more appropriate, and to help comply with the HSE guidance document L74.

L47 First Aid at Work. The Health and Safety (First Aid) Regulations 1981: Guidance on Regulations 2013. ISBM 9780717665600 is an important document though in the case of a recommendation for orange waste sacks, it is a yellow sack specified in L74. Perhaps both suggestions are incorrect, certainly for the average first aid room dealing with otherwise healthy adults and children with sprains, cuts and grazes etc.  As we know, it is essentially a risk assessment that is necessary, with in most cases will conclude that a Tiger stripe bag is most often the appropriate choice.

Oh dear. Oh dear. Oh dear!

 

 

 

Needle with drop of bloodThere are now two British healthcare team members repatriated from Sierra Leone having suffered sharps or needlestick incidents while caring for patients in the Ebola outbreak there.

Above all, we wish those individuals well and hope that after a necessary period of observation they remain in good health.

It is an expectation that in each of the affected areas engineered sharps safety devices are in use. These can protect during disposal and, in some cases, during needle use. However, most do not protect the user during blood taking. Excellent technique is essential to prevent injury, but if a patient moves unexpectedly there is little that can really be done to stay safe.

There is one additional hope, that these cases raise still further the profile of sharps safety programs and sharps injury prevention to users and those involved in the collection and disposal of sharps waste. There are still far too many avoidable sharps injuries occurring to healthcare professionals and to that forgotten army of litter pickers and waste handlers, to emergency service staff, police and prison officers, and many others.

Let us hope that, long after these two individuals have been discharged from hospital, in good health, the circumstances of the cases are written up for more detailed review by the scientific community. That may assist in future prevention strategies, in the immediate period for the protection of those still working under such difficult and high risk circumstances in West Africa, and in the longer term by giving a boost to sharps injury prevention overall.

 

 

 

 

Needle with drop of bloodParents sue hospital over illness 7-year-old allegedly contracted from needlestick

GRETNA, Louisiana – The parents of a 7-year-old who allegedly contracted an auto-immune disorder after being stuck by a contaminated needle while in the care of a local hospital and healthcare providers are suing.

Joseph A. Vizzini and Jessica Vizzini, individually and on behalf of their minor child, filed suit against Ochsner Clinic Foundation, Lisa De Fusco MD, Michael Saucier MD and an unknown lab technician in the 24th Judicial District Court on Oct. 9.

The Vizzinis claim that their child was a patient at the Rothchild Ochsner Pediatric Clinic on Oct. 11, 2011 when an unknown lab technician accidentally stuck herself with a needle and proceeded to use the same needle – that was then contaminated – to draw blood from their child. The plaintiffs allege that following the incident their child has developed several serious health conditions, including Reynaud’s Disease, arthritis, ethromalalgia vascular disease, autoimmune disorder and migraines, they attribute his exposure to the lab technicians blood via the contaminated needle. The Vizzinis contend that treating physicians have been unable to provide an explanation for their child’s medical problems.

The defendant is accused of medical malpractice.

An unspecified amount in damages is sought by the plaintiff.

http://louisianarecord.com/news/265496-parents-sue-hospital-over-illness-7-year-old-allegedly-contracted-from-needle-stick

 

We consider the risks of any sharps injury are of Hepatitis C, Hepatitis B and/or HIV infection. In reality, there are many more bacterial and viral infections documented to have been transmitted by sharps injury, and one or to “funnies” including protozoal infection though these latter tend to occur only in laboratory settings.

In this case, however, the advocates seem to propose the most remarkable array of consequences in conjunction with a possible sharps injury event.

 

 

 

Recycling and waste management business Veolia is investing £1 million in cyclist safety equipment for its fleet of refuse vehicles.

Some good news for a change, especially for cyclists.

The TurnAlarm system, from Vision Techniques, will be fitted to all refuse vehicles, in a bid to improve cyclist safety. Veolia is also specifying the system for all new vehicles over 3.5 tonnes.

TurnAlarm delivers an audible and visual warning to approaching cyclists, with high-intensity LEDs flashing from the side of the vehicle and an audible warning that the ‘vehicle is turning’.

Veolia’s system also includes a module to measure speed, preventing the alarm from activating if the vehicle is travelling at more than 10mph. Blind spot signs will also be displayed on the rear and near side of each vehicle.

The company is also rolling out cyclist awareness training for its drivers, which will be completed by September 2015.

See more at: http://www.transportengineer.org.uk/transport-engineer-news/veolia-invests-1m-in-cyclist-safety-equipment-for-refuse-fleet/65902/

 

Well done, Veolia. Others please follow.