Incinerator_JPG-pwrt2Two workers suffered breathing problems after an explosion at Royal Bolton Hospital’s clinical waste incinerator.

Firefighters were called to the hospital at 9.40pm on Tuesday 14 October and they said the force of the blast was so strong they heard it from Farnworth fire station – a mile-and-a-half away in Albert Road.

A large amount of smoke poured out of the incinerator after the incident, but both the company that operates it and the fire service say it is non-toxic.

The two staff who monitor the facility suffered from breathing the smoke, but did not need treatment.

Crew commander Mark Outhwaite said: “It all came down to sheer luck in that they were standing in one place.

“Had they been any nearer to the incinerator, it could have been a different story.”

Crew commander Outhwaite added: “There was debris from the incinerator everywhere and the two men were covered in it.

“They keep a wheelbarrow beneath it to collect soot and it was crushed by the force of the explosion.

“Had the workers been near it, we would be dealing with fatalities.”

After the incident, the incinerator was shut down and a safety procedure was activated, hospital bosses said. An investigation has now been launched.

The incinerator takes 36 hours to cool down and it would be hard to begin the probe until then.

“The workers said that they do see some small bangs sometimes, perhaps from asthma inhalers, but they have never seen anything that loud before,” said crew commander Outhwaite. He added: “Our role was to check the pipework had not been affected and make sure the area was safe.”

The incinerator turns hospital waste into steam which heats parts of the hospital. Heather Edwards, the hospital’s head of communications, said: “A large bang from the incinerator was heard across the site and the incinerator was put into emergency shutdown.

“A large amount of black smoke came from the chimney as a result, but both the operators of the incinerator, SRCL, and the fire brigade who attended, deemed this was not toxic. “No-one was hurt and SRCL will now be reviewing the situation.”

 

http://www.theboltonnews.co.uk/news/11535629.Explosion_in_incinerator_at_hospital/

 

How secure are your sharps containers? Whether they are in a hospital clinic room or ward, a laboratory, GP surgery or in a public washroom or drug hotspot, sharps containers must be secure.

Containers must be securely assembled. When not in use, the closure should be engaged, though personally I am not entirely happy with the idea of the cover being opened and closed every 5 minutes since with some containers this brings fingers dangerously close to the content within.

The container itself must be located away from the floor where inquisitive children might roam. The evidence for this lies in the number of cases when an unsupervised child has gleefully placed their hand into the mouth of a sharps container as if pulling a prize from a lucky dip barrel.

So it is of concern that in London, Ontario, changes are being sought when it comes to the placement of the city’s needle collection bins after a child was able to grab a used syringe.

Diane Pozeg says the incident happened on July 29th while her son was in the public washroom at the Forks of the Thames while he was with a day camp.

Sharps containers are used to safely collect and store used syringes with needles attached, needles, razor blades, broken glass that has come into contact with blood or other bodily fluids and lancets. The London CAReS program, funded through the City of London, helps to clean and empty the bins and some City of London operations staff also tend to the containers.

She says the young boy was changing in order to play in the splash pad and managed to get his hand into the bin and pull out a syringe.

Pozeg says her son was able to get the needle all the way home where she found it as she was about to tuck him into bed.

“As I was prepping his bed, just fluffing up the sheets, I found a syringe and luckily it still had a cap on it,” Pozeg says. “He had kind of snuck it in there trying to hide it.”

“It just popped out and it just floored me finding it.”

http://www.am980.ca/2014/09/04/26667/

 

Every sharps container must be properly assembled, and securely located in a location where it cannot tip or fall, and where prying hands cannot reach inside. This extends to waste security of filled and sealed containers awaiting collection for disposal, which are still an occasional target for addicts, and beyond as the containers are processed by the disposal sector operators.

 

 

WyboneAt best, hospitals are rather soulless places. With stark design, neutral – or is that bland? – colour schemes, and limited furnishings further justified now to aid infection prevention, even a few brief days in hospital can be soul destroying for adults.

For children, this is ever more so and must surely contribute to, in some cases, a significant additional psychological burden adding to that caused by separation from Mum, Dad and friends, and the distress of all those horrible smells, sights and sounds, the medicines and other treatments.

Improved visiting arrangements for children’s wards may matters a little easier, and in the newer build hospitals designers and planners have recognised the need for a more friendly environment and do brighten up the environment. Regrettably, others seem to rely solely upon the same tired adhesive prints of Disney carton characters stuck to walls and doors. It may distract a 3 year old, at least for a few minutes, but older children derive no comfort from this.

And then, whatever the approach to environment design and furnishings, it becomes necessary to plonk one or more healthcare waste sack holders in that environment. Can there appearance be improved?

Wybone have a solution to this with their zoo animal bin stickers. Nice idea, assuming that the stickers are sufficiently robust to survive daily cleaning without deterioration and peeling at the corners.

The stickers look attractive, and would work equally well on any existing sack holders without the additional cost of buying an entire set of new bins. Its a clever idea, and do note that the main image colour reflects the sack designation of green, orange, yellow or black in order not to detract from the visual prompt for source segregation. Continue reading “New designs for hospital waste bins” »

An NHS Trust has agreed to pay £75k to a nurse whose marriage broke down after she developed OCD when she was pricked by needle at work.

The trainee nurse has been awarded over £75,000 compensation after a prick on her finger at work transformed her into a cleaning obsessive. Alcinda Tobbal could not kiss or make love to her husband for fear of ‘contamination’ after being jabbed with a dirty needle whilst working as a nurse assistant at Whipps Cross Hospital in east London
The 45-year-old developed a ‘severe’ obsessive compulsive disorder focused on cleanliness after the incident in February 2008, a court heard.

She was dismissed from her job due to the effects of the extreme OCD condition, which saw her wearing gloves even in baking hot weather and scrubbing her children’s shoes with bleach whenever they had been outside.

But the most damaging aspect of her condition was that she became incapable of having intimate relations with, or even kissing, her bus driver husband, leading to the disintegration of their marriage, after he dubbed her ‘mental’. Continue reading “NHS pays £75k to nurse who developed OCD after sharps injury” »

KFC Restaurant in Brighton leaves sharps bin on toilet floorIt is, to many of us, quite straightforward. Use a sharps bin and ensure that this is securely located away from curious little hands, in a place from where it will not get knocked or tipped etc.

So now we have sharps bins in many additional locations, in public toilets, some gardens and church yards, back alleys and other drug hot spots, gyms, and now in the local KFC restaurant!

No wonder that a young mum was shocked when her daughter went to the toilet while enjoying her finger lickin’ chicken, to find a sharps bin on the floor of this Brighton KFC restaurant! Ironically having an orange lid, yet inevitably to be used by IV drug  users thus to collect syringes having, in the eyes of the Environment Agency, an environmentally harmful drug residue even if empty – though I can’t imagine a user wasting a single drop.

Credit to KFC for addressing a real and very serious problem in such a positive way. However, while that sharps bin sits on the floor it is a temptation to youngsters and others, keen to use it as a general refuse bin or curious to root inside to see what they might find. And all they will get is a sharps injury.

Just go a few steps further please. A properly wall mounted secure sharps bin would be far more appropriate, inherently safer, and less obvious to those who just want their picture in the local paper.

 

 

 

 

“A 2-year-old girl became the second child reported to be stuck by a “dirty needle” in Rolla, Missouri in the last seven weeks.

“According to the Rolla Police Department’s daily media log, an entry for Sunday, April 6, stated that the girl was “stuck in her left palm with a ‘dirty needle’ while playing in her front yard” in the 900 block of Fourth Street.

“According to Rolla police, a 12-year-old boy was stuck in the arm by a “dirty needle” after he and another 12-year-old boy started playing with several used hypodermic syringes they found Feb. 21 in the 1000 block of Laguille Court near Mark Twain Elementary School.

“A post from Sunday on the police department’s Facebook page states that “drug users (who also carry communicable diseases) would rather throw their used contaminated needles in conspicuous places so they don’t get busted by the police for being in ‘possession of drug paraphernalia.’ The problem is when we have heavy rains like we had a few days ago those needles float out of those places and into places where children can find them.

Read more: http://www.therolladailynews.com/article/20140407/News/140408881#ixzz2yHy9yJbm

See also 2-year old stuck by discarded needle

 

 

A Strabane schoolgirl has had an apparently lucky escape after falling onto a discarded syringe needle while walking home from school.

The horrifying incident happened close to the town’s St Mary’s Primary School. The 12-year-old was on her way home from an after-school club when she tripped and fell. She landed on the needle, cutting her hand.

Her anguished mother took her to Altnagelvin hospital on Friday where tests were carried out. They have since come back clear. Examinations of the needle have also indicated that it was clean and had not been previously used.

See more at: http://ulsterherald.com/2014/04/07/schoolgirl-falls-on-discarded-needle/#sthash.ugU19FYV.dpuf

Sadly, that’s not quite the end of it, since there remains a 6-9 month period during which the risk, however small, may continue. The girl may leave A&E with just a plaster covering a cut or puncture site but the risk of infection, and the even greater risk of post-traumatic anxiety focussed upon the risk of infection, cannot so easily be dismissed.

Let’s hope the girl and her family, who can be similarly and perhaps more severely affected, will by OK.

 

 

 

A 2-year old girl was ‘jabbed’ in the palm of her hand – penetrating her skin – after picking the needle up from the floor of a toilet at the MacDonald’s restaurant in the Castlemilk district of Glasgow.

Mum reported that the little girl had picked the needle up from the floor of a toilet in the restaurant, and was later assessed at Glasgow Victoria Infirmary.

I wonder how this incident will impact on the overall mapping of sharps finds across Scottish cities, and if that system pas finds on private land and in domestic or commercial premises. Probably not.

see Thousands of syringes on Scotland’s streets

 

 

 

Dozens of dirty needles were discovered by a dog walker on a riverbank, prompting fears for the safety of passers-by.

Andree Wood, a nurse from Grangetown in Cardiff, takes her three-year-old pooch Lilly for a walk under Penarth bridge at Taff Embankment twice a day – but said she has never seen so many needles discarded on the footpath.

“I am very much concerned that anyone could stand on one of the needles as it’s such a popular spot for dog walkers and people who go fishing.

Mum-of-three Andree said she has come across a couple of needles under the bridge about every six months since she started walking Lilly. “I have never seen this amount of needles before,” she said. “It’s awful.”

A South Wales Police spokesman said the needles have now been cleared from under the bridge.

It is just rather strange that, as shown in the picture from Wales Today, so many needles and their outer wrappers were discarded in one spot. Presumably, they were dumped from a bag or box.

 

 

 

A boy has stepped onto a needle on Lyme’s main beach.

The five-year-old boy was playing football on the main sandy beach when he stepped on the needle, assumed to be unwrapped, at about 2.30pm, 2.5 metres from the boundary wall near Jane’s Cafe.

The boy, visiting from Somerset, was immediately taken to Dorset County Hospital in Dorchester. He is now receiving a 12-month course of anti-Hepatitis B medication and will have HIV blood tests in six months.

http://www.viewfrompublishing.co.uk/news_view/31514/8/1/lyme-regis-boy-steps-on-needle-on-lyme%E2%80%99s

At five years old, the boy will have been aware of his parents’ anxiety and distress, and will have had the additional stress of a visit to hospital, blood tests and inoculations etc. By now he is probably over that, though there is more to come. But for his mum and dad, and for the extended family, the anguish will continue.

 

 

 

A worried mother faces months of uncertainty after her son stepped on a used syringe at a South Mackay playground.

The seven-year-old boy underwent the first of a long series of tests at Mackay Base Hospital on Saturday.

He would have to have more tests in three months and again six months after that before being cleared of any infection, the mother of five said.

“I’m staying positive, but I’m prepared for the worst,” she said. “I just want him not to worry about it.”

 

Mum is now campaigning by distributing flyers to neighbours warning of needle dangers an advising on safe disposal. As she says, “having a diabetic child I know how to dispose of needles, it’s easy“.

Mackay is a small coastal city in Queensland, Australia, looking out to the Coral Sea. Regrettably, it is not free from IV drug abuse, and this is the consequence.

Though it is reported that people congregate in the unlit park after dark, police and other direct action will only drive the push elsewhere, without necessarily reducing the risk of accidental sharps injury. Since this is a considerable hazard and major public health issue, the next option might be to provide a secure sharps box, though few residents would be likely to accept that, especially in a children’s playground.

This leads to two questions. Are there enough funds to provide a secure and safe location for injections, a “shooting gallery” and would the community accept this? And secondly, what about offering fully automatic or passive engineered safety sharps that would deactivate and return to a safe condition once used?

Both options will cost money. But in the long term, how much will they save?

http://www.news-mail.com.au/news/child-steps-on-needle-in-mackay-health/2187271/

 

 

Needle with drop of bloodA MindMetre research note on the implementation of EU Directive 2010/32/EU in UK NHS Acute Trusts paints a poor picture of sharps safety compliance.

Now long after the required date for implementation, the introduction of safety engineered safety sharps, and everything else that goes along with the Health and Safety (Sharps Instruments in Healthcare) Regulations 2013 which became live on 11th May 2013, a third of hospital trusts in England are failing to comply with safety regulations designed to reduce the risk of sharps injuries to staff.

MindMetre analysts found 33% of Trusts did not instruct staff to use safety devices “wherever possible” in their sharps policies, despite it being an explicit requirement of health and safety regulations introduced last year on the back of the European Union directive.

The report from business analysts MindMetre investigated the implementation of directive 2010/32/EU, which came into force in May 2010, and was followed by UK guidance from the Health and Safety Executive.

Using the Freedom of Information Act, the analysts obtained details of safety policies from 159 hospital trusts.

Their report said: “The emerging picture is one of widespread progress towards adoption and compliance, but also one which shows that there is considerable ground yet to be covered.” Continue reading “One third of NHS acute Trusts in breach of EU & UK sharps rules” »

A 16 month old toddler has died after overdosing on iron tablets he thought were ‘Mummy’s sweets’ after his sister climbed onto the bathroom sink to reach them.

When children are in the house, ALL tablets and capsules etc are dangerous and should be kept under lock and key to prevent accidental poisoning.

For adults, the additional risks of stockpiling old and unwanted medicinal products, whether prescription drugs or not, include unwanted adverse effects from deteriorating and out-of-date medicines, and in a few of intentional self-harm.

Though limits on prescriptions should alleviate the latter, GPs and others have repeatedly blamed patients for asking for a prescription, and then for repeat prescriptions, without a hint of irony since it is their own responsibility, not the patient’s, to assess each request and prescribe accordingly. Regrettably, that takes just a little too much time and effort.

And our concern, of disposal of these unwanted products that accumulate in a kitchen or bathroom cupboard, is to ensure environmentally sound disposal. That cannot happen if unwanted pharmaceuticals are thrown into a black sack or poured down the toilet.

Until the Environment Agency awake from their slumbers and address this issue, instead of fussing about an occasional blister pack that the might observe in an orange sack, the better and safer this will be. Lower NHS costs, fewer accidental overdoses, less intentional self-harm, and far lower environmental impact from inappropriate disposal.

There is a GP surgery or clinic, or a family pharmacy in every High Street and shopping precinct, and in every large supermarket. The opportunities to operate a properly funded and effective take-back scheme are there, but need purpose and negotiation, and a willingness to make an effort at least to initiate those negotiations and drive them forward in a positive and encouraging way. Regrettably, that isn’t the way of the Environment Agency, but why not?

see also Prescription drug residues in natural water sources

and Cutting medicines waste through prescription control

and Wales urges patients to avoid prescription waste

and Presciption numbers rocket to new high

and Drug residues from wastes – the impact on the environment?

and http://www.ianblenkharn.com/?s=prescription

 

 

 

 

City Hall (Town Hall) bathrooms in the city of Racine, Wisconsin, are to get needle containers.

“Mayor John Dickert and Racine Public Health Administrator Dottie-Kay Bowersox said Thursday that they had been wanting to install the receptacles for a while, especially given the high rate of diabetes in the city and county at large.

“Many diabetics must give themselves daily insulin injections and those injections can often take place when they are away from home.

“The city was also prompted to install the containers after two city employees — a public works employee and a health department employee — each accidentally pricked themselves last year with used syringes.

“The Health Department employee was accidentally pricked while administering a blood draw at the clinic at City Hall, 730 Washington Ave. The incident with the public works employee occurred out in field, when the employee accidentally came in contact with a syringe that had been thrown in the trash, Bowersox said. It was not clear what the needle had been used for, she said.

We just wonder quite how many insulin-dependent diabetics work at or visit City Hall? What are the rest injecting?

 

 

 

A young girl was reportedly “distraught” after finding syringes on her seat on a Melbourne tram seat, according to a witness.

The needles were concealed on her seat, according to a post on the user-generated website reddit.

“The needles were jammed into the back and bottom of the seat, between the cushions. Angled outwards,” the witness explained. “The child was crying and distraught.”

Melbourne’s Yarra Trams confirmed that an incident occurred, but a spokesman insisted that the needles were capped, facing inward, and neither mother or daughter were harmed.

The reddit thread also detailed a new style of game where people jab unwitting strangers with fresh needles “to scare the sh*t out of them”.

“It’s done from behind in the back of the arm or leg,” the user wrote.

“You feel the prick of the needle but might not realise what it is and just think you bumped into something sharp until you see some f***er with a needle”.

Takes all sorts!

 

 

 

 

In an astounding piece from the Armenian News Agency, it is claimed that “A person cannot be infected with AIDS with a needle”!

The Head of the Armenian AIDS Prevention Centre, Janetta Petrosyan, commenting on incidents where persons are striking individuals with a needle as they pass in crowded public spaces, it is said with some authority that this cannot transmit HIV infection.

It is unlikely, and as stated the HIV virus does not survive drops in temperature, exposure to sunlight or ozone, or desiccation well. With further limitations on transmissibility by the volume of blood present and how fresh that blood is, the concentration of virus particles in the blood (virus titre), the type of needle (hollow or solid), the depth of injury, and first aid measures together with the efficacy of post-exposure prophylaxis, if indicated, HIV transmission is indeed perhaps unlikely.

However, it cannot be overlooked that in such circumstances there are other nasty virus agents that are far more infective and easily transmitted such as Hepatitis C. Thus, bold statements that HIV cannot be transmitted by a sharps injury of this type seem scientifically unfounded and clinically misleading, since it may dissuade affected individuals from seeking medical assistance and follow-up.

With HIV and Hep B/C on the rise in Armenia, if Petrosyan is so sure of this perhaps she would like to try it herself. It’s a risk not worth taking, which harks back to the earlier AIDS prevention slogan, ‘Don’t die of ignorance’.

 

Needle with drop of bloodIn Uganda, an HIV positive nurse has injected a 2-year old baby with a needle she had used on herself.

The baby’s parents discovered the nurse at Victoria Medical Centre, injecting their child with a needle after taking the baby girl to the hospital for a treatment. It was discovered soon after that the nurse was HIV positive and had used a needle on the baby that had made contact with her own blood.

The nurse claims that she accidentally pricked herself with the needle while trying to administer a shot to the baby and that she didn’t intend to infect the child, but authorities are still investigating.

http://www.opposingviews.com/i/health/hiv-positive-nurse-injects-baby-needle-she-used-herself

 

 

 

“More than a dozen cleaners at Cheltenham General Hospital say they have been left severely traumatised after they were stabbed by hypodermic needles in the last 12 months.

“At least 13 members of staff at the hospital have reported being pierced by used syringes in the last year due to “improper disposal” by medical teams.

“The “domestic assistants” have condemned “poor practices” by the hospital’s doctors and nurses which they say are putting the health of the cleaning teams at risk.

“Cheltenham General Hospital has admitted liability for seven cases of piercing by hypodermic needles and one case of contributory negligence.

Regrettably, there is no mention of intervention by any of the various regulators that might step up to the plate here, either HSE or CQC, perhaps even the Environment Agency.

One can only hope that the costs of a private compensation claim has been sufficient to drive a sustained improvement in disposal practise.

Although sharps injury rates are highest among frontline healthcare professionals, we should remind ourselves that a US study comparing injury rates with employment statistics revealed an overall rate of injury among support staff 10x greater than that for nurses, and 30–40x  greater than for clinicians (Leigh et al. Characteristics of persons and jobs with needlestick injuries in a national data set. Am J Infect Contr 2008; 36(6): 414–20).

I guess that the cleaners at Cheltenham General Hospital found that out the hard way.

 

 

Clinical wastes and indeed just about all other waste streams are managed poorly right across the Indian sub-continent.

A good friend living and working in Goa tells tales of almost daily waste mismanagement, waste-related crime and, more often than not, relatively simple problems that can have far reaching consequences solely due to lack of joined-up waste management systems.

A report from Kerela, of clinical wastes dumped at the roadside, is typical. Wastes have been bagged but dumped, or perhaps dropped accidentally, at the roadside, creating a problem for those using the road, and those tasked with the clean-up. But the TV news report shows much of the wastes smoke stained but essentially unburned.  Has someone tried to do the right thing, but been thwarted by a fundamental lack of resources?

 

 

Good to read CIWM Journal this month, and the annual review of the industry’s fastest growing waste and resource management companies.

High on the list at number 24, having previously been unlisted, is Healthcare Environmental Services Limited. Clearly, a clinical waste sector success for 2013.

Though its possible to view tables such as this in so many different ways, by employee numbers, by turnover or profit/dividend, 2 year CAGR (Compound Annual Growth Rate ), by gross geographic area of operation or contract futures, even by number of RIDDOR incidents and/or lost day incidents.

Whatever the measure, Healthcare Environmental Services Limited has had another good year. Well done.

 

The Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), established in Québec since 1980, is a scientific research organization well-known for the quality of its work and the expertise of its personnel. It has just released an important research assessment, Evaluation of Manual Dexterity, Tactile Sensitivity and Comfort When Wearing Needlestick-Resistant Gloves.

This new study from the IRSST is an exploratory evaluation of manual dexterity, tactile sensitivity and comfort when needlestick-resistant gloves are worn on the job. Continue reading “Which is the best sharps safety glove?” »

A bag of hypodermic needles dumped outside a school has turned a Cape Town family’s lives into a “living hell”.

This was after the bag, dumped near a Junior Primary School in Brooklyn, was found by pupils and brought to the playground on Monday. One of the pupils, an 8 year old boy, paid the price.

“We don’t know exactly what happened, but they were playing with the bag and then he got pricked,” said his older brother. The used needle went deep, puncturing the skin and drawing blood.

The doctors started doing all these blood tests , sticking all these needles in his arms. He just sat there with this blank face, he was really brave,” said his mother.

While the blood test results will be available in three months, doctors have already started the child on anti-retrovirals to prevent a possible HIV infection.

Sitting with his family at their Milnerton home, the boy does not seem to understand the seriousness of the situation. The anti-retrovirals have made him nauseous and tired, but to him it is a lot of fuss about a wound that has already started to heal.

Despite the young boy’s bravery and stoicism, the implications may be profound. Stress and anxiety through and beyond that long wait for confirmation that all is well will affect Mum and Dad and the entire extended family.

 

 

A Dundee family face an agonising six-month wait after their young son was pricked by a used needle on a bus.

The six-year-old boy was injured following an incident aboard the bus last Monday.

He was taken to Ninewells Hospital where medical staff took blood and gave him a booster injection. And now the family must wait six months to find out if their child has been infected with a virus like hepatitis or HIV.

Interestingly, that booster injection is described as a tetanus booster in this report. However, in this circumstance, a tetanus booster would be as much use as a chocolate teapot. In the circumstances, I would be equally concerned to know what more sensible interventions and precautionary or forward-looking plans have been put into place in case something more appropriate had been overlooked.

The child’s father said: “When they got on the bus he asked if he could go up stairs. The next thing he came down looking chalk white and said to his mum: ‘I’ve been stabbed’.

“She asked him what had stabbed him and he said one of those dirty needles. He said it had browny red stuff in it.

Good luck to the little lad, and to his family.

see http://www.eveningtelegraph.co.uk/news/local/dad-speaks-of-horror-after-boy-jagged-by-needle-on-dundee-bus-1.142110

and http://www.bbc.co.uk/news/uk-scotland-tayside-central-24533028

 

 

A local newspaper reports a Muskegon County, Michigan, man found with heroin needle in arm in a parking lot.

That is not uncommon, and is a situation that ambulance crews and other first aider’s will be familiar with. So, what to do?

Firstly will be care of the individual, which in itself can be particularly challenging and often rather unrewarding. The needle must be removed, and disposed safely.

The situation does give a lie to the expectation that placing sharps bins in those areas where IV drug abusers congregate will reduce the incidence of carelessly discarded sharps. If the drugs do their job, either as the user might hope for or less safely due to contaminants and adulterants, then the individual will be in a fit state to consider sharps safety and the welfare of others.

Safety sharps may help, but who will pay for these, and then risk a backlash from the moral majority when teaching addicts and others just how to use them?

Passive, spring loaded safety sharps might work, and have the advantage of preventing reuse thus eliminating needle sharing. But they are expensive and if any safety system is to be used it will most likely be the much cheaper active safety device. These require the user to flip over a sheath, that can be later removed to allow the syringe to be reused. However, if an addict cannot even withdraw a needle from their arm, then the advantaged of any safety engineered needle device is as slight as a sharps bin for field use in local hot spots of drug abuse.

Safety sharps can help reduce the incidence of needle and syringe sharing. Thus, without any additional impact on reducing risks from sharps injury, the public health advantage of reduced needle sharing is reason enough to go ahead. This would be money well spent.

Getting these needles into sharps bins is a key goal and we support it fully. But don’t expect that it will be hugely successful.

Temporary workers hired by Ohio State University to separate plastics and cardboard came across medical waste and various medical files, the workers told 10 TV News in Columbus.

The workers were separating items as part of the university’s zero waste program. Several workers described various medical waste in the items they were separating, including needles, catheters and IVs. Those workers also told the television station that they saw patient records in the paper as well.

Officials from the university declined to go on camera for an interview, but provided the station with a list of procedures on how it would be impossible for medical waste to end up in the stream that workers were sorting.

As we noted recently, green initiatives can and do go badly wrong and perhaps this is just another example.

Details of the Ohio incident are limited. Medical files should be managed securely, particularly in the US where patients and next of kin will file a lawsuit for any breach in confidentiality at the very drop of a hat.

As for the medical (clinical) wastes, clearly something has gone badly wrong in segregation and management of separate waste streams.

What is most obvious is the matter of temporary workers.  They are called in from an agency and put to work within minutes. Any induction is, at best, notional in content and in all probability of limited value. Essential PPE items will be recycled from a previous user – no problem there if they are in good condition. But what about supervision. At the very bottom of the pile, those agency staff that make a substantial contribution to the workforce of most UK waste management companies, including those handling clinical wastes, receive inadequate training to do their job safely. That is huge problem, since training an agency worker for 1/2 day of more, when they may only stay for a short time is not money well spent.

Supervision is the key, but that is rather limited in scope, even in the best of companies. Once more, supervision of costly, and that hits the bottom line.

But these agency workers need some reasonable standard of protection for injury and infection. First among this must be a mandatory selection of appropriate PPE items, and a list of do’s and don’ts.

That list should be in the worker’s own language, since there is no value in a brief spoken introduction to a worker who cannot or does not understand because of their nationality and limited English language skills.

And then they’re gone back to the agency. But responsibility does not finish then and there, though many would like to think otherwise.

Perhaps the ideal solution to this tricky problem is a written list of those do’s and don’ts, in a range of languages  – check first that they can read – supplemented with some take-home information about hygiene and the need to report any exposures, with necessarily some reasoned explanation of how those exposures may arise ie, sharps injury, contamination of broken skin, splashes to the mouth or eyes.

The purpose if to inform, not frighten, so great detail is not required. Inevitably, information should be supplemented with some basic hygiene information. On arrival, this written sheet would supplement, not replace, a basic induction delivered orally. And none of this is an excuse for inadequate supervision!

Is this value for money?

Yes it is, if it prevents a claim and even more so if it prevents an avoidable incident that now would be likely to incur additional costs when HSE come knocking. And those agency workers, who disappear back into a transient pool, might just be  back again, better and more efficient or effective than before. Of better still, future employees, setting off from day one on the right foot.

 

 

Needle with drop of bloodA New Castle, Pennsylvania police officer accidentally punctured his thumb with a needle allegedly used by a man to inject heroin.

Police had been called to a man who was on the ground in the park but when they arrived the man refused help and walked away.

Fire department personnel informed the responding officer of a hypodermic needle with suspected heroin residue that was on the grass near where Park had been lying. The officer picked up the needle to discard it and as he tried to cap it, it went through the cap and punctured his thumb.

http://www.ncnewsonline.com/update/x862171488/Man-charged-in-heroin-needle-incident

This is obviously a devastating injury for the policeman, but does suggest a lack of common sense. Picking up the needle may have been the obvious thing to do, to retain evidence perhaps, r simply to prevent injury to others. But without suitable puncture resistant gloves, or some tool such as forceps, then the risk increases. And trying to recap the needle is a recipe for disaster.

And disaster did occur.  Recapping of needles has long been abandoned in healthcare. It is a manoeuvre that is prone to sharps injury in the contralateral hand and once prohibited those vast number of sharps injuries fall in number dramatically.

Obviously, that important safety message hasn’t spread far outside the healthcare arena.

And yet recapping of needles might protect. Safety engineered needles rather does away with the problem – if those safety needles are activated by the user before discard – but these are not yet in universal use. No needle exchange services are yet using safety engineered needles since they are marginally more expensive and take some time to learn the new look and feel in order to be proficient in safe injection, and disposal, practice.

And few diabetics are using them. Many will be moving to insulin pens but there are still millions of insulin needles used without safety devices, justified by cost and the need for training that is simply far too resource intensive to consider.

Until that changes, discarded or wrongly packaged or dropped needles spilled form an improperly closed sharps bin are going to be uncapped. For the unwary, that accidental needlestick might be devastating.

 

 

 

 

 

 

A mother has an anxious after a ‘dirty needle’ prick at Frankston Beach near Melbourne.

As always, the beach-side area attracts IV drug users who seek some degree of isolation and privacy, at least from the Police, while buying and selling, and consuming their drugs. This creates particular problems for those responsible for beach security and cleanliness, and for those tasked with the mechanics of beach cleaning since discarded needles settle rapidly into soft sand making their location and retrieval particularly difficult.

“I went to the doctor’s straight away to get a blood test done and I won’t get the results until October some time.”

Despite being nervous about the results, the mother said she was staying ­positive.

“I am quietly optimistic. I am angrier if anything, (I believe) the council is only raking the beach once a fortnight.”

“Council undertakes constant beach cleaning during peak summer times, and cleaning is also more frequent in cooler months following storms when needles are more likely to be washed ashore.

http://www.heraldsun.com.au/leader/bayside/mother-anxious-after-dirty-needle-prick-at-frankston-beach/story-fngnvli9-1226718798811

 

The quotes appearing in the original news report are quite interesting. If she had blood tests and now faces an anxious wait for the result, why not any precautionary treatment, for Hepatitis B or even for HIV (there is no preventative treatment for Hepatitis C)?

It is interesting also to know that “the council is only raking the beach once a fortnight.” That may be a resource-driven decision, and/or one that has been risk assessed. But with this sharps injury, has the risk assessment been reviewed and is their any evidence to justify its revision, thus with more frequent patrols and cleaning?

And lastly, I might question the focus on needles being washed ashore, when the strong likelihood is of a problem and source far closer to home, with a solution that must be managed locally.

 

 

Two young lads have suffered near-miss sharps exposures in separate incidents in the UK, in each case while enjoying an outing to play in the park.

In Maidenhead, a nine-year-old boy had a lucky escape after picking up a used needle while playing innocently in a park. He was enjoying a family trip to Boyn Grove Park on Monday when he made the shocking discovery while playing in an overgrown wooded area of the park

he returned from the bushes with the needle, to the horror of mum and dad. “I was actually terrified for him,” said mum. “At first we thought it was just a pencil.” Unaware of what he had picked up, he was quickly told to drop the needle which he had found alongside a pile of empty beer and wine bottles.

“The first thing we did was to make sure his hands were all OK and there was no break of the skin,” said mum.

The mum-of-two regularly visits the park with her two sons, and now wants to warn parents to be more careful when letting their children play in open spaces. She is also calling on the council to take more action to thoroughly clean parks of any dangerous debris.

“Those responsible for leaving behind these hazardous objects are thoughtless and show no consideration for the safety of the public and their use of open spaces,” she added.

A spokesman from the council said it took the issues of people finding needles ‘extremely seriously’ and urged anyone who made an unwanted discovery to contact the council immediately.

http://www.maidenhead-advertiser.co.uk/News/Areas/Maidenhead/Warning-after-boy-9-picks-up-used-needle-at-park-28082013.htm

 

And in an unrelated incident, an unfortunate 9-year-old boy pricked his finger on discarded needle at Castle Hill, Huddersfield.

The lad was playing with his little brother and cousins near Jubilee Tower in Huddersfield. As he was picking up stones from beneath a tree he was jabbed by the needle, causing his thumb to bleed.

Thinking he would get into trouble, the boy at first said he’d cut his thumb on a tree branch but then admitted what had happened. The family had the forethought to collect the needle and took him to Huddersfield Royal Infirmary.

He had a blood test to check for infections but must wait three months for the results. The hospital started him on a course of injections for hepatitis B as a precaution.

“He had the first hepatitis injection at the hospital, which was pretty unpleasant, and he has to have another in a couple of weeks and then a third in three months.”

So, the poor lad has 3 painful injections, and still bears the risk of Hepatitis C infection or HIV, and will no doubt pick up on the inevitable distress of his parents and relatives who will face many months of anguish and who will, no doubt, watch him like a hawk for years to come.

http://www.examiner.co.uk/news/west-yorkshire-news/nine-year-old-huddersfield-boy-pricked-finger-5793367

 

Good luck to them all.

 

 

We have reported many needle find incidents recently, and that is barely the tip of a very big iceberg. So, as data accumulates concerning reported needle finds, can anything be achieved by collating those data?

Another report of a needle find, this time of a Toronto lady who had the misfortune to step on a discarded syringe, the needle of which pierced deep into her heel reveals just what can be done.

So, when the local paper submitted a Freedom of Information request to the city authority, 18 months of data on discarded syringe-related reports to the city’s 311 service line was obtained.

 The data revealed 137 requests were submitted to the city’s 311 help centre between January 2012 and June 6, 2013, resulting in the recovery of 571 discarded needles from Toronto parks, sidewalks and alleys. The number may actually be higher, since the Star lowballed the total due to vague estimations within many of the 311 requests.

The consolidated information shows the number of needles reported in Ward 6 — which encapsulates Mimico — increased from one last year to five so far this year — not including the one Monk stepped on. Also, out of 44 wards, this outlying Etobicoke-Lakeshore ward ranks seventh for the most needle-related 311 reports.

The data can be found here.

It’s a great resource, to consider the simple practicalities of litter management and in particular of hot-spot management, to consider placement of secure sharps bins, to focus needle exchange services and other support to IV drug users, an to identify those highest risk areas that require regular patrols. Police might cross-reference the data with crime reports, to improve patrol and surveillance activities.

This is a great resource. Though similar data must be available to all UK local authorities never have I found anything like this. A missed opportunity, though with many local authorities expecting those who report needle finds to go back and pick it up themselves, I have doubts if data could be collated in any useful way at all.

 

 

Is there no end to the places people find a discarded hypodermic needle, some discarded quite casually, others hidden in an attempt to hide the evidence, and some placed far more maliciously, intended to harm others?

We have described many of these on the Clinical Waste Discussion Forum. Here is yet another.

A mother purchased a pair of shoes for her child, but when he put them on she discovered that there was a needle inside, fashioned so it would poke the young victim.

She discovered a small hypodermic needle glued inside the red croc-style shoes she purchased for her seven-year-old son at Walmart.

http://www.terracestandard.com/news/219128691.html