Clinical Waste Disposal | Blenkharn Environmental

Stericycle – vitriol and threats continue

We have previously reported the extent of vitriol directed at Stericycle for these perfectly legitimate contracting of waste disposal services to so-called ‘abortion clinics’ in US. Now, a group is calling for an investigation of Stericycle’s “Burning of Babies Killed By Gosnell” (a US physician currently in court for alleged malpractice in performing late terminations of pregnancy).

The national Campaign to Stop Stericycle (CSS) pro-life group is calling for an investigation into the connection between a convicted Philadelphia abortionist and the top medical waste disposal company in America regarding the unlawful disposal of newborn and third trimester babies.

http://christiannews.net/2013/05/16/group-calls-for-investigation-of-waste-company-stericycles-burning-of-babies-killed-by-gosnell/

Glucose testing kit in needlestick incident

There are millions of glucose test lancets used daily, to test the blood sugar levels of individuals with diabetes. I use them daily.

They are used in hospitals – where several incidents have occurred of disease transmission caused by a careless, probably criminally irresponsible, failure to use a new needle or lancet for each patient and to sanitise the lancet holder between patients – and widely used in the community, by every patient with insulin-dependent diabetes and many others with Type II diabetes controlled by drugs and/or diet.

How to dispose of these lancets? In hospitals and other healthcare premises, it should be a straightforward issue of dropping them into a sharps bin immediately after use. At home, matters are less easy. We might hope that insulin-injecting diabetics have been given a sharps bin for their used needles and insulin pens, and the blood test lancets can be placed into these. For others, the change of a GP issuing a sharps bin alongside a blood testing kit are rather slim, if not impossible. And, of course, no straightforward procedure for disposal once a bin has been filled.

Four primary school children in Tasmania have cause a health scare after pricking each other with a needle from a glucose testing kit.

The children at a school in the Derwent Valley, northwest of Hobart, underwent infection tests as a precaution after the needlestick incident on 9 May. “The incident involved four primary school students who used one or more needles from a diabetic test kit to prick each other,” Tasmania’s acting director of public health Dr Mark Veitch said in a statement.

The risk is perhaps small, but not so small as to be discounted and these children will need follow-up over several months. The psychological impact, for the children and more so for their patents, cannot be overstated.

And kids will be kids. Strangely, a discarded needle can be in some way attractive and pierce inquisitive little fingers. That message must reach each and every user of hypodermic needles and blood testing lancets to ensure safe disposal at all times.

Diabetics’ needles

Nobody wants to fund collections of clinical waste from the community. Though some companies make a business out of ‘smalls’ it operates generally on small margins and yet is costly to the PCTs, and now their new era replacements, and to Local Authorities.

Some GP surgeries will receive properly packaged sharps, though often failing to provide on prescription those sharps bins that diabetics will should use. Likewise, some high street pharmacists will accept used needles, as do some hospitals as part of their commitment to outpatient support from diabetic clinics and the like.

It the latter case, patients may take their boxed needles at the next outpatient visit, or drop them off at reception. This creates its own problems since the receptionist will not be able to issue by prescription a new sharps bin, creating problems of continuity. In every case, the diversity of options makes administration and funding something of a nightmare.

The US is far behind, since until recently used sharps have entered the trash in the absence of any better and more organised route for safe disposal. But that is changing. For most, the solution has been to prohibit disposal of sharps in household garbage, and to provide sharps safes in accessible locations, at the Police of fire station, at a local supermarket – in the Mall – or at the local County building.

Their are economies of scale. Most self-injecting patients, whether diabetic or others, and almost all IV drug users are sufficiently ambulant that there is no barrier to a visit to the local sharps disposal point. With a network of conveniently located and accessible disposal points, there are logistics advantages as well as savings in administration for funding arrangements. This might also capture some of those ‘private enterprise’ needles from IV drug users and those injecting bodybuilding steroids and tanning supplements that is now on the increase.

The advantages are many and obvious. Perhaps all that stands in the way of this improvement is predictable administrative inertia and public perception issues that can stimulate objections to needle safes placed in locations across the community.

But it seems a good idea, and far better than the present mish-mash arrangements that are many and varied, and subject to frequent change as if deliberately to confuse the service users.

Protecting staff from sharps injury

The implementation of UK legislation to enable compliance with Council Directive 2010/32/EU is now in place and so many organisations are working hard to prepare guidance notes for healthcare providers.

One of the best, so far, is from the NHS Confederation who note that regulations implementing EU law (the “Sharps Directive”) come into force across the UK on 11 May 2013. All NHS employers and employees need to be aware of and act upon the additional requirements (over and above existing health and safety legislation) resulting from the new regulations. This Briefing outlines the key changes and their implications for the NHS.

New regulations on the prevention of sharps injuries will apply from 11 May 2013.

They apply only to employers, contractors – but critically only to contractors who are embedded into on-site operations – and workers in the healthcare sector (whether public or private).

Many of the requirements form part of existing health and safety law in the United Kingdom, but the regulations also introduce extra, more specific, requirements.

The NHS European Office and NHS Employers have worked closely with the Health and Safety Executive and with employers’ organisations and trade unions in Europe, to try to ensure that the new rules are sensible and workable for the NHS.

Download the NHS Confederation publication Protecting healthcare workers from sharps injuries

Disposal of pacemakers after death

When pacemakers find their way to a cremator there is inevitably a rather big bang and substantial consequential contamination that is best avoided.

Funeral directors do their best to capture those bodies with a pacemaker fitted, by examination of the body, by discussion with a hospital or GP, or after questioning of the next of kin. It is a great credit that so very few pacemakers slip though the net.

In a recent piece in the Kent and Sussex Courier it is recorded that, normally, funeral directors dispose of pacemakers via specialised clinical waste companies or take them back to a local hospital.

The writer, Jo Parker, had been in touch with heart hospitals, heart charities and manufacturers of the pacemakers to see if there was some way of recycling these devices, but it’s “not something we do here in the UK. These devices are just destroyed”.

This got herthinking about overseas charities and she stumbled upon a charity called Healing Little Hearts (www.healinglittleheart.org.uk). The founder of this charity is a consultant paediatrician at University Hospital Leicester, Dr Nichani Sanjiv, and he takes medical teams to India to perform life-saving surgery on children whose families can’t afford medical care.

Jo contacted Dr Sanjiv Nichani, who was delighted with the idea of recycling our pacemakers; although Sanjiv himself works with the children in the hospital, he has spoken with his medical colleagues who take care of the very poorest patients that come into the Holy Family Hospital in Mumbai and the Government Hospital, King Edward Medical College and the pacemakers we send will be used to change their lives.

So, having found a charity, Jo thought why not make this bigger than a few Kent members, why not roll this out nationally?

With arrangements in place for removal of pacemakers from cadavers, for their transport and reprocessing, and their export for re-use, this would seem to be an excellent (re)use of a life-saving resource.

Several regulatory barriers exist, that may thwart the best of intentions. Shipment of what is, inevitably, clinical waste may require a license. Export of that waste, even if reclassified as medical supplies is fraught with difficulties and compliance with all necessary regulations can be costly and troublesome, if not impossible. There will be additional legal and other ramifications concerning the safety of the re-processed medical device.

Despite all of these problems, we offer support to Jo Parker and her colleagues for their efforts and hope that unnecessary bureaucracy does not stand in their way.

Body parts found buried in Poland

Sounding more like a tale from some Transylvanian horror, Polish prosecutors say they are questioning a man suspected of burying body parts and other clinical (medical) wastes instead of delivering them for incineration.

A prosecutor in Chorzow, in southern Poland, Marta Zawada-Dybek said Friday that the man, identified as Marek M., has confessed to burying body parts, syringes, bandages and other waste on a plot of land that he owns.

His firm that has contracts with some 300 hospitals and private surgeries to professionally dispose of the waste. But he allegedly buried it rather than pay for its incineration, Zawada-Dybek said. The man’s two brothers work in the firm.

The man is already serving a 16-month prison term for dumping medical waste at a local refuse dump.

Sharps injury legislation, Ireland

Needle with drop of blood Ireland has not been backward at making the most of EU laws and subsidies though it has now found itself in deep financial peril as a consequence.

But less advantageous though equally worthy EU legislation, to implement the requirements of Council Directive 2010/32/EU, has been surprisingly slow to implement in Ireland. Trade unions have claimed that the health of Irish healthcare workers has been put at risk by Ireland’s failure to implement an EU directive on the use of medical needles.

The Irish Congress of Trade Unions says member states were due to adopt the directive – the eve of International Nurses Day.

ICTU’s legal affairs officer Esther Lynch said needlestick injuries among healthcare workers were ‘notoriously’ unreported – and that workers were injured anywhere between 1,000 and 6,000 times a year. ICTU has called on jobs minister Richard Bruton to implement Irish laws, giving legal effect to the EU directive, without delay.

“The Health & Safety Committee of Congress is recommending the establishment of Needlestick & Sharps injury prevention committees to oversee the implementation of the Directive,” Lynch said.

“These committees should include representatives from all levels, employers and unions including health and safety representatives, occupational health, risk management, purchasing, housekeeping, infection control, employee education and training.”

With a number of high profile sharps injury claims from Ireland in recent months, this is perhaps rather surprising. Hopefully, the lack of formal legislation will not stop healthcare providers from doing the right thing and purchasing safety sharps without delay.

Metals residues in soils affected by burnt hospital wastes

In many parts of the world, the treatment of clinical (medical) wastes amounts to little more than open burning with incineration using modern technology having all of the relevant emission control technologies.

This open burning, on surface beds or in burn pits has a profound effect on air quality but until now the impact on soils has not been tested. In a new study from Nigeria by Ephraim, Akpan and Obiajunwa (Investigation of soils affected by burnt hospital wastes in Nigeria using PIXE. http://www.springerplus.com/content/pdf/2193-1801-2-208.pdf) studied the fate of burnt hospital waste and its effect on agricultural soil.

Eleven elements – Si, Cl, K, Ca, Ti, V, Cr, Mn, Fe, Zr and Pb were detected at an elevated concentration when compared with the control. Perhaps not surprisingly, the highest concentrations were obtained for Fe. Moderate enrichment factors for Si, K, Ca, Ti, Cr and Zr were obtained. The level and the fate of these elements especially Cl and Pb is of serious environmental and health concern owing to the fact that there are intensive subsistence agricultural practices at and near the sites of the study. A future investigation to quantify dioxin and furan that is associated with the geochemistry of Cl is essential owing to the toxicity of these compounds.

These are important observations with great relevance to public health implications from this previously unquantified level of soil contamination. When used for agriculture, as an enrichment, the presence of this diversity of contaminating metals may result in uptake into and contamination of subsequent food products, with potentially long-term effects on health and well-being.

Non-consensual testing after needlestick injury: A legal and ethical drama

Non-consensual testing after needlestick injury is an increasingly important issue for many healthcare workers, and also for police, prison officers and others who have suffered a sharps injury with a needle from an individual who is known but in circumstances where his/her infection status is unknown.

This creates an immediate and hugely important question – do we treat the sharps injury victim with anti-retrovival drugs, or can this be avoided safe in the knowledge that the source patient is not infected?

This particular legal and ethical drama is played out regularly – though in the waste sector the opportunity to identify the source patient is inevitably lost raising the index of suspicion for all sharps injuries in this group.

A recent training case is described here, by Charles Foster and Jonathan Herring of the University of Oxford Practical Ethics blog.

Like many patients in ICU, X is incapacitous. He also needs a lot of care. Much of that care involves needles. Late at night, tired and harassed, Nurse Y is trying to give X an intravenous injection. As happens very commonly, she sticks herself with the needle.

What comes next?

The case is reviewed from the perspective of barristers acting for X and for Y. Played out as if in The Royal Courts of Justice the judgment is of crucial importance, but perhaps surprisingly it is not given. You decide!

HIV infection after sharps injury

There has been an increasing tendency in recent years to downplay the risks of acquiring bloodborne virus infection. Statistics are quoted, showing that in general the risks of acquiring a bloodborne virus infection are:

for HIV transmission after a percutaneous exposure approximately 0.3%
for HBV transmission 6 to 30%,
and for HCV transmission is approximately 1.8%

Easy stats and generally low numbers. Reinforcing the message that the risks might be small is the fortunately exceptionally low incidence of reported cases of seroconversion, and an understanding that the risks may be higher with a deep wound, with a large bore hollow needle, with a needle heaving contaminated with fresh blood, with a needle used only moments before with a patient who had a high viral load. Added to this are reassuring messages of the value of immediate first air – making the wound bleed and washing it thoroughly with soap and water – or seeking immediate medical advice and, if appropriate, of taking post-exposure prophylactic (PEP) drugs to prevent HIV and a big jab in the buttock to protect against Hepatitis B. And then, all will be hunky dory!

But of course that isn’t quite so straightforward. Not everyone will receive that immediate first aid from an infectious diseases specialist who can properly manage subsequent PEP and follow-up. Others may be fobbed off and sent away from A&E for just a ‘trivial’ wound without thought for the impact and implications.

Others may simply fob off a small scratch or blood splash to already broken skin or to the eyes, dismissing that splash inoculation as simply a nuisance without recognition of the significant infection risks that it may carry. And how to manage the post-injury follow-up in the information is incomplete; if the needle had been discarded and the period between use and injury is not known; if the needle user cannot be identified?

Since a high proportion of IV drug users are Hepatitis C positive the risks must be heightened, but evidence from albeit a handful of reports are that assessment in A&E is inadequate and even if you can progress past the first triage assessment and see a junior doctor few such sharps injuries are recognised as potentially serious enough to warrant immediate referral to a specialist.

That immediate referral is now mandated by EU Council Directive 2010/32/EU for health service employees but as yet there is no evidence for similar standards for non-healthcare employees such as waste handlers and local authority staff who are being fobbed off with possibly inadequate treatment.

The implications may be profound.

We are increasingly aware of the often severe and profound psychological impact of sharps or needlestick injury† that has been in the news recently after a scientific investigation of this problem but which has been discussed many times over the years on the Clinical Waste Discussion Forum (check using the search system and browse the archive files). This too requires care in the immediate management and follow-up of sharps injuries and other blood and bloodstained body fluid exposures. Those who may be at risk by virtue of their employment must be trained properly and adequately briefed to ‘make a fuss’ for prompt specialist treatment in exposure does occur.

The various criteria and conditions of exposure or injury noted above can heighten or reduce the risk profile of any individual sharps injury event. So it is with considerable concern to read a recent case report from Brazil:

Brum MCB, Filho FFD, Yates ZB, Viana MCV, Chaves EBM. HIV seroconversion in a health care worker who underwent postexposure prophylaxis following needlestick injury. American Journal of Infection Control 2013; 41: 471-2

They describe a case of HIV seroconversion in a health care worker who underwent PEP after accidental HIV exposure in Brazil. In December 2007 a nursing assistant aged 42 years working in an infectious disease unit experienced a thumb injury while performing a hemoglucotest. The health care worker wore a latex glove during the procedure yet was injured while collecting the test device, the lancet of which had not been completely enclosed and was left on the table after the procedure. The percutaneous injury on the surface of the thumb caused slight bleeding that was immediately washed.

Leaving aside the possibility of drug resistance of this particular strain of HIV, which was a possibility but was not proven by laboratory testing, this worker had PEP initiated within 2 hours of injury, maintained for 28 days. However, 4 months after exposure the worker was diagnosed with HIV infection.

There are several levels of concern. Not least is the observation that injury was caused by a lancet, a thin cutting spike intended to draw just a drop of blood from a finger prick for blood sugar testing. No hollow bore needle, and no deep injury – lancets are designed to prevent deep injury no matter how hard you try. These circumstances would, almost certainly, screen out a sharps injury victim from almost every sharps injury management protocol.

† Green B, Griffiths EC. Psychiatric consequences of needlestick injury. Occupational Medicine 2013; 63: 183–8

Community drug waste collections

Once again, we can report of the success of one of the very many drug waste take-back schemes operating in communities in the US.

The Clark County Sheriff’s Office, the federal Drug Enforcement Administration and other local agencies collected 819 pounds of medical waste at a drug take-back event Sept. 29 in Fisher’s Landing. The event collected 10 pounds of inhalers used for asthma. The most recent have occurred in Washington State, netting 420 pounds of medical waste during a four-hour take-back event organised by the Battle Ground Police Department [great name!] which included 267 pounds of controlled substances which will be shipped to the Drug Enforcement Administration for destruction.

The event was sponsored by the DEA in partnership with the Clark County Sheriff’s Office, Clark County Environmental Services, PREVENT! Coalition, and Prevent Together: Battle Ground Prevention Alliance.

The intention of the drug take-back event was to keep medications out of the hands of kids, while also safely disposing of them and preventing them from seeping into landfills and water supplies.

Medications can still disposed of at the Battle Ground Police Department office, thus promoting regular safe disposal without stockpiling, and offering a disposal option that improves on placing unwanted drug waste into the domestic waste stream or down the toilet thus improving environmental protection. Continue reading “Community drug waste collections” »

Sharps bin stickers promote safer injecting

To promote safer injecting and to minimise harm Warwickshire’s Drug and Alcohol Action Team have developed new stickers for sharps boxes.

The stickers have been designed to signpost people to the four Recovery Partnership drug and alcohol treatment centres across Warwickshire.

Injecting drug users are at risk to a number of harms, including:

Damage to the injection site as a result of poor injecting technique
Bacterial and fungal infections(such as localised abscesses and systemic infections) as a result of poor injecting technique, contaminated drug products, and sharing vials and/or reusing injecting equipment
Blood-borne viruses such as HIV, Hepatitis B and Hepatitis C as a result of sharing used injecting equipment or sharing vials (that have become contaminated through reuse of injecting equipment) with other

The aim of this campaign is to encourage all injecting drug users to engage with treatment services in Warwickshire and in particular to get immunised against blood-borne viruses.

Hepatitis C is a major public health issue, research has shown that injecting drug use is the most common route of transmission for Hepatitis C, the cause of up to 90% of all new cases.

The stickers display a phone number and service opening times, and remind users that the drug and alcohol treatment service offered by The Recovery Partnership is confidential and free. Continue reading “Sharps bin stickers promote safer injecting” »

Laboratory wastes

It is widely understood that laboratory wastes will be, or should be, autoclaved locally before removal for disposal. It stems from a statement by Chris Collins that “nothing should leave the laboratory unless it has been autoclaved” which appeared in the Howie Report and subsequent safety-related publication in the mid- to late-80s.

But this aspirational quote never worked. Few laboratories then had sufficient autoclave capacity to achieve this and still few can fulfil this goal.

Some selectivity is practices, with laboratory cultures from microbiology labs autoclaved where possible – and thus not universally – while wastes from other laboratory disciplines are not treated. Continue reading “Laboratory wastes” »

Non-BBV infections after needlestick injury

Needle with drop of blood Sharps or needlestick injury carries with it, in some circumstances, a predictable risk of bloodborne virus infection. The statistics, from which risk can be calculated, are well known and relate to the “average” used hollow bore needle used in clinical practise, and sharps injuries occurring during or soon after use.

There are many additional variables including the time between use of the needle and its involvement in a sharps injury, the amount of blood that it contains, the bore of the needle and depth of injury, the immune status of the victim, post-injury care, the virus concentrations in the blood if any, the time interval between injury and post-exposure prophylaxis if this is indicated, and probably other factors of which we know very little.

But we must not close our minds to the possibility that sharps-related infections are limited to HIV, Hepatitis B and Hepatitis C infections. Other infections can and do occur. In fact, the diversity of infections that have been reported is substantial though the list is bolstered by many individual laboratory acquired infections that arise as, one must hope, a one-off occurrence. Continue reading “Non-BBV infections after needlestick injury” »

A mouthul of blood

Sharps injury is depressingly common but should be preventable. Less easy to prevent is a blood splash that can unexpectedly contaminate the face and eyes – eye in particular are a potent and often unrecognised route for infection.

Several approaches are possible to prevent sharps injury through the use of passive engineered safety sharps, good sharps safety practice including safe disposal, and safe management of BS EN ISO 23907 2012 compliant sharps bins at the point of use and as the pass along the disposal chain.

But not so at Huddersfield Royal Infirmary where some idiot placed a used and part-blood-filled syringe on top of a sharps bin that really should have been in a safe location well away from inquisitive children.

The parents now face a significant worry throughout and beyond a period of precautionary treatment, blood tests etc for the little lad, and hopefully a successful complain to the heath regulators, HSE and anyone else who will take real action to make sure that those responsible are properly reprimanded. If the culprit(s) can be identified I think it appropriate that the conduct committee of their professional body should be invited to investigate, with expulsion if appropriately found.

Huddersfield Royal Infirmary medical director David Wise said: ‘This is unacceptable and should never have happened and for that we apologise to the family.

‘We have reviewed the environment on the unit and are issuing a reminder to all staff that sharps boxes must be kept in a safe location to make sure that this does not happen to anyone else.’

But that’s just not good enough. Placement of sharps into a sharps bin is a perfectly reasonably safety precaution and those who are so lax in syringe disposal should face severe professional reprimand and/or regulatory action. The more fundamental issue of placement of the sharps bin, out of reach of children is too a well-recognised issue and should not be a new concept but part of established and quite routine practice. Failure is a matter for the regulator.

When take back becomes take!

We are well aware of drug take-back schemes, widely used in US and elsewhere to encourage safe disposal of unwanted prescription and other medications that might otherwise enter the domestic waste stream or be flushed down the toilet. Regrettably, in the UK it just doesn’t happen and that is a great shame.

But it doesn’t always go well. In Northampton, Mass, Northampton’s Solid Waste Management Director was charged this week with drug charges.

Kathy Bouquillon was holding a sharps collection at Saturday’s Drug Take Back event on April 27th, and got a bit too involved in her work when take back became simply take!

A day later, she was arrested after she struck a tree with her car. The Court heard how she had numerous drugs in her car that were not prescribed to her following charges of possession of drugs, OUI (operating under the influence) and possession of a can of unregistered pepper spray.

Beach litter – America does it better!

The recent UK Marine Conservation Society’s fight against marine litter with the Big Beach Clean-up is a great contribution to marine and beach hygiene, collecting vast quantities of litter including invariably a lot of clinical wastes.

It’s not just a UK initiative. Worldwide, many environmental groups operate similar schemes, to assist communities clean their beaches of discarded litter, flotsam and jetsam.

But in America, things are always bigger and better. Cleaning up US beaches, an environmental group’s annual sweep of New Jersey’s 127 miles of beaches recovered much waste and some medical (clinical) wastes, but also explosives!

Thousands of volunteers took part Saturday in the clean-ups organized by Clean Ocean Action, which has been doing beach sweeps for 25 years. Congratulations to each and every one of them.

But among other wastes, an unexploded ordnance was found Raritan Bay Waterfront Park in South Amboy. The state police bomb squad unit and other law enforcement agencies responded to the scene, and no injuries were reported.

Disposal of foetuses

The disposal of a foetus can be a particularly difficult issue that requires care in compliance with the wishes of the mother, and with the increasingly complex legal framework.

But it can, and does go wrong:

Continue reading “Disposal of foetuses” »

Sanitary/offensive wastes: Poopy power rocks?

The volumes of sanitary/offensive wastes are vast, and growing steadily with the down-regulation of much additional soft clinical wastes. What are the options for its treatment and disposal?

So far, the Environment Agency has encouraged – effectively forced but with no legitimacy to that heavy-handed approach to ‘regulation’ – landfill disposal which in every conceivable respect is environmentally sound.

Since the primary argument is that any energy-dependent process used to treat these wastes would itself be wasteful (of energy) and thus environmentally unsound, the only option would be a hole in the ground. But that is a mindset which is predicated to impede technological development, to use these sanitary/offensive waste as a resource and develop commercial-scale processes that provide an environmentally sound solution. Continue reading “Sanitary/offensive wastes: Poopy power rocks?” »

Bloodborne virus warning over illegal tattooists

There seem to be plenty of tattooists in the UK but perhaps that really isn’t enough to go around, or they are too expensive.

As a – very poor – alternative, it seems that many illegal tattooists are in operation, unregistered and thus unsupervised. The great risk is of bloodborne virus (BBV) infection, and pyogenic infection of those brave enough to have a tattoo.

http://www.bbc.co.uk/news/uk-22320300

But it is the bloodborne virus risk that is our primary concern, since that extends beyond the process of tattooing and may continue as sharps wastes are disposed. The unregistered and unlicensed operation implies a failure to adhere to required standards of hygiene, and therefore to standards of waste management also. Is it likely that an unlicensed tattoo outfit would bother with safe sharps disposal into a suitable sharps bin? Continue reading “Bloodborne virus warning over illegal tattooists” »

Clinical waste firm aims for zero waste to landfill

Clinical waste company SRCL has announced it is aiming to meet a zero waste to landfill target by the end of the year.

SRCL also revealed that 60% of the waste which is processed through its alternative technology is being used as RDF fuel.

http://www.edie.net/news/5/Clinical-waste-firm-aims-for-zero-waste-to-landfill-/

That figure would be higher, and spread more evenly across other clinical waste treatment companies, if The Environment Agency hand not been so obstructive in its approach to disposal of clinical waste ATT treatment residues. Most can go to W2E or materials recovery but the restrictions placed on disposal options by EA limit this for all but the larger operators and actually encourage landfill disposal, which remains the preferred end for much low grade sanitary/offensive waste that would be far better processed elsewhere, to recover energy by AD, perhaps with an initial recovery of paper fibre. The technologies exist but EA are still belligerently obstructing their commercial development.

Interestingly, SRCL is noted in this report to claim that the company claims to be the largest clinical waste business in the UK, collecting material from around 70% of NHS trusts and has more than 20 energy recovery facilities sites throughout the country. That 70% is one hell of a slice of the action.

Good luck to them, but what was all that nonsense several years ago about the need for competition in this industry, and the provision of choice for the NHS, that was the focus of much attention by The Competition Commission?

Many if not all of the rulings were effectively circumvented, and the whole thing seemed to be a glorious waste of public money.

In the meantime, zero waste is an admirable goal, for SRCL and for everyone else. Let’s hope that they succeed, and support other operators by sharing information on best approaches in order to deliver widespread improvement in waste and resource management.

Sharps injury: a deliberate attack?

A heroin-using grandfather who stuffed a used syringe into a supermarket loaf of bread that was later bought by an unsuspecting mother has been jailed for a year.

The woman discovered the needle – which had been stuck through the middle of the loaf by 62-year-old David Rodgers – after she used the bread to make her 10-year-old son a chicken sandwich for his school lunchbox, Manchester Crown Court heard.

Rodgers, from Weaste, who was traced by a speck of his blood left inside the syringe, had contaminated the loaf in a branch of Tesco Extra in Salford last December.

He claimed to be ‘deeply remorseful’ when he appeared in the dock to answer charges of contaminating or interfering with goods with intent to cause public alarm or anxiety in a rare case.

The needle he concealed in the loaf was found to contain no infectious diseases.

UMF Corp’s Hygiene Specialist Excellence Award Winner announced

Winnie Richards, a member of the Sodexo Environmental Services (ES) team working at the University of Texas Medical Branch (UTMB Health) in Galveston, Texas, has been named the 2013 recipient of the Hygiene Specialist® Excellence award sponsored by UMF Corporation.

The award, in collaboration with IEHA and in its third year, was established to acknowledge the invaluable contribution of ES – the first line of defence – in providing a safe patient environment and reducing healthcare-associated infections (HAIs). ES managers nominate the housekeeper of their choice to receive the award.

Well done to Winnie.

Her role is an important, and often under-recognised one and this UMF award scheme is a worthy initiative that can be used to drive quality management.

Congratulations also to UMF Corporation and Sodexo Environmental Services.

Perhaps a similar scheme might operate in the UK, to reward best performance among cleaners, ancillary staff and waste handlers, either across the increasingly fragmented UK, in the similarly fragmented NHS, or maybe for the larger contracting service and waste sector companies?

Employee reward schemes can be used to drive good performance, to improve attendance records and limit absenteeism, and to encourage the high safety standards that are essential, though perhaps not always seen, in the waste and resource sector.

This septic isle?

Once again, this week (22nd to 28th April 2013) is the highlight of the Marine Conservation Society’s fight against marine litter with the Big Beach Clean-up.

Over 110 beaches across the UK and Ireland are going to see volunteers coming together to do a beach clean and litter survey which will highlight the issues of beach litter around our coastlines.

http://www.mcsuk.org/foreverfish/index.php

Hosted by your local M&S store team – and all credit to Marks and Sparks for their sponsorship of this valuable quarterly event [let's hope they bring some of their lovely sandwiches] - the beach clean and survey will last a couple of hours, leaving the rest of the day free for you to enjoy the beach. Continue reading “This septic isle?” »

Reversal of no liability finding for needlestick injury

In a landmark case involving reversal of a no liability finding for needlestick injury that occurred in a Queensland holiday apartment the circumstances of injury, and the legal wrangles, send shivers down the spine.

Wright v KB Nut Holdings Pty Ltd [2013] QCA 66

The Queensland Court of Appeal has held a hotel manager liable for a needlestick injury that a guest sustained while staying in a short-term rental apartment, reversing the original decision of no liability.

The trial judge had not been satisfied that a more competent cleaner or system of cleaning would have led to the discovery of the needle (which was in the crease of a stairwell and was dislodged by the guest when she was cleaning the apartment). He did not consider it reasonable to expect an apartment manager or cleaner to search and discover a concealed needle.

The Court of Appeal reversed this decision, finding that:

it is likely a cleaner using normal skill, diligence and equipment would have detected the needle;
it was probable that the needle was obscured from the guest’s vision as a direct result of the unclean state in which the apartment was handed over to her;
the hotel manager knew or should have known of the risk of injury; and
the build-up of ‘filth’ in the apartment increased the risk that dangerous objects would not be seen until after they were stood on or touched, which may have been with bare feet or hands.

The hotel manager was ordered to pay compensation of $494,759.38, plus interest.

This decision confirms the importance that rental property owners need to place on implementing thorough systems of regular cleaning and inspections.

Quite right too. But isn’t it a warning also, that if you arrive at a rental apartment or hotel room, the immediate response when finding it dirty is to walk back out again and go somewhere else – its not your job to get down and clean it!

And of course, we wish the injured guest well, with the medical and psychological implications of that sharps injury. AS$494,759.38 (about £330.000) should help.

Hospital hotels?

The press are today full of comment about hospital hotels, a new – at least new to the UK – initiative to use hotels as a half-way house for patients not quiet well enough to go home but good enough to move be moved out of a hospital ward.

It’s an idea predictably popular with Government and with the Department of Health since it frees much-needed hospital beds and todays news reports presumably represent a concerted political manoeuvre to test the waters of public opinion.

Hospital hotel transfers have been used in several countries already, most notably in Scandinavia, though an early trial at UCH London resulted in the unexpected and particularly embarrassing death of a patient while billeted at the local hotel. Continue reading “Hospital hotels?” »

What would you do?

Yahoo Answers is not something that I recommend, though no doubt it has its uses and many people find it particularly useful. When I’m teaching, I instruct students in no uncertain terms that written work drawn from Yahoo Answers or from Wikipedia score zero marks – it’s lazy and of a poor is non-existent standard – and may irritate me sufficiently to impact on future marks!

But Yahoo Answers does have a following, and today I visited it for the first time ever. The item that caught my eye was a question, posed by someone from the South West, that I will reproduce in full here:

How to address a carer burning clinical waste in the garden? Continue reading “What would you do?” »

Psychiatric consequences of needlestick injury

Some time has passed since this paper by Green and Griffiths was published. Unsurprisingly, the professional journals and magazines, and the trades union RCN are up in arms about the impact to nurses, and separately to surgeons and physicians. Quite right too.

But the paper, which investigated the psychological welfare of 17 individuals having sharps injury. Only 5 of these five (29%) were in “the health sector (nurses and paramedics)” while the remainder fell into a category of ‘other occupations’ which involved police officers, porters, cleaners, a builder, a manager and one unemployed person.

Of the 3 brief case individual reports included in the paper, only 1 was a healthcare worker. This lady was injured while working in an accident and emergency department. Perhaps a nurse, or possibly a support worker/cleaner, we are not told, the lady was emptying a clinic bin and was replacing a bag when a needle, which had been incorrectly disposed of, pierced her leg. The remaining 2 cases involved a coach driver and postal worker respectively.

Leaving aside the serious issue of a healthcare professional incorrectly placing a used needle into a soft-walled clinical waste sack, the occupations of those involved in this sharps injury series requires further consideration. With so much noised from the medical and nursing professions, about the risks and impact of sharps injury that they may face, it seems that it is the ancillary worker and others who are at real risk.

We at Blenkharn Environmental and at the Clinical Waste Discussion Forum and are doing all we can to highlight the risks of waste handlers and ancillary and support staff. Perhaps the waste and services sectors simply have no voice. At least, they could shout a little louder.

Clinical waste management in Tanzania

“While Tanzania’s leading health facility, the Dar-es-Salaam Muhimbili National Hospital (MNH) boasts of having a well-managed system for disposing infectious medical waste, The Citizen on Saturday has discovered that the situation elsewhere in the country is rather appalling.

“Environmental health experts have confided to this newspaper that most of the lower level health facilities are grappling with poorly managed systems of handling the dangerous garbage, posing serious environmental and human health risks as a consequence.

‘’Hospital waste management is still a big problem in the country to date’’ Prof Samuel Manyele confirmed this week – which is about three years after he published a series of studies that exposed poor health care waste management in Tanzania. Continue reading “Clinical waste management in Tanzania” »

An ignominious end, before life has even begun

Care and disposal of the dead is becoming a hot topic at the moment.

In St. Paul, Minnesota, the Regions Hospital has admitted a second stillborn baby was ‘discarded’ in error and turned up in the hospital laundry.

“The hospital released that statement two days after acknowledging that the stillborn boy — who tumbled out of linens being prepared for cleaning Tuesday — came from the Regions Hospital morgue.

“The first baby — a stillborn, premature boy died April 4 at 22 weeks gestation. That body had been wrapped in linens in the morgue. A preliminary investigation found that someone mistakenly thought the bundled body was laundry that needed cleaning.

http://www.republican-eagle.com/event/article/id/87613/

Blenkharn Environmental Led by Science Driven by Research

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How to address a carer burning clinical waste in the garden? Continue reading “What would you do?” »

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Blenkharn
Environmental

Led by Science
Driven by Research