Needle with drop of bloodWhat price a needlestick injury?  The average is around £2,000 but in one notable case now more that 12 years ago a young doctor managed to pick up more than £500,000 compensation claiming psychological damage after a sharps injury but without seroconversion.

Involve a solicitor and you will make them rich as fees are not inconsiderable, and you might get a little extra too, but not that much.

And at the bottom of the pile is this poor guy from Darlington, as described in a report today in the Northern Echo:

 

A VETERAN has called for change after being housed in a former ‘drugs den’ with blood and heroin covering the walls.

North-East man Mike Raymond served in the Army for nine years and was shot in Afghanistan, before leaving to face a struggle with anxiety and PTSD (post-traumatic stress disorder).

The 28-year-old moved to Darlington in March after being offered accommodation and support by the Salvation Army Housing Association (SAHA).

Having only seen pictures of his flat, on Wilshire Place, Mr Raymond was appalled to move in and find the property in a state “unfit for human habitation”.

With blood spots and a substance believed to be heroin marking the walls, Mr Raymond became convinced he was living in the former home of a drug addict.

Days later, he stood barefoot on a needle hidden in the carpet and found several more scattered under the “filthy” floor covering.

After undergoing hospital tests following the incident, Mr Raymond asked the SAHA for help in transforming the property.

He claims he was charged £109 to have the carpets removed, given about £50 to redecorate the flat and offered high street vouchers in relation to his needle-stick injury.

Mr Raymond has also been the victim of regular anti-social behaviour with those living nearby blamed for gluing up his door locks and targeting him with verbal abuse.

Requests to move to a quieter flat around the corner have been declined and he is now calling for more to be done to support those in his position.

He said: “It was disgusting, when I moved in I didn’t want to touch anything.

“They said the flat had been cleaned and the marks on the wall were coffee and of no concern.

“After standing on the needle, I had tests that made my anxiety worse and I didn’t want to touch anyone in case I passed something on.

“The flat was unfit for anyone to live in and they knew that – it’s not right.”

A spokesman for the SAHA said: “We are deeply concerned by Mr Raymond’s experience.

“The action we have taken today is to launch an urgent investigation as we do not wish this situation to have fallen short of the high standards we deliver within our organisation.

“We would also like to apologise to him for any additional disruption he has experienced and assure him of our attention as a matter of urgency to resolve this.”

 

A few high Street shopping vouchers seems to be insulting, even though the housing association was run by a sound charitable organisation that needs to account for every penny in order to help as many people as possible.

What do you think?

 

 

 

It is now easy to get needlestick (sharps) injury insurance in the UK though how easy it will be to succeed in a claim remains to be seen, and many solicitors are advertising their claim services in the event of injury.

Together with specific legislation to ensure suitable engineered sharps safety devices – though still some Trusts are delaying their introduction – see Compliance with Safer Sharps legislation – the UK Hall of Shame – there is far greater awareness, regular training and established protocols for investigation and specialist care in the event of an incident. Regrettably however non-healthcare staff are still receiving a poor service in A&E that should itself be the subject of litigation as well as a report to the regulator, in this case CQC.

While we have no objection to private healthcare, an advertisement to private “Needle Stick Injury Profile” testing raised an eyebrow in the extreme! For an inclusive price of £229.00 you can have blood taken and tested for:

  • Hepatitis B surface antigen
  • Hepatitis C antibodies
  • Hepatitis C antigen (early detection)
  • HIV 1+2 antibodies and p24 antigen
  • Serum saved for 2 years

Results are available within hours of receipt of samples. But how many hours? Time is important, and a turn-round time of 4 hours is promised.

The service is described as “(Donor – Not recipient)” but surely this is a test of the recipient of the needlestick injury and not of the donor, ie, the patient on whom a needle or blade had first been used for which specific consent requirements are essential and far outwith the scope of this service.

But testing is often essential. That decision must be on a carefully risk-assessed and clinical evaluation though occasionally testing might provide reassurance to a concerned “victim” where testing is not really indicated.

However, what is of concern here is the lack of specialist medical expertise. Touting a blood testing service – however much that might costs – without the necessary prior clinical assessment and without follow-up to interpret the results and plan 3 month and 6 month repeats with, if indicated, early antiviral prophylaxis is simply wrong.

For those who purchase this service this additional support may be available – we simply do not know – though this would surely all be at considerable increased cost.

For those who suffer a sharps or needlestick injury, the full range of services of the NHS should swing into action, quickly and without delay, to include specialist clinical assessment according to defined clinical protocols, and including all necessary prophylactic drug therapies and long-term follow-up.

This is not the place for private blood testing.

 

 

 

 

JobsVeolia’s Energy Recovery Facilities utilise world-class technology to safely transform residual waste in to energy.

For the national grid, they generate enough energy to power over 189,000 homes annually. Energy Recovery makes an important contribution to reducing the UK’s long-term energy gap and helps to increase landfill diversion as part of an integrated waste management strategy.

We are looking for a Team Leader with experience of dealing with Clinical or hazardous waste to join our team in Tyseley, Birmingham. You will be responsible for providing operational support to the Clinical, Pharmaceutical, Commercial & Industrial Waste disposal for VESB and Secure Destruction Services for Veolia UK.

Key responsibilities:

  • Supervise the Clinical Waste Operatives, ensuring staff are allocated tasks accordingly to meet the requirements of waste acceptance and waste throughput, assisting in this work as appropriate.
  • Maintain statutory and statistical information associated with the Clinical and Site Operation in accordance with applicable Company Procedures.
  • Supervise the Day Operation Staff, scheduling work and allocating tasks as required to maintain the ERF site in a clean, tidy and safe condition as required by the Site Permit.
  • Liaise with Clinical Waste Customers as required to maintain a high quality and reliable service, while ensuring compliance with the requirements of the Site Authorisation and appropriate legislation.
  • Ensure compliance with the company’s Quality and Environmental Management System and Health and Safety Policies. Ensure that the facility operates within legal requirements and environmental legislation ISO 9001,1401,1800
  • Ensure contractors are compliant with the requirements of the BMS and in particular EA guidance note 5.07.

Job Type: Standard

Qualifications:

Apprentice trained Engineer / Technician, qualified in a relevant Engineering or Scientific discipline, however extensive relevant experience will be considered

Extensive experience predominantly in one or two of the following areas and working knowledge of the others:

Practical approach to problem solving
Proactive
Self motivated
Ability to work in a multi project environment
Ability to forge and maintain good inter personal working relationships
Capable of preparing technology proposals
Strong communicator across all levels
Presentation skills across all levels including technical report writing
Requiring minimal supervision and able to cope with numerous issues simultaneously

Capable of prioritising tasks accordingly

Ability to interrogate / understand maintenance to provide accurate plant condition information / recommendations.

Competent problem solver with a practical approach to solving problems.

Knowledge of current H&S,

To apply for this position, candidates must be eligible to live and work in the UK

 

http://www.cv-library.co.uk/job/202706994/Energy-from-Clinical-Waste-Team-Leader?s=100320

 

If you apply for this post, do tell them you heard about it from the Clinical Waste Discussion Forum

… and Good Luck!

 

 

 

needles_newportA Newport teenager who found around 100 needles dumped in a popular lane has criticised the City Council for not removing them sooner.

The young man, 16, said he first saw the pile of needles in the lane which is used to access the Iceland supermarket off Clarence Place, on Friday. The teenager used the route again on Saturday morning to get to the train station and found them lying in exactly the same place at around 9am. He took a photo of them and that his aunt, who does not wish to be named, posted it onto the Argus social media site.

He said he was gravely concerned that children who often use the lane were at serious risk of injury or infection and tried to report the hazardous waste to the council over the weekend.

“I live about five minutes away and walk that route every day as it is a faster route to the station. I also walk my little sister along there.

“I have seen rubbish there before but never needles.

“There were around 100 with some scattered along the lane.

“I saw the council’s street cleaners and told them about it. I said that someone needs to clean them up straight away and they told me that it was not their responsibility.

“In my opinion it should have been done straight away.

“It’s not acceptable that they remain there for most of the weekend, with kids using the lane.”

Mr Morris said he had heard children asking their parents what the needles were.

“Some of them don’t have caps on it’s a real hazard.

“They should have cleaned it up as soon as I reported it to them and the matter made a priority.”

Mr Morris said the needles had been taken away by Monday morning but wanted to see a quicker response time in their removal.

He also made attempts to contact Newport City Council by phone to report the matter on both Saturday and Sunday and wants to see a weekend helpline set up for residents to report such incidents.

A Newport City Council spokeswoman said it’s streetscene department removed a quantity of syringes from privately-owned land at the back of Clarence Place on Monday.

http://www.southwalesargus.co.uk/news/13586388.Concern_after_100_needles_found_dumped_in_a_Newport_lane/

 

So, a response that was neither instant nor same day, and thus with a Friday to Monday lag disagreement about the quality of that response from Newport City Council. Perhaps they don’t have streetscene staff working on Fridays, Saturdays or Sundays.  That is improbable and the more likely explanation is a closed office that fails to process these reports with the necessary urgency.

We have many reports of “urgent” requests for needle retrieval to be left on an answerphone – hence the presumably tongue-in-cheek claims of immediate response, by the answerphone, – to be completed only days later. Perhaps in the minds of Newport City Council that is adequate?

It seems however, that those involved have done a good job in prodding Newport City Council to action. On their web pages, there is no mention of needles and related drug litter, and no dedicated reporting mechanism. Newport City Council does not collect clinical or medical waste.

 

 

 

The World Bank has supported a project to build a medical waste treatment area with a total cost of VND120 billion (US$5.4 million) in this central province, health officials said.

Of the total cost, some VND106 billion ($5 million) will be funded through a loan from the World Bank and the rest will come from the local budget.

Vietnam-medicalwasteThe health sector is working with the province’s authorities to complete the necessary procedures for building the medical waste treatment area, Nguyen Tan Duc, director of the province’s Health Department, said.

The project, which is scheduled to be completed by 2017, will focus on improving the management of solid waste from health care centres in the province. It covers the construction of a dedicated treatment area for hazardous medical waste from hospitals and health care centres. The project will also organise training classes to enhance awareness of the proper management of medical waste.

Once completed, the project will help treat 400kg of medical waste per day. The hazardous clinical/medical waste will be sterilised prior to being buried in the province’s landfills.

 

This news comes from VietnamNet. The image that they have used to illustrate the piece shows an open yellow clinical waste sack filled with items including several syringes.

Regrettably, this goes against best practice that demands disposal of syringes and needles intact but uncapped, since there is an additional risk of sharps injury during needle removal. This also addresses concerns as to the fate of those loose needles that might too be lurking unseen in that sack. That is unsafe and greatly increases the hazard to waste handlers and the risk of sharps or needlestick injury.

A blush pink Marigold won’t protect!

 

 

 

 

Shambolic’ treatment of cleaner turned away from three health centres after being pricked by a potentially dirty needle.

A cleaner pricked by a dirty needle was left horrified after being denied treatment by three separate health centres.

David Crisp was cleaning public toilets in Trinity Street, Fareham, when he picked up tissue paper not knowing a needle was wrapped inside.

The 40-year-old was pricked by the needle and, on the advice of his boss, was told to go to A&E at Queen Alexandra Hospital, Cosham.

But Mr Crisp, of Cochrane Close, Gosport, was turned away at A&E and later told he could not be helped by his GP practice and at a walk-in centre as all three were following different protocols and believed they were acting correctly in sending him elsewhere.

After calling the NHS helpline 111 more than five hours later, Mr Crisp was told to go back to A&E.

Now a Clinical Commissioning Group – which pays for health services – is looking to advise all practices to follow the same policies to ensure patients are not let down again.

Mr Crisp said: ‘The whole day was shambolic and it left me feeling very emotional and angry – even several days later. I was concerned about HIV and hepatitis C, worried I could have either of these and that I was delayed treatment. I was turned away from A&E as it was 2pm and was told to see my GP.’

But when his wife called Brune Medical Centre, in Rowner Road, Gosport, she was told by a receptionist that needlestick injuries are treated at A&E.

Mr Crisp went to the Guildhall walk-in centre in Portsmouth, where he was given advice but told they could not help any further.

And when the father-of-three called NHS 111 at 7pm, he was told the best place for him to go was A&E.

‘After all that I couldn’t believe I was being sent back to the place where it all began,’ said Mr Crisp.

‘What made me angry was I needed treatment quickly but was left waiting several hours instead.’

Mr Crisp has since been given vaccinations and will need to have blood tests and boosters for the next year as he awaits initial results.

Dr Stuart Morgan, senior partner at the Brune Medical Centre, said: ‘It was our firm understanding patients with needlestick injuries should be seen in A&E. We have apologised to the patient for any impression given that we were not willing to see him, and we have been in contact with several NHS services to ensure he has received appropriate treatment.

‘We are entirely satisfied our receptionist did everything she felt appropriate in the circumstances.’

A QA spokesman said: ‘Our needlestick policy is that within working hours patients should visit their employer’s occupational health service or their GP, and out-of-hours should go to the emergency department for a risk assessment and appropriate follow-up.’

A Care UK spokesman, which runs the Guildhall walk-in centre, said: ‘The contract we operate under does not permit the team working there to carry out blood tests on patients who are not registered with the centre, unless the GPs have reason to believe the patient has cancer.

‘As a result of this contractual obligation, we refer patients that have been pricked by a potentially dirty needle on to another NHS service for tests.’

http://www.portsmouth.co.uk/news/health/local-health/shambolic-treatment-of-cleaner-turned-away-from-three-health-centres-after-being-pricked-by-a-potentially-dirty-needle-1-6874360

 

This appalling tale of incompetence is regrettably far too common, though it much reach the top – or is that the bottom? – of a very sorry pile of clinical negligence.

We have on record members of the public told to collect discarded needles in the stead of a council employee as a cost-saving measure, and of council employees,  waste handlers in the clinical and general utility areas, and ancillary staff, being denied treatment for a sharps injury that on triage is dismissed as a trivial injury. But sharps injury is NEVER trivial.

The most appropriate plan to adopt in the event of sharps injury is firstly not to suck or squeeze the wound, wash it gently but thoroughly and clean the wound with soap and running water, encourage bleeding without pressing or squeezing the wound too hard, and to cover the would lightly with a clean dry dressing.

Then, go IMMEDIATELY to a nearby ACCIDENT & EMERGENCY department, preferably at a major hospital. Explain what happened and don’t be fobbed off. There may be a delay as more serious cases are managed as a greater priority but time can be critical and excess delay is not acceptable. Ask for urgent treatment and remind the front line staff of the risk of bloodborne virus infection.

If a delay does occur, be prepared to push, shout, stamp, to get seen. NEVER accept advice to got to another hospital or minor injuries unit as these do not have access to the specialist infection diseases advice that might be required. NEVER go to a GP clinic.

It might help if the employers of those who might suffer sharps injury as part of their duties prepare a small laminated sharps injury action card to be carried in all waste collection vehicles and at other strategic locations. In the event of injury, take this with you to A&E, to remind the staff of the potential implications and severity of sharps injury and blood splash exposures and to ensure that you are not dismissed as having a trivial and largely unseen minor injury.

This last point will be taken up with the safety group of CIWM, and Blenkharn Environmental will be working on suitable wording for an action card. This should be available the Clinical Waste Discussion Forum and CIWM website as soon as possible. This can be modified locally, with Company name and emergency contact numbers etc, laminated and distributed for the benefit of all at-risk staff.

 

 

 

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.

 

 

A Mansfield, US, based business is at the centre of an investigation by the FBI.

Federal authorities say four men have been indicted in an alleged conspiracy to defraud investors of $7 million for a hypodermic needle device called “The Sharps Terminator.”

William Schureck, 80, of Lexington, Daryl Dane Donohue, 66, of Mansfield, Kenneth Jackson, 58, of Glenmont and Dennis Deciancio, 72, of Macedonia, all four men affiliated with the company called Medical Safety Solutions or MSS. The men were indicted on 31-counts that include fraud, conspiracy to commit mail and wire fraud, money laundering, and making false statements.

According to the indictment, the defendants misrepresented a product that was not federally approved or ready for mass production. They’re also accused of seeking buyers for private shares of stock in the company that weren’t registered securities between 2007 and 2013.

The indictment also states that Jackson and Schureck transferred money to cover other expenses and Jackson gambled more $3 million at the Mountaineer Casino between 2009 and 2013.

This might be something of an administrative matter, or lack of registration, failure to compete the necessary forms and/or submit to official testing procedures. And of course that trifling matter of $7 million. If however it relates, even in part, to bogus claims that sharps can be managed more safely using http://www.sharpsterminator.com/ than any alternative, or that the device is proven in fact to be unsafe, then that would clearly be far worse.

 

 

 

 

“Needles in recycling waste force Tewkesbury Borough Council to send 21 tonnes of rubbish to landfill.

“Hypodermic needles have contaminated 21 tonnes of recycling in Tewkesbury, forcing the borough council to send all of the rubbish to landfill.

“All of the recycling waste collected from blue bins in the borough gets hand sorted and needles have been found on a number of occasions since January this year.

“The needles pose a real threat to the health of workers when they sort through the borough’s rubbish at a material recycling facility near Bishop’s Cleeve.

“As a result the borough council is taking dramatic action to keep them safe

http://www.gloucestershireecho.co.uk/Needles-recycling-waste-force-Tewkesbury-Borough/story-26900282-detail/story.html#ixzz3gQZMCfpT

 

This “dramatic action” seems firstly improbably, and if correct a huge over-reaction that was likely to be unnecessary. It’s always a problem when needles appear on picking lines and every care must be taken to train staff and provide appropriate PPE including god quality gloves, even to agency and temp staff. A plan should exist to stop the line(s) and retrieve needles for appropriate disposal.

Scooping up an day’s throughput and dumping the entire lot, many vehicle loads, to landfill seems unnecessary and entirely inappropriate. It would also be costly but I suspect its the Council that takes the hit as its contractors will have ensured that the financial responsibility is not theirs.

If I were working for the Environment Agency I would now be asking very tough questions as to why this course of action was taken.

 

 

 

 

New data from the on-going Unlinked Anonymous Monitoring (UAM) Survey of HIV and Viral Hepatitis among People Who Inject Drugs (PWID) have been published on the PHE website.

The updated set of tables present data from the survey for the period 2004 to 2014 inclusive. These data are from the main UAM Survey, which is targeted at people who inject psychoactive drugs, such as, heroin, crack cocaine and amphetamines.

This article presents an overview of the trends between 2004 and 2014 for HIV, hepatitis B, hepatitis C and risk behaviours from people who inject psychoactive drugs participating in the main UAM Survey. In addition to data for the whole of England, Wales and Northern Ireland (the areas covered by this survey), the tables include data for each country separately and the regions of England. Further data from this survey related to hepatitis C will appear in the Hepatitis C in the UK: 2015 report [3] to be published later this month.

HIV

The prevalence of HIV among the 3,091 PWID who took part in the main UAM Survey across England, Wales and Northern Ireland in 2014 was 1.0% (95% CI, 0.07%-1.4%). Between 2004 and 2013, prevalence varied between 1.1% and 1.6%. In 2014, the HIV prevalence was 1.1% (95% CI, 0.22%-3.4%) in Wales and 0.65% (95% CI, 0.01%-3.9%) in Northern Ireland. In England, the HIV prevalence was 1.0% (95% CI, 0.69%-1.5%) in 2014, not significantly different from 2004 when the prevalence was 1.4% (95% CI, 1.0%-2.0%). Read the rest of this entry »

There are several ways to dispose of a used hypodermic needle, especially after being use to administer a DIY injection of illicit drugs?

This time, its Bangor in North Wales. Described as shocking footage, this video was taken on a drug-blighted estate, prompting calls for action from ‘disgusted’ families in the area

A man squats outside a block of flats in broad daylight and injects himself before casually throwing the needle in bushes.

The shock footage that highlights the scale of the drug problem on a troubled North Wales estate, reports the Daily Post.

The footage, taken through a window at the Plas Glyndwr flats in Bangor, was posted by county councillor Chris O’Neal on Facebook and prompted a huge reaction on social media.

We are told that the needle has since been disposed of by a member of staff from housing association Cartrefi Cymunedol Gwynedd (CCG). We can only hope that all of the others are retrieved and disposed safely, without risk of injury to members of the public or staff.

see also Dundee addict unconscious, trousers down and holding a needle

Woman pictured unconscious, trousers down and holding a needle in a Dundee close. Admits breach of the peace.

A Dundee woman has been pictured unconscious, trousers down and holding a needle in her left hand in a disturbing image that exposed Scotland’s heroin shame.

In Court she admitted her part in the ‘horror episode’. The pair were found in a close in Dundee’s Albert Street, slumped in a corner of the entrance way to a Dundee tenement block in a drug induced stupor.

“The accused was found to be in a state of undress and had her trousers down to her ankles exposing her underwear.

“Witnesses thought she may have fallen down the stairs and approached her.

“They noticed she was holding a hypodermic needle in her hand.

“The matter was reported to police who arrived shortly after.

“The accused was bleeding from the injection site in her groin and an ambulance was called.”

With a 2 month jail sentence for the man and a so-far deferred sentence for the woman who admitted a breach of the peace, the case highlight the real horrors of IV drug abuse at its lowest. It is dangerous for members of the public, for emergency services staff and for those whose task is to clean up drug litter and blood from the scene afterwards.

 

 

 

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.

 

 

 

Contaminated needles and clinical waste found at illegal tattoo studio

As if by some sort of surprise, news reports tell of contaminated needles and clinical waste found at an illegal tattoo studio in Devon.

A Devon council has successfully closed an illegal tattoo shop after environmental health officers discovered contaminated and discarded needles and clinical waste.

Adam Jones, of Winner Street in Paignton, was found guilty of tattooing at an unregistered studio in Church Street, Paignton at Torquay Magistrates Court.

He was fined £1,000, ordered to pay £120 costs and £120 victim surcharge in his absence.

After receiving complaints about the illegal tattoo studio, environmental health officers from Torbay Council went to investigate.

Among the evidence found were contaminated and discarded needles, clinical waste and other tattooing related items.

A council spokesman said people who want to run a legitimate tattoo business must register with the local authority.

He said: “Registered businesses are subjected to regular inspection in order to maintain high hygiene standards. By using an unregistered tattoo studio, the public run the risk of serious infection from poor and unhygienic practices and harm to the wider community.”

 

Illegal and unlicensed tattooists are apparently quite common, though inevitably most are unknown to regulators. EHO’s will regulate, but first there needs some sort of problem such as inappropriate disposal of wastes causing complaints or, worse, an outbreak of infection. If not, these establishments that may be little more than a bedroom enterprise, are likely to stay hidden.

 

 

 

 

 

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 »

Just published:

Healthcare Wastes
Blenkharn JI
In, Reference Module in Earth Systems and Environmental Sciences. Elsevier Inc, 2015. 25pp http://dx.doi.org/10.1016/B978-0-12-409548-9.09488-4

Available only from Elsevier

Though it would be unthinkable to wish a sharps or needlestick injury on anyone, there is just a hint of poetic justice in the report from the Exeter Express and Echo.

“A DRUG dealer was caught red handed after being seen acting suspiciously in an Exeter supermarket carpark.

Two police officers followed the man behind a set of recycling bins behind Morrisons in Beacon Heath.

They caught the dealer and buyer the heroin and crack cocaine exchange took place. The buyer tried to throw the drugs away but the dealer was found with £100 which had just been paid to purchase five wraps of heroin and two of crack cocaine.

The 42-year old man from Exeter admitted two offences of supplying class A drugs and one of possessing criminal property.

He was jailed and suspended for 18 months and ordered to undertake an intensive drug rehabilitation course by Recorder Mr John Williams at Exeter Crown Court.

His sentence was suspended because the dealer had already started to address his drug problem and had been working well with probation and the police ‘Turnaround’ team.

Police recovered five wraps of heroin and two of cocaine weighing a total of two grams.

Miss Kelly Scrivener, who defended the dealer said he was doing well on a previous probation order but the drug treatment element had ended shortly before this offence and he started using heroin again.

She said: ”He was exploited by his dealer. He was deliberately over supplied and took the drugs and the next day told he owed him money and asked to deliver these drugs for him.”

She said he had been employed at the Gabriel House homeless hostel in the past but been forced to give up his job after suffering a needlestick injury.

The man is now receiving drug rehabilitation and working with the Turnaround team.

http://www.exeterexpressandecho.co.uk/Exeter-drug-dealer-road-recovery-caught-dealing/story-26470122-detail/story.html

 

 

So, the addict becomes a dealer, and while working at Gabriel House, the charitable support organisation that delivers an invaluable residential resettlement project for men and couples, aged 18 – 65, who are homeless, suffers a sharps injury.

Gabriel House will, I am sure, have a strict ‘no drugs’ policy. However, in this case someone’s IV drug use resulted in sharps injury to an addict and dealer.

Poetic justice?  Perhaps.

A dramatic example of the complexity and almost inevitable downward spiral and widespread collateral damage caused by drug abuse.

 

 

A number of Rotary Clubs in Mongolia and the United States and grant makers, collaborate to purchase locally made sharps containers (biohazard boxes for sharp medical waste) made in Mongolia to meet the World Health Organization’s (WHO) technical specifications.

FIRE (Flagstaff International Relief Effort) distributes the boxes and provides important training to health care workers, waste handlers and inspection agents about the proper use of sharps containers and safe disposal of sharps waste nationwide.  The objective is to substantially reduce the number of needle sticks and lacerations with contaminated needles or other medical sharps waste, inadvertently preventing the spread of blood borne viruses in the health care environment.

To date, 94,000 sharps containers have been distributed to 229 health care facilities throughout six provinces.  That is enough for a two-year supply for every hospital and health care clinic in these six provinces.

Thank you Rotary, FIRE, and all others who have contributed to this invaluable contribution toward improvement in safety and public health.

 

 

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

 

 

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.

 

 

 

Stuck in wall of motelA woman visiting Portland, Oregon, was greeted by a shocking scene in her motel room: dirty needles stuck in the wall.

She visited the city on April 10, 2015 to attend the Portland Swap Meet at the Expo Center. She booked a room through the website Hotels.com and ended up at the Americas Best Value Inn and Suites in Northeast Portland.

She checked in to room 249 and started videotaping the experience after she discovered what appear to be dirty needles stuck in a wall of the room.

“This is going in to our room. The room appears to be nice. Notice that the beds are messy. Look up close, there’s dirty spots,” Shipman narrates on the video.

“Went to plug my phone into the jack, and looked up, and low and behold, look what we have,” she explained.

She discovered two syringes stuck in the wall like darts.

“One still has stuff in it. This one, you can’t really see from the phone, but there’s blood down the wall, and on the end of the needle”.

It is often not considered how often sharps and associated drug waste, and waste from diabetic blood testing and insulin administration, is discarded in hotel rooms.

 

Take a look next time you stay in a hotel. Check out the housekeeping cart, and spot the sharps bin. What I have never seen is graspers of other tools including sharps-resistant gloves, and we can only hope that the staff have been properly trained in safe retrieval as much as sharps bin use.

Hotels rely on a high proportion of short term, seasonal and temporary staff. When a sharps injury to a staff member has occurred, it seems not unlikely that a Court will be particularly sympathetic to a claim for damages, and generous with the award since this is now an entirely predictable risk.

 

 

Needle with drop of bloodA mum has spoken of her disgust after finding a used needle and splattered blood in an Aberdeen fast food restaurant.

She found the needle, a lighter, and blood on the floor in the disabled toilet in Burger King on Aberdeen’s Union Street.

One can only sympathise with the restaurant chain. What are they to do?  Ban those who look like IV dug users – how can they tell?  Close the toilets?  Install sharps bins?

Whatever action they might take, they will face a barrage of complaint.  Regular checks by cleaning and/or security staff, and properly equipped and trained cleaners is probably the only answer, but without a check after every single users and with locks on the doors even that is flawed.

Needle with drop of bloodWe are all concerned about the risk of sharps or needlestick injury, with the health & safety implications of bloodborne virus and other pathogen transmission, infection and psychological injury, and perhaps a hefty personal injury claim.

But it’s not only we humans who suffer sharps injury from drug litter and discarded needles. Pets too can have problems if the chance to step on a discarded needle and dog owners are being warned to be on their guard for discarded needles in fields.

11-23-12 (2)A Whitley Bay lady had been walking her Golden Retriever Bruin through Churchill Playing Fields in Whitley Bay on Good Friday when he stepped on a hypodermic needle, which went into the pad on his paw.

“I contacted the police and they are coming to collect it, and then raise the issue at a forthcoming forum meeting to warn people of the potential danger. ”She was able to get him to a vets where he was given an injection and antibiotics, but was left with a £112 bill.

Now she is warning others to be on their guard. “Bruin started limping with his paw in the air and his toes curled under.

“I thought it was a golf tee or a rawlplug, but when I started to pull it out, I was shocked to see it was a needle.

She added: “Bruin has been sick a couple of times but now he seems fine.

“I’m now avoiding the field, and taking him in the opposite direction for his walks.

“There is anti-social behaviour in the area at the minute anyway.”

Get well soon, Bruin.

 

 

 

Indiana has seen a significant outbreak of HIV infection among needle-sharing IV drug users.

One primary concern among IV drug users is that declaring their needle use will attract police attention thus driving their habits still further underground. But State officials say more than two dozen people are now taking part in a needle-exchange program aimed at stemming an HIV outbreak in a rural southern Indiana county.

Indiana’s Joint Information Center said that 29 people had participated in Scott County’s needle-exchange program by Thursday. Those participants have received 1,151 clean syringes and returned 437 used ones.

Gov. Mike Pence temporarily waived Indiana’s ban on needle-exchange programs in a March 26 order authorizing one solely for Scott County. The program began there April 4.

Needle-sharing among intravenous drug users has spurred the outbreak, and 106 people had tested positive for HIV by Thursday.

Banning needle exchange schemes seems to be a ludicrous response to a problem that will never go away, but may get far worse without a complete range of public health measures that include the provisions of clean needles and ideally a clean, safe and hygienic injection facility of “shooting gallery” for their use.

 

http://www.hometownstations.com/story/28778734/29-now-taking-part-in-indiana-needle-exchange-to-combat-hiv

http://www.indystar.com/story/opinion/editorials/2015/04/11/editorial-wave-heroin-abuse-pounding-indiana-swift-action-needed/25657799/ 

 

A WARNING notice has been put up at public toilets after drug users started leaving needles in cubicles.

The problem in the toilets behind Buckley Library, which are regularly used by children and elderly people, has prompted Buckley Town Council to put up the notice warning people of the dangers posed by drug paraphernalia.

Council clerk Martin Wright said cleaners were finding needles in cubicles every day for a period a few weeks ago.

The public warning pinned to the entrance door also says the toilets have recently been vandalised.

If there is a problem, blue light illumination is  good start to make the environment unfavourable for injection, and perhaps a secure and properly managed sharps bin too.

http://www.leaderlive.co.uk/news/146767/warning-over-drug-needles-in-public-loos.aspx

 

A warning notice pinned to the door seems insufficient, driving away legitimate users to create a near derelict and abandoned environment for IV drug users.

That would be counter productive.

 

 

From India, meet the man who seems to enjoy sticking over 500 needles into his face….

 

 

 

 

No comment!

 

 

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

 

 

 

Syringe in play box 1A woman was horrified to find a used syringe full of liquid lying on top of a Peppa Pig book in a hospital toy box.

  • Woman, 22, found a used syringe full of liquid in a hospital toy box
  • She posted picture with a caption saying: ‘NHS at its ‘fucking finest’
  • Syringe discovered on top of a Peppa pig book and surrounded by toys
  • Bassetlaw Hospital said syringe had not been disposed properly by staff

The 22-year-old woman found a used syringe full of liquid lying on top of a Peppa Pig book in a hospital toy box after a member of staff did not dispose of it safely.

She posted a picture of the syringe surrounded by children’s toys with a caption saying ‘NHS at its ‘fucking finest’.

The woman, who wished to remain anonymous, said it was ‘shameful behaviour’ from Bassetlaw Hospital in Worksop, Nottinghamshire, and asked ‘how can anyone be so careless?’

Bosses at the hospital investigated the incident and admitted that a member of staff did not dispose of the syringe safely.

Atrocious standards of safety in an NHS hospital resulting in a syringe filled with some, to us, unidentified pharmaceutical product left in the play box on a children’s ward.  It doesn’t often get worse than that!

 

http://www.dailymail.co.uk/news/article-2983008/Woman-horrified-used-syringe-liquid-lying-Peppa-Pig-book-hospital-toy-box.html

 

 

 

Tinsulin penwo pupils, 14, expelled after infection scare at public school when 15 pupils were stabbed with needle.

  • Two schoolboys jabbed classmates at a top public school with needle
    Teenagers used a diabetic pen found in a classroom, it was reported
    Needle is usually used to test blood sugar levels for people with diabetes

The pair, both 14, were dismissed from the school in south England after claims they found a used diabetes pen, which normally tests levels of glucose in the blood, belonging to a pupil before attacking their classmates with it.

School authorities alerted the police and public health officials, who recommended that the students be tested for Hepatitis B, Hepatitis C and HIV, it is claimed.

They used the needle of the diabetes pen, believed to have been left behind by someone with the condition, which is usually used to test levels of glucose in the blood.

Teachers immediately called the police and public health officials, with affected students undergoing emergency tests.

The police took no further action but the boys were expelled.

A spokesman for the school said: ‘We can confirm that an incident took place at the school last month involving a diabetic testing pen.

‘The incident was extremely concerning and as soon as we became aware of it all parents of pupils involved were contacted immediately and given the advice received from public health experts.

‘While the risk of infection was low or negligible, children affected were advised to have blood tests all of which proved negative.’

Read more: http://www.dailymail.co.uk/news/article-2986729/HIV-scare-leading-public-school-15-pupils-stabbed-needle.html#ixzz3VbKuLQBu

 

 

 

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/