Waste management - some selected publications
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"Green shoots of
recycling"
Blenkharn JI.
Brit Med J. Mar29, 2009.
http://www.bmj.com/cgi/eletters/338/mar10_2/b609
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"Waste management
requirements of community iv therapy services"
Blenkharn JI.
Brit J Community Nursing 2009; 14: 38-9
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Clinical Wastes
Blenkharn JI.
Health Service Risks Special Report: Croner’s Health Service Risks.
2008, Issue 140, 14 November 2008. pp 2 – 7.
Publ Wolters Kluwer (UK) Ltd
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Croner |
Sharps disposal – A
universal responsibility.
Blenkharn JI.
Brit J Dermatology 2008 159: 1212
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Quo vadis? Science and
regulation as uneasy bedfellows
Blenkharn JI.
The Open Waste Management
Journal 2008; 1: 1-3
In the waste management
field and the wider environmental sciences arena, science and regulation
have become increasingly uneasy bedfellows. Scientific research should
create the bedrock that underpins environmental legislation, shaping its
construction, interpretation and implementation. It is the currency of
investment in the future of waste management. Society must be assured
that scientific knowledge has been subject to rigorous peer review to
ensure its credibility and high standard. The architects of our waste
management legislation must be similarly rigorous and fully transparent
in their application of that knowledge and its use in the shaping of the
legislative framework.
The interface of science
and policy presents both opportunities and challenges. Imposing
penalties under regulations structured without satisfying a reasonable
burden of scientific proof in their construction is questionably as
wrong as seeking prosecution without evidence of fact. Science has its
own professional standards and a universal Code of Practice for
scientific conduct to which all investigators must adhere. Regulators
must do likewise, to ensure that the need for an effective scientific
foundation to legislation is properly met at all times, managed
effectively and applied objectively and with uniformity.
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Luminol-based
forensic detection of latent blood: an approach to rapid
wide-area screening combined with Glo-Germ™ oil simulant studies
Blenkharn JI.
Journal of Hospital Infection 2008; 69: 405-406
Bloodborne virus
infection is a constant threat for those working with clinical
wastes. Sharps injury is the obvious hazard, but infection may
be transmitted also by splashes to the eyes or mucous membranes,
or contamination of pre-existing skin lesions.
Basic safety and
hygiene precautions should suffice. Proper packaging of wastes,
puncture-resistant gloves or gauntlets, and effective
handwashing when gloves are removed should be sufficient. But
are hygiene standards acceptable?
Testing for latent blood
contamination is now available. This can be used as part of a specific or
more general environmental hygiene appraisal, to evaluate the efficacy of
cleaning regimens, to assist in the training of staff, or to ensure
compliance with hand and environmental hygiene and safety protocols.
Further information
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Clinical wastes in the community: local authority
management of discarded drug litter
Blenkharn JI.
Public Health 2008; 122: 725-728
The
inexorable spread of intravenous drug abuse has
resulted in increasingly common finds of drug litter
in the community. This may include used syringes and
hypodermic needle along with other paraphernalia,
creating a particular risk of sharps or needlestick
injury and the transmission of bloodborne virus
infection.
Local Authorities have a statutory duty to manage
the prompt collection and safe disposal of these
hazardous items.
Only
353 of 526 (66.9%) Local Authorities provided
information concerning the collection of drug litter
discarded in the community. Though 25 LAs indicated
that the retrieval of needle finds would be managed
as a matter of urgency actual response times, though
infrequently specified, ranged from within 1, 2 or 4
hours up to within 7 days. Safety and healthcare
guidance provided to the public was infrequent, and
often incomplete or confusing, with no consensus of
the correct approach to be taken. 'Do not touch' was
the advice of 89 Local Authorities, though 18 others
invited the public to pick up needles and take them
home to await collection, or to a local GP or
Pharmacy where a suitable sharps bin would be
available. Others advised the finder to pick up
needles only if there was any immediate danger
(n=89), but gave no indication of safe methods for
retrieval or the arrangements for later safe
disposal.
The
arrangements for the prompt collection and safe
disposal of discarded drug litter by Local
Authorities is generally inadequate, may not comply
with current guidance, and may be unsafe.
Please contact
Ian Blenkharn for a reprint..
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Airport Dermatophytoses
Blenkharn JI.
Public Health 2008;
122: 1291-1292
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Community-acquired needlestick injuries - rapid and safe
retrieval of discarded needles is essential
Blenkharn JI.
Pediatrics 2008;
122: 1405
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Sharps injury in healthcare waste handlers
Blenkharn JI & Odd C.
Ann Occupat Health 2008; 52: 281-6
Sharps injury is a constant and most serious risk
for healthcare waste handlers.
In
this comprehensive study of healthcare waste
handlers, the incidence of sharps injury was
approximately 1 in 29000 man hours. The use and
value of ballistic protective gloves and trousers is
examined, and the underlying causes for sharps
injury examined.
There
appears to be some lack of understanding among waste
handlers of the risks of sharps injury, and of those
wastes that may be most hazardous. Glove use and
hand hygiene was in some cases deficient, in part
due to this lack of recognition of the risks
involved. This echoes similar deficiencies in glove
use and had hygiene among healthcare staff. This
identifies additional training needs that are
presently not met. However,
it is clear from the results that healthcare staff
are failing in their Duty of Care to ensure correct
and safe disposal of sharps with 36 or 40 injuries
caused by sharps placed in thin-walled plastic waste
sacks intended only for soft wastes.
Please contact
Ian Blenkharn for a reprint.
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Needlestick injuries in primary care
Blenkharn JI.
J Public Health (Oxford)
2008; 30(4): 514
In
response to a paper from Wales that examined the
risks to community healthcare staff including GPs
and practice nurses, it is apparent that the risks
to waste handlers are significantly greater and that
the incidence of sharps injuries may in fact be
higher.
This
brings to the attention of community medical groups
the risks to waste handlers, identifying the need
for prompt specialist care that is rarely if ever
available in the Community, and of course the need
for greater care from sharps users.
The paper is
appear soon in the Journal of Public Health and a reprint will
become available soon.
Please contact
Ian Blenkharn for further information.
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Clinical wastes in the community: Local authority
management of clinical wastes from domestic premises
Blenkharn JI.
Public Health 2008; 122: 526-31
The
increasing numbers of patients receiving often
complex home-based health care, and the growing
number of insulin-dependent diabetic, home
haemodialysis and continuous ambulatory peritoneal
dialysis patients, contributes to the substantial
volumes of clinical waste generated from domestic
premises.
Arrangements for the collection and safe disposal of
these potentially hazardous wastes, generally
managed by local authorities, may be inadequate and,
in part, unsafe. An audit of the websites of the 526
local authorities in England, Wales, Scotland and
Northern Ireland was performed. This evaluated the
information provided concerning clinical waste
collections from domestic premises, the limits and
constraints on this service, service accessibility,
the practical arrangements for collection of wastes,
and the health and safety issues of clinical waste
management for patients who manage their own care in
the community.
Weekly collections were most common, although
several local authorities offered additional
flexibility depending on need. Limits on the minimum
or maximum volumes of waste to be collected, or on
the types of clinical wastes accepted for disposal,
do not support domiciliary health care and create an
additional burden for patients and their carers. Of
particular concern was the health and safety
implication of instructions to place potentially
hazardous clinical wastes in a freely accessible
location outside the home, at the doorstep or on the
footpath, as early as 4 am on the day of collection
or the night before collection.
The
arrangements for local authority clinical waste
collections from domestic premises are, in part,
inadequate and may be unsafe. The arrangements do
not properly support domicillary patients or their
carers.
A
reprint is available in PDF format but cannot be
made available for direct download due to copyright
limitations. Please contact
Ian Blenkharn for further information.
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Hygiene and waste management in UK hospitals: are
self-reported compliance scores always valid?
Blenkharn JI.
Journal of Public Health (Oxford) 2007;
29(4): 472-3
Evidence from audits of
healthcare (clinical) waste management in UK hospitals performed in 2005
and 2006 had revealed generally poor standards of performance. In many
hospitals, unlocked clinical waste carts were common, with many carts
overflowing, with gaping lids and spilled items lying free at their
base. Individual clinical waste sacks and sharps containers were
frequently left on the floor, both within hospital buildings and in the
hospital grounds, apparently due to a lack of sufficient waste carts and
an inadequate frequency of collections for transfer of wastes to a
secure central storage compound.
The current annual health
check report published by the Healthcare Commission reports that 93% of
NHS Trusts (n=368) declared compliance for Core Standard C4e that
specifies standards for the safe handling and disposal of waste.
Overall, these data sit uncomfortably with the evidence of widespread
deficiencies in clinical waste segregation, storage and security noted
during successive audits.
The evolving legislative
framework and operational standards demand rigorous segregation of
wastes, the correct use of an unambiguous segregation scheme and
containment of potentially hazardous clinical wastes, and secure storage
of those wastes pending onward disposal. Notwithstanding, the
fundamental requirement for safe, effective and secure management of
potentially hazardous clinical wastes has remained unchanged. With
evidence of multiple waste management deficiencies at hospitals that
report full compliance with Core Standard C4e, the results of the annual
health check process can falsely enhance the record of compliance in
some UK hospitals, suggesting that self-reported compliance scores may
not always be valid.
A
reprint is available in PDF format but cannot be
made available for direct download due to copyright
limitations. Please contact
Ian Blenkharn for further information.
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Standards of clinical waste
management in
hospitals - a second look
Blenkharn JI.
Public Health 2007; 121: 540-545
The
arrangements for bulk clinical waste handling were
audited in 16 UK hospitals, one year after an
earlier audit that revealed many deficiencies in
performance.
The
standard of performance in clinical waste management
in UK hospitals remains poor, with evidence of
neglect of basic hygiene, housekeeping and safety
standards. However, codes of practice exist, and
despite implementation of the Hazardous Waste
Regulations 2006 that provide further control on all
wastes management issues, the reality of clinical
waste management in some National Health Service
(NHS) hospitals continues to be largely inadequate.
A reprint is available in PDF format
but cannot be made available for direct download due
to copyright limitations. Please contact
Ian Blenkharn to receive a free copy.
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The
best and the worst of waste management?
Blenkharn JI.
CIWM Journal May 2007 12
These are the
questions asked in a short note in CIWM Journal.
A simple question perhaps, but the answers will be
many and varied. What gets your vote as the best,
and the worst, modern developments across the waste
industries? A development in policy or legislation,
a technological development or a few simple words
that have managed to change public perception and
practice?
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Domestic of kitchen recycling - an additional health
hazard for householders?
Blenkharn JI.
J Public Health (Oxf) 2007; 29: 95-6
The rapid expansion of
kitchen waste composting (recycling) schemes for UK households creates a
heightened risk of foodborne infection. More than 50% of 102 UK
households audited for their approach to the recycling of kitchen wastes
kept the food waste bin in or close to the kitchen and rarely, if ever,
washed hands after contact with that bin. As contamination of raw foods
result in contamination of the waste bin, this becomes a potent reservoir
that will perpetuate the cycle of contamination, multiplication and
dissemination of foodborne intestinal pathogens.
A reprint is available in PDF format. Please contact
Ian Blenkharn for further information.
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Classification and management of clinical wastes
Blenkharn JI.
J Hosp Infect 2007; 65: 177-178
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Avian influenza: a need for forward planning?
CIWM
Journal
December 2006 p12
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The
disposal of medical wastes
Business Technology Review: Life Sciences
Fall 2006
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Be careful in the kitchen
Most Local Authorities in the UK now
insist on the separation of kitchen (food) wastes from domestic
premises, with separate collections of these wastes that are now
elimination from landfill deposit or municipal incineration in favour of
commercial composting. All good stuff, except that many households
face problems with the arrangements pout in place for collections.
Reports of fly-blown containers, insect infestations, increases in
rodent sightings and nuisance from smell have been common and
widespread, particularly during the hot summer months. If press
reports are to be believed, most Local Authorities have resisted the
overwhelming clamour of complaints and battle on regardless.
Foodborne infection
associated with kitchen waste recycling creates a particular problem for
householders. In a survey of households required by Local
Authorities to separate kitchen wastes, most kept the food waste
container that had been provided in or close to the kitchen, rather than
in a more remote location as for a dustbin. Critically, it appears that
this proximity does not promote handwashing that might have been
considered after depositing more general wastes in a dustbin.
Since many food products are contaminated with food poisoning organisms
at the time of supply, and these multiply in wastes at ambient storage
temperatures, the food waste bin becomes a potent source for widespread
contamination of the kitchen environment. in the absence of
heightened standards of environmental and personal hygiene, an increase
in the incidence of foodborne infection can be expected.
Collection staff may be at similar risk.
Lids and handles of food waste containers will be heavily contaminated;
splash contamination is inevitable during emptying of bins. The
correct use of PPE and provision of vehicle mounted handwashing
facilities is essential to protect collection staff. Smoking,
eating and drinking must be prohibited prior to removal of PPE and hand
sanitation in order o protect staff from acquired infection.
A reprint is available in PDF format. Please contact
Ian Blenkharn for further information.
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The cost of kerbside
recycling?
Most Local Authorities now undertake
extensive kerbside recycling of glass bottles and jars, paper, food
wastes, and a range of other recyclable materials. Observation of two
collection crews leaning far into their vehicles' glass bins, smashing
bottles and jars with a hammer top to secure greater capacity, and
reduce the frequency of return to base for unloading makes it apparent
that, for those involved, the high cost of kerbside recycling may
include the loss of their sight!
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Potential compromise of hospital hygiene by clinical waste carts
Blenkharn JI.
Journal of Hospital Infection 2006;
63: 423-427
Bulk waste storage carts are common in hospitals, and undoubtedly assist in the day-to-day management of clinical wastes. Intended for the transport and interim storage of primary clinical waste containers, carts are often located close to or within hospital buildings to receive wastes from wards and clinical departments.
Examination of a random selection of bulk clinical waste carts at 9 acute hospitals across Greater London revealed external soiling in all of 23 carts. Eight carts were soiled also on the inner surfaces, with some evidence of bloodstains, and free fluids in the base of 5 carts. Staphylococcus aureus and enterococci were recovered, in low numbers, from the lids (n=7) and wheels (n=10) of carts, with
Escherichia coli, Enterobacter species and
Pseudomonas aeruginosa from the wheels only of a further 5 carts. Two carts were heavily contaminated with
Aspergillus species.
Pathogens originating from clinical wastes may be transferred from contaminated bulk waste carts to the wider hospital environment. It may thus be prudent to require that bulk carts be kept outside clinical areas, and preferably outside all hospital buildings. This becomes particularly important in circumstances where carts supplied by contractors are not dedicated to a single hospital or NHS Trust.
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A backward step - Landfill disposal of clinical wastes
Blenkharn JI.
Journal of Hospital Infection 2006; 63: 105-106
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Glove use by ancillary and support staff - a paradox of prevention?
Blenkharn JI.
Journal of Hospital Infection 2006; 62: 519-520
The use and mis-use of protective gloves by hospital ancillary and support staff are discussed, and the possible implications of failure in correct glove use considered in relation to hospital hygiene and infection control
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Pathology wastes are unquestionably hazardous
Blenkharn JI.
Biomedical Scientist 2006; February p139
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Lowering standards of clinical waste management - Do the Hazardous Waste Regulations conflict with CDC Universal Precautions?
Blenkharn JI.
Journal of Hospital Infection 2006; 62: 467-472
Guidelines for the classification of clinical wastes, produced in support of the Hazardous Waste Regulations 2005 may be less than satisfactory. These guidelines conflict with the universally recognised
Standard Precautions for the Prevention of Infection that are intended to ensure the safety of healthcare staff and of patients, reduce the incidence of hospital acquired infection, and to support effective hygiene standards in hospitals. This conflict is explored, with consideration of the health and safety implications for healthcare and support staff and for workers in the waste management sector, and to the broader issues of hospital hygiene and infection control.
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Standards of clinical waste management in UK hospitals
Blenkharn JI.
Journal of Hospital Infection 2006; 62: 300-303
The arrangements for bulk clinical waste handling were studied in 26 UK hospitals. Storage of carts in areas freely accessible to members of the public and failure to lock individual waste carts was common. Many clinical waste carts and the areas dedicated to their storage were in a poor state of repair. To eliminate the possibility for acquired infection through unauthorised and inappropriate access to clinical wastes and to minimise adverse local or systemic effects resulting from contact with waste pharmaceuticals, to comply with the Duty of Care imposed by UK Health & Safety legislation, and to satisfy concerns regarding the general standard of hospital hygiene, substantial improvement is required in the management of clinical wastes in hospitals.
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Medical wastes management in the south of Brazil
Blenkharn JI.
Waste Management 2006; 26: 315-317
What standards for hazardous waste disposal must apply to remote regions of developing countries? Where resources are limited, the imposition of exacting emission control can be counterproductive. Cost-effective local solutions tailored to the available resources of small communities provide achievable goals. International aid, together with carefully targeted research and development, is needed to assist developing countries achieve improved standards in waste disposal.
A reprint is available in PDF format
but cannot be made available for direct download due
to copyright limitations. Please contact
Ian Blenkharn to receive a free copy.
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Natural disasters: a view from afar
Blenkharn JI.
Waste Management 2006: 26: 318
The many natural disasters occurring around the world, together with armed conflict and terrorist action, have implications for and impact upon hazardous waste management. The difficult juxtaposition of the paramount need for immediate humanitarian aid and the rigid pre-existing control and emission standards for hazardous waste disposal is explored, in the context of the devastating consequences of Hurricane Katrina. Can there ever be a right time to cut corners?
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Infection Control Special. Expanding waste lines: Good Management
Blenkharn JI.
Health Service Journal 2005; 115: 28-29
The impact of changing legal constraints on the management of clinical wastes in healthcare premises is reviewed. Considering in particular the Hazardous Wastes Regulations and prevailing Health & Safety legislation, the impact of changing regulations is considered, and potential pitfalls identified.
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Pathology waste - issues, implications and regulations
Blenkharn JI.
Biomedical Scientist 2005; 49: 678-682
When Pathology wastes are removed from the laboratory for onward disposal they will usually join similar waste streams from other areas of the hospital. With implementation of the new Hazardous Waste Regulations and concerns about Health & Safety legislation, laboratory managers should liaise closely with site managers to ensure appropriate streaming of wastes leaving the laboratory. It is proposed that the training of laboratory personnel is supplemented to include more extensive training in aspects of waste disposal, and that mandatory laboratory accreditation is extended to ensure more thorough review of laboratory waste management procedures.
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Impact of Hazardous Waste Regulations
Blenkharn JI.
Health Estate, Journal of the Institute of Healthcare Engineering and Estate Management 2005; 59: 23-25
This paper discusses the practicality of implementation of the Hazardous Waste Regulations in a busy hospital. With limited resources, and often critical constraints in space and manpower, is it practical or appropriate to create separate hazardous and non-hazardous clinical waste streams, predicated on an often inadequate assumption of infection risk?
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Safe disposal and effective destruction of clinical wastes [Leading Article]
Blenkharn JI.
Journal of Hospital Infection 2005; 60: 295-297
This paper discusses the practicality, and limitations, of proof-of-process testing for destructive waste treatments such as incineration.
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Fugitive discharges and waste disposal
Blenkharn JI.
British Journal of Biomedical Science 2001; 57: 181-182 and 339-341
Autoclave treatment of clinical and laboratory wastes is widely undertaken. The possibility for release of viable micro-organisms from the feedstock, emitted with steam and water (condensate) discharges in the early purging and heating phases of autoclave operation are considered, with recommendations for managing this risk of exposure.
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Safe disposal of sharps
Blenkharn JI.
Lancet 1998; 351: 760
Further options for the effective destruction of used sharps in developing countries, preventing illicit re-use and providing a low cost, low-tech solution to safe disposal.
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The disposal of clinical wastes
Blenkharn JI.
Journal of Hospital Infection 1995; 90 (Supplement): 514-520
The many sources for clinical wastes are considered, with a review of the available disposal technologies. Commonly encountered problems often follow inadequate standards of care in disposal and handling of wastes in healthcare premises, that impact profoundly on the safety and well-being of others. A broad team approach to the management of healthcare wastes in healthcare premises is advocated in order to improve standards, reduce or eliminate errors , and prevent high-risk incidents that may result in inoculation injury in ancillary and support staff.
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Clinical and laboratory waste incineration
Blenkharn JI. & Oakland D.
Medical Laboratory Sciences 1992; 49: 149-150
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Safety and efficiency of clinical waste incineration
Blenkharn JI. & Oakland D.
Journal of Hospital Infection 1991; 17: 311-313
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Disposal of clinical waste
Blenkharn JI.
Institute of Medical Laboratory Sciences Gazette 1991; 35: 547-549
A review of the issues, practicalities, and shortcomings of clinical waste disposal in hospitals, with particular emphasis to the management of wastes from Pathology laboratories.
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Clinical waste disposal
Blenkharn JI.
Journal of the Institute of Sterile Services Management 1990; 1: 20-23
A review of the issues, practicalities, and shortcomings of clinical waste disposal in hospitals.
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Emission of viable bacteria with the exhaust flue gases from hospital incinerators
Blenkharn JI. & Oakland D.
Journal of Hospital Infection 1989; 14: 73-78
High temperature incineration is widely considered as a definitive process, ensuring the destruction and complete sterilisation of clinical wastes. This paper reports findings from a study of a twin chamber oil fired incinerator operating at temperatures up to 1,000C. From a feedstock of clinical waste, sampling of exhaust gases revealed numbers of viable bacteria up to 400/cu m. The possibility that these bacteria may have originated from the feedstock is discussed.
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Infection control, hospital hygiene & epidemiology
- some selected publications
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Airport
dermatophytoses?
Blenkharn JI.
Public Health 2008; 122: 1291- 1292 |
request
reprint |
Luminol-based
forensic detection of latent blood: an approach to rapid
wide-area screening combined with Glo-Germ™ oil simulant studies
Blenkharn JI.
Journal of Hospital Infection 2008; 69: 405-406
Bloodborne virus
infection is a constant threat for those working with clinical
wastes. Sharps injury is the obvious hazard, but infection may
be transmitted also by splashes to the eyes or mucous membranes,
or contamination of pre-existing skin lesions.
Basic safety and
hygiene precautions should suffice. Proper packaging of wastes,
puncture-resistant gloves or gauntlets, and effective
handwashing when gloves are removed should be sufficient. But
are hygiene standards acceptable?
Testing for latent blood
contamination is now available. This can be used as part of a specific or
more general environmental hygiene appraisal, to evaluate the efficacy of
cleaning regimens, to assist in the training of staff, or to ensure
compliance with hand and environmental hygiene and safety protocols.
Further information
|
|
Needlestick injuries in primary care
Blenkharn JI.
J Public Health 2008 (in the press)
In
response to a paper from Wales that examined the
risks to community healthcare staff including GPs
and practice nurses, it is apparent that the risks
to waste handlers are significantly greater and that
the incidence of sharps injuries may in fact be
higher.
This
brings to the attention of community medical groups
the risks to waste handlers, identifying the need
for prompt specialist care that is rarely if ever
available in the Community, and of course the need
for greater care from sharps users.
The paper is
appear soon in the Journal of Public Health and a reprint will
become available soon.
Please contact
Ian Blenkharn for further information.
|
|
Hygiene and waste management in UK hospitals: are
self-reported compliance scores always valid?
Blenkharn JI.
Journal of Public Health (Oxford) 2007;
29(4): 472-3
Evidence from audits of
healthcare (clinical) waste management in UK hospitals performed in 2005
and 2006 had revealed generally poor standards of performance. In many
hospitals, unlocked clinical waste carts were common, with many carts
overflowing, with gaping lids and spilled items lying free at their
base. Individual clinical waste sacks and sharps containers were
frequently left on the floor, both within hospital buildings and in the
hospital grounds, apparently due to a lack of sufficient waste carts and
an inadequate frequency of collections for transfer of wastes to a
secure central storage compound.
The current annual health
check report published by the Healthcare Commission reports that 93% of
NHS Trusts (n=368) declared compliance for Core Standard C4e that
specifies standards for the safe handling and disposal of waste.
Overall, these data sit uncomfortably with the evidence of widespread
deficiencies in clinical waste segregation, storage and security noted
during successive audits.
The evolving legislative
framework and operational standards demand rigorous segregation of
wastes, the correct use of an unambiguous segregation scheme and
containment of potentially hazardous clinical wastes, and secure storage
of those wastes pending onward disposal. Notwithstanding, the
fundamental requirement for safe, effective and secure management of
potentially hazardous clinical wastes has remained unchanged. With
evidence of multiple waste management deficiencies at hospitals that
report full compliance with Core Standard C4e, the results of the annual
health check process can falsely enhance the record of compliance in
some UK hospitals, suggesting that self-reported compliance scores may
not always be valid.
A
reprint is available in PDF format but cannot be
made available for direct download due to copyright
limitations. Please contact
Ian Blenkharn for further information.
|
|
….and where did your baggage end up?
Blenkharn JI.
Journal of Hospital Infection 2004; 58: 306
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request
reprint |
Preventing transmission of infection during mouth-to-mouth resuscitation
Blenkharn JI & Zideman DA.
Journal of Emergency Medicine 1992; 10: 624-5
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Prevention of transmission of infection during mouth-to-mouth resuscitation
Blenkharn JI, Buckingham SE & Zideman D.
Resuscitation 1990; 19: 151-157
The risk of transmission of infection during exhaled air resuscitation procedures (mouth-to-mouth resuscitation) can be reduced or eliminated by the use of a barrier protective device incorporating a suitable filter that permits effective air exchange while retaining droplets and free fluids.
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request
reprint |
Infection risks from electrically operated breast pumps
Blenkharn JI.
Journal of Hospital Infection 1989; 13: 27-31
Electrically operated breast pumps may become contaminated following the passage of droplets and finer aerosols into internal tubing and the pump motor. Despite use of a sterile collecting bottle, retrograde contamination of freshly collected milk may occur the collecting bottle may occur from previously contaminated components of the pump.
Contamination of parts not normally accessible for cleansing by the user can be prevented by the use of an efficient hydrophobic air filter and simple overflow prevention device.
|
request
reprint |
Infection during percutaneous transhepatic biliary drainage
Blenkharn JI & Benjamin IS.
Surgery 1989; 105: 239
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Suction apparatus and hospital infection due to multiply-resistant
Klebsiella aerogenes
Blenkharn JI & Hughes VM.
Journal of Hospital Infection 1982; 3: 173-178
A major hospital-wide outbreak of infection due to multiple antibiotic resistant
Klebsiella aerogenes K21 was associated with the use of clinical suction apparatus, using epidemiological study and supported by molecular and genetic typing of isolates.
Suction apparatus was contaminated internally with epidemic strains of
K aerogenes; inlet and outlet connections, and the primary chamber of the suction device were contaminated resulting in some suction units in the ejection of a fine aerosol laden with
Klebsiella.
Incorrect equipment use and inadequate maintenance was responsible for the outbreak, that affected 66 patients over a 10 month period. Hospital-wide spread of infection resulted from transfer (sharing) of contaminated equipment between individual wards.
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request
reprint |
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Equipment development & device evaluation
- some selected publications
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Infection risks from electrically operated breast pumps
Blenkharn JI.
Journal of Hospital Infection 1989; 13: 27-31
Electrically operated breast pumps may become contaminated following the passage of droplets and finer aerosols into internal tubing and the pump motor. Despite use of a sterile collecting bottle, retrograde contamination of freshly collected milk may occur the collecting bottle may occur from previously contaminated components of the pump.
Contamination of parts not normally accessible for cleansing by the user can be prevented by the use of an efficient hydrophobic air filter and simple overflow prevention device.
|
request
reprint |
Safety devices to prevent airborne infection from clinical suction apparatus
Blenkharn JI.
Journal of Hospital Infection 1988; 12: 109-115
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request
reprint |
A new safety system for air filtration in clinical suction apparatus
Blenkharn JI.
Journal of Hospital Infection 1987; 10: 236-242
A low cost "differential pressure indicator" is described, that allows constant pressure measurement across the substance of a standard in-line air filter. A visible or audible warning, optionally combined with automatic shut-down of the vacuum source, is given when the differential pressure rises above a pre-set value proportional to significant loss of filter efficiency.
The indicator promotes best use of in-line filters, and protects against infection and cross-infection hazards associated with clinical suction apparatus and similar clinical equipment.
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Prevention of bacteriuria during urinary catheterization of patients in intensive care units: evaluation of the Ureofix 500 closed drainage system
Blenkharn JI.
Journal of Hospital Infection 1985; 6: 187-193
In a consecutive study of 1088 patients admitted to a general (medical and surgical) intensive care unit the incidence of catheter-associated urinary tract infection among 512 patients managed with a conventional urine meter drainage system was 26.8%. Introduction of the Ureofix 500 closed system urine meter enabled a reduction of catheter-associated infection to 12.2% of 576 patients.
The unique design characteristics of the Ureofix 500 urine meter drainage system fulfils the criteria for use in the intensive care unit and affords significant protection (p<0.001) against catheter-associated urinary tract infection in the high risk patient.
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Septic complications of percutaneous transhepatic biliary drainage: evaluation of a new closed drainage system
Blenkharn JI, McPherson GAD & Blumgart LH.
American Journal of Surgery 1984; 147: 318-321
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An improved system for external biliary drainage
Blenkharn JI, McPherson GAD & Blumgart LH.
Lancet 1981; ii: 781-782
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Antibiotic studies; chemotherapy - some selected publications
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Antibiotic prophylaxis for biliary tract surgery: selection of patient and agent
Aloj G, Bianco C, Covelli I, Blenkharn JI, Benjamin IS & Blumgart LH.
International Surgery 1991; 76: 131-134
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Antibakterielle und verwandte Eigenschaften von Taurolin - ein Überlick
Blenkharn JI.
In: Reding R. (Ed)
Chirurgische Gastroenterologie mit interdisziplinären Gesprächen: Neptun-Symposium Rostock.
Publ: TM-Verlag, Hameln. 1991; 4: 143-151
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In vitro
antibacterial activity of noxythiolin and taurolidine
Blenkharn JI.
Journal of Pharmacy and Pharmacology 1990; 42: 589-590
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Taurolin-Anwendung bei schweren chirurgischen Infektionen (Peritonitis), ihre Objektivierung durch experimentelle und klinische Methoden
Reding R, Blenkharn JI & Pfirrmann RW.
In: Gruenagel, H.H. (Ed)
Chirurgische Gastroenterologie mit interdisziplinären Gesprächen: Peritonitis.
Publ: TM-Verlag, Hameln. 1990; 2: 251-257
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In-vitro-Aktivitat von Taurolidin. Moglichkeiten der
Empfindlichkeitstestung im Agar-Diffusiontest
Blenkharn JI.
In: Gruenagel HH. (Ed)
Chirurgische Gastroenterologie mit interdisziplinären Gesprächen: Pankreatitis.
Publ: TM-Verlag, Hameln. 1990; 2: 267-268
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Anti-adherence properties of taurolidine and noxythiolin
Blenkharn JI.
Journal of Chemotherapy 1989; Suppl 4: 233-234
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Antibacterial activity of piperacillin and gentamicin using a dynamic system simulating
in vivo pharmacokinetics
Blenkharn JI.
Journal of Chemotherapy 1989; Suppl 4: 487-489
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reprint |
Sustained anti-adherence activity of taurolidine (Taurolin) and noxythiolin (Noxyflex S) solutions
Blenkharn JI.
Journal of Pharmacy and Pharmacology 1988; 40: 509-511
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Comparative per-operative pharmacokinetics of piperacillin and gentamicin
Blenkharn JI, Sinha J, Leather A & Benjamin IS.
Surgical Research Communications 1988; 4: 249-256
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The differential cytotoxicity of antiseptic agents
Blenkharn JI.
Journal of Pharmacy and Pharmacology 1987; 39: 477-479
The cytotoxicity of noxythiolin and chlorhexidine was evaluated in vitro using a range of tissue culture cell lines of differing degrees of neoplasticity. Noxythiolin exerted a marked cytotoxic effect toward established neoplastic cell lines, though this was greatly reduced with normal control (non-neoplastic) cells. By contrast, the toxicity of chlorhexidine against non-neoplastic control cells was similar to that observed against neoplastic cells.
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The antimicrobial activity of Taurolin - a possible additive for parenteral nutrition solutions
Blenkharn JI.
Journal of Clinical Nutrition 1987; 6: 35-38
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Decreased biliary excretion of piperacillin after percutaneous relief of extrahepatic obstructive jaundice
Blenkharn JI, Habib N, Mok D, John L, McPherson GAD, Gibson R, Blumgart LH & Benjamin IS.
Antimicrobial Agents and Chemotherapy 1985; 28: 778-780
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Additional selected publications
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Pathologic and hemodynamic sequelae of unilobar biliary obstruction and associated liver atrophy
Hadjis NS, Blenkharn JI, Hatzis G, Demianiuk C, Guzail M & Benjamin IS.
Surgery 1991; 109: 671-676
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Patterns of serum alkaline phosphatase activity in unilateral hepatic duct obstruction: a clinical and experimental study
Hadjis NS, Blenkharn JI, Hatzis G, Adam A, Beacham J & Blumgart LH.
Surgery 1990; 107: 193-200
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Outcome of radical surgery in hilar cholangiocarcinoma
Hadjis NS, Blenkharn JI, Alexander N, Benjamin IS & Blumgart LH.
Surgery 1990; 107: 597-604
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Isolation of
Streptococcus pneumoniae from bile
Blenkharn JI & Blumgart LH.
Journal of Infection 1986; 12: 175-178
Two patients are described in whom culture of bile obtained at the time of percutaneous transhepatic cholangiography, and from a percutaneous transhepatic biliary drain, grew
Streptococcus pneumoniae. In both cases, S pneumoniae was recovered from the gall bladder and common bile duct at the time of later surgery. In both cases, isolates were susceptible to and soluble in bile
in vitro.
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A low-cost antifoam additive for agar-based culture media
Blenkharn JI & Wood S.
Journal of Applied Bacteriology 1987; 63: 465-468
The preparation of agar plates is greatly assisted by antifoam additives to the agar prior to sterilisation. Using a 28.5% aqueous emulsion of polydimethyl siloxane together with silica, stearate emulsifiers, an inert thickening agent and sorbic acid (Dow Corning Antifoam Agent M30) at a concentration of 100ppm in molten agar facilitated preparation of poured agar plates with only minimal loss due to bubble formation. Testing using a wide variety of commonly encountered human commensal and pathogenic bacteria showed no change in colonial morphology or rate of growth.
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Bacterial infection of hepatic hydatid cysts with
Haemophilus influenzae
Blenkharn JI, Benjamin IS & Blumgart LH.
Journal of Infection 1987; 15: 169-171
Two patients with hepatic hydatid cysts are described. In both patients the cysts had become infected with
Haemophilus influenzae, recovered from the cyst contents at the time of surgery. The route of bacterial infection and the significance of the previously unrecorded association remains unclear.
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