Hepatitis B virus infection among medical waste handlers in Addis Ababa, Ethiopia is a real problem. In a detailed research paper from that country, the incidence of Hepatitis B was greater in medical waste handlers than in a matched group of non-medical waste handlers.

One might imagine that standards of waste packaging were not quite as good as ours, and that the incidence of infection amount hospital patients was greater than we might expect so the risks were substantially greater too. Added to this, with lesser standards of hygiene and inadequate PPE provision the report underscores the need for caution in our own work since there is a constant risk of infection transmission. As we proceed with an exceptionally low incidence of acquired infection, slopy hazards creep in and down-regulation of wastes promoted largely by cost-drivers and regulatory ideology are bolstered by claims of low infection risk. But that may not be the case and an unwelcome increase in infections might be just around the corner.