Belay Anagaw, Yitayal Shiferaw, Berhanu Anagaw, Yeshambel Belyhun, Woldearegay Erku, Fantahun Biadgelegn, Beyene Moges, Agersew Alemu, Feleke Moges & Andargachew Mulu. Seroprevalence of Hepatitis B and C viruses among medical waste handlers at Gondar town Health institutions, Northwest Ethiopia. BMC Research Notes 2012, 5:55. http://www.biomedcentral.com/1756-0500/5/55

This excellent study aimed to determine the prevalence of hepatitis B and/or C viruses and associated risk factors among clinical (medical) waste handlers (in hospitals rather than in a commercial waste management operation though the issues are largely identical). Approaching the investigation by the use of a cross-sectional study conducted from April 2011 to June 2011 in government health institutions at Gondar, the authors observed that the prevalence of Hep B and Hep C virus infections were significantly higher in clinical waste handlers in relation to non-clinical waste handlers. There were poor waste management system which contributed for occurrence of higher degree of sharps injury and blood and body fluids splash.

Predictable perhaps, and we might take a rather high-handed view of these data to conclude, incorrectly, that the high infection rates were a feature of poor standards of waste management in Ethiopia. That is a reasonably obvious conclusion but of course the fundamental issue was exposure of waste handlers to blood and blood-stained body fluids, and to sharps.

However and whenever this happens, waste handlers are at risk of virus infection. In the UK, with effective PPE items, waste packaging and increasing automated handling of bulk wastes the risks are moderated somewhat but not fully eliminated.

Training and awareness were seen as key factors in prevention and increasing safety standards, and in the reduction of infection rates. That training included specific training in PPE use and basic hygiene precautions, issues that often fall short of an adequate standard in the UK clinical waste disposal sector.

If we could run blood tests on waste handlers in the UK the results may indeed show some as yet unrecognised transmission events. Other studies performed by Blenkharn Environmental and available as part of a range of hygiene and safety training and assessment tools identifies often extensive splash inoculation events; sharps injuries continue to occur. Perhaps only the scale of these events is different, though by avoiding such studies in the UK we can’t be too sure about that.