There is increasing concern about hygiene precautions in the clinical area, for the protection of patients, but in the occupational arena the message seems hard to get through.
Infections associated with clinical waste disposal are related in the main to infections transmitted by sharps injury and blood and bloodstained body fluid exposure to the face and eyes, though splash inoculation seems to be misunderstood and often overlooked.
More generally, bulk waste carts (Eurocarts) have been demonstrated to carry a range of micro-organisms that may be carried to and from the clinical area, and perhaps between different hospitals. That is a serious risk and may support the spread of pathogens including those more problematic antibiotic-resistant strains.
Now new research from the US, demonstrating the escape of fungal pathogens with air currents generated when the lid of a clinical waste sack holder is opened or closed. The same was not found when tested with bacteria but the authors consider this a technical error in their approach to study and postulate the far easier escape of organisms from dry mixed clinical wastes. That should not surprise us, but it should give cause for concern.
Who is at risk? Clearly, patients are at the top of the list, and also waste handlers who are exposed to the air contaminated from the repeated manual or automated handling of large numbers of waste sacks. Compression of sacks as the pass along the disposal chain must surely exacerbate this problem. In studies performed by Blenkharn Environmental waste handlers were repeatedly exposed to, and their clothing contaminated with, splashes including blood splashes from the wastes. Parallel sampling of air in the vicinity of work moving filled clinical waste sacks showed small numbers of pathogens likely to be associated with releases from wastes, but also larger numbers of harmless organisms typically associated with strenuous human activity and shed from skin and clothing.
This should be a matter of additional concern. More evidence is needed, and research partners are required/
Can YOU help with a study of workwear hygiene?