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Recycling of injection equipments in Pakistan. Dr. Syed Abdul Mujeeb Dr. Arshad Altaf Assistant Professor Senior Instructor Blood Transfusion Services Community Health Sciences Jinnah Postgraduate Medical Centre The Aga Khan University Karachi, Pakistan. Karachi, Pakistan .

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recycling of injection equipments in pakistan

Recycling of injection equipments in Pakistan

Dr. Syed Abdul Mujeeb Dr. Arshad Altaf

Assistant Professor Senior Instructor

Blood Transfusion Services Community Health Sciences

Jinnah Postgraduate Medical Centre The Aga Khan University

Karachi, Pakistan. Karachi, Pakistan.

unsafe injection practices
Unsafe injection practices
  • Average injection/person/year - 8.5
  • Reuse of needles and syringes - 85%
  • HCV infection among recipients of unsafe injections - 44%
  • Anecdotal reports of recycling of medical waste.

Khan et al. WHO Bull. 2000.78:949-1066

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objective of the study
Objective of the study
  • To evaluate risk of infection with bloodborne pathogens associated with breaks in universal precaution and how how healthcare waste produced by clinical laboratories is managed in Pakistan

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methods
Methods.
  • Clinical laboratories (CL) selected=50
  • CL investigated =44
  • Hospital based CL private =26
  • Hospital based CL public =18

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methods1
Methods.
  • Observational check list
  • Interviews
  • Pathologists, technologist
  • Sweepers of healthcare waste
  • Dealers of healthcare waste
  • Dealers of used syringes

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safe practices
Safe practices.
  • Use of gloves =4.5%(4)
  • Use of gowns =27%(12)
  • Use of disinfectant =16%(17)
  • Needle cutter = 68%(28)
  • Use of needle cutters =29%(8)

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disposal of medical waste pathologists technologists 44
Disposal of medical waste(Pathologists/technologists(44).
  • Community waste site=70%(26)
  • Use of incinerator =16%(7)
  • Selling to dealers of medical waste =9%(4)
  • Crushing and destruction=7%(3)
  • Zonal Municipal Corporation ZMC =7%(3)
  • Declined to respond =2%(1)

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sweepers 17
Sweepers(17)
  • Selling used syringes = 88%(15)
  • Selling price/kg = $0.06-0.2
  • Readiness to sell to the investigator at higher price =100%(17)
  • Average needle injuries = 0-5/week

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scavengers boys 26
Scavengers boys(26)
  • 15-18 years age group = 96%(25)
  • Visits timing = morning,afternoon
  • Average collection =20-25 syringes/day
  • Selling price = $0.06-0.2
  • Average needle injuries/week = 0-3

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health care waste dealers 8
Health care waste dealers (8)
  • Acknowledge dealing in healthcare waste business =100% (8)
  • Selling to dealers of used syringes =100% (8)
  • Readiness to sell to the investigator at higher price =100%(8)
  • Average needle injuries/week = 0-2

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dealers of used syringes 8
Dealers of used syringes(8)
  • Selling of used syringes to plastic ware industry =100%(8)
  • Crusher to crush syringes were available at sites =100(8)
  • Readiness to sell investigator at higher price =75%(6)
  • Readiness to sell investigator after washing =25%(2)
  • Readiness to sell investigator after washing and repackaging =12%(1)

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conclusions
Conclusions
  • Healthcare waste management is not safe in the country
  • People other than healthcare workers who are in recycling business are at risk of acquiring diseases.
  • Possibility of availability of unsafe syringes in the market.

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recommendations
Recommendations
  • Education and training health care workers for universal safety precautions
  • More organized efforts of ZMC to collect healthcare waste
  • Development of monitoring system to see adherence to infection control practices, and proper disposal of medical waste

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recommendations contd
Recommendations contd.
  • Educate and promote disinfection of used syringes and destruction of needles before the final disposal

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