Displaying publications 1 - 20 of 23 in total

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  1. Su G, Ong HC, Ibrahim S, Fattah IMR, Mofijur M, Chong CT
    Environ Pollut, 2021 Jun 15;279:116934.
    PMID: 33744627 DOI: 10.1016/j.envpol.2021.116934
    The COVID-19 pandemic has exerted great shocks and challenges to the environment, society and economy. Simultaneously, an intractable issue appeared: a considerable number of hazardous medical wastes have been generated from the hospitals, clinics, and other health care facilities, constituting a serious threat to public health and environmental sustainability without proper management. Traditional disposal methods like incineration, landfill and autoclaving are unable to reduce environmental burden due to the issues such as toxic gas release, large land occupation, and unsustainability. While the application of clean and safe pyrolysis technology on the medical wastes treatment to produce high-grade bioproducts has the potential to alleviate the situation. Besides, medical wastes are excellent and ideal raw materials, which possess high hydrogen, carbon content and heating value. Consequently, pyrolysis of medical wastes can deal with wastes and generate valuable products like bio-oil and biochar. Consequently, this paper presents a critical and comprehensive review of the pyrolysis of medical wastes. It demonstrates the feasibility of pyrolysis, which mainly includes pyrolysis characteristics, product properties, related problems, the prospects and future challenges of pyrolysis of medical wastes.
    Matched MeSH terms: Medical Waste*
  2. Dharmaraj S, Ashokkumar V, Pandiyan R, Halimatul Munawaroh HS, Chew KW, Chen WH, et al.
    Chemosphere, 2021 Jul;275:130092.
    PMID: 33984908 DOI: 10.1016/j.chemosphere.2021.130092
    COVID-19 has led to the enormous rise of medical wastes throughout the world, and these have mainly been generated from hospitals, clinics, and other healthcare establishments. This creates an additional challenge in medical waste management, particularly in developing countries. Improper managing of medical waste may have serious public health issues and a significant impact on the environment. There are currently three disinfection technologies, namely incineration, chemical and physical processes, that are available to treat COVID-19 medical waste (CMW). This study focuses on thermochemical process, particularly pyrolysis process to treat the medical waste. Pyrolysis is a process that utilizes the thermal instability of organic components in medical waste to convert them into valuable products. Besides, the technique is environmentally friendly, more efficient and cost-effective, requires less landfill capacity, and causes lower pollution. The current pandemic situation generates a large amount of plastic medical wastes, which mainly consists of polyethylene, polypropylene, polystyrene, polyethylene terephthalate, and nylon. These plastic wastes can be converted into valuable energy products like oil, gas and char through pyrolysis process. This review provides detailed information about CMW handling, treatment, valuable product generation, and proper discharge into the open environment.
    Matched MeSH terms: Medical Waste*
  3. Bai VR, Vanitha G, Zainal Ariff AR
    Infect Control Hosp Epidemiol, 2013 Nov;34(11):1234-5.
    PMID: 24113615 DOI: 10.1086/673461
    Matched MeSH terms: Medical Waste/classification*; Medical Waste Disposal/economics*
  4. Ang TN, Young BR, Taylor M, Burrell R, Aroua MK, Baroutian S
    Chemosphere, 2020 Jan;239:124839.
    PMID: 31726519 DOI: 10.1016/j.chemosphere.2019.124839
    The inhalational anaesthetic agent - sevoflurane is widely employed for the induction and maintenance of surgical anaesthesia. Sevoflurane possesses a high global warming potential that imposes negative impact to the environment. The only way to resolve the issue is to remove sevoflurane from the medical waste gas before it reaches the atmosphere. A continuous adsorption study with a fixed-bed column was conducted using two commercial granular activated carbons (E-GAC and H-GAC), to selectively remove sevoflurane. The effect of bed depth (Z, 5-15 cm), gas flow rate (Q, 0.5-6.0 L/min) and inlet sevoflurane concentration (C0, ∼55-700 mg/L) was investigated. E-GAC demonstrated ∼60% higher adsorption capacity than H-GAC under the same operating conditions. Varying the levels of Z, Q and C0 showed significant differences in the adsorption capacities of E-GAC, whereas only changing the C0 level had significant differences for H-GAC. Three breakthrough models (Adams-Bohart, Thomas, and Yoon-Nelson) and Bed-depth/service time (BDST) analysis were applied to predict the breakthrough characteristics of the adsorption tests and determine the characteristic parameters of the column. The Yoon-Nelson and Thomas model-predicted breakthrough curves were in good agreement with the experimental values. In the case of the Adams-Bohart model, a low correlation was observed. The predicted breakthrough time (tb) based on kinetic constant (kBDST) in BDST analysis showed satisfactory agreement with the measured values. The results suggest the possibility of designing, scaling up and optimising an adsorption system for removing sevoflurane with the aid of the models and BDST analysis.
    Matched MeSH terms: Medical Waste/analysis*; Medical Waste Disposal/methods*
  5. Abedin MJ, Khandaker MU, Uddin MR, Karim MR, Uddin Ahamad MS, Islam MA, et al.
    Chemosphere, 2022 Jun;297:134022.
    PMID: 35202672 DOI: 10.1016/j.chemosphere.2022.134022
    This study investigates the Covid-19 driven indiscriminate disposal of PPE wastes (mostly face mask and medical wastes) in Chittagong metropolitan area (CMA), Bangladesh. Based on the field monitoring, the mean PPE density (PPE/m2± SD) was calculated to be 0.0226 ± 0.0145, 0.0164 ± 0.0122, and 0.0110 ± 0.00863 for July, August, and September 2021, respectively (during the peak time of Covid-19 in Bangladesh). Moreover, gross information on PPE waste generation in the city was calculated using several parameters such as population density, face mask acceptance rate by urban population, total Covid-19 confirmed cases, quarantined and isolated patients, corresponding medical waste generation rate (kg/bed/day), etc. Moreover, the waste generated due to face mask and other PPEs in the CMA during the whole Covid-19 period (April 4, 2020 to September 5, 2021) were calculated to be 64183.03 and 128695.75 tons, respectively. It has been observed that the negligence of general people, lack of awareness about environmental pollution, and poor municipal waste management practices are the root causes for the contamination of the dwelling environment by PPE wastes. As a result, new challenges have emerged in solid waste management, which necessitates the development of an appropriate waste management strategy. The ultimate policies and strategies may help to achieve the SDG goals 3, 6, 11, 12, 13, and 15, and increase public perception on the use and subsequent disposal of PPEs, especially face masks.
    Matched MeSH terms: Medical Waste*
  6. Mohana AA, Islam MM, Rahman M, Pramanik SK, Haque N, Gao L, et al.
    Chemosphere, 2023 Jan;311(Pt 2):137014.
    PMID: 36328315 DOI: 10.1016/j.chemosphere.2022.137014
    Since the end of 2019, the world has faced a major crisis because of the outbreak of COVID-19 disease which has created a severe threat to humanity. To control this pandemic, the World Health Organization gave some guidelines like wearing PPE (personal protective equipment) (e.g., face masks, overshoes, gloves), social distancing, hand hygiene and shutting down all modes of public transport services. During this pandemic, plastic products (e.g., household plastics, PPE and sanitizer bottles) have substantially prevented the spread of this virus. Since the outbreak, approximately 1.6 million tons of plastic waste have been generated daily. However, single-use PPE like face masks (N95), surgical masks and hand gloves contain many non-biodegradable plastics materials. These abandoned products have created a huge number of plastic debris which ended up as microplastics (MPs) followed by nanoplastics (NPs) in nature that are hazardous to the eco-system. These MPs and NPs also act as vectors for the various pathogenic contaminants. The goal of this review is to offer an extensive discussion on the formation of NPs and MPs from all of these abandoned plastics and their long-term impact on the environment as well as human health. This review paper also attempts to assess the present global scenario and the main challenge of waste management to reduce the potential NP/MPs pollution to improve the eco-systems.
    Matched MeSH terms: Medical Waste*
  7. Noman EA, Al-Gheethi AA, Rahman NN, Nagao H, Ab Kadir MO
    Environ Sci Pollut Res Int, 2016 Oct;23(19):19806-24.
    PMID: 27417327 DOI: 10.1007/s11356-016-7161-8
    The study aimed to determine the fungal diversity in clinical waste samples from a healthcare facility in Penang Malaysia. Different fungi species were detected in 83.75 % of the 92 clinical waste samples that were screened from different sections of the healthcare facility. One hundred fifty fungal isolates comprising of 8 genera and 36 species were obtained. They were purified by using single spore isolation technique. Subsequently, the isolates were identified by phenotypic method based on morphological and culture characteristics on different culture media. Among all fungal isolates, Aspergillus spp. in section Nigri 10.2 %, Aspergillus niger 9.5 %, Aspergillus fumigatus 8.8 %, Penicillium. simplicissium 8 %, Aspergillus tubingensis 7.3 %, Aspergillus terreus var. terreus 6.6 %, Penicillium waksmanii 5.9 % and Curvularia lunata 6.5 % were the most frequent. Among five sections of the Wellness Centre, the clinical wastes collected from the diagnostic labs of haematology section had the highest numbers of fungal species (29 species). Glove wastes had the highest numbers of fungal species (19 species) among 17 types of clinical wastes screened. Among all fungal species, Aspergillus spp. exhibited higher growth at 37 °C than at 28 °C, indicating the potential of these opportunistic fungi to cause diseases in human. These results indicated the potential of hospital wastes as reservoirs for fungal species.
    Matched MeSH terms: Medical Waste/analysis*
  8. Hossain MS, Santhanam A, Nik Norulaini NA, Omar AK
    Waste Manag, 2011 Apr;31(4):754-66.
    PMID: 21186116 DOI: 10.1016/j.wasman.2010.11.008
    The management of clinical solid waste (CSW) continues to be a major challenge, particularly, in most healthcare facilities of the developing world. Poor conduct and inappropriate disposal methods exercised during handling and disposal of CSW is increasing significant health hazards and environmental pollution due to the infectious nature of the waste. This article summarises a literature review into existing CSW management practices in the healthcare centers. The information gathered in this paper has been derived from the desk study of open literature survey. Numerous researches have been conducted on the management of CSW. Although, significant steps have been taken on matters related to safe handling and disposal of the clinical waste, but improper management practice is evident from the point of initial collection to the final disposal. In most cases, the main reasons of the mismanagement of CSW are the lack of appropriate legislation, lack of specialized clinical staffs, lack of awareness and effective control. Furthermore, most of the healthcare centers of the developing world have faced financial difficulties and therefore looking for cost effective disposal methods of clinical waste. This paper emphasizes to continue the recycle-reuse program of CSW materials after sterilization by using supercritical fluid carbon dioxide (SF-CO2) sterilization technology at the point of initial collection. Emphasis is on the priority to inactivate the infectious micro-organisms in CSW. In that case, waste would not pose any threat to healthcare workers. The recycling-reuse program would be carried out successfully with the non-specialized clinical staffs. Therefore, the adoption of SF-CO2 sterilization technology in management of clinical solid waste can reduce exposure to infectious waste, decrease labor, lower costs, and yield better compliance with regulatory. Thus healthcare facilities can both save money and provide a safe environment for patients, healthcare staffs and clinical staffs.
    Matched MeSH terms: Medical Waste Disposal/economics; Medical Waste Disposal/legislation & jurisprudence; Medical Waste Disposal/methods*
  9. Idris A, Saed K
    J Hazard Mater, 2002 Jul 22;93(2):201-8.
    PMID: 12117466
    Ash produced from a hospital waste incinerator was treated using a high temperature melting process at 1200 degrees C. The quality of the produced slag was characterized by X-ray diffraction (XRD), X-ray fluorescence (XRF), leaching tests and sequential chemical extraction of metals. The slag contained large amounts of SiO(2,) CaO, Al(2)O(3), Sn, Ni, Cu, Ba and B. XRD analysis revealed a moderate crystal structure for the melted slag and identified the main crystals as quartz (SiO(2)), kaolinite (Al(2)Si(2)O(5)(OH)(4)), albite (NaAlSi(3)O(8)) and gibbsite (Al(OH)(3)). The observed crystal structure assists in preventing the leaching of heavy metals from the slag. Furthermore, the leaching results found the produced slag to comply with disposal limits set by the US EPA. Results from sequential chemical extraction analysis showed that metals in the slag exhibited the strongest preference to be bound to the residual fraction (stable fraction), which is known to have very low leaching characteristics. Melting was found to stabilize heavy metals in hospital waste successfully and therefore it can be an acceptable method for disposal.
    Matched MeSH terms: Medical Waste Disposal*
  10. Leddin D, Omary MB, Veitch A, Metz G, Amrani N, Aabakken L, et al.
    Gut, 2021 11;70(11):2025-2029.
    PMID: 34620696 DOI: 10.1136/gutjnl-2021-325789
    Matched MeSH terms: Medical Waste*
  11. Leddin D, Omary MB, Veitch A, Metz G, Amrani N, Aabakken L, et al.
    Gastroenterology, 2021 11;161(5):1354-1360.
    PMID: 34629165 DOI: 10.1053/j.gastro.2021.08.001
    Matched MeSH terms: Medical Waste Disposal*
  12. Nosheen F, Malik N, Mehmood Z, Jabeen F, Mahmood A, Ibrahim M, et al.
    Environ Res, 2022 Dec;215(Pt 2):114240.
    PMID: 36103930 DOI: 10.1016/j.envres.2022.114240
    Biomedical waste from healthcare activities poses a higher hazard of infection and damage than other types of trash. The main objective of the study was to assess the awareness knowledge and practices of biomedical waste management (BMWM) among health care professionals in the health care units. The cross-sectional study was carried out to access the awareness, knowledge and practices of health care professionals for BMWM. Using a qualitative approach, the study was escorted in two Apex hospitals i.e. the Allied Hospital and the District Head Quarter Hospital, Faisalabad, Pakistan from August 5, 2019 to October 15, 2019. More than 90% of respondents knew the phrase BMWM, but just 35.4% had awareness about biomedical waste regulations. About 71.6% of the respondents were familiar with biomedical waste's color-coding segregation. The study concludes gap in the awareness, knowledge and practices for BMWM. The sanitary workers of the hospitals had no knowledge about BMWM and the BMWM/healthcare waste management rule 2005 established in Pakistan due to the lack of training regarding waste management and the segregation process. Some of the staff members were aware of the BMWM practices under the rules and regulations of Pakistan but were unable to implement at their work place. It is necessary to dispose of the biomedical waste according to the established terms and conditions of BMWM rules (2005) of Pakistan. Weak structure of BMWM was observed at the study sites due to the lack of training, liabilities and absence of penalties against improper biomedical waste disposal as violation of the rules and regulations. It's a dire need of the time to consider the biomedical waste as hazardous waste and make policies for its safe disposal and ensure the implementation of the policies in all the medical centers of Pakistan.
    Matched MeSH terms: Medical Waste Disposal*
  13. Hantoko D, Li X, Pariatamby A, Yoshikawa K, Horttanainen M, Yan M
    J Environ Manage, 2021 May 15;286:112140.
    PMID: 33652254 DOI: 10.1016/j.jenvman.2021.112140
    The COVID-19 pandemic has imposed a global emergency and also has raised issues with waste management practices. This study emphasized the challenges of increased waste disposal during the COVID-19 crisis and its response practices. Data obtained from the scientific research papers, publications from the governments and multilateral organizations, and media reports were used to quantify the effect of the pandemic towards waste generation. A huge increase in the amount of used personal protective equipments (facemasks, gloves, and other protective stuffs) and wide distribution of infectious wastes from hospitals, health care facilities, and quarantined households was found. The amount of food and plastic waste also increased during the pandemic. These factors caused waste treatment facilities to be overwhelmed, forcing emergency treatment and disposals (e.g., co-disposal in a municipal solid waste incinerator, cement kilns, industrial furnaces, and deep burial) to ramp up processing capacity. This paper discussed the ways the operation of those facilities must be improved to cope with the challenge of handling medical waste, as well as working around the restrictions imposed due to COVID-19. The study also highlights the need for short, mid, and longer-term responses towards waste management during the pandemic. Furthermore, the practices discussed in this paper may provide an option for alternative approaches and development of sustainable strategies for mitigating similar pandemics in the future.
    Matched MeSH terms: Medical Waste Disposal*
  14. Khor HG, Cho I, Lee KRCK, Chieng LL
    J Cataract Refract Surg, 2020 02;46(2):215-221.
    PMID: 32126034 DOI: 10.1097/j.jcrs.0000000000000009
    PURPOSE: To determine the amount of waste produced from phacoemulsification surgeries and ways to curtail the problem.

    SETTING: Miri Hospital, Sarawak, Malaysia.

    DESIGN: Prospective study.

    METHODS: Phacoemulsification surgery cases were included in this study; nonphacoemulsification surgeries were excluded. The waste was subdivided into 3 main categories, general waste, clinical waste, and sharps. The waste produced by ophthalmologists and trainees was accounted for separately. The mean weight of waste per case was obtained by dividing the total weight of waste produced with the total number of cases.

    RESULTS: The total waste produced from a total of 203 cases of phacoemulsification surgeries was 167.965 kg, of which, 95.063 kg (56.6%) were clinical waste, 63.197 kg (37.6%) were general waste, and 9.705 kg (5.8%) were sharps; 32.193 kg (50.9%) out of the general waste pool were recyclable waste products. The mean waste production per case of phacoemulsification surgery for an ophthalmologist was 0.814 kg, 1.086 kg per case for a trainee. A case of phacoemulsification surgery would produce 0.282 kg of carbon dioxide equivalents in the setup based on the recyclable general waste.

    CONCLUSIONS: The average waste produced per case of phacoemulsification surgery in Miri Hospital was 0.827 kg. After excluding the recyclable material, the average waste produced per case was 0.669 kg. Following the 3 R's principles (reduce, reuse, and recycle) in the handling of waste production might reduce environmental impact.

    Matched MeSH terms: Medical Waste/classification*; Medical Waste/statistics & numerical data*
  15. Hossain MS, Nik Ab Rahman NN, Balakrishnan V, Alkarkhi AF, Ahmad Rajion Z, Ab Kadir MO
    Waste Manag, 2015 Apr;38:462-73.
    PMID: 25636860 DOI: 10.1016/j.wasman.2015.01.003
    Clinical solid waste (CSW) poses a challenge to health care facilities because of the presence of pathogenic microorganisms, leading to concerns in the effective sterilization of the CSW for safe handling and elimination of infectious disease transmission. In the present study, supercritical carbon dioxide (SC-CO2) was applied to inactivate gram-positive Staphylococcus aureus, Enterococcus faecalis, Bacillus subtilis, and gram-negative Escherichia coli in CSW. The effects of SC-CO2 sterilization parameters such as pressure, temperature, and time were investigated and optimized by response surface methodology (RSM). Results showed that the data were adequately fitted into the second-order polynomial model. The linear quadratic terms and interaction between pressure and temperature had significant effects on the inactivation of S. aureus, E. coli, E. faecalis, and B. subtilis in CSW. Optimum conditions for the complete inactivation of bacteria within the experimental range of the studied variables were 20 MPa, 60 °C, and 60 min. The SC-CO2-treated bacterial cells, observed under a scanning electron microscope, showed morphological changes, including cell breakage and dislodged cell walls, which could have caused the inactivation. This espouses the inference that SC-CO2 exerts strong inactivating effects on the bacteria present in CSW, and has the potential to be used in CSW management for the safe handling and recycling-reuse of CSW materials.
    Matched MeSH terms: Medical Waste Disposal/methods*
  16. Hossain MS, Balakrishnan V, Rahman NN, Sarker MZ, Kadir MO
    Int J Environ Res Public Health, 2012 Mar;9(3):855-67.
    PMID: 22690168 DOI: 10.3390/ijerph9030855
    A steam autoclave was used to sterilize bacteria in clinical solid waste in order to determine an alternative to incineration technology in clinical solid waste management. The influence of contact time (0, 5, 15, 30 and 60 min) and temperature (111 °C, 121 °C and 131 °C) at automated saturated steam pressure was investigated. Results showed that with increasing contact time and temperature, the number of surviving bacteria decreased. The optimum experimental conditions as measured by degree of inactivation of bacteria were 121 °C for 15 minutes (min) for Gram negative bacteria, 121 °C and 131 °C for 60 and 30 min for Gram positive bacteria, respectively. The re-growth of bacteria in sterilized waste was also evaluated in the present study. It was found that bacterial re-growth started two days after the inactivation. The present study recommends that the steam autoclave cannot be considered as an alternative technology to incineration in clinical solid waste management.
    Matched MeSH terms: Medical Waste*
  17. Lim MT
    MyJurnal
    There is a growing concern of unintended consequences of inappropriate medications disposal on the environment and public health. Objective: The aims of this study are to determine patients’ medications disposal methods and their awareness of the pharmacy medications take back program.
    Method: A cross sectional survey using a self-administered closed-ended questionnaire on information, medications disposal and views, awareness of medications take back program and reasons for their unwillingness to return the unused and unwanted medication to pharmacy or doctor. A convenient sample of 438 patients at Out Patient Pharmacy and Patient Registration areas in the hospital was collected and completed within three months.
    Results: Only 44.5% had ever received information about medications disposal and were significantly more likely to return to pharmacy or doctor (29.2% versus 6.0%, p < 0.001). There were significant differences between tertiary and nontertiary with regard to not returning to pharmacy or doctor (22.8% versus 42.0 %, p = 0.004). Some common medications disposal methods were throwing medications away with household garbage, 38.3% (n = 168), returning to pharmacy or doctor, 35.1% (n = 154) and flushing medications down the toilet or sink 11.0% (n = 48). About 50.2% (n = 220) knew about medications take back program and were significantly more willing to return the medication to the assigned location (34.7 % versus 20.1%, p < 0.001). The main reasons for unwillingness were availability of time, not convenient or a bother and out-of-vicinity location.
    Conclusion: There is a clear need to create public awareness about issues on safe medication disposal and medications take back program,
    Study site: Outpatient pharmacy, and patient registration area in Sultanah Aminah Hospital, Johor, Malaysia
    Matched MeSH terms: Medical Waste Disposal
  18. Hasan UA, Mohd Hairon S, Yaacob NM, Daud A, Abdul Hamid A, Hassan N, et al.
    PMID: 31514391 DOI: 10.3390/ijerph16183356
    Background: Structured education is needed to cultivate safe sharp disposal behavior among diabetic patients. Thus, this study aimed to assess the effectiveness of the Diabetes Community Sharp Disposal Education Module in improving knowledge and sharp disposal practice among Malaysian Type 2 diabetic patients. Methods: This quasi-experimental study was conducted at primary health clinics in two districts in Kelantan, a state in the North-East Region of Peninsular Malaysia. A total of 132 Type 2 diabetic patients on insulin therapy were involved, with 68 participants in each control and intervention group. The health education intervention was based on the validated Diabetes Community Sharp Disposal Education Module. The knowledge and practices were measured using a validated questionnaire at baseline, one month, and three months after the intervention. Results: There was a significant increment in the mean knowledge score for intervention group; from baseline to one month follow up and from baseline to three months follow up [Greenhouse-Geisser; F(1.5, 199.7) = 62.38, p < 0.001; effect size (η2) = 0.318]. Intervention group had significantly higher mean knowledge score as compared to control group; at one month and three months follow up [F(1, 134) = 17.38, p < 0.001; effect size (η2) = 0.115]. There was a statistically significant increment in the proportion of participants in the intervention group who practiced the proper community sharp disposal method over time, X2(2) = 52.061, p < 0.001. Conclusions: The Diabetes Community Sharp Disposal Education Module was an effective health education tool to improve knowledge and encourage Malaysian diabetic patients to engage with proper sharp disposal practices.
    Matched MeSH terms: Medical Waste Disposal*
  19. Ishak AS, Haque MS, Sadhra SS
    Occup Med (Lond), 2019 Apr 13;69(2):99-105.
    PMID: 30295884 DOI: 10.1093/occmed/kqy129
    BACKGROUND: Needlestick injury (NSI) is a significant occupational health issue among healthcare workers (HCWs).

    AIMS: To determine the national self-reported incidence and risk factors for NSI among Malaysian Ministry of Health (MOH) HCWs.

    METHODS: Using data from the MOH national sharps injury surveillance programme, information on reported NSIs over a 1-year period (2016) for different HCW subgroups were extracted and analysed.

    RESULTS: A total of 1234 NSI cases were reported in 2016, giving an overall incidence of 6 injuries per 1000 HCWs. Medical doctors recorded the highest incidence (21.1 per 1000 HCWs) followed by dental staff (7.5), pharmacy staff (4.2), nurses (3.7), medical assistants (3.4) and allied and auxiliary staff (1.0). Doctors had significantly increased risk of NSI compared with allied and auxiliary staff (relative risk [RR] = 20.7, 95% confidence interval [CI] 15.5-27.5), medical assistants (RR = 6.1, 95% CI 4.5-8.2), nurses (RR = 5.7, 95% CI 5.0-6.6), pharmacy staff (RR = 5.0, 95% CI 3.7-6.6) and dental staff (RR = 2.8, 95% CI 2.2-3.5). Significant differences were found in age and sharps- handling experience between occupational subgroups (P < 0.001 for both variables). Male employees had higher risk than females (RR = 1.33, 95% CI 1.18-1.50), with a significant difference seen in their sharps-handling experience (P < 0.01). Important risk factors included unsafe practices such as recapping of needles and their improper disposal.

    CONCLUSIONS: The national incidence of NSI amongst Malaysian HCWs was lower compared with other countries, but unsafe practices remain an important concern. There is a need to formulate, implement and monitor safe and consistent practices for the different healthcare professionals.

    Matched MeSH terms: Medical Waste Disposal/standards
  20. Amir Sultan MM, Goh CT, Wan Puteh SE, Mokhtar M
    Int J Health Care Qual Assur, 2019 Feb 11;32(1):34-44.
    PMID: 30859864 DOI: 10.1108/IJHCQA-08-2017-0161
    PURPOSE: Mercury is widely used in medical and healthcare facilities as dental amalgam, mercury-added medical devices, thiomersal-containing vaccines, laboratory analysis and for other general applications despite the hazards. Various agencies consistently promote mercury-free medical facilities through mercury-free alternatives and better management practices, which are in line with the Minamata Convention on Mercury that aims to protect human health and environment from anthropogenic mercury release. The paper aims to discuss these issues.

    DESIGN/METHODOLOGY/APPROACH: The authors conducted a gap analysis on recommended practices gathered from the literature and current practices gathered through semi-structured interviews with Malaysian medical personnel. A life cycle approach was adopted covering mercury use: input, storage, handling, accident, waste disposal and governance phases.

    FINDINGS: The authors found that there are significant gaps between recommended and current mercury management practices. Analysis indicates improper mercury management as the main contributor to these gaps. The authors found from recommended practices that core components needing improvement include: mercury management action plan, mercury use identification team, purchasing policy, proper guidelines and monitoring systems.

    PRACTICAL IMPLICATIONS: This study helps us to understand mercury management practices and suggests essential steps to establish a mercury-free medical facility.

    ORIGINALITY/VALUE: This study explored the gaps between recommended and current mercury management practices in a medical facility and contributes to the Minamata Convention on Mercury aspirations.

    Matched MeSH terms: Medical Waste Disposal/standards*
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