Evidence summary for the management of insulin injection-related sharps waste disposal in patients with diabetes mellitus / 中国实用护理杂志

Objective:To retrieve and summarize the best evidence related to the management of insulin injection-related sharps waste disposal in diabetic patients at home and abroad, so as to provide reference for clinical healthcare professionals.Methods:This was a evidence-based research. Evidence on insulin injection-related sharps waste management in patients with diabetes, including guidelines, expert consensus, evidence summaries, best practice information sheet, recommended practices, clinical decisions and systematic reviews was systematically searched from domestic and international databases and professional websites, and the search time frame was from the establishment of the database to December 2021. Evidence was extracted and summarized following a quality evaluation of the literature that met the criteria.Results:A total of 15 papers were included, summarizing 25 pieces of best evidence on four areas including risk assessment and management of sharps waste associated with insulin injections, education and training, and the use of safe devices and sharps containers.Conclusions:Best evidence on the management of insulin injection-related sharps waste disposal provides evidence to support clinical practice for healthcare professionals to standardized sharps waste disposal practices in patients with diabetes.

mpacto ambiental y riesgos potenciales generados en los rellenos sanitarios: revisión narrativa de la literatur / Environmental Impact and Potential Risks Generated in Sanitary Landfills - Narrative literature review / Impactos ambientais e riscos potenciais dos aterros sanitários: Revisão narrativa da literatura

Introducción: El derecho a un medio ambiente sano posibilita a las personas desarrollarse y vivir de manera satis-factoria. Desafortunadamente, la actividad humana ha impactado en el ambiente y no siempre de forma positiva, y uno de los aspectos perjudiciales para el medio ambiente son los desechos o residuos sólidos y su inadecuado manejo, tratamiento y disposición. Objetivo: Caracterizar el impacto ambiental y riesgos potenciales generados en los rellenos sanitarios. Metodología: Revisión narrativa de la literatura sobre el impacto ambiental y los riesgos potenciales en los relle-nos sanitarios, obtenida en bases de datos como Ovid, Proquest, SciELO, ScienceDirect, Taylor & Francis, Google Scholar, Scopus, Redalyc y Pubmed. Desarrollo y discusión: Los rellenos sanitarios constituyen riesgos potenciales de contingencias que afectan la salud, como enfermedades (respiratorias, cutáneas o gastrointestinales) y accidentes (cortaduras, pinchazos o quemaduras) y daños en el ambiente, como sobrecalentamiento y contaminación atmosférica derivados de la inadecuada disposición de desechos. Entre los factores de riesgo se identifican gases, lixiviados contaminados, material electrónico, olores, incendios, contaminación del agua subterránea por lixiviados, cambio climático global y el incumplimiento de normas en la construcción de rellenos sanitarios. Conclusión: Se advierte un impacto negativo para el medio ambiente y la salud de la población derivado de la inadecuada eliminación de desechos sólidos en los rellenos sanitarios.

Introduction: The right to a healthy environment enables people to develop and live satisfactorily. Unfortunately, human activity has impacted the environment and not always in a positive way, one of the harmful aspects for the environment is the generation of waste products or solid waste and the inadequate, handling, treatment and disposal of them. Objective: To characterize the environmental impact and potential risks generated in landfills. Methodology: A narrative review of the literature regarding the environmental impact and potential risks in landfills was carried out, obtained from databases such as Ovid, Proquest, SciELO, Science-Direct, Taylor & Francis, Google Scholar, Scopus, Redalyc, Pubmed. For the information search, the keywords were considered and for their choice the inclusion and exclusion criteria. Development and Discussion: Landfills demonstrate potential risks of contingencies that affect health, such as diseases (respiratory, cutaneous, gastrointestinal) and accidents (cuts, punctures, burns) and damage to the environment such as overheating and air pollution derived from the in-adequate disposal of waste. Risk factors identify gases, contaminated leachate, electronic material, odors, fires, groundwater contamination by leachate, global climate change and non-compliance with landfill construction. Conclusion: There is a negative impact on the environment and the health of the population derived from the inadequate disposal of solid waste in landfills.

Introdução: O direito a um ambiente saudável permite que as pessoas se desenvolvam e vivam de forma satisfatória. Infelizmente, a atividade humana teve impacto sobre o meio ambiente e nem sempre de forma positiva, e um dos aspetos prejudiciais para o meio ambiente são os resíduos sólidos e seu manejo, tratamento e disposição inadequados. Objetivo: Caracterizar o impacto ambiental e os potenciais riscos gerados nos aterros sanitários. Métodos: Revisão narrativa da literatura sobre o impacto ambiental e os potenciais riscos nos aterros sanitários, obtida de bancos de dados como Ovid, Proquest, SciELO, ScienceDirect, Taylor & Francis, Google Scholar, Scopus, Redalyc e Pubmed. Desenvolvimento e discussão: Os aterros sanitários constituem riscos potenciais de contingencias que afetam a saúde, tais como doenças (respiratórias, cutâneas ou gastrointestinais) e acidentes (cortes, furos ou queimaduras) e danos ao meio ambiente, tais como superaquecimento e poluição atmosférica derivados da inadequada disposição dos resíduos. Os fatores de risco incluem gases, lixiviado contaminado, material eletrônico, odores, incêndios, contaminação de águas subterrânea por lixiviado, mudança climática global e não conformidade com as normas na construção de aterros sanitários.Conclusão: Há um impacto negativo sobre o meio ambiente e a saúde da população devido ao descarte inadequado de resíduos sólidos em aterros sanitários.

Infecciones nosocomiales en unidades de observación de emergencia y su asociación con el hacinamiento y la ventilación / Nosocomial infections in emergency observation units and their association with overcrowding and ventilation

RESUMEN Con el objetivo de medir la frecuencia de las infecciones nosocomiales en las unidades de observación de medicina interna de los servicios de emergencia en dos hospitales de nivel III de Lima, se realizó un estudio de prevalencia de periodo durante cinco días en pacientes admitidos después de las 72 horas de observación y con descarte de infección comunitaria, utilizando datos obtenidos de las historias clínicas. Adicionalmente, se evaluó el hacinamiento y la ventilación de las salas de hospitalización. La frecuencia de las infecciones nosocomiales en los servicios de emergencia fue 8,1%, cuatro veces lo reportado como prevalencia de periodo en el Perú. Los factores de riesgo asociados fueron el tiempo prolongado de estancia y la carencia de ventilación apropiada del ambiente hospitalario. La ventilación inapropiada triplica el riesgo de aparición de infecciones nosocomiales.

ABSTRACT The aim of this study was to measure the frequency of nosocomial infections in the internal medicine observation units of the emergency services in two level III hospitals in Lima. A 5-day prevalence study was carried out on patients admitted after a 72 hours observation period, in whom community-based infections were ruled out. Data was obtained from clinical records. Additionally, overcrowding and ventilation in the hospitalization rooms were evaluated. The frequency of nosocomial infections in the emergency services was found to be 8.1%, four times what was reported as period prevalence in Peru. The associated risk factors were prolonged length of stay and lack of proper ventilation in the hospital environment. Inadequate ventilation triples the risk of nosocomial infections.

O uso de indicadores de desempenho na avaliação da qualidade operacional dos aterros sanitários do estado do Rio de Janeiro no triênio 2013-2015 / The use of performance indicators in the evaluation of the operational quality of the Rio de Janeiro state sanitary landfill in the 2013-2015 triennium

RESUMO Encerrar vazadouros, implantar e operar aterros sanitários são importantes passos para consolidar um sistema de gestão de resíduos sólidos urbanos (RSU) eficiente e sustentável. No estado do Rio de Janeiro, desde 2007, existem avanços significativos nesse processo. Entretanto, é fundamental transcender as terminologias que distinguem os locais de disposição final e avaliar a real qualidade da prestação desse serviço público. Não resta dúvida que encerrar vazadouros deve ser prioridade dos estados e municípios, todavia, não se deve distanciar o olhar da avaliação constante do desempenho ambiental dessas atividades e, consequentemente, de suas qualidades operacionais. Baseado nesse princípio, o estado do Rio de Janeiro, por meio do Instituto Estadual do Ambiente (INEA), desenvolveu, em 2013, uma metodologia para a obtenção do Índice de Qualidade de Destinação Final de Resíduos (IQDR). O principal objetivo deste artigo é avaliar o resultado da aplicação do IQDR do Rio de Janeiro em 19 aterros sanitários e em sete aterros controlados do Estado entre os anos de 2013 e 2015. Essa análise possibilitou criticar as estratégias propostas pelas políticas públicas de gestão de resíduos vigentes no estado, bem como a sua eficácia. Constatou-se que os aterros de Seropédica, Campos e São Gonçalo apresentaram os melhores desempenhos no período avaliado, tendo sido considerados adequados. Juntos, esses aterros receberam mais de 10 milhões de toneladas de RSU no período, 58% da quantidade coletada no estado. Os aterros de Miguel Pereira, Barra do Piraí e Piraí apresentaram o pior desempenho - foram considerados inadequados - , tendo recebido cerca de 47 mil toneladas de RSU no período, menos de 1% do montante coletado no estado.

ABSTRACT Shutting down dumpsites, implanting and operating landfills are important steps to consolidate an efficient and sustainable urban solid waste management system. In the state of Rio de Janeiro, since 2007, there have been significant advances in this process. However, it is fundamental to transcend the terminology that distinguishes the final disposal sites and to evaluate the real quality of the provision of this public service. There is no doubt that shutting down dumpsites should be a priority for states and municipalities, however, this thought should not distance oneself from the constant evaluation of the environmental performance of these activities and, consequently, the operational quality of the landfills. Based on this principle, the state of Rio de Janeiro, through the State Environmental Institute (INEA), developed in 2013 a methodology for obtaining the Final Destination of Waste Quality Index. The main objective of this article is to evaluate the results of the application of Rio de Janeiro's Final Destination of Waste Quality Index, in the years of 2013, 2014, and 2015. This analysis made it possible to criticize the strategies proposed by the public policies for waste management in the state, as well as their effectiveness. It was verified that the landfills of Seropédica, Campos, and São Gonçalo presented the best performances and were considered adequate. Together, these landfills received more than ten million tons in the period, about 58% of the urban solid waste collected in the state. The Miguel Pereira, Barra do Piraí, and Piraí landfills presented the worst performance, considered inadequate, receiving about 47,000 tons in the period, less than 1% of the MSW collected in the state.

Autocuidado de pessoas com diabetes mellitus: reuso e descarte de seringas e agulhas / Autocuidado de personas con diabetes mellitus: reutilizacióny desecho de jeringas y agujas / Self-care of people with mellitus diabetes: reuse and disposal of syringes and needles

RESUMO Objetivo: Analisar a taxa de reuso de seringas e agulhas e identificar as práticas de descarte de perfurocortantes por usuários de insulina. Método: Estudo transversal, realizado com pessoas diagnosticadas com diabetes mellitus tipo II de um Centro de Referência em Diagnóstico e Terapêutica da região Centro-Oeste do Brasil. Foram utilizados dados secundários provenientes de prontuários e fichas de consulta. As diferenças de proporção foram estimadas pelo teste qui-quadrado, considerando-se p<0,05. Resultados: A taxa de reuso de seringas e agulhas foi de 94,9%. Houve alta prevalência do reuso de seringas e agulhas por mulheres, com mais de 60 anos, com tempo de estudo menor do que cinco anos, que possuíam mais de 11 anos de diagnóstico. A maioria dos usuários descartou as agulhas e seringas no lixo domiciliar. Tais dados evidenciam que as práticas de autocuidado realizadas pelas pessoas com DM quanto ao reuso e descarte de perfurocortantes não são seguras e podem favorecer complicações. Conclusão: Apesar das características demográficas e clínicas não terem apresentado associação com o reuso, esforços devem ser direcionados para as práticas de educação em saúde, levando em consideração o contexto da pessoa, a condição socioeconômica, nível de escolaridade e seu papel ativo no seguimento do tratamento.

RESUMEN Objetivo: analizar la taza de reutilización de jeringas y agujas e identificar las prácticas de desecho de punzocortantes por usuarios de insulina. Método: estudio transversal, realizado con personas diagnosticadas con diabetes mellitus tipo II de un Centro de Referencia en Diagnóstico y Terapéutica de la región Centro-Oeste de Brasil. Fueron utilizados datos secundarios provenientes de registros médicos y fichas de consulta. Las diferencias de proporción fueron analizadas por la prueba de chi-cuadrado, considerándose p<0,05. Resultados: la taza de reutilización de jeringas y agujas fue de 94,9%. Hubo alta prevalencia de la reutilización de jeringas y agujas por mujeres, con más de 60 años, con tiempo de estudio menor que cinco años, que poseían más de 11 años de diagnóstico. La mayoría de los usuarios descartólas agujas y jeringas en la basura domiciliaria. Tales datos evidencian que las prácticas de autocuidado realizadas por las personas con DM respecto a la reutilización y desecho de punzocortantes no son seguras y pueden favorecer complicaciones. Conclusión: Aunque las características demográficas y clínicas no hayan presentado asociación con la reutilización, esfuerzos deben ser dirigidos para las prácticas de educación en salud, teniendo en cuenta el contexto de la persona, la condición socioeconómica, el nivel de escolaridad y su rol activo en el sector del tratamiento.

ABSTRACT Objective: To analyze the rate of reuse of syringes and needles and identify the practices of disposal of sharps by insulin users. Method: Cross-sectional study conducted with people diagnosed with type II diabetes mellitus at a Reference Center for Diagnosis and Therapy in the Midwest region of Brazil. Secondary data from medical records and consultation forms were used. Differences in proportions were estimated by the chi-square test, considering p < 0.05. Results: The rate of reuse of syringes and needles was 94.9%. There was a high prevalence of reuse of syringes and needles by women, people aged over 60 years, with less than five years of schooling, and more than 11 years of diagnosis. Most users discarded needles and syringes in domestic waste. Thus, self-care practices of people with DM regarding the reuse and disposal of sharps are not safe and may favor complications. Conclusion: Althoughdemographic and clinical characteristics had no association with reuse, efforts should be directed towards health education practices, taking into account the person's context, socioeconomic condition, educational level, and active role in the follow-up treatment.

Crescimento e teor de cromo em mamoneira cultivada em solo receptor de resíduos de curtume e carboníferos / Growth and chrome content of castor bean plants cultivated in soil with application of tannery residues and coal mining waste

RESUMO A produção de resíduos tem aumentado em proporção direta com a industrialização dos países. Sendo assim, a disposição adequada desses resíduos é uma questão largamente discutida entre os órgãos ambientais. Por isso, o objetivo deste trabalho foi estudar o efeito residual de adições sucessivas de resíduos de curtume e da mineração de carvão sobre as propriedades químicas do solo e o acúmulo de cromo (Cr) em mamoneira. Os tratamentos aplicados em condições de campo foram: T1 - controle, ou seja, solo sem adubação; T2 - solo adubado com nitrogênio-fósforo-potássio (NPK) + calcário para atingir pH 6,0; T3 - solo misturado com lodo de curtume em dose adequada para se atingir pH 6,0 + PK; T4 - solo receptor de duas vezes a dose de lodo de curtume utilizada no T3 + PK; T5 - solo misturado com resíduo carbonífero + NPK + calcário em quantidade adequada para atingir pH 6,0; T6 - solo misturado com resíduo carbonífero + lodo de curtume em dose adequada para atingir pH 6,0 + PK; T7 - solo misturado com serragem cromada + NPK + calcário em quantidade adequada para atingir pH 6,0; T8 - solo misturado com Cr mineral + lodo de curtume em dose adequada para se atingir pH 6,0 + PK. Em campo, o solo recebeu os diferentes tratamentos. Posteriormente, amostras desse solo foram acondicionadas em vasos e o experimento com as plantas foi conduzido em delineamento inteiramente ao acaso, com três repetições por tratamento. O rendimento de matéria seca mostrou que a aplicação de serragem cromada (T7) proporcionou o maior crescimento da mamoneira, bem como os maiores teores de P no seu tecido. Os teores de Cr na parte aérea das plantas não atingiram níveis que podem ser considerados de contaminação desses vegetais. A distribuição desse elemento nas diferentes partes das plantas de mamoneira demonstrou a possibilidade de utilização futura dos grãos para produção de biodiesel.

ABSTRACT The production of waste has been increasing in direct proportion to the industrialization of the countries. Therefore, the adequate disposal of these wastes is an issue widely discussed among environmental agencies. Thus, the aim of this work was to study the residual effect of successive additions of tannery and coal mining waste on the chemical properties of the soil and the accumulation of chromium in castor bean plants. The treatments applied under field conditions were: T1 - control, that is, soil without fertilization; T2- soil fertilized with nitrogen-phosphorus-potassium (NPK) + limestone to reach pH 6.0; T3 - soil mixed with tannery sludge at a dose adequate to reach pH 6.0 + PK; T4 - soil receptor of twice the dose of tannery sludge used in treatment 3 + PK; T5 - soil mixed with coal residue + NPK + limestone in an amount adequate to reach pH 6.0; T6 - soil mixed with coal residue + tannery slurry at a dose adequate to reach pH 6.0 + PK; T7 - soil mixed with chrome sawdust + NPK + limestone in adequate quantity to reach pH 6.0; T8 - soil mixed with mineral Cr + tannery sludge at a dose adequate to reach pH 6.0 + PK. In the field, the soil received the different treatments. Subsequently, samples of this soil were conditioned in pots and the experiment with the plants was conducted in a completely randomized design, with three replicates per treatment. Subsequently, samples of this soil were placed in pots and the experiment with plants was conducted in a completely randomized design, with three replications per treatment. The dry matter yield showed that the application of chrome sawdust (T7) provided the highest growth of the castor bean, as well as the higher levels of P in its tissue. Chromium content in the aerial part of the plants did not reach levels that can be considered as contamination of these plants. The distribution of chromium in the different parts of the castor bean plants demonstrated the possibility of future use of the grains to produce biodiesel.

Discernment, apropos on dispensation of hospital waste among paramedics: a descriptive study

Background: India is one of the most populated and rapidly growing countries in the world and is the source of humongous amounts of waste every year, including municipal solid waste, hazardous waste, biomedical waste or e-waste. Healthcare is one of the largest sectors in India both in terms of revenue and employment. With growing healthcare, there is a requirement of management of bio-medical waste. This study is conducted to assess discernment, apropos on dispensation of hospital waste by paramedics.Methods: A cross-sectional study was conducted to assess the discernment and apropos of paramedical staff in 3 private hospitals regarding disposal of waste in Bhopal city and convenience sampling was used. A total of 204 individuals were approached for the study. The collected data analysed by using SPSS 21.0 and Descriptive analysis was done.Results: Total 204 paramedical staff participated in the study out of which 125 (61.2%) were males and 79 (38.7%) were males. It showed that there was limited level of knowledge, attitude and practices among class 3 workers i.e., attenders as compared to nurses and technicians.Conclusions: Study concluded that there is lack of knowledge about waste management which leads to improper waste disposal and pointed out that class 3 workers have less knowledge as compared to class 1 and class 2 workers. The technicians and nurses comparatively were having better knowledge and attitude, and also practiced waste management better than the attenders

Zoonosis and veterinary waste disposal in rural practice / Zoonosis y disposición de desperdicios veterinarios en la práctica rural

The objectives of this study were to estimate: (a) the frequency of zoonoses in large animal veterinarians from rural areas of the province of Buenos Aires, Argentina, and (b) to describe the use and disposal of personal protective equipment (PPE) and selective veterinary clinical waste. A cross-sectional study was carried out on large animal veterinary practitioners in the Province of Buenos Aires (n = 106). One third (29.2%) of them had been diagnosed with a zoonosis by laboratory-methods, being brucellosis the most frequent (22.6%). The more years passed since their graduation, the greater the chances of becoming ill (p < 0.001). Gloves were the most adopted PPE; however, other elements had little or no use at all. Older and experienced professionals used PPE less frequently than young inexperienced practitioners. Some PPE was frequently reused and the final disposal of veterinary waste was often inappropriate. A change in behavior is an urgent need to preserve not only the veterinarians' health but also their families' wellbeing and to ensure proper disposal of potentially hazardous waste.

Los objetivos de este trabajo fueron los siguientes: a) estimar la frecuencia de zoonosis en veterinarios de grandes animales que desarrollan su labor en la provincia de Buenos Aires; b) describir el uso y la disposición de los elementos de protección personal (EPP) y otros residuos generados durante el trabajo de estos veterinarios. Para ello se realizó un estudio transversal en una muestra de 106 profesionales. En un tercio de ellos (29,2%) se había sido diagnosticado por métodos de laboratorio alguna zoonosis; la brucelosis fue la más frecuente (22,6%). Se encontró que a mayor tiempo transcurrido desde la graduación, mayor era la probabilidad de enfermarse (p< 0,001). Sobre la base de las respuestas obtenidas en cuestionarios estructurados, se determinó lo siguiente: que los guantes fueron el EPP más adoptado, mientras que otros elementos tuvieron escasa o nula adopción; que los profesionales de mayor edad y experiencia usaron EPP con menos frecuencia que los practicantes más jóvenes e inexpertos; y que algunos EPP se reutilizaban con frecuencia y que la eliminación final de los desechos veterinarios fue a menudo inapropiada. Considerando estos hallazgos, es claro que se requiere un cambio de comportamiento para preservar no solo la salud de los veterinarios, sino también para asegurar el bienestar de sus familias y garantizar la eliminación adecuada de los residuos potencialmente peligrosos.

Knowledge, attitude and practice study on bio-medical waste management among interns in a tertiary care hospital in Kancheepuram, Tamil Nadu

Background: All the wastes which are generated by the hospital are collectively called as health care waste. The medical interns exposed to various health hazards while working in the hospital during their training period. The study was done with the aim to assess the knowledge and awareness regarding various aspects of biomedical waste management amongst interns in a tertiary care hospital, Kancheepuram, Tamil Nadu.Methods: This was a descriptive cross sectional study carried out among 94 interns who had cleared the final MBBS exams and 81 interns who participated in the study after giving informed consent. A pretested, self-administered questionnaire on knowledge and awareness of bio-medical waste management policy and practice were given to the interns. Statistical analysis was done using Microsoft Excel.Results: Around 63% interns knew the correct definition of biomedical waste. 24.6% interns were aware that authorization is required for biomedical waste management by Central Pollution Control board. Only 22.2% of the interns had undergone the training programme and 64.1% were keen to attend training program for biomedical waste management. 88.8% knew about sources of generation of BMW and 96% had knowledge of bio-hazard symbol. 72.5% had knowledge of segregation of waste but none had knowledge of correct colour coding. 91.3% said that record maintenance was essential for biomedical waste management. 96.2% agreed that BMW is teamwork.Conclusions: It is hour of need for rigorous training, IEC program for all the medical interns to make them aware of the various health hazards associated with biomedical waste products.

Microbiological contamination and content of heavy metals in unlined landfill sites of Ulaanbaatar

Background:The aim of the study was to investigate bacterial and heavy metal pollution in four landfill sites of Ulaanbaatar. Surveyed landfills included closed and currently operating unlined landfills. Methods:In order to sample, we divided each landfill sites into three zones including zone 1: cover soil or in the boundary of the landfill, zone 2: from the boundary of the landfill to hygiene zone (25 м2to 500 м2out of cover soil), zone 3: from hygiene zone to settlement areas and compared the pollution.Results:The titre of Cl.perfringens, presence of Salmonella and total bacteria were not significantly different for landfill sites. The titre of E.coli and the titre of Proteus for industrial landfill sitewere significantly different than other sites.The titre of E.coliand the titre of Proteusfor the zone 1 were significantly different than the zone 3. The presence of Salmonellaand the total bacteria for the zone 1 was significantly different than the zone 2 and zone 3. The titre of Cl.perfringenswas not significantly different for landfill zones. The bacterial indicators were not significantly different for seasons of the year. Content of heavy metals in soil landfills were Pb 0.1-63 mg/kg, Cr 0.4-5124 mg/kg, Ni 3.2-84 mg/kg, Zn 21.7-776 mg/kg, Cd 0.01-2.8 mg/kg.Conclusions:Microbiological contamination and content of heavy metals in closed unlined landfill are not different from currently operating unlined landfills.

Perception regarding Bio-medical Waste Management among medical students in a Tertiary Care Hospital

Background: Bio-medical waste is perilous and can be a health hazard. There is considerable role of medical undergraduates, interns and post-graduates in preventing hazardous consequences from mishandling of bio-medical waste. Aims & Objectives: To assess the knowledge, attitude and practice about Bio-medical waste management among medical undergraduates, interns and post-graduate students. Methodology: A cross-sectional study was carried out among 75 participants including MBBS students, interns and post-graduate students (25 from each group) at King George’s Medical University, Lucknow through purposive sampling technique over a period of one month. A structured self-administered questionnaire was used for data collection. Data were analyzed using Chi-square, Fischer-exact, one-way ANOVA and Post Hoc (Tukey) Tests. Results: MBBS students had more knowledge and the better attitude towards BMW management guidelines as compared to interns and post-graduates(p<0.001), while post-graduate students were more aware of the needle-stick injury and were correctly practicing BMW management as compared to MBBS students and interns(p<0.001). Conclusions: Knowledge, attitude and practice regarding BMW management is still inadequate among MBBS students, interns and post-graduates, so repeated training-retraining and supportive supervision regarding the same should be foster. Strict regulations and surprise perusals might be a strong impetus for medical students and other health personnel.

Development of a Safe Syringe Disposal System Moving towards Automated Syringe Data Collection / 대한의료정보학회지

OBJECTIVES: An automatic needle destroyer (ANDY) was developed to prevent needlestick injuries, and usability tests were conducted in several hospitals. The addition of extra features to the ANDY is in progress, such as data collection and automatic identification of used syringes. Thus, this report describes how the ANDY can be used to track the data of used syringes. METHODS: The motor torque required for barrel separation differs according to syringe diameters. By monitoring the electric current which is consumed for the motor torque, the type of syringe can be identified. Twelve prototypes were produced, and five usability tests were conducted in hospitals. RESULTS: After use, a syringe is inserted into the proposed device, and the needle portion is then cut and separated from the syringe body (barrel) and discarded. The needles are collected in a sharps container for hygienic disposal, and the barrel is dropped into a general medical waste container. CONCLUSIONS: The ANDY can be used to track the syringe used for each patient. The barcode can be read while the syringe rotates in the main body of the ANDY with a built-in omnidirectional scanner. Collection of information during syringe disposal can facilitate stock management. This system could also be extended to other types of consumable medical devices, although it would still be a challenge to differentiate each medical device.

Assessment of Awareness About Various Dental Waste Management Practices Among Dental Students and Practicing Clinicians

Abstract Objective: To evaluate the knowledge of students and dental practitioners about dental and biomedical waste disposal and to impart emphasis on important aspects such as eco-friendly waste management. Material and Methods: This questionnaire-based study involved 186 participants which comprised of 5 domains, namely laws regarding biomedical waste, steps of waste management, categories of dental waste, general hazards of improper waste disposal and certain material/process specific questions Results: Assessment of the first domain showed that only 58.4% of participants were able to correctly identify the Pollution Control Board of India as the regulatory body for the transport of medical waste. The second domain assessment revealed that 55.9% of subjects were adequately aware of the knowledge handling hospital waste. Assessment of the third domain displayed that the majority of the respondents (91.9%) knew categories of dental waste generated. Evaluation of fourth domain exhibited that 89.8% students agreed that biomedical waste management (BWM) must be made a practical exercise in dental schools to reduce "Know-Do gap" between undergraduates and postgraduates and the last domain demonstrated that only 32.3% of the participants knew the environmentally friendly technique to convert organic waste into commercially useful byproducts Conclusion: It was found that postgraduates had a better awareness of the proper methods to dispose of healthcare waste when compared to students and interns. However, the overall level of awareness was less than adequate. The need for special training in BWM in the clinical set up was highlighted through this study.

Medication waste disposal practices among patients attending selected out patient departments in a tertiary care institution: a cross sectional survey

Background: Medication waste has major implications on human and animal health, environmental safety and the health economy. Low and middle income countries have paid less attention to proper medication waste disposal at household and community level. This is the first baseline assessment on medication waste disposal practices among the general public in Sri Lanka.Methods: This was a descriptive, cross-sectional survey, conducted via face to face interviews using a structured questionnaire among selected outpatient clinics at the National Hospital of Sri Lanka. A non-probability sampling technique was used to achieve a representative sample from each clinic. The data collectors were trained prior to administering the questionnaire. Data was presented as descriptive statistics using percentages. Chi-square test was used to find associations.Results: From the total number of participants (n=200) majority were females 135 (67.5%). Majority of the participants (78%) stated that they have unused medicines at home. Among them, tablet form was the commonest (78%) followed by topical preparations (49%). Commonest reason for having unused medicines at home were self-discontinuation as illness resolved (57.5%). There was a significant difference between the knowledge and practices when disposing tablet form (<0.001), syrups (0.002), topical preparations (0.04) and sharps (<0.001). Majority (23%) discarded sharp to rubbish bins. Rubbish bin was the commonest mode of disposal for all dosage forms as well as devices.Conclusions: In this sample majority had unused medicines at home which was compatible with the pattern seen in other countries and need proper attention.

Aptidão da Bacia Hidrográfica do Rio Almada diante da implantação de áreas para disposição ambiental de rejeitos / The waste disposal suitability of Almada River Watershed

RESUMO Este trabalho objetivou identificar a adequabilidade da Bacia Hidrográfica do Rio Almada (BHRA) diante da implantação de áreas para a disposição de rejeitos por intermédio do reconhecimento das características dos atributos do meio físico e de uso e ocupação do solo. A metodologia adotada teve, inicialmente, as suas atividades associadas ao levantamento dos estudos ambientais e à consolidação dos mapeamentos temáticos já realizados na área da BHRA. Em seguida, os planos de informações temáticas, a exemplo de substrato rochoso, solos e formas de relevo, tiveram as suas características enquadradas em classes de adequabilidade à implantação de rejeitos de acordo com a proposta de Zuquette. Os resultados encontrados atestam o cenário em que a área da BHRA apresenta mais concentração de adequabilidades severas e restritivas localizadas nas porções oeste, norte e leste, em virtude da extensa ocorrência de áreas de preservação permanente (APPs) associadas às áreas de declividade superior a 45º e em porções de topo de morros, além da presença marcante de bolsões de floresta densa.

ABSTRACT This work had the objective to identify the suitability of the Almada River Watershed (ARW) front of the deployment areas for waste disposal from the recognition of physical environment and land use occupation characteristics. The methodology had initially its activities associated with the survey of environmental studies and consolidation of thematic maps already made in the ARW area. Then the plans of thematic information, like bedrock, soils and landforms, had its features framed in suitability classes to the implementation of waste disposal in accordance with the proposal of Zuquette. The results attested to the scenario in which the area of ARW has a higher concentration of severe and restrictive suitability located in the west, north and east portions, due to the extensive occurrence of permanent preservation areas in upper 45º slope areas and top portions of hills, associated with the presence of dense forest.

Green conversion of municipal solid wastes into fuels and chemicals

Presently, the society is facing a serious challenge for the effective management of the increasing amount of produced municipal solid wastes. The accumulated waste has caused a series of environmental problems such as uncontrolled release of greenhouse gases. Moreover, the increasing amount of wastes has resulted in a shortage of areas available for waste disposal, resulting in a nonsustainable waste management. These problems led to serious public concerns, which in turn resulted in political actions aiming to reduce the amount of wastes reaching the environment. These actions aim to promote sustainable waste management solutions. The main objective of these policies is to promote the recycling of municipal solid waste and the conversion of waste to energy and valuable chemicals. These conversions can be performed using either biological (e.g., anaerobic digestion) or thermochemical processes (e.g., pyrolysis). Research efforts during the last years have been fruitful, and many publications demonstrated the effective conversation of municipal solid waste to energy and chemicals. These processes are discussed in the current review article together with the change of the waste policy that was implemented in the EU during the last years.

Identificação de áreas adequadas para a construção de aterros sanitários e usinas de triagem e compostagem na mesorregião da Zona da Mata, Minas Gerais / Identification of suitable areas for construction of landfill and waste selection and composting plants in the mesoregion of Zona da Mata, Minas Gerais

RESUMO A disposição final inadequada dos resíduos sólidos urbanos (RSU) em lixões é realizada em 60% dos municípios brasileiros. Ademais, a escolha das áreas para a implantação desses depósitos, comumente, não leva em consideração as restrições legais vigentes. Na Zona da Mata mineira, esse fator é agravado pela existência de extensas áreas de preservação permanente, que implica em reduzido número de áreas disponíveis para tratamento de resíduos. O consórcio intermunicipal, como forma de gestão compartilhada, é considerado uma alternativa prevista em lei para regularizar essa situação. Para nortear o consorciamento, a Fundação Estadual do Meio Ambiente (FEAM), por meio do Sistema Estadual de Meio Ambiente e Recursos Hídricos (SISEMA), subdividiu o estado em arranjos territoriais ótimos (ATOs). Considerando que as formas adequadas de tratamento de RSU mais adotadas no Brasil são aterros sanitários e usinas de triagem e compostagem, este trabalho teve como objetivo identificar áreas para a implantação de aterros sanitários e usinas de triagem e compostagem na Zona da Mata. Ademais, foi realizado o cálculo estimado das áreas requeridas para atender aos ATOs através de consórcios e o número de áreas existentes que atendessem à extensão mínima calculada. Para tanto, foi construída uma extensa base de dados para a identificação das áreas restritas legalmente e realização de análises espaciais multicritério utilizando os softwares de geoprocessamento ArcGIS e IDRISI Taiga. As análises resultaram em número reduzido de áreas passíveis de serem utilizadas para o tratamento de resíduos dificultando, assim, a utilização dos ATOs como referência para a gestão de RSU.

ABSTRACT Inappropriate solid waste disposal is found in 60% of Brazilian cities and, in most cases, site selection does not follow legal or regulatory restrictions. In the Zona da Mata region, southeast Brazil, this process is still more problematic because of the large permanent protection areas, which results in a low number of available areas for waste treatment. Considering multiple cities consortium as an alternative to ensure solid waste disposal sites in Minas Gerais state, the Minas Gerais Environmental Foundation (FEAM), using the State System of Environment and Water Resources (SISEMA), subdivided the state in optimum territorial arrangements (ATOs), which comprise units to be used in waste management shared by the cities within each ATO. Considering that the most adopted forms for appropriate solid waste treatment in Brazil are landfills and plants for sorting and composting, this study aimed to determine suitable areas for landfill and plants for waste sorting and composting in the Zona da Mata region. Furthermore, site surface sizes to each ATO were calculated and the number of suitable areas for each ATO was determined. A detailed and extensive database was generated by collecting spatial information that could be used in geoprocessing softwares (ArcGIS and IDRISI Taiga) to develop spatial analysis. In general, the analysis resulted in a reduced number of suitable sites, thus making it difficult to use ATOs in shared waste management.

Contribuições para a evolução do gerenciamento de resíduos sólidos urbanos no Brasil com base na experiência Européia / Contribution to the development of municipal solid waste management in Brazil based on European experience

RESUMO: Esse trabalho tem como objetivo apresentar dados relevantes sobre o gerenciamento de resíduos sólidos urbanos (RSU) na Europa de forma a se estabelecer paralelos e subsidiar a discussão no Brasil. É apresentada uma contextualização da situação atual da gestão dos resíduos sólidos urbanos no Brasil, onde os efeitos da Política Nacional de Resíduos Sólidos já se fazem sentir, sobretudo com o aumento da disposição final de RSU em aterros sanitários, predominantemente nas regiões metropolitanas. A reciclagem no país, em grande parte, ainda baseia-se na coleta informal por catadores ou na ação de organizações privadas. Na Europa, a partir da Diretiva 1999/31/EC, que estabeleceu metas para a disposição de resíduos em aterros sanitários, e da Diretiva 94/62/EC, sobre recolhimento de embalagens, a gestão de RSU se alterou profundamente. São apresentados dados das tecnologias predominantes de tratamento e disposição final de RSU e alguns mecanismos para implementação da mudança de cenário na Europa. O exemplo suíço é detalhado, mostrando como a cobrança de tarifas impulsiona as ações da população. É preciso reconhecer que o gerenciamento de resíduos sólidos urbanos RSU tem que ser planejado da coleta até o destino final, utilizando e integrando diferentes tecnologias de tratamento, ​​de acordo com as características locais. É relevante para o Brasil a avaliação criteriosa das soluções disponíveis, do ponto de vista técnico e operacional, considerando fortemente a sua aplicabilidade local.

ABSTRACT: This paper aims to present relevant data on municipal solid waste (MSW) management in Europe in order to establish parallel and support the discussion in Brazil. The current situation of municipal solid waste management in Brazil is presented. It is possible to see some consequences of the Brazilian National Solid Waste Policy, especially concerning the increase of MSW disposal in landfills, mostly in metropolitan areas. Recycling in the country is largely based on informal collection by waste pickers or action by private organizations. In Europe the MSW management has largely changed as consequence of the Directive 1999/31/EC, which set targets for waste disposal in landfills, and the Directive 94/62/EC, about packaging collection. This paper presents data about predominant MSW treatment and disposal technologies and some mechanisms applied to implementing the scenario changes in Europe. The Swiss example is detailed showing how the charging of fees drives people's actions. It must be recognized that the MSW management has to be planned from collection to final destination, using and integrating different treatment technologies, in accordance with local characteristics. It is relevant to Brazil a carefully evaluation, both technically and operationally, of the available solutions considering their local applicability.

Indices of Cardiovascular Diseases and Malaria Parisitemia amongst Solid Waste Disposal Workers in Port Harcourt Nigeria.

The aim of this study was to evaluate the health risks of solid waste disposal workers and scavengers, involved in the handling and disposal of municipal wastes, especially their cardiovascular health. The study was carried out in Port Harcourt, Nigeria from 2011 to 2013. Male solid waste disposal workers and scavengers (n=100) aged between 19 and 53years who have worked from six months to 15 years in waste disposal industry, were used in this study. Twenty six percent were aged 40 years and above while 74% were aged between 19 to 39 years. These were compared with 100 male subjects of same age group (21 to 50) who were not solid waste disposal workers; they served as the control group. Their blood pressures (systolic and diastolic) were measured using a standard mercury sphygmomanometer, weight was measured using calibrated electronic scale and height was measured using a Stadiometer. Body Mass Index (BMI) was calculated by the formula (weight/height2). These were used as indices of cardiovascular disease in the volunteers. The level of malaria parasitemia was evaluated. A well-structured questionnaire was given to each volunteer in this study as a behavioral determinant. Mean systolic pressure of the solid waste disposal workers and the control group were 136±13.58 mmHg (Mean ± SD) and 117±12-04 mmHg respectively. The diastolic pressures were 88±12.73 mmHg and 71±10.71 mmHg respectively. This was significant (p<0.01) despite the fact that the solid waste disposal workers had a lower BMI value (24.25±3.19 Kg/M2) than the controls (29.46±3.75 Kg/M2). The increase in blood pressure cuts across duration of exposure, 55.84% of the solid waste disposal workers reported regular alcohol intake, while 43.27% reported current tobacco use against 20% and 7% of the control group. There was no significant difference (p>0.01) when the blood pressures of solid waste disposal workers aged 40 and above was compared with that of 19 to 39 age group. Prevalence of malaria parasitaemia was higher in the solid waste disposal workers in comparison to the controls 92% and 69% respectively.