Medical sharps in Portugal: a cross-sectional survey of disposal practices among the diabetic population.

OBJECTIVE: We aim to determine the disposal site for biohazardous materials resulting from diabetes surveillance and therapy. DESIGN: Cross-sectional study. SETTING: Five Portuguese primary care facilities. PARTICIPANTS: We randomly sampled diabetic patients representative of five primary care facilities. Inclusion criteria consisted in patients≥18 years old with an active diagnosis of diabetes mellitus (DM). Patients unable to provide written informed consent were excluded. OUTCOME MEASURE: Sociodemographic variables, diabetes duration, type of treatment, medical sharps disposal practices and whether adequate disposal information were provided. RESULTS: A total of 1436 diabetics were included. Overall, 53.8% of diabetics conducted regular capillary glicemia measurements, although 45.3% of them had no medical indication. Statistically significant predictors of adequate disposal were not having an active professional status (p=0.011) and having a DM duration between 5 and 10 years (p=0.014). Only being professionally inactive remained an independent predictor after multivariate logistic regression. Less than a fifth of patients on injectable therapy report having been advised by healthcare staff regarding sharps disposal. Over a fifth of the latter report having received wrong advice. The majority of diabetics dispose of biohazardous materials in unsorted household waste (68.1% of needles/devices with needles and 71.6% of lancets). Other incorrect disposal sites identified were recycling bins, toilet and home accumulation. Only 19.1% of the needles/devices with needles and 13.1% of the lancets were disposed of at healthcare facilities. CONCLUSIONS: Most diabetics have unsafe disposal practices for their biohazardous materials, mostly in unsorted household waste. We identified that being unemployed independently predicts adequate disposal of medical sharps and found evidence of low patient literacy on the topic, as well as poor patient education. Therefore, educating and raising awareness among healthcare professionals is crucial to address this public health issue.

Evaluation of pitch up of two-axle solid waste collection compactor trucks in the static condition.

The study of pitch up limit for solid waste collection compactor trucks in tilted public roads is of great relevance both for the planning of waste collection, mainly in cities with very uneven street gradient, or for use as a design parameter in projects involving public roads. Considering the typical construction and use of rear loader waste compactor equipment, the centre of gravity moves towards the rear of the vehicle as it is loaded, resulting in overload in the rear axle at the end of the waste collection period. In the city of Belo Horizonte (Brazil), several cases of pitch up have been reported for this type of vehicle, in streets with different inclinations and with loading situations in which the load box was not completely full. The present study investigated the variation of the imminence pitch up angles of the two-axle, rear-loading, solid waste collection compactor truck in a static condition, determined by the variation of its centre of gravity coordinates, which were obtained experimentally by means of a testing programme for different loading situations. The critical inclination angle was 0.347 rad (19.89°), which corresponds to a ramp inclination of 36.17%, for the condition of total weight of 157.06 kN (16 027 kgf) with payload of 63.42 kN (6472 kgf).