injection safety in epi: more than just ad syringes and safety boxes
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Injection Safety in EPI: More than just AD Syringes and Safety Boxes. World Health Organization HTP/V&B/EPI. Immunizations. Therapeutic injections. Use of the Estimated 12 Billions Injections Administered Annually Worldwide. Measles campaigns?. - PowerPoint PPT PresentationTRANSCRIPT
Injection Safety in EPI:More than just AD
Syringes and Safety Boxes
World Health Organization
HTP/V&B/EPI
Use of the Estimated 12 Billions Injections Administered Annually
Worldwide
Immunizations Therapeutic injections
Measles campaigns?
Injection Safety
In a year, unsafe injections may be responsible for:
$ 8 to 16 Million cases of Hepatitis B
$ 2 to 5 Million cases of Hepatitis C
$ 80,000 to 160,000 cases of HIV
Injection Safety: Definition
No harm to the recipient No harm to the health-care worker No harm to the community
Reuse of equipment
Unsafe collection
Unsafe disposal
INJECTION SAFETYINJECTION SAFETYKey steps Key steps to improve safety to improve safety
Use of injection safety equipment Adequate injection technique
Disposal of used sharps in safety boxes Appropriate waste management
Injection Safety
Sharp Containers
Injection Safety
Sharps container
UNSAFESAFE
ChallengeHow to safely dispose
of used injection equipment within the EPI and during mass
vaccination campaigns?
Assuring safe disposal of used injection material within the EPI
• Waste mgmt is a chronic and frequently overlooked component of EPI
• EPI waste only a small proportion of healthcare waste
• Weak health and community waste mgmt systems. Mass vaccination campaigns greatly increases this ns greatly increases this chronic problemchronic problem
• Waste mgmt is an essential component of mass vaccination campaigns
• Early planning necessary to identify options and develop achievable plans
Challenges for Waste Management during mass vaccination campaigns
• No “one-size-fits-all” solution
• Need local assessment, simple solutions
• Environmental concerns, pressure groups, Kyoto agreement, bans on burning in some countries
• Implementation of the “Polluter Pays” principle
• Waste mgmt must be budgeted/funded/planned
• Measles and other vaccination campaigns should assist in the development of long-term EPI waste mgmt solutions
Options for disposing of used injection material within the EPI
Open burning and burying High temperature incineration Burial Dumping in pit latrine or other secure pit Transport for off-site treatment New technologies/recycling
Injection Safety
Open burning - cheap and practical option Combustion is at lower temperature May not completely destroy injection equipment More toxic emission, chances of more waste
scatter Usually done in open pit or metal drums Fence off and clear area and warn people to stay
away from site Ashes should then be buried
Injection Safety
High temperature incineration The high temperature kills microorganisms Destroys syringes and needles by burning at high
temperature (800 0C) Minimal toxic fumes from incinerator, less air
pollution Reduce volume of waste to minimum Requires special facilities Costly & complex to operate depending on model
Advantages of high temperature incineration
Assures complete combustion of used injection equipment
Markedly decreased risk of toxic emissions if properly used
Increased melting of needles Less risk of blood-borne infections to the
community
EPI Waste Management
Protection of the Human Environment (PHE)
Technical Options for Managing Waste
Burning – High temperature
De MontfordLocally built brick IncineratorUS $1000Installed
EPI Waste Management
Protection of the Human Environment (PHE)
Technical Options for Managing Waste
Burning – High temperature
After-burning
Air inlet
Factory builtPrefabricated IncineratorUS $5000Installed
Injection Safety
Burial Burial can be for unburnt injection waste or
waste generated by burning The pit should be at least 1 meter in depth It should be cordoned off to prevent access
to site by people/children
EPI Waste Management
Protection of the Human Environment (PHE)
Technical Options for Managing Waste
Waste Burial Pit
Assurance of injection safety with the EPI
Conclusions• Proper equipment is necessary, but not sufficient.• Careful planning/budgeting/training needed
• Injection safety requires a long-term vision
•Short-term solutions available
•Creativity/teamwork needed to find long-term sustainable solutions
• Solving the overall health care waste mgmt challenge is beyond the scope of the EPI
• Mass vaccination campaigns should contribute towards finding sustainable solutions to the challenge of EPI waste mgmt. “Bundling” should include waste mgmt plans and financing