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Injection Safety in EPI: More than just AD Syringes and Safety Boxes

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?.

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Injection Safety in EPI: More than just AD Syringes and Safety Boxes

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  1. Injection Safety in EPI:More than just AD Syringes and Safety Boxes World Health Organization HTP/V&B/EPI

  2. Immunizations Therapeutic injections Use of the Estimated 12 Billions Injections Administered Annually Worldwide Measles campaigns?

  3. 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

  4. No harm to the recipient No harm to the health-care worker No harm to the community Injection Safety: Definition Unsafe disposal Reuse of equipment Unsafe collection

  5. INJECTION SAFETY Key steps to improve safety Use of injection safety equipment Adequate injection technique Appropriate waste management Disposal of used sharps in safety boxes

  6. Sharp Containers Injection Safety

  7. Sharps container Injection Safety SAFE UNSAFE

  8. Challenge How to safely dispose of used injection equipment within the EPI and during mass vaccination campaigns?

  9. 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 chronic problem • Waste mgmt is an essential component of mass vaccination campaigns • Early planning necessary to identify options and develop achievable plans

  10. 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

  11. Open burning and burying High temperature incineration Burial Dumping in pit latrine or other secure pit Transport for off-site treatment New technologies/recycling Options for disposing of used injection material within the EPI

  12. 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

  13. 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 Injection Safety

  14. 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 Advantages of high temperature incineration

  15. EPI Waste Management • Technical Options for Managing Waste • Burning – High temperature De Montford Locally built brick Incinerator US $1000 Installed Protection of the Human Environment (PHE)

  16. EPI Waste Management • Technical Options for Managing Waste • Burning – High temperature Factory built Prefabricated Incinerator US $5000 Installed Protection of the Human Environment (PHE)

  17. 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 Injection Safety

  18. EPI Waste Management Technical Options for Managing Waste Waste Burial Pit Protection of the Human Environment (PHE)

  19. 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

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