{"title":"Infectious Waste Disposal in Developing Countries: Recommended Minimal Practices from a Hospital Survey in Southeast Asia","authors":"E. Cole","doi":"10.1177/109135050000500204","DOIUrl":"https://doi.org/10.1177/109135050000500204","url":null,"abstract":"When managed ineffectively, infectious hospital wastes in developing countries can compromise the quality of patient care and create significant occupational, public, and environmental health risks. Three types of hospital facilities in a developing country were studied to assess waste separation, transport, treatment, and disposal practices. The staff of a municipal General Hospital (1,650 beds) did not appropriately separate wastes and disposed of untreated solid wastes by surface dumping near the hospital grounds, pending municipal collection and disposal in an unsecured landfill. While personnel of a rural Divisional Hospital (150 beds) did not effectively separate sharps from other forms of medical waste, they disposed of all solid wastes on hospital grounds in a secured ground pit, followed by burning and soil cover. Workers at a rural Township Hospital (25 beds) separated wastes and disposed of them by; (i) burning general and most medical wastes in a ground pit, (ii) using a separate pit with metal cover and delivery tube to burn needle and other sharps, and (iii) incinerating all forms of paper wastes.","PeriodicalId":212933,"journal":{"name":"American Biological Safety Association Journal","volume":"38 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120979712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Arthropod Containment Guidelines under Development","authors":"M. Benedict","doi":"10.1177/109135050000500208","DOIUrl":"https://doi.org/10.1177/109135050000500208","url":null,"abstract":"In response to the perceived absence of specific guidelines for laboratory containment of arthropods of public health importance, a committee has been appointed by the American Society of Tropical Medicine and Hygiene (ASTMH) to develop a document that fills this need. The document is currently in draft status, but when finalized and accepted by the ASTMH, will be recommended to NIH-CDC for inclusion in revised form in Biosafety in Microbiological and Biomedical Laboratories (BMBL). While the format is based","PeriodicalId":212933,"journal":{"name":"American Biological Safety Association Journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125738340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Tuberculosis Outbreak among Medical Waste Workers","authors":"A. Weber, Y. Boudreau, V. Mortimer","doi":"10.1177/109135050000500207","DOIUrl":"https://doi.org/10.1177/109135050000500207","url":null,"abstract":"Occupational exposures to Mycobacterium tuberculosis and bloodborne pathogens were evaluated during the processing of medical waste at a commercial treatment site. The facility utilized a method consisting of shredding waste followed by disinfection with dielectric heat. A previous epidemiologic investigation revealed three employees with active tuberculosis, the etiologic agent in each case having a different drug susceptibility pattern. This finding eliminated the possibility of person-to-person transmission between employees. Further evaluation confirmed that one employee was infected with a strain of M. tuberculosis identical to an isolate recovered from a patient treated at a clinic that sent waste to the treatment facility. Factors contributing to exposures included: the aerosolization of products contained in the waste, deficiencies in the facility design, absence of safety policies, inadequate design and operation of processing equipment. Furthermore, misunderstandings among employees regarding equipment operating procedures, use of personal protective equipment, and routes of disease transmission may have also been involved in employees exposures.","PeriodicalId":212933,"journal":{"name":"American Biological Safety Association Journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133799410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medical and Infectious Waste Management","authors":"I. Salkin, E. Krisiunas, W. Turnberg","doi":"10.1177/109135050000500206","DOIUrl":"https://doi.org/10.1177/109135050000500206","url":null,"abstract":"There is no uniform national standard for defining the wastes that comprise the regulated medical waste (RMW) stream. Based on the variability associated with infectious disease causation, no method exists to determine the potential “infectivity” posed by RMW. Because of this, regulated medical waste definitions developed by the various federal, state, and local government entities are based on the agencies' judgments of risk from the perspective of the jurisdiction to which the definition will apply. It then becomes the responsibility of the regulated community to recognize the various agencies with jurisdiction over definitions and to address the definitional elements of each, recognizing and addressing the inconsistencies that may exist.","PeriodicalId":212933,"journal":{"name":"American Biological Safety Association Journal","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132816822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Regulated Medical Waste: A Special Edition of the Journal of the American Biological Safety Association","authors":"I. Salkin","doi":"10.1177/109135050000500203","DOIUrl":"https://doi.org/10.1177/109135050000500203","url":null,"abstract":"In 1988, the Congress of the United States enacted the Medical Waste Tracking Act in response to public pressure brought about by several incidents purportedly involving regulated medical waste (RMW) washing-up along the coasts of three Northeast states. It was further alleged that this waste had entered New York City harbor as a result of illegal disposal activities of one or more waste haulers. It would later be established that very little of the waste contained what would be defined as RMW components, and that the materials had entered the harbor through the New York City storm drainage system rather than through the unlawful actions of waste transporters. However, these facts did not prevent the legislatures of a majority of states from promulgating their own laws and regulations to control the generation, processing, treatment and disposal of RMW. Although the federal statute \"sunset\" in 1991, most states and several federal agencies maintain some form of regulatory oversight over the waste generated through the delivery of health care and research involving potential human infectious agents. While several studies over the last 10 years have demonstrated that there are occupational risks associated with RMW, there has not been, to the guest editor's knowledge, a single report documenting the acquisition of an infectious disease among the public related to RMW. Most of the investigations which have been published in the literature have found that the general public's health would not likely be adversely affected by RMW generated by health care facilities. However, the public perceives RMW as a real and direct health threat. The numerous reports in the popular press of physical injuries (generally needlesticks) caused by RMW, especially when they occur in such public locations a parks and playgrounds, magnify the threat posed by RMW in the collective mind of the public. In addition, the","PeriodicalId":212933,"journal":{"name":"American Biological Safety Association Journal","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125965324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Biological Contamination of the Building Environment: Sampling and Analysis","authors":"R. Fink, E. Gilman","doi":"10.1177/109135050000500106","DOIUrl":"https://doi.org/10.1177/109135050000500106","url":null,"abstract":"Occupational-Related Illness Due to Microorganisms Examination of the microbial environment began in the late 1600's when Antony van Leeuwenhoek observed microorganisms (\"animalcules\") in water. In the mid-eighteenth century Lazzaro Spallanzani concluded, after a lengthy series of experiments, that the \"animalcules\" observed in water were carried by the air. These organisms in the air and water were not considered potential disease agents until the work of Pasteur and Koch demonstrated that certain microbes could cause disease. The first pathogen purified and identified was Bacillus anthracis, a serious livestock pathogen and an agent of occupationally acquired illness. Since the pioneering work of Pasteur and Koch a large number of occupational illnesses have been determined to have a microbiological basis. People involved in agricultural related occupations experienced large proportions of these illnesses. This is due to two factors; 1) agricultural workers have intimate contact with soil and 2) specialized environmental conditions on the farm permit high numbers of specific organisms to grow. For example, farmers often store large amounts of hay and grain in buildings that are relatively airtight. This storage condition leads to high humidity and temperature that results in the microbial decay of the organic material by thermophilic actinomycetes (Micropolyspora faeni, Thermoactinomyces spp.). These are the principal agents of farmer's lung disease. Farmer's lung disease has also occurred in mushroom workers exposed to compost dust\", The use of ventilators in barns and silos will reduce the temperature below the optimum for the growth of actinomycetes and therefore will reduce the incidence of farmer's lung. Agricultural workers are also exposed to a wide variety of fungi (Aureobasidium, Aspergillus, Penicillium. Botrytis, Cladosporium, Alternaria spp.), many of which have been implicated in causing","PeriodicalId":212933,"journal":{"name":"American Biological Safety Association Journal","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114784461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Kournikakis, R. Harding, J. Tremblay, Maureen L. Simpson
{"title":"Comparison of Protection Factors for Selected Medical, Industrial and Military Masks","authors":"B. Kournikakis, R. Harding, J. Tremblay, Maureen L. Simpson","doi":"10.1177/109135050000500105","DOIUrl":"https://doi.org/10.1177/109135050000500105","url":null,"abstract":"Personal protection against infectious or toxic aerosols is a growing area of concern among many different occupational groups. Selection of appropriate respiratory protection should be based upon the level of risk present and the degree of protection afforded by the different types of protective masks available. In this study we have determined the relative protection factors for various commercial and military respiratory protective devices when challenged with a polydispersed submicron to micron sized particulate aerosol.","PeriodicalId":212933,"journal":{"name":"American Biological Safety Association Journal","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128136393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Shilkret, Z. Liu, F. Santos, M. Dillon, M. Schulman, B. Kreiswirth, P. Bifani, S. Moghazeh, B. Mathema
{"title":"Misdiagnoses of Tuberculosis Resulting from Laboratory Cross-Contamination of Mycobacterium Tuberculosis Cultures—New Jersey, 1998","authors":"K. Shilkret, Z. Liu, F. Santos, M. Dillon, M. Schulman, B. Kreiswirth, P. Bifani, S. Moghazeh, B. Mathema","doi":"10.1177/109135050000500107","DOIUrl":"https://doi.org/10.1177/109135050000500107","url":null,"abstract":"A diagnosis of tuberculosis (TB) is rarely disputed if Mycobacterium tuberculosis is isolated from a clinical specimen; however, specimen contamination may occur (1-3). Identification of TB strain patterns through molecular typing or DNA fingerprinting is a recent advancement in TB laboratory techniques (3-7). CDC's National Tuberculosis Genotyping and Surveillance Network (NTGSN) performs DNA fingerprinting on TB isolates to determine the frequency of clustering among M. tuberculosis strains in project surveillance sites. In November 1998, NTGSN detected 11 isolates from previously reported TB cases among persons in New Jersey whose DNA fingerprints matched the avirulent laboratory M. tuberculosis control strain H37Ra. H37Ra does not cause active TB in humans, but it has been reported as a source of cross-contamination (8). In collaboration with the New Jersey Department of Health and Senior Services, CDC investigated H37Ra as a possible cause of TB disease and/or TB misdiagnoses caused by laboratory cross-contamination in the 11 case-patients. This report describes findings from two of the 11 cases and summarizes the results of this investigation, which indicate that TB was misdiagnosed and demonstrate the value of DNA fingerprinting to identify occurrences of cross-contamination of patient specimens.","PeriodicalId":212933,"journal":{"name":"American Biological Safety Association Journal","volume":"161 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133249760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}