Evaluation of Needle Remover Devices

Program for Appropriate Technology in Health

Balcan, UK

Needle Removers• Concept• Advantages• Disadvantages• Contamination Study• Design Tradeoffs

SIGN—October 2002

Balcan, UK

Needle remover collects needles in a secure container

Syringe bodies are put in a safety box

Needles are dumped from the container into a protected pit

Concept

Safely remove used needles from syringes

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Advantages• Decrease waste volume

• Decrease/contain sharps waste

• Lower cost of handling/transport

• Fewer safety boxes

• Help prevent reuse

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Disadvantagesoffset by...Additional cost

Supply needs

Possible splatter contamination

– Reusable containers– Bundling?

– 90% less sharps waste– Fewer safety boxes– Lower transport cost– Long life of device

– Conduct study

SIGN—October 2002

Increased handling

– Fewer sharps downstream

Study Background

Literature shows risk of infection

– Pathogens spread by hands

– Splash to the eye

• Lauer JL, VanDrunen NA, Washburn JW, Balfour HH Jr. Transmission of hepatitis B virus in clinical laboratory areas. J Infect Dis 1979;140:513-6.• Follett EA, Sleigh JD. Hepatitis B as a hazard to laboratory staff: a re-appraisal. J Clin Pathol 1980;33:1017-20.• Levy BS, Harris JC, Smith JL, Washburn JW, Mature J, Davis A, Crosson JT, Polesky H, Hanson M. Hepatitis B in ward and clinical laboratory

employees of a general hospital. Am J Epidemiol 1977;106:330-5.• Sartori M, Terra GL, Aglietta M, Manzin A, Navino C, Verzetti G. Transmission of hepatitis C via blood splash into conjunctiva. Custom 1:

19930713 DCOM- 19930713 LR - 20001218 1993;25:270-1.• Ippolito G, Puro V, Petrosillo N, De Carli G, Micheloni G, Magliano E. Simultaneous infection with HIV and hepatitis C virus following

occupational conjunctival blood exposure. JAMA 1998;280:28.

Design• Qualitative

• Visual Marker

• Sensitivity < 1mm diameter

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Method

• 0.25 ml dye solution, lumen filled

• Control drips prior to use

• Compliant use, manufacturer’s IFUs

• 20 uses per device

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Materials• 5 devices from 4 manufacturers

• 2 cutters, 3 pullers

• WHO Safety Box

• Pliers

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Results

• No splatter from any device EXCEPT...

• Pliers

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Limits• Does not measure aerosolization

• Does not measure non-

compliant use

• One syringe size (23 gauge 1

inch)SIGN—October 2002

Needle Removers• Concept• Advantages• Disadvantages• Contamination Study• Design Tradeoffs

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Nomoresharps, Australia

Design Tradeoffs• Cost vs. durability

• Portability vs. static use

• Needle container reusable

vs. disposable

• Syringe destruction

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Appropriate Device

• Inexpensive• Non-electric• Reliable and durable • Safe• Simple to use

SIGN—October 2002