The risks of improper disposal – Prettpal Somel Initial Medical

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  Posted by: The Probe      6th February 2019

All healthcare providers have a duty of care to ensure that medical waste is suitably managed and disposed of. While we should expect all staff working with potentially hazardous materials to be aware of waste management protocols, it is of course human nature to make mistakes. The consequences of improper disposal of dental waste can be dire, so whatever measures can be taken to minimise the chance of such errors occurring should be pursued.

Better understanding fosters diligence. Everyone knows that safely disposing of waste is important, but a deeper understanding of why and the potential consequences of not doing so will help ensure staff are especially mindful while going about their duties.

 

What could go wrong?

Recently, members of the public were horrified to learn about a catastrophic failure in waste disposal, wherein a company working for the NHS had been unable to incinerate waste in a timely fashion, kept quiet about it, and ended up stockpiling hundreds of tonnes of hazardous materials including human body parts.[i]While this incident did not pose a direct threat to the public, the story was widely covered in the press and was met with shock and disgust. It is a timely reminder that such failures can have disastrous consequences, both practically and to a business’s reputation.

While such stories are attention grabbing, even small-scale lapses can create big problems, particularly in the aggregate.

 

Mercury

Mercury has historically been widely used in dental amalgam. Mercury vapour has long been known as a health hazard – the phrase “Mad as a hatter” is commonly believed to have originated from people witnessing hat makers in the throes of mercury poisoning, due to the use of mercury nitrate to cure felt.[ii]Whether this origin is fictional or not, the threat of mercury vapour to you, your staff and your patients is very real – mercury poisoning can result in irreversible neurological damage.[iii]It is for this reason that mercury suppression agents are utilised.

 

Silver

Silver has seen widespread use in medical applications thanks to its intrinsic antibacterial, antiviral and antifungal properties. It is well known as a classic constituent of dental amalgam, and more recently silver nanoparticles have been incorporated into a host of different biomaterials used for everything from implant coatings to treatments for oral cancers.[iv]However, these same qualities make it potentially harmful in the wild. While the vast majority of silver can be safely removed by bodily processes, dissolved silver can accumulate in organs and fat deposits.[v]In humans, excessive exposure to silver can lead to irreversible pigmentation of the skin and/or eyes (argyria and argyrosis respectively).[vi]While silver is comparatively safe as far as hazardous elements go, high concentrations of silver contaminating and accumulating in water is a concern, and even trace amounts entering the sewage system will add up.[vii]

 

Blood & sharps

The primary danger from sharps is the potential to be exposed to bloodborne viruses such as Hepatitis and HIV. There are still tens of thousands of needlestick injuries a year, around 10% of which occur after disposal. Thankfully the risk of transmission isn’t absolute, but even when no illness develops this can be a very stressful and anxiety provoking experience for those affected.[viii]Even on materials that are not sharp, appropriate care should be taken with items contaminated with blood.

Keep it simple, keep it safe

 

The more complicated a system, the more room there is for mistakes to creep in.

The Department of Health has outlined a colour coded system, considered best practice for healthcare waste management and segregation. Initial Medical follows these recommendations and has produced Colour Coded Characters, expressly designed to be easy to understand and easy to remember. This system facilitates at a glance understanding and recall, keeping things simple and straightforward so mistakes aren’t made.

Environmental law specifies that waste producers, such as your practice, have a “cradle to grave” responsibility over that waste; from control and storage, through transportation, until eventual disposal. By using a reputable partner you can rest assured that your obligations are met and all materials will be disposed of with the utmost care.

 

 

For further information please visit www.initial.co.uk/medicalor Tel: 0870 850 4045

 

 

REFERENCES

[i]BBC News. Human body parts ‘pile up’ in NHS waste backlog. BBC News.October 4, 2018. Link: https://www.bbc.co.uk/news/health-45750389[Last accessed November 15, 2018].

[ii]Martin G. As mad as a hatter. The Phrase Finder. Link: https://www.phrases.org.uk/meanings/mad-as-a-hatter.html[Last accessed November 15, 2018].

[iii]Mahaffey K. Mercury exposure: medical and public health issues. Transactions of the American Clinical and Climatological Association.2005; 116: 127-154. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1473138/[Last accessed November 15, 2018].

[iv]Bapat R., Chaubal T., Joshi C., Bapat P., Choudhury H., Pandey M., Gorain B., Kesharwani P. An overview of application of silver nanoparticles for biomaterials in dentistry. Materials Science and Engineering: C. 2018; 91: 881-898. Link: https://www.sciencedirect.com/science/article/pii/S0928493117335956[Last accessed November 15, 2018].

[v]Noronha V., Paula A., Durán G., Galembeck A., Cogo-Müller K., Franz-Montan M., Durán N. Silver nanoparticles in dentistry. Dental Materials.  2017; 33(10): 1110-1126. Link: https://www.sciencedirect.com/science/article/pii/S0109564117303767[Last accessed November 15, 2018].

[vi]Drake P., Hazelwood K. Exposure-related health effects of silver and silver compounds a review. The Annals of Occupational Hygiene.2005; 49(7): 575-585. Link https://academic.oup.com/annweh/article/49/7/575/148203#1208935[Last accessed November 15, 2018].

[vii]Eckelman M., Graedel T. Silver emissions and their environmental impacts: a multilevel assessment. Environmental Science & Technology. 2007; 41(17): 6283-6289. Link: https://pubs.acs.org/doi/abs/10.1021/es062970d[Last accessed November 15, 2018].

[viii]The NHS Staff Council. Managing the risks of sharps injuries. NHS Employers.2015. Link: https://www.nhsemployers.org/-/media/Employers/Documents/Retain-and-improve/Health-and-wellbeing/Managing-the-risks-of-sharps-injuries-v7.pdf[Last accessed November 15, 2018].


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