Sustainable management of medical plastic waste through carbon dioxide-assisted pyrolysis.

To address the challenges associated with medical plastic waste and to characterize its heterogeneity, non-recyclability, and potential biohazard risks, this study explored a carbon dioxide (CO2)-assisted pyrolysis process as a sustainable disposal method. Medical plastic waste typically includes polypropylene, polystyrene, and polyvinyl chloride. To experimentally evaluate the functional reactivity of CO2, we employed three pyrolysis setups (one-stage, two-stage, and catalytic processes). The technical advantages of using CO2 over inert gases such as nitrogen (N2) were demonstrated through pyrolysis tests. The results showed that energy production was enhanced under CO2 conditions, with catalytic pyrolysis generating 146% more flammable gases compared to pyrolysis in an N2 environment. The use of CO2 also led to a reduction in the formation of toxic chemicals due to improved thermal cracking. The CO2-assisted pyrolysis process exhibited net negative CO2 emissions when a catalyst was present, as a substantial amount of CO2 was consumed during the process. In conclusion, CO2-assisted pyrolysis of medical plastic waste offers a sustainable management solution that maximizes the utilization of carbon resources.

Effective methods for the decontamination of healthcare waste: Ozone and UV-C radiation process.

Human-generated waste, including infectious healthcare waste, poses significant risks to public health and the environment. The COVID-19 pandemic has increased the global production of infectious waste, emphasizing the need for safe and sustainable waste management practices. While autoclaves are commonly used for on-site disposal, alternative methods like ozone gas and UV-C radiation offer environmentally friendly options that effectively eliminate pathogens without leaving toxic residues. Inadequate waste management can contribute to disease transmission, while open burning releases harmful pollutants. This study investigated the effectiveness of different disinfection agents - ozone gas and UV-C radiation - on infectious solid waste contaminated with bacteria. The bacterial indicators examined were Staphylococcus aureus, Bacillus subtilis, and Pseudomonas aeruginosa. The experimental methods included operating each ozone and UV-C radiation individually and simultaneously using ozone gas and UV-C radiation. The study also investigated exposure times and various concentrations of ozone gas. The findings demonstrated that the simultaneous application of ozone gas and UV-C radiation was the most effective method for decontaminating infectious solid waste and targeting the selected bacteria. The concentration of ozone gas ranged from 165 to 5000 ppm, depending on generation time and treatment chamber volume, while exposure times varied from 1 to 180 minutes. In applying UV-C rays, complete elimination of S. aureus was observed after 60 minutes up to 6-log, while the reduction of B. subtilis and P. aeruginosa were 2-log and 3-log, respectively. Ozone gas had the ability to inactivate all strains, but when ozone gas and UV-C rays were used simultaneously, this process was accelerated and improved. The total reduction in the bacterial load was 8-log. Considering the increase in population and the subsequent increase in waste generation, adopting an environmentally friendly waste management method can be very advantageous.Implications: This study highlights the effectiveness of simultaneously applying ozone gas and UV-C radiation for decontaminating infectious solid waste, offering an environmentally friendly alternative to traditional thermal treatments like autoclave and incineration. By optimizing ozone concentrations and exposure times, this method reduces disease transmission risks and minimizes environmental impact. These findings are crucial, especially during outbreaks such as the COVID-19 pandemic, providing scalable, sustainable waste management solutions for healthcare facilities. Implementing these techniques can protect public health and the environment, setting a new standard for safe infectious waste disposal worldwide, mitigating hazardous pollutants, and reduce the exposure risk of bio-hazardous residues.

Medication Disposal Patterns and Practices with Awareness of Environmental Contamination Caused by Pharmaceuticals among the General Public in Malaysia.

The proper disposal of pharmaceuticals has become a prime concern in contemporary healthcare and environmental management. The evolving awareness highlights the ecological and public health risks associated with pharmaceutical waste. Therefore, evaluating medication disposal patterns and public awareness regarding pharmaceutical-related environmental issues is crucial for promoting responsible practices. The primary aim of this study is to identify the determinants of participation in the Medicine Return Program (MRP) among Malaysians. This cross-sectional study employed snowball sampling and an online questionnaire, disseminated via multiple social media platforms. Results: Out of 389 respondents, 46% were 18 to 29 years old, 61% were female, and 69.7% attained a tertiary educational level. Most of them (71.5%) reported disposing of their unused medicines into the rubbish bin, indicating that this disposal method is prevalent among Malaysians. Only 26.2% participated in the MRP program. The study revealed that 73.0% of respondents were aware of pharmaceutical-related environmental contamination. Furthermore, significant associations were demonstrated between a factor of receiving advice from healthcare professionals (p < 0.001), awareness level on environmental pharmaceutical contamination (p < 0.001) and MRP (p < 0.001) and willingness to participate in MRP (p < 0.001) with MRP support. This study provides valuable insights on Malaysian pharmaceutical disposal practices and the factors influencing MRP participation. These findings can inform targeted interventions and public health campaigns to improve medication disposal behaviors and reduce pharmaceutical waste's environmental impact.

Review of sustainable practices for the gynecology operating room.

PURPOSE OF REVIEW: Climate change has immediate impacts on women's health. Hospitals and operating rooms are large contributors to greenhouse gas (GHG) emissions and waste. This article will review current green initiatives designed to minimize environmental impact in the operating room and highlight areas for future improvement. RECENT FINDINGS: From a materials perspective, reusable goods result in less GHG emissions while being just as efficacious, well tolerated, and easy to use. Materials should be opened judiciously, only as necessary. Processing regulated medical waste produces greater GHG emissions, so waste should be properly sorted, and items which are not biohazard waste should be processed separately. Choosing appropriate anesthesia and utilizing an 'off' setting, in which operating rooms are shut down when not in use, can also drastically decrease the environmental impact of surgery. Further research is needed to determine effective implementation in hospitals. SUMMARY: This article summarizes current attempts to make operating rooms more sustainable. Many practices result in a decreased carbon footprint and cost savings without adversely affecting patient outcomes. Gynecologic surgeons and the hospitals in which they practice need to focus on implementing these changes in a timely fashion.

"O.R. GOES GREEN": a first step toward reducing our carbon footprint in the operating room and hospital.

Hospitals in Europe produce approximately 6 million tons of medical waste annually, about one-third of this originating in operating rooms. Most of it is solid waste, which can be recycled if bodily fluids do not contaminate it. Only 2-3% of hospital waste must be disposed of as infectious waste, and this is much lower than the 50-70% of garbage in the biohazard waste stream. In June 2021, at the main operating room of the Department of General Surgery of the University of Turin, we began a separate collection program for materials consisting of plastic, paper, TNT (material not contaminated by bodily fluids), and biohazardous waste. We calculated the number of boxes and the weight of special waste disposed produced every month in one operating room for 18 months. The monthly number of Sanibox and the monthly weight of biohazardous waste decreased during the observation period. The reduction trend was not constant but showed variations during the 18 months. Direct proportionality between number of low-complexity procedures and production of biohazardous waste was found (p = 0.050). We observed an optimization in the collection and filling of plastic, paper and TNT boxes separated and sent for recycling. One of the barriers to recycling hospital waste, and surgical waste in particular, is the failure to separate infectious waste from clean waste. A careful separate collection of waste in the operating room is the first step in reducing environmental pollution and management costs for the disposal of hospital waste.

Anti-cancer drug waste disposal practices and wastewater management in hospitals: A Lebanese survey.

INTRODUCTION: To achieve continuous environmental sustainability and protect the population's health, healthcare waste (in liquid or solid form) needs appropriate management and suitable treatment strategies before its final disposal in the environment in order to reduce its adverse impacts. This study aims to identify disparities in the waste management of anti-cancer drugs and the wastewater generated in Lebanese hospitals. METHODS: Three questionnaires were designed to evaluate the level of knowledge, awareness and experience of hospital personnel regardless of their job levels. Data was collected in December 2019 from three departments of each participating hospital: pharmacy, oncology and maintenance departments. A descriptive analysis was conducted to summarise the survey results. RESULTS: The results revealed a lack of transparency and awareness of the participants, with a high frequency of 'prefer not to say' responses when asked about the disposal methods of anti-cancer drugs and with only 5.7% of the participants in the pharmacy department sharing their disposal procedures. The same perception was deduced regarding hospitals' wastewater treatment, where responses were often contradicting, preventing making assumptions about the fate of hospital wastewater. CONCLUSION: The results of this survey support the need to establish a more comprehensive waste management programme in Lebanon that would be maintained through regular training and supervision.

Evaluation of handling, storage, and disposal practices of oral anticancer medications among cancer patients and their caregivers at home setting in the Princess Noorah Oncology Center.

BACKGROUD: Oral medications are commonly prescribed for many cancer patients. Unfortunately, most of them are dispensed without proper counseling about handling practices. We aimed to evaluate the handling, storage, and disposal practices of oral anticancer medications among cancer patients and their caregivers at home. METHODS: A cross-sectional questionnaire was filled in by adult cancer patients or caregivers who received oral anticancers and/or visited an outpatient pharmacy over two months. RESULTS: A total of 201 participants were interviewed, 67% were female, and nearly 44% were between 40 and 60 years of age. The majority of participants were educated (78%). The top five medications involved were: tamoxifen, capecitabine, letrozole, dasatinib, and imatinib. More than 95% of participants reported that medications were kept away from children and pets in the original container and stored away from extreme heat, cold, and humidity. Hand washing and wearing gloves were not consistently practiced. Only 5% reported "Always" wearing gloves, while 24% reported "Always" washing hands after handling anticancer medications. The participants reported that they had been informed about safe handling and storage by their physician (39%) and pharmacist (25%), while 34% had not been informed. In terms of disposal practices, 66% of patients have not had any unused or expired medications, 29% disposed them in the trash, and 27% returned them. CONCLUSIONS: Our findings suggest that patients and caregivers' handling practices of oral anticancer medications are inconsistent with the published recommendations. Hence, appropriate and comprehensive education is needed to mitigate the risk of exposure to these agents in the home setting.

Ferramenta eletrônica para o gerenciamento de explantes ortopédicos em tempo real / Electronic tool for managing orthopedic explants in real time

Introdução: O descarte do resíduo produzido é um dos grandes problemas mundiais; mensurar o quanto afeta a nossa saúde, a comunidade, o meio ambiente e o ecossistema é um desafio e diversas legislações tentam minimizar os danos causados pelo descarte inadequado e incorreto. O resíduo dos hospitais é denominado Resíduo de serviço de saúde (RSS) e deve ser tratado de acordo com a sua classificação, o explante ortopédico é um desses RSS e tem uma legislação própria para o seu manuseio e descarte desde 2012. Sempre que aparecem novas normatizações faz-se necessário a adequação do serviço de saúde e da equipe, as tecnologias podem ser utilizadas para auxiliar nesse processo. Refletindo sobre essas questões surgiu a questão que norteou o estudo: Seria possível desenvolver uma ferramenta eletrônica, do tipo aplicativo, para auxiliar no gerenciamento de explantes ortopédicos? Objetivos: Criar uma ferramenta eletrônica do tipo aplicativo para auxiliar no gerenciamento de explantes ortopédicos; criar protocolos que visem a institucionalização do fluxo de descarte dos explantes ortopédicos com base nas legislações e boas práticas vigentes e estabelecer um fluxo de acompanhamento de explantes ortopédicos a partir da necessidade da realização de uma cirurgia para a retirada de um implante ortopédico até a sua disposição final ambientalmente adequada. Metodologia: trata-se de uma pesquisa aplicada que visa o desenvolvimento de um software, do tipo aplicativo para smartphone, de cunho multiprofissional, para o gerenciamento de explantes ortopédicos. Para a elaboração do aplicativo foi seguido os conceitos de Pressman e suas definições quanto a fase de prototipação: comunicação, projeto rápido, modelagem do projeto rápido, construção do protótipo e emprego, entrega e alinhamento. Essas fases foram abordadas como etapas da pesquisa. O cenário do estudo foi um hospital-escola público integrante da rede de hospitais do Ministério da Educação. O público-alvo do estudo foi aquele a qual se destina a utilização da tecnologia, os gerentes, a equipe de enfermagem, os instrumentadores cirúrgicos do bloco cirúrgico do hospital-escola e os usuários do sistema de saúde submetidos a procedimentos cirúrgicos para retirada de explantes cirúrgicos. Resultados: Foram elaborados 8 (oito) produtos; dois em formato de artigo, o primeiro intitulado: "Gerenciamento de explantes ortopédicos e a realidade brasileira: uma revisão integrativa" e o segundo "A criação de aplicativo para auxílio no gerenciamento de explantes ortopédicos: uma realidade", 2 fluxogramas, 3 protocolos e um aplicativo intitulado "Explantes ortopédicos". O desenvolvimento do aplicativo foi realizado de forma interativa incremental, na linguagem de programação disponível no site da "Fábrica de aplicativos". Na fase de comunicação foram elaborados cinco documentos sendo eles dois formulários e três protocolos, além de dois fluxogramas que nos guiaram nas demais fases de criação do aplicativo. Conclusão: É possível criar uma ferramenta eletrônica do tipo aplicativo para auxiliar no gerenciamento de explantes ortopédicos assim como criar protocolos que visem a institucionalização do fluxo de descarte e acompanhamento desses para que tenham uma disposição final ambientalmente adequada

Introduction: Disposal of waste produced is one of the world's major problems; measuring how much it affects our health, community, environment and ecosystem is a challenge and various laws try to minimize the damage caused by improper and incorrect disposal. The waste of hospitals is called Health Service Residue (RSS) and should be treated according to their classification, the orthopedic explant is one of these RSS and has its own legislation for its handling and disposal since 2012. Whenever new norms appear, it is necessary to adapt the health service and the team, the technologies can be used to assist in this process. Reflecting on these questions, the question that guided the study arose: Would it be possible to develop an electronic tool, of the application type, to assist in the management of orthopedic explants? Objectives: Create an electronic tool of the type application to assist in the management of orthopedic explants; create protocols aimed at the institutionalization of the disposal flow of orthopedic explants based on the laws and good practices current and establish a follow-up flow of orthopedic explants from the need for surgery for the removal of an orthopedic implant until its final disposal is environmentally appropriate. Methodology: this is an applied research that aims at the development of a software, type smartphone application, of a multiprofessional nature, for the management of orthopedic explants. For the elaboration of the application was followed the concepts of Pressman and its definitions regarding the prototyping phase: communication, fast design, rapid design modeling, prototype construction and employment, delivery and alignment. These phases were addressed as stages of the research. The study scenario was a public teaching hospital that is part of the hospital network of the Ministry of Education. The target audience of the study was the one that was intended to use the technology, managers, the nursing team, surgical instruments of the surgical block of the teaching hospital and users of the health system submitted to surgical procedures for removal of surgical explants. Results: Eight (8) products were elaborated; two in article format, the first entitled: "Management of orthopedic explants and the Brazilian reality: an integrative review" and the second "The creation of an application to assist in the management of orthopedic explants: a reality", 2 flowcharts, 3 protocols and an application entitled "Orthopedic Explants". The development of the application was carried out interactively incrementally, in the programming language available on the "Application Factory" website. In the communication phase, five documents were elaborated, two forms and three protocols, in addition to two flowcharts that guided us in the other phases of application creation. Conclusions: It is possible to create an electronic tool of the application type to assist in the management of orthopedic explants as well as to create protocols that aim at the institutionalization of the disposal flow and monitoring of these so that they have an environmentally appropriate final disposition

AEG-SEED position paper for the resumption of endoscopic activity after the peak phase of the COVID-19 pandemic. / Documento de posicionamiento AEG-SEED para el reinicio de la actividad endoscópica tras la fase pico de la pandemia de COVID-19.

INTRODUCTION: The COVID-19 pandemic has led to the suspension of programmed activity in most of the Endoscopy Units in our environment. The aim of this document is to facilitate the resumption of elective endoscopic activity in an efficient and safe manner. MATERIAL AND METHODS: A series of questions considered to be of clinical and logistical relevance were formulated. In order to elaborate the answers, a structured bibliographic search was carried out in the main databases and the recommendations of the main Public Health and Digestive Endoscopy institutions were reviewed. The final recommendations were agreed upon through telematic means. RESULTS: A total of 33 recommendations were made. The main aspects discussed are: 1) Reassessment and prioritization of the indication, 2) Restructuring of spaces, schedules and health personnel, 3) Screening for infection, 4) Hygiene measures and personal protective equipment. CONCLUSION: The AEG and SEED recommend restarting endoscopic activity in a phased, safe manner, adapted to local resources and the epidemiological situation of SARS-CoV-2 infection.

Removal of heavy metals in medical waste incineration fly ash by Na2EDTA combined with zero-valent iron and recycle of Na2EDTA: Acolumnar experiment study.

In this study, an effective circulating system was developed to remove heavy metals in medical waste incineration (MWI) fly ash. MWI fly ash (MWIFA)-column experiments were performed to remove Cu, Pb, Zn, Cd, and Ni from MWIFA using EDTA disodium (Na2EDTA). Iron-column experiments were conducted to study the removal effect of zero-valent iron on the five heavy metals from washing wastewater. Toxicity Characteristic Leaching Procedure (TCLP) test method was employed to evaluate heavy metals toxicity of MWIFA residues generated after 0-0.2 mol/L Na2EDTA solution treated. After being washed by 0.2 mol/L Na2EDTA solution, TCLP leaching values of Cu, Pb, Zn, Cd, and Ni were the lowest and satisfied the standard (GB 5085.3-2007), and the leaching values were 58.4 ± 2.0 mg/L, 2.81 ± 0.14 mg/L, 64.3 ± 4.0 mg/L, 0.156 ± 0.005 mg/L, 0.381 ± 0.006 mg/L. Concentrations of Cu, Pb, Zn, Cd, and Ni in iron-column effluent were reduced by 99.7%, 91.6%, 91.6%, 75.4%, and 75.7%, respectively. Na2EDTA was recovered and recycled to the removal of heavy metals from MWIFA. Comparing new Na2EDTA solution with recycled Na2EDTA solution, recycled Na2EDTA and water could be reutilized to dispose MWIFA. The removal efficiencies of Cu, Pb, Zn, Cd, and Ni by recycled 0.2 mol/L Na2EDTA solution were 67.1%, 68.8%, 63.2%, 73.9%, 50.7%, respectively, the removal efficiencies using recovered Na2EDTA decreased by 2.6%, 3.9%, 3.3%, 4.2%, and 1.6%, respectively. Successive batch experiments were also conducted to evaluate industrialization potential and reusable times for recycled Na2EDTA. After four recirculation cycles, extraction efficiencies of Pb and Cd (removal efficiency at different cycles divided by removal efficiency of new Na2EDTA) declined toward 80%. Results from this research indicated that this circulating system possessed industrialization potential. Implications: An effective circulating system was developed to remove heavy metals in MWI fly ash (MWIFA). Integration of Na2EDTA with Fe0 promoted the removal of heavy metals from MWIFA. Na2EDTA, NaCl and water were stepwise extracted from iron-column effluent, respectively. Recovered Na2EDTA can still effectively remove heavy metals from MWIFA. Results from this research indicated that this circulating system possessed industrialization potential.

An approach to assess and identify polymers in the health-care waste of a Brazilian university hospital.

This work presents the health-care waste (HCW) management and an approach to assess and identify polymers in a General Surgery Unit - Internment Service (GSU) of a Brazilian university hospital, to estimate the main polymers presenting in medical devices that are consumed during a year, discarded either as infecting (Group A) or as scarifying residue (Group E). Among the waste produced from the medical devices, 3.14 ton (98.79%) were composed of polymers (63.06% of plastics and 35.73% elastomers) while around 0.03 ton (1.21%) by metals. The proposed approach is composed of 4 steps: (1) Collecting data about consumed medical devices to be categorized into the residues Groups (A and E); (2) Identifying the polymeric composition with information provided by suppliers; (3) Characterizing the polymer functional groups by Fourier-Transform Infrared Spectroscopy (FTIR) and (4) Determining the polymer melting point by Differential Scanning Calorimetry (DSC). According to the results, the analyzed HCW was composed mainly of polypropylene (80.88%), high-density polyethylene (5.28%), polystyrene (4.51%), and cellulose (3.58%), from a total of 11 different polymers.

Nursing recommendations for facing dissemination of COVID-19 in Brazilian Nursing Homes / Recomendaciones para abordar la propagación de COVID-19 en Hogares para Ancianos / Recomendações para o enfrentamento da disseminação da COVID-19 em Instituições de Longa Permanência para Idosos

ABSTRACT Objective: to develop a protocol of recommendations for facing dissemination of COVID-19 in Brazilian Nursing Homes. Method: a study of experts' recommendations using a structured form applied through the Delphi Technique, obtaining 100% agreement among professionals after four rounds of analysis. The population comprised six nurses members of the Scientific Department of Gerontological Nursing of the Brazilian Association of Nursing (Associação Brasileira de Enfermagem) Results: the protocol was structured in a nucleus of nursing interventions to face the spread of COVID-19 in Nursing Homes, consisting of 8 actions. Final considerations: the protocol can help nurse managers to organize assistance to face the pandemic, which can be adaptable to each reality, making training nurses and health teams easier.

RESUMEN Objetivo: desarrollar un protocolo de recomendaciones para abordar la propagación de COVID-19 en hogares para ancianos. Método: estudio de recomendaciones de expertos utilizando una forma estructurada aplicada utilizando la técnica Delphi, obteniendo un 100% de acuerdo entre profesionales después de cuatro rondas de análisis. La población estaba compuesta por seis enfermeras que son miembros del departamento científico de enfermería gerontológica de la Asociación Brasileña de Enfermería (Associação Brasileira de Enfermagem). Resultados: el protocolo se estructuró en un núcleo de intervenciones de enfermería para enfrentar la difusión de COVID-19 en Hogares para Ancianos y consta de 8 acciones. Consideraciones finales: el protocolo puede ayudar a los gerentes de enfermería a organizar la asistencia para enfrentar la pandemia, que puede adaptarse a cada realidad, facilitando la capacitación de los equipos de enfermería y salud.

RESUMO Objetivo: elaborar um protocolo de recomendações para o enfrentamento da disseminação da COVID-19 em Instituições de Longa Permanência para Idosos. Método: estudo de recomendações de especialistas utilizando-se um formulário estruturado aplicado por meio da Técnica Delphi, obtendo-se 100% de concordância entre os profissionais após quatro rodadas de análise. A população foi constituída por seis enfermeiros membros do Departamento Científico de Enfermagem Gerontológica da Associação Brasileira de Enfermagem. Resultados: o protocolo foi estruturado em um núcleo de intervenções de enfermagem para o enfrentamento da disseminação da COVID-19 em Instituições de Longa Permanência para Idosos, consistindo em 8 ações. Considerações finais: o protocolo poderá auxiliar os enfermeiros gestores a organizar a assistência para enfrentar a pandemia, que pode ser adaptável a cada realidade, facilitando o treinamento das equipes de enfermagem e saúde.

Storage and disposal of expired medicines in home pharmacies: emerging public health problems / Armazenamento e descarte dos medicamentos vencidos em farmácias caseiras: problemas emergentes para a saúde pública

ABSTRACT Objective To characterize storage and disposal practices associated with expired medicines in home pharmacies of Primary Care users. Methods Cross-sectional study based on data collected from 423 users of 15 Primary Care units located in a Brazilian city, between August 2014 and July 2016. Data were collected via face-to-face interviews. Categorical (demographic and socioeconomic characteristics) and continuous variables were expressed as proportions and means and standard deviations, respectively . Storage behaviors and disposal practices associated with unused and expired medicines were described as frequencies. Results Most (83%) interviewees were female and approximately 70% had completed high school. The kitchen was the most common medicine storage place (58.6%). Approximately 75% of participants reported inappropriate medicine disposal practices. Conclusion This study revealed high rates of inappropriate medicine disposal practices with direct impacts on pharmacological treatment and the environment. Continuing education of healthcare professionals and the general public is required to raise awareness about proper medicine use and disposal.

RESUMO Objetivo Caracterizar o armazenamento e o descarte de medicamentos vencidos contidos em farmácias caseiras de usuários da Atenção Primária à Saúde. Métodos Estudo transversal, realizado com 423 usuários de 15 unidades de saúde da Atenção Primária em um município brasileiro. Os dados foram coletados de agosto de 2014 a julho de 2016, por meio de entrevistas face a face. As características demográficas e socioeconômicas foram descritas por meio de proporções para as variáveis categóricas. As formas de armazenamento e o descarte de medicamentos vencidos ou não vencidos foram descritos em forma de frequência. Resultados Dentre os entrevistados, 83% eram do sexo feminino e aproximadamente 70% possuíam Ensino Médio completo. A cozinha foi o local mais citado para armazenamento de medicamentos (58,6%). Cerca de 75% dos participantes relataram descartar os medicamentos de forma incorreta. Conclusão O estudo evidenciou que grande proporção dos entrevistados possui hábitos incorretos de descarte, que, por sua vez, impactam diretamente no tratamento medicamentoso e na natureza. Assim, é necessária a educação continuada dos profissionais de saúde e da população, a fim de conscientizar a população sobre a correta utilização e o descarte de medicamentos.

Zoonosis and veterinary waste disposal in rural practice / Zoonosis y disposición de desperdicios veterinarios en la práctica rural

The objectives of this study were to estimate: (a) the frequency of zoonoses in large animal veterinarians from rural areas of the province of Buenos Aires, Argentina, and (b) to describe the use and disposal of personal protective equipment (PPE) and selective veterinary clinical waste. A cross-sectional study was carried out on large animal veterinary practitioners in the Province of Buenos Aires (n = 106). One third (29.2%) of them had been diagnosed with a zoonosis by laboratory-methods, being brucellosis the most frequent (22.6%). The more years passed since their graduation, the greater the chances of becoming ill (p < 0.001). Gloves were the most adopted PPE; however, other elements had little or no use at all. Older and experienced professionals used PPE less frequently than young inexperienced practitioners. Some PPE was frequently reused and the final disposal of veterinary waste was often inappropriate. A change in behavior is an urgent need to preserve not only the veterinarians' health but also their families' wellbeing and to ensure proper disposal of potentially hazardous waste.

Los objetivos de este trabajo fueron los siguientes: a) estimar la frecuencia de zoonosis en veterinarios de grandes animales que desarrollan su labor en la provincia de Buenos Aires; b) describir el uso y la disposición de los elementos de protección personal (EPP) y otros residuos generados durante el trabajo de estos veterinarios. Para ello se realizó un estudio transversal en una muestra de 106 profesionales. En un tercio de ellos (29,2%) se había sido diagnosticado por métodos de laboratorio alguna zoonosis; la brucelosis fue la más frecuente (22,6%). Se encontró que a mayor tiempo transcurrido desde la graduación, mayor era la probabilidad de enfermarse (p< 0,001). Sobre la base de las respuestas obtenidas en cuestionarios estructurados, se determinó lo siguiente: que los guantes fueron el EPP más adoptado, mientras que otros elementos tuvieron escasa o nula adopción; que los profesionales de mayor edad y experiencia usaron EPP con menos frecuencia que los practicantes más jóvenes e inexpertos; y que algunos EPP se reutilizaban con frecuencia y que la eliminación final de los desechos veterinarios fue a menudo inapropiada. Considerando estos hallazgos, es claro que se requiere un cambio de comportamiento para preservar no solo la salud de los veterinarios, sino también para asegurar el bienestar de sus familias y garantizar la eliminación adecuada de los residuos potencialmente peligrosos.

Conversion of organic biomedical waste into potential fertilizer using isolated organisms from cow dung for a cleaner environment.

Management of organic biomedical waste is a global quandary, and it is becoming difficult to confront day by day. Conversion of organic biomedical waste into fertilizer is of great concern. In the present research, organic biomedical waste samples (blood swabs, dressing swabs, and used cotton) were collected then after cow dung was collected in sterile container and immediately transported to the laboratory and screened for any gastrointestinal infection by using routine microscopy for intestinal parasitic infection, routine bacterial culture, and fecal occult blood for any intestinal bleeding. Then after, the pure culture of organisms and fungus were prepared, and further samples were subjected to degradation for 288 h by using various organisms and fungus. Then after, the specific quantity of biomedical waste was subjected for incineration. The physicochemical parameters of biomedical waste samples were analyzed. Then treated samples were mixed with soil to confirm a role as potential fertilizer. Then after, tomato plantation was done and phytochemical parameters of tomato plant were analyzed. This study states that organic biomedical waste produces a sanitary and stable fertilizer.

Health-Care Waste: Knowledge of Primary Care nurses / Residuos de los Servicios de Salud: el conocimiento de enfermeros de la Atención Básica / Resíduos de Serviços de Saúde: conhecimento de enfermeiros da Atenção Básica

ABSTRACT Objective: to describe the knowledge of nurses on Health-Care Waste Management (HCW) in Family Health Units (FHU) of São Carlos city, São Paulo State. Method: exploratory, descriptive and quantitative approach. The research was carried out with nurses of 16 FHU of the municipality of São Carlos-SP. Data were collected through an interview using a tool validated and analyzed using descriptive statistics. Results: it is noteworthy that 68.7% (11) of the nurses did not know how to describe how chemical waste was sorted. In addition, regarding the treatment of HCW, 50.0% (8) of the nurses did not know if the general waste were subjected to some type of treatment. Conclusion: the HCW management can be considered a challenge in the nurses' agenda inserted in the Primary Care services, which refers to the need to implement periodic training on the management of this waste.

RESUMEN Objetivo: describir el conocimiento de los enfermeros sobre la gestión de los Residuos de Servicios de Salud (RSS) en Unidades de Salud de la Familia (USF) de São Carlos, Estado de São Paulo. Método: estudio exploratorio, descriptivo y de abordaje cuantitativo. La investigación fue realizada con los enfermeros de 16 USF del municipio de São Carlos-SP. Los datos se recogieron mediante entrevista, utilizando un instrumento validado y que fueron analizados usando la estadística descriptiva. Resultados: se destaca que 68,7% (11) de los enfermeros no supieron describir cómo los residuos químicos eran segregados. Además, en cuanto al tratamiento de RSS, 50,0% (8) de los enfermeros no supieron informar si los residuos comunes eran sometidos a algún tipo de tratamiento. Conclusión: la gestión de los RSS puede ser considerada un desafío en la agenda de los enfermeros insertados en los servicios de Atención Básica, lo que remite a la necesidad de la implementación de capacitación periódica sobre el manejo de esos residuos.

RESUMO Objetivo: descrever o conhecimento dos enfermeiros sobre o gerenciamento dos Resíduos de Serviços de Saúde (RSS) em Unidades de Saúde da Família (USF) de São Carlos, Estado de São Paulo. Método: estudo exploratório, descritivo e de abordagem quantitativa. A pesquisa foi realizada com os enfermeiros de 16 USF do município de São Carlos-SP. Os dados foram coletados por meio de entrevista, utilizando um instrumento validado e foram analisados por meio da estatística descritiva. Resultados: destaca-se que 68,7% (11) dos enfermeiros não souberam descrever como os resíduos químicos eram segregados. Além disso, quanto ao tratamento de RSS, 50,0% (8) dos enfermeiros não souberam informar se os resíduos comuns eram submetidos a algum tipo de tratamento. Conclusão: o gerenciamento dos RSS pode ser considerado um desafio na agenda dos enfermeiros inseridos nos serviços da Atenção Básica, o que remete à necessidade da implementação de capacitação periódica sobre o manejo desses resíduos.

Selection of inactivation medium for fungal spores in clinical wastes by supercritical carbon dioxide.

The present study aimed to select the best medium for inactivation of Aspergillus fumigatus, Aspergillus spp. in section Nigri, A. niger, A. terreus var. terreus, A. tubingensis, Penicillium waksmanii, P. simplicissimum, and Aspergillus sp. strain no. 145 spores in clinical wastes by using supercritical carbon dioxide (SC-CO2). There were three types of solutions used including normal saline, seawater, distilled water, and physiological saline with 1% of methanol; each solution was tested at 5, 10, and 20 mL of the water contents. The experiments were conducted at the optimum operating parameters of supercritical carbon dioxide (30 MPa, 75 °C, 90 min). The results showed that the inactivation rate was more effective in distilled water with the presence of 1% methanol (6 log reductions). Meanwhile, the seawater decreases inactivation rate more than normal saline (4.5 vs. 5.1 log reduction). On the other hand, the experiments performed with different volumes of distilled water (5, 10, and 20 mL) indicated that A. niger spores were completely inactivated with 10 mL of distilled water. The inactivation rate of fungal spores decreased from 6 to 4.5 log as the amount of distilled water increased from 10 to 20 mL. The analysis for the spore morphology of A. fumigatus and Aspergillus spp. in section Nigri using scanning electron microscopy (SEM) has revealed the role of temperature and pressure in the SC-CO2 in the destruction of the cell walls of the spores. It can be concluded that the distilled water represent the best medium for inactivation of fungal spores in the clinical solid wastes by SC-CO2.