Impact of education on the knowledge, attitude and practice of disposal of expired and unused medications among pharmacy students.

OBJECTIVE: To assess the impact of education among pharmacy students on their level of knowledge, attitude and practices in the disposal of expired and unused medications. MATERIALS AND METHODS: A pre-test post-test study without control group was conducted in which a total of 573 students pursuing Bachelor of Pharmacy and Doctor of Pharmacy programmes were enrolled. The impact of education provided was analysed with the aid of a previously validated KAP questionnaire. Data on KAP was analysed using SPSS software 24.0. RESULTS AND DISCUSSION: The knowledge, attitude and practice of the total students improved from 74.17±17.063 to 91.06±11.87, 75.92±19.26 to 91.73±12.318 and 43.11±22.77 to 82.06±16.149 respectively. The improvement with respect to knowledge and attitude was significantly high among Doctor of Pharmacy students when compared to Bachelor of Pharmacy, with P value<0.001 for both domains. CONCLUSION: The present study concludes on the effectiveness of educational intervention in generating a positive impact on the student population with respective to adequate disposal practices to be followed for unused and expired medications.

The Pattern of Disposal Practices of Unused and Expired Medications Among Healthcare Professionals: A Cross-Sectional Survey in Rajendra Institute of Medical Sciences, Ranchi, Jharkhand.

BACKGROUND: Medicines play a crucial role in treating various diseases. Most individuals, in their haste to get through their day, have developed the bad habit of improperly discarding their unwanted or expired prescriptions, which poses a number of risks to human health and contributes to environmental degradation. Disposal procedures of unused and expired pharmaceuticals among health care personnel at tertiary care centers have been the subject of very little research to date. Therefore, the purpose of this study is to examine how medical staff at Rajendra Institute of Medical Sciences in Ranchi, Jharkhand, handle stale or unwanted prescription drugs. METHODS: The design of the study was cross-sectional analytical conducted among 385 health care professionals. Pretested semi-structured questionnaires prepared in Google Forms (Google LLC, Mountain View, California, United States) have been used for evaluation. RESULTS: The completely filled questionnaires were analyzed, evaluated, and expressed in the percentage using Microsoft Excel (Microsoft Corporation, Redmond, Washington, United States). The most common method of disposal of unused and expired medications was throwing them in the dustbin. CONCLUSIONS: In this study, although, all the participants were health care professionals, because of the hectic schedule majority of them used unsafe methods of drug disposal. So, in order to protect our ecosystem, appropriate policy should be made to implement the methods for the safe disposal of unused and expired medications.

Expired medications and disposal practices in Arab households.

OBJECTIVES: Over the past few decades, the accumulation of expired and unused medications in households has become a concern. Most people are unaware of how to properly dispose of unused and/or expired medicines. Our objective was to inspect the extent of expired medications within Arab households in United Arab Emirates (UAE), to determine which therapeutic groups yield greater amounts of unused medications, and evaluate drugs' disposal practices. METHODS: This descriptive study was written in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist for cross-sectional studies. It was conducted among Arab households in UAE (n = 503) using an online questionnaire between November 2020 and January 2021. Questions were related to participants' socio-demographics, the prevalence of expired medications in households and their disposal. KEY FINDINGS: Around 58% of the respondents had expired medications in their houses and 74% had drugs that were never used. The most common medicines left unused were analgesics (34%) followed by cosmetics (27%) and antibiotics (26%). More than 42% of expired medications were in solid dosage forms, 28% were semisolid and 24% were liquid dosage forms. The predominant disposal method among the surveyed participants was throwing medications into the garbage (86%). CONCLUSIONS: Large quantities of expired medications in Arab households exist with a high prevalence of analgesics, antibiotics and cosmetics. Arab households are unaware of the proper drug disposal procedures. Therefore, community pharmacists are recommended to offer training on proper medication disposal practices and to encourage the public to return medications to pharmacies.

Electronic waste control and management in Ghana: A critical assessment of the law, perceptions and practices.

The aim of the study was to assess the impact of Ghana's hazardous and e-waste control and management Act 917 of 2016 on current e-waste management practices and the level of awareness among key stakeholders (general public, repairers, wholesalers/retailers, recyclers and importers of electronic items) in the Greater Accra Region of Ghana. Both quantitative and qualitative data were collected and examined in this study. Results showed a low level (12%) of awareness among stakeholders on the e-waste legislation. Almost 13% of respondents had been educated on e-waste management. Community engagement and the mass media were the main sources of information on e-waste. Significant associations between background information of respondents and awareness level on 'Ghana's Act 917' were observed. Relative to general e-waste issues, only education and stakeholder showed significant associations with e-waste legislation and management. The main e-waste disposal methods adopted by respondents were disposal at dumpsites (22.7%), repair and reuse (21.1%) and reselling (20.1%). Almost 10% of respondents made changes to their e-waste disposal practices over the past 5 years. These changes were mainly due to the economic benefits derived from reselling e-waste (37.6%) and the perceived adverse impacts of e-waste on the environment (23.9%). Overall, there is the need to intensify awareness on 'Ghana's Act 917', especially issues regarding sustainable e-waste management practices.

Accumulation of biomedical waste during the COVID-19 pandemic: concerns and strategies for effective treatment.

This study deals with the pollution impact of biomedical waste (BMW) generation due to the COVID-19 pandemic at both the global and national levels. This discussion is important in light of clear scientific evidence that, apart from the airborne transmission of the disease, the virus also survives on different surfaces and poses the risk of infection. Moreover, an investigation is conducted on BMW generation in tons/day in India during the COVID-19 period, with implications for future projection. Additionally, a pioneering study was conducted to estimate the usage of facemasks during the COVID-19 pandemic in India. This paper also provides a feasible solution, by adopting a modern perspective, towards managing BMW generated in the context of SARS-CoV-2 at isolation wards and crematoriums. Strategical approaches have been suggested for segregating and safely disposing BMW. The latest availability of disposal facilities is discussed based on source data provided by the Central Pollution Control Board (CPCB), India. Among the many disposal methods, incineration technologies are examined in depth. The impact of existing incineration technology on the environment and human health has been extensively studied. This study suggests strategies for controlling BMW generation during the COVID-19 pandemic.

A critical review of uranium contamination in groundwater: Treatment and sludge disposal.

Dissolved uranium in groundwater at high concentrations is an emerging global threat to human and ecological health due to its radioactivity and chemical toxicity. Uranium can enter groundwater by geochemical reactions, natural deposition from minerals, mining, uranium ore processing, and spent fuel disposal. Although much progress has been made in uranium remediation in recent years, most published reviews on uranium treatment have focused on specific methods, particularly adsorption. This article systematically reviews the major treatment technologies, explains their mechanism and progress of uranium removal, and compares their performance under various environmental conditions. Of all treatment methods, adsorption has received much attention due to its ease of use and adaptability under various conditions. However, salinity and competition from other ions limit its application in actual field conditions. Biosorption and bioremediation are also promising methods due to their low-cost and chemical-free operation. Strong base anion exchange resins are more effective at typical groundwater pH conditions. Advanced oxidation processes like photocatalysis produce less sludge and are effective even at low uranium concentrations. Electrocoagulation shows significantly improved performance when organic ligands are added prior to treatment. The significant advantages of membrane filtration are high removal efficiency and the ability to recover uranium. While each technology has its merits and demerits, no single technology is entirely suitable under all conditions. One major area of concern with all technologies is the need to dispose of liquid and solid waste generated after treatment safely. Future research must focus on developing hybrid and state-of-the-art technologies for effective and sustainable uranium removal from groundwater. Developing holistic management strategies for uranium removal will hinge on understanding its speciation, mechanisms of fate and transport, and socio-economic conditions of the affected areas.

Are used face masks handled as infectious waste? Novel pollution driven by the COVID-19 pandemic.

The extensive use of face masks has raised concerns about environmental pollution through improper disposal of used face masks after the emergence of COVID-19. The increasing use of PPEs to preventing the spread of COVID-19 has resulted in several environmental hazards, creating a new environmental barrier for solid waste management and worsened plastic pollution. This study aimed at assessing the occurrence and distribution of face masks in a metropolitan (Adum - Kumasi), municipal (Ejisu), community (Abenase) and an institution (KNUST) in Ghana. The study showed that a total of 535 face masks were numerated along a stretch of 1,720 m with a density ranging from 0.04 m to 0.42 m. A no significant relationship (P = 0.602) was established between the observation distances and the number of waste face masks numerated. The study also showed that for a 1% increase in the number of face masks on working days, there would be a 0.775% increase in non-working days. A review of literature showed that the disposal of used face masks results in the release of micro- and nano-plastics, Pb, Cu, Sb, Zn, Mn, Ti, Fe and Ca into environmental media. Plastic pollution may be a concern to ecosystems due to its persistence in the environment, lack of environmental awareness, sensitization and education, and poor waste management systems. To ensure a sustainable management of waste face masks, significant efforts are needed. These may include proper disposal, redesigning and producing masks from biodegradable materials, incorporating waste face masks into construction materials, and recycling PPE by pyrolyzing are suggested options for the effective management of face masks.

Lack of Awareness of the Impact of Improperly Disposed Of Medications and Associated Factors: A Cross-Sectional Survey in Indonesian Households.

Introduction: Disposal of unused medications through environmentally unsafe routes is common in Indonesia. The lack of awareness of the impact of improperly disposed of medications is a significant contributing factor. The objectives of this study were to identify factors associated with lack of awareness of the impact of improperly disposed of unused medications and to assess the associations of awareness with medication disposal practices among the general population in Indonesia. Patients and methods: An observational cross-sectional survey was conducted using nonprobability sampling in Bandung, Indonesia, from November 2017 to January 2018 among respondents who were older than 18 years, had used any medication in the past, were literate, and had signed an informed consent document. Disposal practices and awareness regarding the impact of improperly disposed of unused medications were collected using an online- and a paper-based pre-validated questionnaire. The paper-based questionnaires were distributed to respondents in public places such as city center, markets, and religious places. Binary logistic regression was performed to assess associations of sociodemographic and other related factors with a lack of awareness. Odds ratios (ORs) with 95% confidence intervals (CIs) are reported. Results: Of 497 participating respondents, 433 and 64 respondents filled an online- or a paper-based questionnaire, respectively. Most respondents were female, aged between 18 and 30 years, and students/university students. Of 497 respondents, more than half (53.1%) were not aware that improper medication disposal could harm the environment and population health. Most respondents (79.5%) had never received information about proper medication disposal practices. The education level, the number of stored medications at home, and previous education about medication disposal practices were significantly associated with awareness of proper practices. In the multivariate analysis, only those with previous education about medication disposal practices were less likely to report a lack of awareness (OR: 0.043; 95% CI: 0.02-0.09). Respondents with a lack of awareness tended to dispose of their unused medications in the garbage or shared them with friends or relatives. Conclusion: There is a clear need to increase awareness of the importance of proper medication disposal practices, in particular among the student population of Bandung city, Indonesia. Healthcare providers can play an important role by educating this specific population on the proper disposal of unused medications.

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.

Unused and Expired Medications Disposal Practices among the General Public in Selangor, Malaysia.

The appropriate disposal practice of unused and expired medications has become a global challenge that has caught the attention of health policymakers, pharmaceutical organizations, healthcare professionals, and the wider community. The current study aimed to evaluate the awareness, attitudes, and behaviors relating to the disposal practice of unused and expired medications and medication wastage issues among the general public in Selangor, Malaysia. The quantitative, cross-sectional study was conducted using a pre-validated structured survey form. Among the approached individuals, 426 showed their willingness to participate in the study. More than 80% of the study population reported being aware of the medication wastage issue and its impact on patients and the economy. The respondents with a higher level of education (OR = 1.85; 95% CI = 1.18-2.52; p < 0.003) were more likely to be cognizant of the detrimental consequences of inappropriate waste disposal. The female respondents were more likely to report comprehending that the availability of free healthcare resources is contributing to medication waste (OR = 1.33, 95% CI = 1.015-2.34; p < 0.005). The majority of respondents reported throwing away unused medications (202; 47.4%) and expired medications (362; 84.9%) in the garbage. The respondents believed that the provision of appropriate directions by healthcare professionals (312; 73.2%) and prescribing/dispensing medications in quantities for the duration that ensures patient adherence (114; 26.7%) could minimize medication wastage. The Ministry of Health (258; 60.5%), pharmaceutical organizations (212; 49.7%), and pharmacists (193; 45.3%) were the respondents' perceived responsible sources of information. The current findings reported that respondents were familiar that inappropriate practices of medication wastage might have harmful consequences. However, a gap exists between their awareness and practice, and the disposal approaches practiced by the respondents were generally not appropriate.

Disposal Practices of Unused Medications Among Patients in Public Health Centers of Dessie Town, Northeast Ethiopia: A Cross-sectional Study.

BACKGROUND: Disposal of pharmaceutical waste among patients is a global challenge especially in developing countries like Ethiopia. Improper medication disposal can lead to health problems and environmental contaminations. Therefore, the present study aimed to assess disposal practices of unused medications among patients in public health centers of Dessie town, Northeast Ethiopia. METHODS: A descriptive cross-sectional study was conducted among 263 patients in four public health centers of Dessie town, Ethiopia from March to June, 2019. Face-to-face interviews using structured questionnaires were used to collect data from each study subject. RESULTS: The majority of the respondents, 224 (85.17%) had unused medications at their home during the study period. The most commonly reported disposal method in the present study was flushing down into a toilet 66 (25.09%). None of the respondents practiced returning unused medications to Pharmacy. Moreover, 85 (32.31%) of the respondents reported never disposing their medications and believed that it is acceptable to store medications at home for future use. CONCLUSION: In the present study, there was a high practice of keeping medications at home and most of the disposal practices were not recommended methods. In addition, most of the respondents did not get advice from pharmacists and other health care professionals on how to dispose off unused medications. Hence, there is a need for proper education and guidance of patients regarding disposal practices of unused medications.

Disposal Practices of Unused Medications Among Patients in Public Health Centers of Dessie Town, Northeast Ethiopia: A Cross Sectional Survey.

BACKGROUND: Disposal of pharmaceutical waste among patients is a global challenge, especially in developing countries like Ethiopia. Improper medication disposal can lead to health problems and environmental contamination. Therefore, the present study was aimed to assess disposal practices of unused medications among patients in public health centers of Dessie town, Northeast Ethiopia. METHODS: A descriptive cross-sectional survey was conducted among 263 patients in four public health centers of Dessie town, Ethiopia from March to June 2019. Face-to-face interviews using structured questionnaires were used to collect data from each study subject. RESULTS: The majority of the respondents, 224 (85.17%), had unused medications at their home during the study period. The most commonly reported disposal method in the present study was flushing down into a toilet, 66 (25.09%). None of the respondents practiced returning unused medications to the pharmacy. Moreover, 85 (32.31%) of the respondents reported never disposing of their medications and believed that it is acceptable to store medications at home for future use. CONCLUSION: In the present study, there was a high practice of keeping medications at home and most of the disposal practices were not recommended methods. In addition, most of the respondents did not receive advice from pharmacists and other health-care professionals on how to dispose of unused medications. Hence, there is a need for proper education and guidance of patients about disposal practices of unused medications.

Current Disposal Practices of Unused and Expired Medicines Among General Public in Delhi and National Capital Region, India.

BACKGROUND: Stocking unused or expired medicines or donating these to others can lead to accidental or inappropriate ingestion, increasing the risk of adverse drug reaction(s) and even lead to antibiotic resistance. Further improper disposal of expired or unused medicines is associated with environmental pollution, health hazards and damage to ecosystem. Ecopharmacovigilance is an important area in this context. OBJECTIVE: To explore the awareness and disposal practices of unused/expired in the general public. MATERIALS AND METHODS: The current study is an observational, cross-sectional, questionnaire-based study conducted in 956 medicine consumers in New Delhi and National Capital Region, India. The knowledge, attitude, and practice of consumers regarding the disposal of unused medicines were evaluated. RESULTS: The majority (89.9%) of consumers opined that expiry of medicine(s) meant for completion of shelf life, production of toxic chemical and loss of or decreasing of beneficial effects of medicines. Majority (87%) of the consumers stored medicines at home. Almost all (92.6%) of the consumers threw away the expired medicines after storing for few days. Consumers discarded the expired medicines mainly in household trash (73%). The majority (93%) of consumers were in favour of a government program to collect unused or expired medicines from their home. CONCLUSION: The knowledge and practices of consumers towards disposal of unused and expired medicines needs to be improved. Health care professionals, government and policy makers should offer training to educate and guide the general public on safe and proper disposal practices of expired or unused medicines.

Discarding IVF embryos: reporting on global practices.

PURPOSE: To provide a global scale report on a representative sample of the clinical embryology community depicting the practice of discarding supernumerary IVF embryos. METHODS: A web-based questionnaire titled "Anonymous questionnaire on embryo disposal practices" was designed in order to ensure anonymous participation of practicing clinical embryologists around the world. RESULTS: During a data collection period of 8 months, 703 filled-in questionnaires from 65 countries were acquired. According to the data acquired, the majority of practitioners, dispose of embryos by placing them directly in a trash can strictly dedicated for embryo disposal for both fresh and frozen cycles (39% and 36.7% respectively). Moreover, 66.4% of practitioners discard the embryos separately-case by case-at different time points during the day. Over half of embryologists (54%) wait until day 6 to discard the surplus embryos, while 65.5% do not implement a specially allocated incubator space as a designated waiting area prior to disposal. The majority of 63.1% reported that this is a witnessed procedure. The vast majority of embryologists (93%) do not employ different protocols for different groups of patients. Nonetheless, 17.8% reported the request to perform a ceremony for these embryos. Assessing the embryologists' perspective, 59.5% of participants stated that the embryology practice would benefit from a universally accepted and practiced protocol. CONCLUSION(S): This study uniquely provides insight into global embryo disposal practices and trends. Results highlight the divergence between reported practices, while indicating the significance on standardization of practice, with embryologists acknowledging the need for a universally accepted protocol implementation.

Assessment of knowledge, attitude and practice towards disposal of unused and expired pharmaceuticals among community in Harar city, Eastern Ethiopia.

BACKGROUND: Pharmaceuticals are produced and consumed in increasing volume every year. Unfortunately, not all medications that go in to the hand of the consumers get consumed; large quantities remain unused or expire. The accumulation of medication at household and unsafe disposal of unwanted medicines could lead to inappropriate medicine sharing, accidental childhood poisonings and diversion of medicines to illicit use. METHODS: A descriptive cross-sectional study was conducted among 695 residents in kebele(ward) 16 of Jinela woreda(district), Harar city from February 27-April 27. A multi-stage sampling technique was used to select individual households. Face-to-face interview using structured questionnaires were conducted to collect data from each study subject. The cleaned data was entered in to epidata analyzed using SPSS version 20 software. Descriptive statistics on sample characteristics was computed including frequencies and percentage and presented using tables and figures. RESULTS: Most participants displayed correct understanding toward medication waste (72.9%) and its effect on environmental if disposed improperly (86%). A large portion of the respondents did not know about drug-take-back system 464 (66.9%). In order to minimize the entry of pharmaceuticals into environment, 68.6% of the participants suggested the need for proper guidance to the consumer. Majority of the respondents believed risk related to the presence of unwanted drug in home, potential harm to children, lack of adequate information on safe disposal practice and need for take-back program. Approximately 66% of the respondents had unused medicine stored at home and the common types of medicines kept in households were analgesics (62.7%) and antibiotics (24%). Preferred ways of disposal of both unused and expired medicine was throwing away in household garbage (53.2%) and two third of them disposed the pharmaceuticals in its original package and dosage form. CONCLUSION: In present study, there was high practice of keeping medication at home and most disposal approach indicated by the participants was not recommended methods. Awareness about proper disposal of unused and expired medicines among the public should be created. Guidelines on safe disposal are required and an organized method of collecting unused and expired pharmaceuticals needs to be introduced.

Behavior, preferences, and willingness to pay for measures aimed at preventing pollution by pharmaceuticals and personal care products in China.

The release of pharmaceuticals and personal care products (PPCPs) into the environment has been held up as a potential threat to ecosystem and human health. Using a custom-designed survey of residents living in Xiamen, China, this paper examines individuals' disposal practices, awareness of the environmental impact of PPCPs, and willingness to pay for measures aimed at reducing the likelihood of PPCPs being released into the environment. The vast majority of respondents report that they dispose of PPCPs through the thrash. The results of a contingent valuation experiment suggest a substantial willingness to pay (WTP) for policy measures aimed at reducing PPCP pollution. Income as well as subjective perceptions relating to overall financial health, expenditure on PPCPs, and overall concern with environmental issues emerged as significant predictors of respondents' WTP. Our results should be of interest to policymakers looking for ways to mitigate the introduction of PPCPs in the environment. Integr Environ Assess Manag 2016;12:793-800. © 2015 SETAC.