RESUMEN
OBJECTIVES: To investigate the cause of an outbreak of needlestick injuries (NSIs) in hospital employees. SETTING: A 700-bed university hospital. DESIGN: Outbreak investigation, laboratory evaluation of a medical waste disposal device, cost analysis. METHODS: Employee health department records were reviewed of workers suffering sticks from needles piercing fiberboard-contaminated material containers (CMCs). A laboratory evaluation of needle-puncture resistance properties of the CMCs was performed using a testing apparatus. The cost of a hospital waste disposal program using fiberboard CMCs was compared with the cost of a program using rigid plastic (polypropylene) boxes. RESULTS: During 40 months of surveillance in 1986 and from 1989 to 1991, only one NSI had occurred from a needle piercing a CMC. During 9 months in 1993, 13 NSIs occurred due to needles piercing CMCs (P < .001). No clinical illness resulted from the NSIs. The outbreak was halted by a temporary change to plastic (polypropylene) boxes for sharps disposal ($4.92 to $23.33/cu ft) until receipt of a box with a newly designed solid fiberboard liner ($1.25/cu ft). CMC liners used during the epidemic had a mean needle puncture resistance of 527 g, as compared with 660 g for liners used before the outbreak (P < .001). The new solid fiberboard liner has a mean puncture resistance of 1,765 g. A program of waste disposal using fiberboard CMCs was found to cost approximately one-seventh the cost of a program using plastic boxes for disposal of infectious waste. CONCLUSION: A program for infectious waste disposal using fiberboard CMCs can be safe and cost-effective if appropriate standards for puncture resistance are met.
Asunto(s)
Contención de Riesgos Biológicos , Brotes de Enfermedades , Eliminación de Residuos Sanitarios , Lesiones por Pinchazo de Aguja/epidemiología , Personal de Hospital/estadística & datos numéricos , Contención de Riesgos Biológicos/economía , Contención de Riesgos Biológicos/instrumentación , Costos y Análisis de Costo , Estudios de Evaluación como Asunto , Costos de Hospital , Hospitales Universitarios , Humanos , Eliminación de Residuos Sanitarios/economía , Eliminación de Residuos Sanitarios/instrumentación , Lesiones por Pinchazo de Aguja/etiología , Lesiones por Pinchazo de Aguja/prevención & control , Plásticos , Evaluación de Programas y Proyectos de Salud/economía , Virginia/epidemiologíaRESUMEN
Mature female cats of known reproductive history were randomly divided into groups for natural breeding or mating following hormonal induction of estrus. Treatment with a single injection of 100 international units of pregnant mares' serum followed in 7 days by 50 international units of human chorionic gonadotropin produced results comparable to natural breeding. Daily injections of pregnant mares' serum (300-500 international units total) resulted in fewer successful pregnancies and adversely affected the ability of kittens to survive to weaning.