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
SIGN—October 2002
Advantages• Decrease waste volume
• Decrease/contain sharps waste
• Lower cost of handling/transport
• Fewer safety boxes
• Help prevent reuse
SIGN—October 2002
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
SIGN—October 2002
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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SIGN—October 2002
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
SIGN—October 2002
Nomoresharps, Australia
Design Tradeoffs• Cost vs. durability
• Portability vs. static use
• Needle container reusable
vs. disposable
• Syringe destruction
SIGN—October 2002
Appropriate Device
• Inexpensive• Non-electric• Reliable and durable • Safe• Simple to use
SIGN—October 2002