INTRODUCTION: Unregulated biomedical waste management is an emerging public health problem in the Philippines. This study aimed to differentiate the knowledge, attitudes, and practices of nurses and medical technologists toward biomedical waste management. METHODS: Using an analytic cross-sectional study design, an online survey of nurses and medical technologists from hospitals around the Philippines was conducted. A 27-item questionnaire covering knowledge, attitudes and practices was used. The percentages of correct answers and mean scores in each domain was compared between the nurses and medical technologists. RESULTS: A total of 196 respondents consisting of 77 registered nurses and 119 medical technologists were included in the study. Medical technologists had significantly better knowledge scores than nurses on disposal procedures for expired blood units and by-products waste (55% vs. 19%, p = 0.026). Both had low correct responses on adequate disposal of human tissue remains, throwing blood waste into domestic waste, and throwing of expired medications in domestic waste. There was no significant difference in the attitude of nurses and medical technologists. Nurses had significantly better practice scores on disposal of liquid waste in bags (84.4% vs. 68.9, p = 0.018), but medical technologists fared better at disposal of human tissue together with other waste (13.0% vs. 2.5%, p = 0.006). CONCLUSION Both nurses and medical technologists had adequate knowledge of some aspects but were lacking in others. There was no significant difference in the attitude of nurses and medical technologists towards biomedical waste management. Half of the respondents practiced proper biomedical waste management.
Medical Laboratory Personnel ; Waste Management ; Knowledge ; Attitude

BACKGROUND: The increasing production of un-recycled waste is a great threat to public health. Therefore, assessment and measurement of people's beliefs and perceptions with regard to these threats can contribute to the development of suitable educational messages promoting waste separation behaviors. This study aimed to carry out the scale development and psychometric evaluation of behaviors and beliefs associated with waste separation among female students. METHOD: This methodological research was performed in 2019. The primary questionnaire was developed based on the assessment of waste separation beliefs and behaviors based on the extended parallel process model. Afterwards, to confirm the content and face validity of the research tool, the opinions of 14 faculty members and certain students were asked for, respectively. In order to assess the construct validity of the questionnaire, exploratory factor analysis was performed based on the data collected from 386 female students in Isfahan University of Medical Sciences, Iran. The internal and external reliability of the tool was determined through estimating Cronbach's alpha and test-retest based on intraclass correlation (ICC) index, respectively. RESULTS: The mean age and academic semester of the students were 22 ± 1.9 years and 5.58 ± 2.6, respectively. The primary version of the questionnaire was designed with 65 items; one item was omitted during the content validity process. Construct validity with factor analysis technique yielded nine dimensions including 64 items with a factor loading above 0.3. The overall reliability of the research tool was confirmed at Cronbach's alpha of 0.87. Furthermore, the ICC of the entire questionnaire was 0.89. CONCLUSION According to the results of the study, the final 64-item questionnaire could be used by various researchers to assess waste separation beliefs and behaviors considering suitable psychometric features.
Female ; Humans ; Iran ; Medical Waste Disposal ; Psychometrics ; Students, Medical ; psychology ; Young Adult

OBJECTIVES: An automatic needle destroyer (ANDY) was developed to prevent needlestick injuries, and usability tests were conducted in several hospitals. The addition of extra features to the ANDY is in progress, such as data collection and automatic identification of used syringes. Thus, this report describes how the ANDY can be used to track the data of used syringes. METHODS: The motor torque required for barrel separation differs according to syringe diameters. By monitoring the electric current which is consumed for the motor torque, the type of syringe can be identified. Twelve prototypes were produced, and five usability tests were conducted in hospitals. RESULTS: After use, a syringe is inserted into the proposed device, and the needle portion is then cut and separated from the syringe body (barrel) and discarded. The needles are collected in a sharps container for hygienic disposal, and the barrel is dropped into a general medical waste container. CONCLUSIONS: The ANDY can be used to track the syringe used for each patient. The barcode can be read while the syringe rotates in the main body of the ANDY with a built-in omnidirectional scanner. Collection of information during syringe disposal can facilitate stock management. This system could also be extended to other types of consumable medical devices, although it would still be a challenge to differentiate each medical device.
Data Collection* ; Disposable Equipment ; Equipment and Supplies ; Equipment Design ; Humans ; Medical Waste ; Medical Waste Disposal ; Needles ; Needlestick Injuries ; Syringes* ; Torque

BACKGROUND: Human adipose tissue is routinely discarded as medical waste. However, this tissue may have valuable clinical applications since methods have been devised to effectively isolate adipose-derived extracellular matrix (ECM), growth factors (GFs), and stem cells. In this review, we analyze the literature that devised these methods and then suggest an optimal method based on their characterization results. METHODS: Methods that we analyze in this article include: extraction of adipose tissue, decellularization, confirmation of decellularization, identification of residual active ingredients (ECM, GFs, and cells), removal of immunogens, and comparing structural/physiological/biochemical characteristics of active ingredients. RESULTS: Human adipose ECMs are composed of collagen type I–VII, laminin, fibronectin, elastin, and glycosaminoglycan (GAG). GFs immobilized in GAG include basic fibroblast growth factor (bFGF), transforming growth factor beta 1(TGF-b1), insulin like growth factor 1 (IGF-1), vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), BMP4 (bone morphogenetic protein 4), nerve growth factor (NGF), hepatocyte growth factor (HGF), and epithermal growth factor (EGF). Stem cells in the stromal-vascular fraction display mesenchymal markers, self-renewal gene expression, and multi-differentiation potential. CONCLUSION: Depending on the preparation method, the volume, biological activity, and physical properties of ECM, GFs, and adipose tissue-derived cells can vary. Thus, the optimal preparation method is dependent on the intended application of the adipose tissue-derived products.
Adipose Tissue ; Collagen ; Elastin ; Extracellular Matrix ; Fibroblast Growth Factor 2 ; Fibronectins ; Gene Expression ; Hepatocyte Growth Factor ; Humans ; Insulin ; Intercellular Signaling Peptides and Proteins ; Laminin ; Medical Waste ; Methods ; Nerve Growth Factor ; Platelet-Derived Growth Factor ; Stem Cells ; Transforming Growth Factor beta ; Vascular Endothelial Growth Factor A

PURPOSE: The purpose of this study is to find out how much influence nursing students' environmental consciousness and knowledge of medical waste have on their attitudes toward medical waste. METHODS: The subjects were 211 nursing students recruited from 2 universities. Data were collected with a structured self-report questionnaire comprising measures of environmental consciousness, and knowledge of and attitude toward medical waste. Data analysis was conducted with the SPSS/WIN 25.0 program. RESULTS: A total of 211 copies of the questionnaire were used for the final analysis, except for 9 untrusted responses out of 220 that included missing values. Those subjects' environmental consciousness who received environmental education in middle and high schools was higher (t=3.15, p=.002). The higher their grades, the better their knowledge of medical waste (F=3.40, p=.035). Those subjects’ knowledge of medical waste who received medical waste education was relatively high (t=3.14, p=.002). Those subjects with clinical practice experience had more sensitive attitudes toward medical waste (t=2.06, p=.041). Those subjects' attitudes toward Medical waste who received medical waste education at the universities were relatively high (t=2.04, p=.043). The subjects' environmental consciousness was positively correlated with their attitudes toward medical waste (r=.44, p<.001). The most influential factor in their attitudes toward medical waste is their environmental attitudes and medical waste education. CONCLUSION: The higher the nursing students' environmental consciousness, the higher their attitudes toward medical waste. It is necessary to provide environment and medical waste education for nursing students in order to strengthen their environmental consciousness and attitude toward medical waste.
Consciousness ; Education ; Humans ; Medical Waste ; Nursing ; Statistics as Topic ; Students, Nursing

OBJECTIVES: This study aimed to evaluate the relationship between oral health professionals' knowledge, attitude, and practice with regard to infectious waste management and to identify related factors influencing it. METHODS: The study comprised of 219 oral health professionals from select dental clinics and public health centers recruited between August 25, 2016 and September 5, 2016, who agreed to participate in the study with full understanding of the study objectives. A self-reported questionnaire was administered, which consisted of 22 items on knowledge of infectious waste management, 9 items on attitude, and 16 items on practice. Data were analyzed using Pearson's correlation coefficient and stepwise multiple regression analyses. RESULTS: The age, knowledge, and clinical attitude of oral health professionals significantly correlated with waste management practice. Specifically, infectious waste management practice improved with increasing age, a greater level of knowledge, and a more positive clinical attitude. Additionally, the standardized regression coefficient demonstrated that, of these three factors, clinical attitude more strongly correlated with effective waste management practice, followed by age and level of knowledge. CONCLUSIONS: These results indicated that oral health professionals had a low level of knowledge regarding infectious waste management, and a more positive clinical attitude resulted in better practices. Therefore, the development of detailed and active education guidelines and strategies are needed to enhance the attitude, knowledge, and practice of oral health professionals with regard to infectious waste management.
Dental Clinics ; Education ; Oral Health ; Public Health ; Waste Management

One-third of all hospital-regulated medical waste (RMW) comes from the operating room (OR), and it considerably consists of disposable packaging and wrapping materials for the sterilization of surgical instruments. This study sought to identify the amount and type of waste produced by ORs in order to reduce the RMW so as to achieve environmentally-friendly waste management in the OR. We performed an initial waste segregation of 4 total knee replacement arthroplasties (TKRAs) and 1 total hip replacement arthroplasty, and later of 1 extra TKRA, 1 laparoscopic anterior resection of the colon, and 1 pelviscopy (with radical vaginal hysterectomy), performed at our OR. The total mass of non-regulated medical waste (non-RMW) and blue wrap amounted to 30.5 kg (24.9%), and that of RMW to 92.1 kg (75.1%). In the course of the study, we noted that the non-RMW included recyclables, such as papers, plastics, cardboards, and various wrapping materials. The study showed that a reduction in RMW generation can be achieved through the systematic segregation of OR waste.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Colon ; Medical Waste* ; Operating Rooms* ; Plastics ; Product Packaging ; Recycling ; Sterilization ; Surgical Instruments ; Waste Management

BACKGROUND: Human Wharton’s jelly mesenchymal stem cells (HWJMSCs) isolated from medical waste product can be considered as an accessible source of cells in regenerative medicine. Stem cell-derived hepatocytes have poor function and need appropriate niche to reconstruct the liver structure. Therefore, we attempted to find a novel approach in differentiating HWJMSCs into functional hepatic cells using 3D culture conditions and liver extract that recapitulates vital stage in liver development. MATERIALS AND METHODS: HWJMSCs were extracted from human Wharton’s jelly, characterized by flow cytometry, and differentiated towards osteogenic and adipogenic lineages. HWJMSCs were co-cultured with HUVECs in 3D matrigel/collagen scaffolds in the presence of fetal liver extract for 14 days. The expression of specific liver genes were evaluated by lectins, PAS and immunocytochemistry. RESULTS: According to flow cytometry data, isolated cells from HWJMSCs were shown to express MSC markers. HWJMSCs co-cultured with HUVECs in matrigel/collagen scaffold with extract expressed albumin, lectins UEA and PNA. Immunohistochemistry of the cells in matrigel/collagen scaffold with or without extract exhibited a positive reaction for CK19. CONCLUSIONS: Co-culturing of the HWJMSC/HUVEC in 3D matrigel/collagen scaffold is bimimicary of in vivo cell condition. The results showed that administration of the liver extract in 3D matrigel/collagen culture of HWJMSC/HUVEC can induce hepatocyte marker expression.
Collagen ; Endothelial Cells* ; Flow Cytometry ; Hepatocytes ; Humans* ; Immunohistochemistry ; Lectins ; Liver* ; Medical Waste ; Mesenchymal Stromal Cells* ; Regenerative Medicine

OBJECTIVES: The aim of this study was to assess the rate of and risk factors for exposure to hepatitis B virus (HBV) and hepatitis C virus (HCV) among medical waste handlers. METHODS: A cross-sectional study was conducted from December 2014 to January 2015. A total of 152 medical waste handlers (MWH) and 82 non-medical waste handlers (NMWH) were studied. Serum samples were collected from participants and screened for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc) and anti-HCV using rapid immunochromatography assay. MWH were also screened for hepatitis B surface antibody (anti-HBs). RESULTS: The respective prevalence of HBsAg, anti-HBc and anti-HCV was 1.3%, 39.4%, and 0.7% in MWH, compared to 2.4%, 17.1%, and 1.2%, respectively, in NMWH. Among MWH, 58.6% were susceptible to HBV infection. There was a significant difference in the rate of lifetime exposure to HBV in MWH compared with NMWH (odds ratio [OR], 3.17; 95% confidence interval [CI], 1.64 to 6.13). However, there was no significant difference between participant groups with respect to current HBV infection (OR, 0.53; 95%CI, 0.07 to 3.86) or anti-HCV (OR, 0.54; 95%CI, 0.03 to 8.69). Age older than 40 years and working in a hospital laundry were independent predictors of lifetime exposure to HBV infection. Eleven (7.2%) respondents were vaccinated against HBV. CONCLUSIONS: Lifetime exposure to HBV infection was significantly higher in MWH than in NMWH. The majority of MWH was not vaccinated against HBV and thus remains susceptible to contracting the infection. Screening upon hire followed by vaccination of MWH is recommended to reduce the transmission of HBV.
Cross-Sectional Studies ; Ethiopia* ; Hepacivirus ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Immunochromatography ; Mass Screening ; Medical Waste* ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Vaccination

OBJECTIVES: Emergency medical personnel (EMPs) are pre-hospital emergency responders who are at risk of exposure to infections and may also serve as a source for the transmission of infections. However, few studies of infection control have specifically addressed EMPs in the Republic of Korea (hereafter Korea). The goal of this study was to assess the current status of infection prevention and control programs (IPCPs) for EMPs in Korea. METHODS: A cross-sectional survey was conducted to quantitatively assess the resources and activities of IPCPs. A total of 907 EMPs in five metropolitan cities completed a structured questionnaire from September 2014 to January 2015. The data were analyzed using descriptive statistics, multi-response analysis, and the chi-square test. RESULTS: The mean age of the participants was 34.8+/-15.1 years. IPCPs were found to have weaknesses with regard to the following resources: the assignment of infection control personnel (ICP) (79.5%), hand hygiene resources such as waterless antiseptics (79.3%), the use of paper towels (38.9%), personal protective equipment such as face shields (46.9%), and safety containers for sharps and a separated space for the disposal of infectious waste (10.1%). Likewise, the following activities were found to be inadequately incorporated into the workflow of EMPs: education about infection control (77.5%), post-exposure management (35.9%), and the decontamination of items and spaces after use (88.4%). ICP were found to have a significant effect on the resources and activities of IPCPs (p<0.001). The resources and activities of IPCPs were found to be significantly different among the five cities (p<0.001). CONCLUSIONS: IPCPs for EMPs showed some limitations in their resources and activities. IPCPs should be actively supported, and specific IPCP activities for EMPs should be developed.
Adult ; Cross Infection/*prevention & control ; Cross-Sectional Studies ; Emergency Medical Services ; Female ; Hand Hygiene ; Health Personnel/*psychology ; Humans ; *Infection Control ; Male ; Medical Waste Disposal ; Middle Aged ; Protective Devices ; Republic of Korea ; Self Report ; Surveys and Questionnaires