Description:
Background: The needle-syringe (N-S), invented 150 years ago, while invaluable in medicine, also pose several risks, primarily through intentional or inadvertent unsterile re-use, as well as through needlestick injury and improper waste disposal. These pose a substantial burden in resulting transmission of blood-borne pathogens (BBPs) in healthcare workers, patients and others exposed to these sharps.
The World Health Organization estimates that unsafe injections result in 260,000 human immunodeficiency virus (HIV), 21 million hepatitis B virus (HBV), and 2 million hepatitis C virus (HCV) infections and 9.2 million Disability-Adjusted Life Years (DALYs) lost annually.
Fundamentally, the N-S is “over-engineered” for its routine use. For a medical procedure that is low pressure and takes a few seconds, one is left with an almost indestructible stainless steel needle and a durable plastic syringe. In some developed countries, the solution has been to use sterile, disposable N-Ss only once, activate their needletip-shielding devices, and then discard each in a safety container (and ultimately incinerated). Such safety syringes are uncommon among diabetics and intravenous drug users (IDUs), however; therefore safe disposal of used N-S in these two populations remain an issue.
In developing countries, N-S with safety features is usually unavailable due to their higher cost. Logistical constraints result in interruptions in the supply of new N-Ss to remote clinics, and make more difficult maintaining proper sharps waste disposal systems. Supply interruptions and limited funds encourage improper recycling of what should be single-use-only N-S. Auto-disabling syringes used in some settings in developing countries (e.g., immunizations) do not yet have needle-shielding features, and are not yet universally available and used to prevent improper re-use. These problems extend to almost all other sharps needed to provide modern health care.
Public Health Impact: Reduction in the number of unsafe injections and sharps injuries will help prevent the spread of HIV, hepatitis B, and hepatitis C.
Examples of specific research areas of interest include, but are not limited to: Development of appropriate and affordable technologies that may contribute to solving the problems of unsafe injection and unsafe sharps disposal. Examples of such technologies -- not to the exclusion of others, which may be materials, methods, techniques, instruments, or devices – include: a) plastic needles to replace steel ones to simplify sharps disposal; b) noncorrosive sterilants without the disadvantages of bleach, or other equipment for effective sterilization of reusable medical instruments; c) locally-fueled melter ovens or other simple, practical sharps waste encapsulation or disposal systems; and d) needle-free devices for administering off-the-shelf formulations of existing vaccines and drugs.
