A survey was conducted on the possible factors influencing exposure to mercury vapour during the handling of amalgam and amalgam contaminated products at dental clinics in Norrbotten, the northern part of Sweden, as well as the current methods being used to minimise, if not prevent such exposures. Increased room temperature, a serious problem when working with amalgam, was the most common complaint from the dental personnel reflecting the observation that ventilation in most clinics was far from being satisfactory. However, methods of treating amalgam-contaminated waste products as well as the classification of products as high- or low-risk wastes also differed a lot. The results further showed that although majority of the dental personnel showed concern on the possible hazards of mercury vapour exposure and were interested in having the level of mercury vapour measured in their clinics, very few had access to any protective equipment against it. And among the few who had some forms of protective wear, most found the equipment disturbing and disruptive of work performance.
A comparative analysis of Russian and European legislation concerning to the waste management has been performed. There were revealed principal differences in Russian and European legislation in methodology of the waste classification. In Europe, there is no methodology for breaking up waste into hazard classes, and for the denomination of the danger there are used hazard lists which fail to give information about the extent of their danger. Medical waste in the European legislation are not selected into the separate category as being included in terms of articles and lists in the annexes to the directives or other legal acts. There are considered requirements of the Russian and European legislation in the area of the landfill waste burial. In the frameworks of the proposals for the implementation of international experience in the waste management there was drafted the project of Sanitary rules on hygiene requirements to the arrangement and the contents of landfills for residential solid waste, which includes requirements concerning not only residential solid waste, but also medical waste.
The paper substantiates a need for specific regulation of biological waste products due to their high potential danger to the environment. Being governed by the normative legal acts on the provision of the population with sanitary-and-epidemiological well-being, adopted by the federal executive bodies and the federal executive bodies of the subject of the Russian Federation, the Inspectorate for the Protection of Consumer Rights and Human Welfare in the Republic of Bashkortostan is competent to supervise and control the activity of enterprises and institutions, the conditions and procedures for collection, usage, decontamination, transportation, storage and disposal of waste products and utilization in accordance with the current sanitary rules and regulations. As a result, the authors took part in the elaboration of several long-term programs and resolutions of the Government of the Republic of Bashkortostan Government, realization of which will reduce the impact of environmental pollution on human health.
National Mercury Programs, National Office of Pollution Prevention, Environment Canada, Place Vincent Massey, 20th Floor, 351 St. Joseph Blvd., Hull, QC K1A 0H3. LukeTrip@ec.gc.ca
Dentistry and society have long recognized the benefits of using silver-based amalgams to restore and maintain the dental health of patients. However, recent studies by health and environment experts have shown that mercury is of great concern when it enters the biosphere as a contaminant. A rational approach to pollution prevention is mandatory. This article explains the relationship between mercury, particularly dental amalgam waste, and the environment and describes a new pollution prevention initiative intended to ensure that the dental community becomes part of the solution to this serious environmental health problem.
From June 17 through November 15, 1995, ten episodes of Enterobacter cloacae bloodstream infection and three pyrogenic reactions occurred in patients at a hospital-based hemodialysis center. In a case-control study limited to events occurring during October 1-31, 1995, seven dialysis sessions resulting in E. cloacae bacteremia or pyrogenic reaction without bacteremia were compared with 241 randomly selected control sessions. Dialysis machines were examined, dialysis fluid and equipment were cultured, and E. cloacae isolates were genotyped by pulsed-field gel electrophoresis. Each dialysis machine had a waste-handling option (WHO) through which dialyzer-priming fluid was discarded before each dialysis session; in 7 of 11 machines, one-way check valves designed to prevent backflow from the WHO into patient bloodlines were dysfunctional. In the case-control study, case sessions were more frequent when machines with >/=1 dysfunctional check valves were used. E. cloacae with identical pulsed-field gel electrophoresis patterns were isolated from case patients, dialysis fluid, station drains, and WHO units. Our investigation shows that bloodstream infections and pyrogenic reactions were caused by backflow from contaminated dialysis machine WHO units into patient bloodlines. The outbreak was terminated when WHO use was discontinued, check valves were replaced, and dialysis machine disinfection was enhanced.
Division of Hematopathology, Department of Laboratory Medicine and Pathology, Dalhousie University, Halifax, Nova Scotia, Canada. calvino.cheng@cdha.nshealth.ca
Recent blood shortages and the potential clinical impact of red blood cell (RBC) age highlight the need to understand blood supply delivery. This study addresses the characteristics and mechanics of RBC unit trafficking and storage across the transfusion service, previously undescribed in the literature.
This retrospective qualitative institutionwide survey assessed the comprehensive RBC life cycle within Capital District Health Authority in Nova Scotia, Canada, during 2007.
A total of 15,930 unique RBC units were received from the supplier with 98.6% having mean age of 12.5 days. The mean ages on receipt, transfusion, and time spent in the transfusion system before transfusion were 12, 19.6, and 7.5 days, respectively. Of 12,298 units, 9689 (78.8%) remained within the blood transfusion services (BTSs), while 2609 (21.2%) migrated having been returned a mean of 1.26 times from locations outside BTS (SD, 0.56 times), the latter spending a mean of 18.4 hours outside the BTS. Stationary units had mean age at dispense and time spent in the transfusion system of 19.2 and 6.9 days, respectively, compared to migratory units at 21.3 and 9.9 days, respectively (p
