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Lowering standards of clinical waste management: do the hazardous waste regulations conflict with the CDC's universal/standard precautions?

机译:降低临床废物管理标准:危险废物法规是否与CDC的通用/标准预防措施相冲突?

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Clinical waste is a costly and troublesome commodity. Comprising the detritus of medical care, the foremost hazard is the risk of infection from micro-organisms present in these wastes. Infection commonly occurs through penetrating injury, the so-called 'sharps' or 'needlestick' injury, although contamination of non-intact skin or splashes to the eye may transmit infection. Bloodborne viruses (hepatitis B, hepatitis C, human immunodeficiency virus) are the most serious threat, although respiratory, soft tissue and enteric infections are not unknown. The European Hazardous Waste Directive, that harmonizes the categorization and control of wastes, permits downregulation of clinical wastes where the risk of infection may be low. Although strengthened by the requirement for risk assessment in waste classification, UK regulatory guidance promoting classification of some clinical wastes as non-hazardous completely ignores the Centers for Disease Control and Prevention's Universal Precautions for the prevention of transmission of human immunodeficiency virus, hepatitis B virus and other bloodborne pathogens in healthcare settings, which seek to prevent bloodborne virus infection in healthcare workers and others, and the more extensive Standard Precautions that extend these principles to the prevention of healthcare-associated infections and the environmental spread of nosocomial pathogens. By creating a potent cost driver encouraging downregulation of some clinical wastes, UK legislation based on the European Hazardous Waste Directive conflicts with the CDC's Universal/Standard Precautions.
机译:临床废物是昂贵且麻烦的商品。由医疗废物构成的最主要危害是这些废物中存在的微生物感染的危险。感染通常是通过穿透性损伤(即所谓的“尖刺”或“针刺”损伤)发生的,尽管未受损皮肤的污染或飞溅到眼睛可能会传播感染。血液传播的病毒(乙型肝炎,丙型肝炎,人类免疫缺陷病毒)是最严重的威胁,尽管呼吸,软组织和肠道感染并非未知。协调废物分类和控制的《欧洲危险废物指令》允许在感染风险可能较低的情况下下调临床废物。尽管由于废物分类中的风险评估要求而得到加强,但英国将某些临床废物分类为非危险性的法规指南完全忽略了疾病控制与预防中心关于预防人类免疫缺陷病毒,乙型肝炎病毒和医疗机构中的其他血源性病原体,旨在防止医护人员和其他人中的血源性病毒感染;以及更广泛的标准预防措施,将这些原理扩展到预防与医疗相关的感染和医院病原体在环境中的传播。通过创建有效的成本驱动因素来鼓励对某些临床废物的下调,基于欧洲危险废物指令的英国立法与CDC的通用/标准预防措施相冲突。

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