Recycling surgical equipment meant

liver411

[B]for single use continues[/B]


http://www.abc.net.au/am/content/2003/s906347.htm



AM - Monday, 21 July , 2003  08:21:34
Reporter: Hamish Fitzsimmons
LINDA MOTTRAM: The recycling of surgical equipment designed for single use
is still widespread in Australia despite serious questions about its safety,
according to a new survey.

The study was conducted in 189 hospitals and it's concerned health
researchers, who warn that the practice could lead to the spread of
infection.

The Federal Health Department's Therapeutic Goods Administration has
recommended that the practice cease.

Hamish Fitzsimmons reports.

HAMISH FITZSIMMONS: In 1994, a Sydney surgeon was found guilty of
unsatisfactory professional conduct after the apparent HIV infection of four
people who attended his surgery in November 1989. The infections are said to
have occurred through the use of recycled medical equipment.

A new study, published in the Australian Medical Journal, has found the
recycling of common surgical equipment designed for single use still occurs
in 15 per cent of Australia's major hospitals, though that figure has
dropped from 68 per cent in 1994.

The leader of the study is Associate Professor, Peter Collignon, the
Director of Microbiology and Infectious Diseases at the Canberra Hospital.

PETER COLLIGNON: The concern is that it's still 15 per cent because these
devices are manufactured as single use only, were used in surgical
procedures, therefore in sterile sites. And our concern is their structure
and design is such that blood can get into nooks and crannies that can be
very difficult to clean and because they're made of plastic you can't
heat-sterilise them, which means you need chemical disinfectants, and
they're not as effective and also they will not get into nooks and crannies
as well.

We believe that cleaning and sterilisation is compromised and therefore they
may potentially be able to transmit infections to the next patient that
they're used on, such as with blood-born viruses, such as Hepatitis C.

HAMISH FITZSIMMONS: The most obvious infection is HIV-AIDS, given that in
1994 a Sydney surgeon was reprimanded after four people in his surgery were
infected with the disease following the use of recycled medical equipment.

PETER COLLIGNON: Well, any virus that's in blood is a potential concern.
Luckily in Australia, HIV is not the commonest virus that's in blood. There
are many more viruses that are much more frequent, such as Hepatitis C, but
this is. the concern we have and the reason we believe that most of these
devices this is inappropriate to re-use them is both, in a lot of times the
cost is relatively low, so we don't think this makes economic sense in that
if you've got a diathermy pencil, it might cost for instance $10. The cost
of reprocessing, with labour and everything else will be much more than
that.

HAMISH FITZSIMMONS: How much does the risk of infection increase by the use
of these re-used tools?

PETER COLLIGNON: Well, I don't think this is horrendous risk to the
community if we put it in perspective. I mean, we don't have hundreds of
people who are getting infections because of this. I mean, the risk is
likely to be small.

I mean, if this was 99.9 per cent safe, you know, which sounds terrific, but
if we're doing millions of these procedures each year, you know, if you do a
million procedures with re-used items and there's a risk of 0.1 per cent,
that's 1,000 people. So. and it's a risk we don't have to have. So even
though I believe overall the risk is low, it's something we don't need to do
and I think we should stop this practice.

LINDA MOTTRAM: Associate Professor, Peter Collingnon, speaking to Hamish
Fitzsimmons.