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  3. Friday, 24 March 2006
POST 00902E : NEEDLE REMOVERS REVIEW Follow-up on Posts 00891E and 00897E 24 March 2006 ___________________________________ Yves Chartier ( responds to Satish comments and concerns (Post 00897E) by explaining the present WHO perspective on the issue.. ___________________________________ Dear Satish, Thank you very much for your email and reaction. I know that PATH and particularly PATH in India has done a lot around needle remover. The project that I had the great opportunity to visit in India was in my point of view very good. There is also no question on the added value of needle removers in waste management, but also in term of safety for waste handlers and communities, this without mentioning options to reprocess the plastic from syringes into other plastic products. In a word, at the waste management stage it brings safety and is an environmentally-friendly option. The question remains on occupational safety. The present policy on sharps from injection activities is: injection - safety box. The use of a needle remover adds an extra step in the process and extra manipulation of the sharp itself. This step requires clear evidence in term of safety. Does the use of needle removers increase the risk of needle-stick injury to injection providers and exposure to blood spray? There is insufficient evidence so far, and the report you refer to mentions it clearly. What are the coming developments: 1. An extra study on routine activities is planned in Bangladesh. The WHO protocol on routine will be used. Reported needle-stick injuries will be documented. The results of this study, if scientifically proven and well in respect with the WHO protocol should bring enough evidence to take a position. 2. I agree with you that many countries are now introducing needle removers. No proper technical specifications may lead to the use of poorly designed devices with the risk of increased needle stick injuries. This would be of course counter-productive as needle removers will be then regarded as unsafe devices. Specifications on needle remover have been developed in 2005. IT Power India led the Waste Working Group for PQS and also developed draft specifications for Needle removers. This has been revised by a good number of people from PATH, WHO and others. Knowing the dynamic to introduce needle removers in many countries, these specifications will be made available very shortly for information. 3. My objective is that by the next SIGN meeting WHO comes with a clearer position on needle removers. As mentioned above evidence that the needle remover does not increase risk for injection providers is the main issue. One of the WHO's recommendation is that, if needle removers are introduced or are already in use, these activities be documented and studied with the support of the WHO protocol to bring evidence in a shorter period of time. I believe that all together we can ensure, through extra studies, that at the next SIGN meeting, a position is taken regarding the use of needle removers. I hope these few lines clarify where WHO wants to go. Be sure that this Yes and No position is unstable and that we are trying our best to come with a clear WHO position on this issue. Once again thank you very much for your email. It is always great to hear from you. Best greetings, Yves Yves CHARTIER Public health engineer Water, Sanitation and Health Public Health and Environment World Health Organization ______________________________________________________________________________ Visit the TECHNET21 Website at You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de internationale en sant, Canada ( ______________________________________________________________________________

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