title: Disposal of syringes, needles, and lancets used by diabetic patients in Pakistan.
abstract: OBJECTIVE
  To assess the use, handling and disposal of insulin injection equipment by diabetic patients in Pakistan.
  
  
  METHODS
  We conducted a cross-sectional study at diabetic clinics in five tertiary centers in Pakistan. All diabetic patients (type 1/type 2) who were on insulin for more than 1 month, were included. An Urdu (local language)-translated questionnaire was used to collect information on insulin administration equipment, the site and frequency of needle use, insulin syringe/pen/lancet disposal, sharing of needles and knowledge about diseases that are spread by sharing contaminated needles.
  
  
  RESULTS
  Of 375 patients, 58% were female. The mean (SD) duration of diabetes was 12.3 (7.3) years, and the duration of insulin use was 4.4 (4.3) years. The majority of the patients used syringes (88.3%) for insulin administration. Additionally, the majority of the patients disposed of used devices (syringes, 92%; pens, 75%; and lancets, 91%) in the household garbage collection bin. About half of the patients (n=185) reported being educated by their physicians about the disposal of sharps. Those who were educated by a physician (adjusted odds ratio (adjOR): 0.36; 95%CI: 0.16-0.81) or could read/write English (adjOR: 0.32; 95%CI: 0.11-0.92) were less likely to dispose of syringes and needles in the household garbage.
  
  
  CONCLUSIONS
  The common disposal of sharps in the household garbage has implications for disease transmission. Education on the safe disposal of sharps may improve the disposal practices.
authors.affiliation: Shifa International Hospital, Islamabad, Pakistan. osama@pakmedinet.com
authors.forename: Osama
authors.initials: O
authors.lastname: Ishtiaq
authors.forename: Asif Mehmood
authors.initials: AM
authors.lastname: Qadri
authors.forename: Saeed
authors.initials: S
authors.lastname: Mehar
authors.forename: Ghulam Murtaza
authors.initials: GM
authors.lastname: Gondal
authors.forename: Tahir
authors.initials: T
authors.lastname: Iqbal
authors.forename: Sobia
authors.initials: S
authors.lastname: Ali
authors.lastname: Mati-ur-Rahman
authors.forename: Naveed Zafar
authors.initials: NZ
authors.lastname: Janjua
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015190:Blood Glucose Self-Monitoring / Q000379:methods; D002648:Child; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D017744:Medical Waste Disposal / Q000379:methods*; D008875:Middle Aged; D016602:Needlestick Injuries / Q000517:prevention & control*; D010154:Pakistan; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D007328:Insulin; D017744:Medical Waste Disposal