title: Disposal of Endoscopic Accessories After Use: Do We Know and Do We Care?
abstract: Significant amounts of medical waste are generated in endoscopy units. Improper disposal has significant health, cost, and environmental implications. The aim of this study was to better understand the appropriateness of handling of medical waste in the endoscopy unit. This is a validated survey completed online and in person by endoscopy staff and gastroenterologists. Main outcome measurements include the method of disposal of endoscopic accessories (snares, dilating balloons, endoscopic retrograde cholangiopancreatography wires, and sphincterotomes) and nasogastric tubes and whether or not in the appropriate disposal bin (i.e., in sharps container, red bags, or regular trash). The appropriateness of the method of disposal was determined per Occupational Safety and Health Administration guidelines. Respondents included 783 endoscopy staff members and 352 gastroenterologists. Fifty-eight percent of endoscopy staff members and 65% of gastroenterologists handled simple endoscopic accessories as regulated medical waste instead of regular trash. Furthermore, 27% of respondents discarded endoscopic accessories as sharps, although they are not considered sharps. Nearly one third of respondents discarded nasogastric tubes and other endoscopic accessories differently, even though both would have same degree of contamination. Only 7 respondents (0.6%) understood disposal costs. All but 23 respondents (2%) felt that medical personnel should be better informed about medical waste. Most medical waste from endoscopy laboratories is handled inappropriately. Endoscopy staff and gastroenterologists' understanding of recommended disposal methods for endoscopic accessories is poor. The data have major financial and environmental implications.
authors.affiliation: Deepak Agrawal, MD, MPH, is Associate Professor of Gastroenterology, Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas. Valerie Shoup, MBA, Director, Sustainability, University of Texas Southwestern Medical Center, Dallas. Amy Montgomery, RN, CGRN, is Gastroenterology Nurse, Endoscopy Unit, Parkland Hospital, Dallas, TX. Jedrek Wosik, MD, is Medicine Resident, Department of Medicine, University of Texas Southwestern, Dallas. Don C. Rockey, MD, is Professor of Gastroenterology, Department of Internal Medicine, Medical University of South Carolina, Charleston.
authors.forename: Deepak
authors.initials: D
authors.lastname: Agrawal
authors.forename: Valerie
authors.initials: V
authors.lastname: Shoup
authors.forename: Amy
authors.initials: A
authors.lastname: Montgomery
authors.forename: Jedrek
authors.initials: J
authors.lastname: Wosik
authors.forename: Don C
authors.initials: DC
authors.lastname: Rockey
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation / Q000379:methods; D003428:Cross Infection / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D019723:Endoscopes; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008297:Male; D017744:Medical Waste Disposal / Q000592:standards*; D020380:Needs Assessment; D012037:Refuse Disposal / Q000379:methods; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
chemical_list: D017744:Medical Waste Disposal