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Jodie Sinnema, edmontonjournal.com
Published: 3:28 pm Oct. 28, 2008
EDMONTON - Syringe reuse is a larger problem
than once thought, even though the practice is inexcusable,
says a health-care epidemiologist in the United States who
helps investigate hepatitis outbreaks linked to dirty
syringes.
"Injection safety was often thought of as a
developing world problem and we kind of took it for granted
in the U.S. and other developed countries," said Joseph Perz,
who works at the Centers for Disease Control and Prevention
in Atlanta. "But as a result of accumulating evidence from
outbreaks and surveys, we are taking a firmer stand on the
need for education and firmer standards."
On Monday, officials revealed that a handful
of staff at the High Prairie Health Complex may have exposed
2,700 dental and endoscopy patients to HIV and hepatitis B
and C by using dirty syringes.
The syringes were inserted into an
intravenous line, not into a patient's arm, then reused on
the next patient, risking contamination since blood and
dirty medication can flow back up the IV line into the
syringe.
That stopped Nov. 2, when the problem was
discovered after 18 years of routine behaviour in the dental
suite, and more than four years in the endoscopy lab.
"Some health-care personnel don't perceive
the risks when the injections are administered through IV
tubing," Perz said. "They perhaps get this false sense of
security."
That, despite multiple outbreaks of
hepatitis B and C in Oklahoma, Nebraska, New York and, just
this year, Las Vegas, where more than 100 people were
infected.
"Even though we've worked to draw attention
to the dangers of reusing syringes and mishandling injected
medications, it's hard to get the message to every provider
that needs to hear it," Perz said, especially in the U.S.
where private clinics aren't inspected as regularly as
hospitals.
"Not reusing syringes should be obvious.
That's step one," he said, noting that universities and
medical schools have to do a better job of teaching people
the bedside details of giving injections safely and
properly.
But Rodney Lester, director of the nurse
anesthesia program at the University of Texas in Houston,
said it's not a gap in teaching, but in the behaviours of
individual health-care workers.
"They get sloppy," said Lester, who studied
syringe reuse in the United States. "They're in a hurry. If
you've got a big syringe loaded up with stuff and you carry
it from patient to patient, you don't have to reload in
between or you don't have to make up another one. Others
will argue, well, it saves money. You can buy thousands of
syringes for a few bucks. It is just crazy that people will
think they are saving any reasonable amount of money while
creating an enormous amount of risk."
Health Minister Ron Liepert and Dr. Albert
de Villiers, the medical officer of health for the Peace
Country Health region, both refused to point fingers or
blame those reusing the syringes.
The staff involved have been retrained and
are still working at the High Prairie Hospital.
Up to 1,300 patients who received
endoscopies between March 1, 2004 and Oct. 2, 2008, as well
as up to 1,400 dental patients who received pain medication
in the recovery room between Jan. 1, 1990 and Oct. 2, 2008,
will be getting letters or phone calls advising them to be
tested for HIV and hepatitis B or hepatitis C.
jsinnema@thejournal.canwest.com
© Edmonton Journal 2008
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