Taking Safer Sharps Where They're Needed

Bringing new technologies to market with a goal of keeping costs where less-affluent countries can afford them, MedPro Safety Products Inc. wants to address the home health market, as well.

• By Jerry Laws
• Sep 01, 2009

Editor's note: Several safety organizations focus on preventing health care workers' needlestick injuries. MedPro Safety Products Inc. of Lexington, Ky., makes safe sharps for the hospital market but also sees opportunities overseas and in home health care. Walter Weller, the company's president, discussed those opportunities and the scope of the needlestick problem in a Dec. 18, 2008, interview with OH&S Editor Jerry Laws. He said MedPro Safety Products, which makes a variety of safe sharps, creates its products by developing a precision prototype, taking it to the market to see how it is accepted and how well it works, and then goes back and make changes if necessary to optimize it. Excerpts from the conversation follow.

OH&S: Tell me about your company.

Walter Weller: We were very active in the 2001 federal needlestick bill. That whole process of testifying, being involved at the state level and on the Hill--we gravitated pretty quickly to understanding, number one, that this industry would clearly move to passive technology, and number two, there is no doubt in our collective analysis that, any time you change a protocol or a practice or the administration of a needle, you increase risk.

So we set out from that point forward to identify technology that would minimize in-service training, minimize any difference or change in the type of needle administration, [and] most importantly, not require--or at least minimize as much as possible--a practitioner's interaction with the device. Push buttons, clips; I'm sure you're familiar with all of the technologies out there. We're kind of a 14-year overnight sensation. We've been around for a long time. We started with a legacy device and spent a lot of time on it. As we got ready to market that device, the entire process that became the federal Needlestick Safety and Prevention Act was launched. At that time, we obviously wanted as a manufacturer to be involved and make sure, number one, that we were going to be allowed to market our device, and number two, we wanted to actively be involved in taking our experiences to that process and learning from that process. I've spent about two years, between the state and federal government, testifying and sitting in front of user groups, going into trials, basically evaluating everything from a large hospital to a single veterinarian unit.

That experience has been, just like the old saying, priceless. When you're dealing in the protection and exposure of bloodborne pathogens to human beings, there's no substitute for sitting out there in the market and watching how and what they do and where their risks are.

Because, ultimately, the people that are doing those injections are the ones who have the most risk. They have all the risk, when it really comes down to it. If you've done an injection with a patient and you've come out and accidentally stick the patient again, they're going to be pretty unhappy, but they're being stuck with their own needle, so to speak. It's the other side of this exposure that's a problem.

It's not a small issue. It's clearly underreported.

I've seen reports indicating it is underreported, but I have not seen the numbers you've quoted: 1 million annual health worker injuries in this country and nearly 8 million contaminated sharps entering the U.S. waste stream daily. How prevalent are these injuries?

Weller: The generally accepted numbers that are floating around: In the United States alone, there are 800,000 to 1 million needlesticks a year, but the estimate is that about 30 percent of needlesticks are reported. So you're looking at a very, very substantive issue when you start to realize there are basically 28 keynote bloodborne pathogens that can create everything from illness to death in a human being. The real killers, obviously, are HIV and Hep C.

HIV is a very sensitive virus in the sense that it has to have the right temperature, it has to have the right environment, and it does not have a long lifespan. Hep C can live for weeks in a dumpster on the back end of a dirty needle.

Those [pathogens] are all issues for another marketplace that we’re looking at. We're working on some safety systems now in home health care. In the United States, there's no protection at the home health care level, there's no requirement for safety systems. We've got a couple of different pieces that we're working on . . . and hope to push some technology forward in that marketplace, as well.

That would be important.

Weller: It is. Honestly, it doesn't take long in this industry to go and listen to one or two or three stories from a practitioner who has been exposed and winds up with something that's bad to fatal to realize why it's needed. Fortunately, in the U.S., it's mandated. There are federal laws about the evaluation and implementation of safety devices. And that portion of it we take very seriously. All we're interested in is putting forward the most efficient, most operative technology that we can get out there.

People in the waste collection business, both in hospitals and outside them, are at real risk. Does your technology protect them, as well?

Weller: Absolutely. In the U.S. marketplace alone, there are now in excess of 18 million diabetics who inject insulin two to four times a day. Some use needle-free systems, and some use needleless systems. But many aren't. And all of those needles are getting into the waste system. Without question, people who are collecting that waste in the trash are exposed.

I don't have hard numbers on that market yet. They're slowly emerging because, again, that's been an exempt marketplace, home health care disposal. If you don't have a requirement to collect data, it's often hard to find. But clearly those injuries occur. They occur throughout the United States and throughout the world, for that matter.

One of the "sidebars" to our technology is trying as efficiently as we can to keep our systems from a cost perspective within the range of being able to get them outside the U.S. and some of the non-traditional marketplaces, especially given the economy today.

Do you have an estimate of how many needlesticks occur worldwide and how many needles are discarded improperly around the world, or in this country?

Weller: In this country, the numbers are pretty large. Potentially, with insulin alone, you could look at anywhere from 20 to 40 million pieces of cannula a day. That's my understanding.

Just from the home health care side of these, I think that 92 or 93 percent of the disposal in the home environment is done in what we'll call, relatively speaking, without a safety system in place. You become reliant on somebody to put it in a Clorox bottle and close it up, as opposed to just putting it in the trash.

Generally speaking, needle usage around the world is about double what it is in the United States. You're safe if you take U.S. numbers and multiply times two for around the world.

Interestingly, the country that has the single largest per capita use of [needle] safety systems in the world is Ireland. It's a cultural issue; it came about not because the government required it. You're seeing now requirements that are coming out in Germany, France, Austria; the countries you would imagine in Western Europe are advanced are pushing all of these systems forward.

There really is a global understanding now of the problem related to contaminated sharps and bloodborne pathogen injuries. The question comes down to how best to get those systems out there, and the big challenge over the next several years is going to be to try to deliver safety into regions that financially don't have either the infrastructure to deliver and pay for those systems or simply don't have a system organized enough to get safety systems involved and implemented into their health care.

Keeping the cost of safe sharps low is certainly important. What about the cost of needlestick injuries?

Weller: To give you an idea, each reported needlestick costs in the ballpark of $3,000 to initially diagnose and to treat. And it goes up from $3,000 depending on the exposure, what type of illness there is, and if in fact the practitioner gets sick. And obviously it can go into the multimillions of dollars when you get into lawsuits over needlestick injuries.