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From: TSS ()
##################### Bovine Spongiform Encephalopathy ##################### Medical Waste and CJD 2003 guidelines CDC ? Operating room (OR) personnel are frequently overwhelmed by their numerous responsibilities of not only “fixing” the patient, but also preventing infection, maintaining a sterile field, utilizing only sterile instruments, and in general, ensuring the patient’s safety, as well as that of the OR staff. Proper fluid management is one of those crucial steps to preserving the wellbeing of both staff and patient. Has your OR personnel been trained in the disposal of liquid waste? Are they aware of state and/or city regulations? Is their bloodborne pathogen training recent? Is annual competency testing required? snip... Of special interest, APIC’s guidelines also point out the more recent anxiety related to Creutzfeldt-Jakob disease (CJD). “Concerns also have been raised about the need for special handling and treatment procedures for wastes generated during the care of patients with CJD or other transmissible spongiform encephalopathies (TSEs),” the guidelines observe. “Prions, the agents that cause TSEs, have significant resistance to inactivation by a variety of physical, chemical, or gaseous methods. No epidemiologic evidence, however, links acquisition of CJD with medical-waste disposal practices. Although handling neurologic tissue for pathologic examination and autopsy materials with care, using barrier precautions, and following specific procedures for the autopsy are prudent measures, employing extraordinary measures once the materials are discarded is unnecessary. Regulated medical wastes generated during the care of the CJD patient can be managed using the same strategies as wastes generated during the care of other patients. After decontamination, these wastes may then be disposed in a sanitary landfill or discharged to the sanitary sewer, as appropriate.”1 http://www.infectioncontroltoday.com/articles/651feat3.html Guidelines for Environmental Infection Control in Health-Care Facilities Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC) U.S. Department of Health and Human Services Centers for Disease Control and Prevention (CDC) Atlanta, GA 30333 2003 snip... 6. Medical Waste and CJD Concerns also have been raised about the need for special handling and treatment procedures for wastes generated during the care of patients with CJD or other transmissible spongiform encephalopathies (TSEs). Prions, the agents that cause TSEs, have significant resistance to inactivation by a variety of physical, chemical, or gaseous methods.1427 No epidemiologic evidence, however, links acquisition of CJD with medical-waste disposal practices. Although handling neurologic tissue for pathologic examination and autopsy materials with care, using barrier precautions, and following specific 117 procedures for the autopsy are prudent measures,1197 employing extraordinary measures once the materials are discarded is unnecessary. Regulated medical wastes generated during the care of the CJD patient can be managed using the same strategies as wastes generated during the care of other patients. After decontamination, these wastes may then be disposed in a sanitary landfill or discharged to the sanitary sewer, as appropriate. ......... snip... http://www.apic.org/AM/Template.cfm?Section=Search§ion=CDC1&template=/CM/ContentDisplay.cfm&ContentFileID=342 VARIANT CREUTZFELDT-JAKOB DISEASE (vCJD) and BLOOD COMPONENTS INFORMATION FOR PATIENTS, February 2006 http://www.hpa.org.uk/infections/topics_az/cjd/BC-InfoforP.pdf http://www.hpa.org.uk/infections/topics_az/cjd/frameworkannex1-Aug2005.pdf © 2006 American Society for Investigative Pathology Detection and Localization of PrPSc in the Skeletal Muscle of Patients with Variant, Iatrogenic, and Sporadic Forms of Creutzfeldt-Jakob Disease http://ajp.amjpathol.org/cgi/content/abstract/168/3/927 21. Dr Matthews noted that data are now available on the infectivity of a wide range of bovine tissues. In September 2005, the World Health Organisation had updated its assessment of the risk of TSE infectivity in tissues. These data, although incomplete, should increase confidence in the safety of particular tissues, particularly if the age of the source animal is also considered. As a result, less reliance need now be placed on the status of the country of origin. Members agreed, but noted that it would be important to assess the quality of the data on which assessments are based. As it seems highly likely that blood, at least from humans infected with vCJD, can be infectious, tissues and organs with a significant blood supply may also confer higher risk. http://www.seac.gov.uk/minutes/draft-91.pdf THE ENVIRONMENTAL RISK FACTORS FOR TSE ARE STILL UNKNOWN, but from recent science coming out lately, the risk factor seems to be increasing, rather than decreasing. CAN SOMEONE PLEASE EXPLAIN TO ME WHY IT IS STILL ACCEPTABLE FOR sanitary landfill or discharged to the sanitary sewer, as appropriate FOR CJD, when the epidemiology of all phenotypes of sporadic CJDs are not known to date, and with apparent new ones of 'unknown' origin being documented as we speak??? http://www.cjdsurveillance.com/resources-casereport.html THE practice of landfilling and or the discharging to the sanitary sewer, and or spreading to land as fertilizer of any human and or animal TSE should be banned immediately. ...TSS TSS #################### https://lists.aegee.org/bse-l.html ####################
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