Quarantine supervision of Wood Packaging Materials (WPM) at Chinese ports of entry from 2003 to 2016

Exotic pests have caused huge losses to agriculture, forestry, and human health. Analyzing information on all concerned pest species and their origin will help to improve the inspection procedures and will help to clarify the relative risks of imported cargo and formulate international trade policies. Records of intercepted pests from wood packaging materials (WPM) from 2003 to 2016 in the China Port Information Network (CPIN) database were analyzed. Results showed that the number of intercepted pests from WPM was lowest in the first quarter and highest in the fourth one. The total number of interceptions increased each year, with 53.33% of intercepted insects followed by nematodes (31.54%). The original continent of most intercepted pests was Asia (49.29%). Xylophagous insects were primarily intercepted from Southeast Asian countries, whereas nematodes were primarily intercepted from Korea, Australia, Mexico, and other countries. WPM interception records were mainly concentrated in China's coastal inspection stations (98.7%), with the largest number of interceptions documented in Shanghai, followed by the inspection stations of Jiangsu Province. The proportion of pest taxa intercepted by the Chinese provinces' stations each year is becoming increasingly balanced. The number of pest disposal treatment measures for intercepted cargoes with dead non-quarantine pests increased significantly from 2012 to 2016. This reflects the fact that Chinese customs inspection stations are becoming increasingly scientific and standardizing the interception and treatment of WPM pests. The issues reflected in the database, with a view to providing a reference for future work by customs officers and researchers.

Non-occupational injuries caused by transport packaging: Residential and retail hazards

BACKGROUND

Background: Pallets are key components of domestic supply chains, and yet present unique hazards when used by homeowners and retailers for unintended uses. No previous works have investigated non-occupational injuries that occur due to unintentional contact with pallets. This study sought to describe the incidence and epidemiology of non-occupational pallet-related injuries as seen in United States emergency departments (EDs).

METHOD

The National Electronic Injury Surveillance System database was used to derive national, weighted estimates of pallet-related injuries by age, sex, injured body part, and location where injury occurred. Data for the years 2014 to 2018 were analyzed with all relevant narratives reviewed.

RESULTS

From 2014 to 2018, there were an estimated 30,493 persons who visited an ED for a pallet-related injury. The yearly incidence of pallet injuries rose during this period. The 35-44 age group (n = 5,481) was most likely to be injured, but about 3,000 children and youth under 18 years of age were injured and more than 4,000 persons 65 years of age or older suffered injuries. The elderly were especially likely to suffer injuries from slip, trip and fall incidents. The lower extremities were the most commonly injured body parts. An estimated 3,964 persons, accounting for approximately 14% of all pallet-related injuries, were treated for injuries incurred while at a retail establishment. African Americans, Hispanics, and the elderly appeared to be disproportionately more likely to have pallet-related injuries in retail locations.

CONCLUSIONS

Non-occupational pallet-related injuries affect a wide range of patients and cause a variety of injuries, with the elderly being especially vulnerable to tripping incidents. Retailer prevention strategies should focus on the misuse of pallets for merchandising purposes. Industry should maintain control of pallets so they are not used for unintended purposes. Practical applications: Retailers should limit the use of pallets for floor-level merchandising purposes and remove pallets from customer-facing locations where unintentional contact could occur. Owners of pallets should maintain them in a controlled supply chain so that they don't leak out into the hands of homeowners. Policy-makers should educate the public about the dangers of used pallets.

Reactions to Standardized Cigarette Packs With Varying Structural Designs, and the Association With Smoking Susceptibility: A Postimplementation Cross-Sectional Survey With Never-Smoking Adolescents in Scotland

INTRODUCTION

From May 20, 2017, cigarettes in the United Kingdom must be sold in standardized (plain) packaging. We explore postimplementation reactions to standardized cigarette packaging among never-smokers in Scotland, whether reactions vary in relation to permitted variations in pack structure, and whether reactions are associated with susceptibility.

AIMS AND METHODS

A cross-sectional survey with 12-17-year-old never-smokers (n = 507) in Scotland, conducted November 2017-November 2018. Participants were shown one "regular" standardized cigarette pack (flip-top lid and straight-edged pack, similar to designs in Australia) and three standardized packs with varied pack structures (beveled-edges, slim pack, and shoulder box), which are permitted postimplementation in the United Kingdom. Participants rated each pack on eight five-point reaction measures (eg, attractiveness). Participants also indicated which pack, if any, they would choose. Smoking susceptibility was the outcome.

RESULTS

The mean reaction scores for all four packs were mostly negative, however the shoulder box was consistently rated less negatively than the regular, slim, or beveled-edge packs. Most participants (87%) said they would not select any of the four packs, although susceptible participants were more likely to select one than nonsusceptible participants (25% vs. 7%; χ 2 = 29.70; p < .001). For all four packs, not finding them off-putting was associated with susceptibility (Adjusted Odds Ratio range: 2.73-3.69), albeit only a minority of adolescents did not find each pack off-putting.

CONCLUSIONS

Adolescents have negative reactions to the standardized cigarette packs implemented in the United Kingdom, albeit permitted variations in structure can reduce the extent of negativity. Most reactions to standardized packaging had no association with susceptibility.

IMPLICATIONS

We provide the first empirical evidence that adolescents find the standardized cigarette packs implemented in the United Kingdom unappealing and that most pack reactions have no association with susceptibility among never-smokers, with the exception of the minority who did not think that they would put them off smoking. This suggests that the legislation is achieving one of its primary aims, to reduce the appeal of packaging. That permitted variations in pack structure (eg, shoulder boxes) somewhat reduce negative reactions suggests that the United Kingdom, and other countries introducing similar legislation, should ensure that all aspects of pack design are fully standardized.

"It's business as usual": adolescents perspectives on the ban of alcohol sachets towards reduction in under age alcohol use in Malawi

BACKGROUND

Alcohol contributes to poor health, social and economic outcomes among adolescents. In Malawi, alcohol consumption among young people significantly increased after the introduction of alcohol sachets. A government ban on the sale of alcohol sachets affected in 2012 aimed to reduce prevalence of alcohol among users. We explored adolescents perceptions regarding the effectiveness of the ban towards reducing alcohol consumption among the under aged in the country.

METHODS

Using a descriptive phenomenological school-based approach, we recruited 44 school-going adolescents, 15-17 year olds using snow ball sampling and conducted 12 individual semi-structured interviews and four group discussions differentiated by sex. We sought a waiver from College of Medicine Ethics Committee (COMREC) to obtain verbal consent from adolescents. All interviews and discussions were digitally recorded and simultaneously transcribed and translated verbatim into English. Data management and analysis was done manually using thematic approach.

RESULTS

Aggressive packaging, and marketing tendencies and lack of restrictive measures in Malawi have rendered the ban ineffective through increased affordability and availability to different income population groups and the underage. Results indicate that even though adolescents perceive the ban as a significant step towards reducing under age alcohol use, personality and drinking motives precede any interventions. Adolescents emphasized on strong personality as a significant factor for reduced alcohol intake or abstinence.

CONCLUSIONS

We recommend strict alcohol policy and enforcement regarding packaging, pricing, positive role modelling by parents and enhanced adolescent personality development through schools and families.

Smokers' Perceptions of Cigarette Packaging With Audio Warning Messages: A Focus Group Study in Scotland

AIMS

The use of audio pack cues or messages is a recent trend in packaging design. There is scope to use audio technology to communicate health and cessation messages via cigarette packaging. We explored how smokers responded to cigarette packs which played audio health messages.

METHODS

Twenty focus groups were conducted in Scotland in 2015 with smokers (n = 120) segmented by age (16-17, 18-24, 25-35, 36-50, >50), gender and social grade. Perceptions of cigarette packs which played audio warnings were explored, with four messages used: (1) a cessation message with a quitline number, (2) mortality message, (3) fertility message, and (4) message about ageing skin.

RESULTS

Audio warnings were thought to increase message impact, particularly among younger smokers, as they would be hard to ignore or avoid, and repetition may lead to the messages being memorized. The warnings were considered annoying or embarrassing, and participants suggested they may discard the packs and use alternative storage. Some participants suggested that the audio warnings were off-putting and may alter their smoking behavior, with the mortality message deemed most effective and was considered relatable and felt personal. Older smokers were least likely to believe that audio warnings would affect their smoking behavior, although some thought that they may enhance cessation attempts among smokers seeking to quit, and could deter new or potential smokers, for example, young people.

CONCLUSIONS

Cigarette packs with audio messaging may have a role to play, now or in the future, as a novel way of communicating health and cessation information.

IMPLICATIONS

There is a lack of research exploring smokers' perceptions of cigarette packs which play audio health messages. This focus group study provides an understanding of smokers' immediate responses to cigarette packs which played a short health message when opened. Smokers generally viewed them as annoying or embarrassing, and some suggested the use of alternative storage. Audio warnings were thought to increase message salience, memorability, and impact, for younger smokers in particular, and some suggested that they be off-putting for themselves or others.

Cigar package quantity and smoking behavior

BACKGROUND

Several jurisdictions in the US and abroad limit the minimum number of cigars that can be sold per package. Research has not evaluated whether small packages might result in cigar use initiation, or whether adding cigars to packages might result in purchasers smoking more cigars.

METHODS

Using nationally representative US adult data from Waves 1 and 2 of the Population Assessment of Tobacco and Health (PATH) Study, we assessed links between cigar package quantity (number of cigars in the package a person usually buys) and (1) price, and (2) cigar and cigarette use over time, for three cigar types: filtered cigars, cigarillos, and large cigars.

RESULTS

Smaller quantity packages (i.e., packages with fewer cigars) were cheaper per-pack than larger quantity packages but more expensive per-stick for all three cigar types. For filtered cigars, past-year starters tended to buy smaller quantity packages compared to longer-term users (geometric mean = 6.31 vs. 11.75, respectively; b = -.18, 95%CI: -.32, -.04). Also, those who bought smaller quantity packages of filtered cigars tended to smoke fewer cigars over time compared to those who bought larger quantity packages (b = 1.16, 95%CI: 0.45, 1.87). Neither of these associations was observed for cigarillos or large cigars. We also found little evidence that buying larger quantity packages predicted continuing to use cigars or using cigarettes.

CONCLUSIONS

Although we found consistent associations between package quantity and price, we found few associations between package quantity and changes in cigar smoking behaviors over time, particularly for cigarillos and large cigars. Key limitations include our adult-only analyses and inability to determine the package quantity that cigar users initiated with. Future studies could examine whether package quantity plays a causal role in filtered cigar use initiation or consumption rates.

Quantifying Children's Non-Supermarket Exposure to Alcohol Marketing via Product Packaging Using Wearable Cameras

OBJECTIVE

The aim of this research was to quantify children's exposure to alcohol marketing via product packaging using wearable cameras, observing sociodemographic differences and contextual features of exposure.

METHOD

In Wellington, New Zealand, 167 children (ages 11-13; 53% girls) wore wearable cameras for 4 consecutive days. The cameras automatically captured images approximately every 7 seconds. Image data (n = 700,000 images) were coded through content analysis to determine the extent of children's exposure to alcohol marketing via product packaging. Negative binomial regression models were used to calculate rates of exposure per day and to examine differences between groups.

RESULTS

Children were exposed to alcohol marketing via product packaging 7.7 times per day, on average. Product packaging contained limited health information and lacked defining features that could provide visual cues to children to differentiate alcohol from other commodities. No statistically significant differences by sociodemographic characteristics were detected.

CONCLUSIONS

Children are frequently exposed to alcohol marketing via product packaging. Such exposure normalizes alcohol in children's environments and fails to send accurate information to children about the health risks associated with alcohol consumption. Mandatory labeling on alcohol product packaging, including prominent health warnings (text, pictorial, and graphic), or plain packaging, provides governments an opportunity to substantially reduce children's overall exposure to alcohol marketing and potentially increase children's awareness of the risks associated with alcohol consumption.

Overview of known plastic packaging-associated chemicals and their hazards

Global plastics production has reached 380 million metric tons in 2015, with around 40% used for packaging. Plastic packaging is diverse and made of multiple polymers and numerous additives, along with other components, such as adhesives or coatings. Further, packaging can contain residues from substances used during manufacturing, such as solvents, along with non-intentionally added substances (NIAS), such as impurities, oligomers, or degradation products. To characterize risks from chemicals potentially released during manufacturing, use, disposal, and/or recycling of packaging, comprehensive information on all chemicals involved is needed. Here, we present a database of Chemicals associated with Plastic Packaging (CPPdb), which includes chemicals used during manufacturing and/or present in final packaging articles. The CPPdb lists 906 chemicals likely associated with plastic packaging and 3377 substances that are possibly associated. Of the 906 chemicals likely associated with plastic packaging, 63 rank highest for human health hazards and 68 for environmental hazards according to the harmonized hazard classifications assigned by the European Chemicals Agency within the Classification, Labeling and Packaging (CLP) regulation implementing the United Nations' Globally Harmonized System (GHS). Further, 7 of the 906 substances are classified in the European Union as persistent, bioaccumulative, and toxic (PBT), or very persistent, very bioaccumulative (vPvB), and 15 as endocrine disrupting chemicals (EDC). Thirty-four of the 906 chemicals are also recognized as EDC or potential EDC in the recent EDC report by the United Nations Environment Programme. The identified hazardous chemicals are used in plastics as monomers, intermediates, solvents, surfactants, plasticizers, stabilizers, biocides, flame retardants, accelerators, and colorants, among other functions. Our work was challenged by a lack of transparency and incompleteness of publicly available information on both the use and toxicity of numerous substances. The most hazardous chemicals identified here should be assessed in detail as potential candidates for substitution.

Young people's perceptions of tobacco packaging: a comparison of EU Tobacco Products Directive & Ireland's Standardisation of Tobacco Act

OBJECTIVES

To measure young people's perceptions of tobacco packaging according to two current pieces of legislation: The EU Tobacco Products Directive (TPD) and Ireland's Public Health (Standardisation of Tobacco Products) Act.

DESIGN

Within-subject experimental cross-sectional survey of a representative sample of secondary school students. School-based pen and paper survey.

SETTING

27 secondary schools across Ireland, randomly stratified for size, geographic location, gender, religious affiliation and school-level socioeconomic status. Data were collected between March and May 2014.

PARTICIPANTS

1378 fifth year secondary school students aged 16-17 in Ireland.

MAIN OUTCOME MEASURES

Young people's perceptions of attractiveness, health risk and smoker characteristics of packs according to EU and Irish branding and packaging guidelines.

RESULTS

Packs with more branding elements were thought to be healthier than standardised packs for Silk Cut (χ(2)=158.58, p<0.001), Marlboro (χ(2)=113.65, p<0.001), and Benson and Hedges (χ(2)=137.95, p<0.001) brands. Generalized estimating equation binary regressions found that gender was a significant predictor of pack attractiveness for Silk Cut, with females being more likely to find the EU packs attractive (β=-0.45, p=0.007). Gender was a significant predictor for females with regards to the perceived popularity of the Silk Cut brand (β=-0.37, p=0.03).

CONCLUSIONS

The removal of brand identifiers, including colour, font and embossing, reduces the perceived appeal of cigarette packs for young people across all three tested brands. Packs standardised according to Irish legislation are perceived as less attractive, less healthy and smoked by less popular people than packs which conform to the EU TPD 2014 guidelines.

SUDOQU: a new dose model to derive criteria for surface contamination of non-food (consumer) goods, containers and conveyances

The Fukushima nuclear accident (Japan, 11 March 2011) revealed the need for well-founded criteria for surface contamination and associated screening levels related to the import of non-food (consumer) goods, containers and conveyances. The only available European-harmonised criteria are those laid down in the IAEA transport regulations, but these criteria date back from the early 1960s and only apply to the safe transport of radioactive materials. The main problem is that a generic dose-assessment model for consumer products is missing. Therefore, RIVM (National Institute for Public Health and the Environment) developed a new methodology entitled SUDOQU (SUrface DOse QUantification) to calculate the annual effective dose for both consumers and non-radiological workers, addressing issues of removability of surface contamination. The methodology can be used to derive criteria and screening levels for surface contamination and could serve as a useful tool for policy-makers and radiation-protection specialists.

The nature and pattern of coronary stent recalls

BACKGROUND

Each year, over 1 million percutaneous coronary interventions (PCIs) are performed in the United States. Coronary stents have been shown to reduce restenosis or abrupt vessel closure and therefore have improved the success of PCI. Rarely, manufacturers recall stents due to unanticipated problems. We sought to study the extent and pattern of stent recall.

OBJECTIVE

To determine the number and rate of stent recall and safety alerts, to identify trends in the rates, and to identify the nature of stent recalls.

SOURCES

The Food and Drug Administration (FDA; http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRES/res.cfm) and Healthcare Recall Management websites (RASMAS; https://alerts.rasmas.noblis.org/rasmas/c/selectViewAlertList.do) were searched. The search terms for recall were, "coronary stent" or "stent."

STUDY PERIOD

Dates were searched between November 2002 and June 2013.

RESULTS

There were 17 coronary stent recalls involving almost 500,000 units; 12 recalls (71%) were before 2006 and 5 recalls (29%) were after. Thirteen recalls (76%) consisted of class II recalls (moderate hazard); the remaining 4 were equally split between class I (severe hazard) and class III (mild hazard; 12% each). The common reasons for recall were concerns with sterility (29%) followed by wrong labeling/packaging (23%) and impaired delivery of stent (18%). In terms of units involved with recalls, 98% (472,189/481,131) were related to wrong labeling/ packaging or misbranding, while 0.1% (542/481,131) were related to potential for broken struts or crack in inflation port hub or sterility. However, approximately 2% of units were related to the potentially lethal problem of impaired balloon inflation. Recalls involved multiple manufacturers with various stent types.

CONCLUSION

The overall incidence of coronary stent recall is low and has declined over the years. The majority of stent recalls are of moderate hazard. However, due to the possibility of serious injury, clinicians should be aware of recalls.

Diversity of containers and buildings infested with Aedes aegypti in Puerto Iguazú, Argentina

Aedes aegypti is the main domestic vector of the dengue virus. Control measures to prevent dengue transmission focus on the treatment and elimination of this vector's oviposition sites. There is limited biological information on Ae. aegypti in Argentina. The aim of this study was to characterize Ae. aegypti oviposition sites in the city of Puerto Iguazú, Argentina. We surveyed an area covering nine neighborhoods in 2005. We identified 191 premises as positive for Ae. aegypti, giving a general house index of 9.6%. Premises classified as residential and vacant lots presented the highest number of infested premises, with 9% and 22% respectively. The total number of surveyed containers was 29,600. The overall container index (CI) was 1.1. The most frequently infested containers were water tanks (CI = 37). These preliminary results suggest that vacant lots and water tanks provide suitable breeding areas and environmental conditions, improving the chances of Ae. aegypti survival in Puerto Iguazú.

Proper packaging for food and no-food products to avoid injuries

OBJECTIVES

This paper aims to present data on proper packaging for food and no-food products to avoid injuries.

METHODS

Data collection was made from the Susy Safe data base and the results of the literature research.

RESULTS

Fatal and near fatal foreign bodies injuries may occur at any age, however it is a particular problem for infants and young children due to a variety of predisposing factors. Safety packaging is therefore a landmark and a model for accident prevention.

CONCLUSIONS

Taken the lack of researches and specificity on this subject, it is warmly suggested that a broader and deeper exploration, both at customer's and public health levels, has to be made, highlighting major risks and complications. Packaging classes are extremely composite, therefore accuracy in data registry must be achieved, since from a preventive point of view it is basilar not only knowing the nature of the foreign body but also having information on its origin.

Promoting health (implicitly)? A longitudinal content analysis of implicit health information in cigarette advertising, 1954-2003

Tobacco studies indicate that health-related information in cigarette advertising leads consumers to underestimate the detrimental health effects of smoking and contributes to their smoking-related perceptions, beliefs, and attitudes. This study examined the frequencies and kinds of implicit health information in cigarette advertising across five distinct smoking eras covering the years 1954-2003. Analysis of 1,135 cigarette advertisements collected through multistage probability sampling of three popular consumer magazines found that the level of implicit health information (i.e., "light" cigarette, cigarette pack color, verbal and visual health cues, cigarette portrayals, and human model-cigarette interaction) in post-Master Settlement Agreement [MSA] era ads is similar to the level in ads from early smoking eras. Specifically, "light" cigarettes were frequently promoted, and presence of light colors in cigarette packs seemed dominant after the probroadcast ban era. Impressionistic verbal health cues (e.g., soft, mild, and refreshing) appeared more frequently in post-MSA era ads than in pre-MSA era ads. Most notably, a majority of the cigarette ads portrayed models smoking, lighting, or offering a cigarette to others. The potential impact of implicit health information is discussed in the contexts of social cognition and Social Cognitive Theory. Policy implications regarding our findings are also detailed.

A comparison of patient adherence and preference of packaging method for oral anticancer agents using conventional pill bottles versus daily pill boxes

Adherence to medications is an important issue in oncology due to the increasing number of anticancer agents, such as targeted therapies, formulated for oral dosing. A prospective, crossover design was utilized in which patients on capecitabine were randomly assigned to one of two packaging methods for one cycle, and then switched over to the alternate packaging method in the subsequent cycle. Twenty-five patients were accrued to this study. Adherence rates were similar when using the daily pill boxes (17/21 = 81%) and when using the conventional pill bottles (18/21 = 86%). However, more patients were satisfied with the daily pill boxes (61% versus 11%, P = 0.027), preferred the daily pill boxes (61% versus 17%, P = 0.061), and thought the daily pill boxes were more helpful in reminding them to take their medications (50% versus 11%, P = 0.070). In conclusion, this small pilot study did not demonstrate that the use of daily pill boxes improved patient adherence with capecitabine, but patient satisfaction and preference for this packaging method were greater than for the conventional pill bottles. Further exploration of this intervention in a larger study is warranted.

Evaluation and analysis of exposure levels of di(2-ethylhexyl) phthalate from blood bags

BACKGROUND

The US FDA and The Ministry of Health, Labor and Welfare of Japan have indicated that the risk assessment of di(2-ethylhexyl) phthalate (DEHP) released from polyvinyl chloride (PVC) medical devices requires immediate attention. In particular, the analysis of the exposure to DEHP from blood bags is very important for medical treatment. However, human exposure to DEHP via blood transfusion remains poorly understood. We evaluated DEHP and mono(2-ethylhexyl) phthalate (MEHP) levels, migration patterns, and metabolism in blood products for the detailed assessment of exposure to DEHP.

METHODS

A method that is based on column-switching liquid chromatography-electrospray mass spectrometry (LC-MS) coupled with on-line extraction was used for the direct analysis of DEHP and MEHP in the blood products. From the Japanese Red Cross Society, 78 blood products (red blood cell concentrate: n=18, irradiated red blood cell concentrate: n=18, whole blood: n=18, blood platelet: n=18, and frozen plasma: n=6) were sampled in January 2003 for use in this study.

RESULTS

The detection levels of DEHP and MEHP ranged from 1.8 to 83.2 microg/ml and from 0.1 to 9.7 microg/ml, respectively. The levels of MEHP and DEHP in the blood products were increased with increasing storage time. In addition, whole blood products in PVC bags had the highest DEHP levels compared to the other blood products. Our results indicate that the maximum level of human exposure to DEHP released from blood bags is 0.7 mg/kg weight/time.

CONCLUSION

This first quantitative evidence may be useful for the risk assessment of DEHP released from blood bags.

Out-of-pocket expenditures for oral contraceptives and number of packs per purchase

OBJECTIVE

Two potential barriers to use of oral contraceptives (OCPs) are out-of-pocket expenditures and the inconvenience of monthly pharmacy visits. This study used nationally representative data to examine the out-of-pocket costs of OCPs and whether women obtain more than 1 pack per purchase.

METHODS

We used data from the 1996 Medical Expenditure Panel Survey. Dependent variables were out-of-pocket expenditures per pack and the number of packs obtained per purchase. Chi2 tests were used to examine the bivariate relationships between the dependent variables and covariates. Regression analyses were used to examine the predictors of OCP expenditures and the number of packs obtained per purchase.

RESULTS

Women paid an average of 14 dollars per pack of OCPs, and 73% obtained only 1 pack per purchase. On average, privately insured women paid 60% of the total expenditures for OCPs. Women who had no prescription drug coverage, who were uninsured, or who were privately insured but not in managed care plans had higher out-of-pocket expenditures. Women who were without prescription drug coverage or who were in managed care plans were more likely to obtain only 1 pack per purchase.

CONCLUSION

Out-of-pocket costs and dispensing restrictions may be barriers to consistent use of OCPs. Women's health care providers should consider options to overcome these barriers, such as the use of mail order prescription services.

Myths and realities in medical packaging

This round-up of packaging myths provides a reality check on the real world of packaging medical products. Table I shows medical device FDA-assisted recalls due to packaging failures.

The importance of evaluating product dispensers when selecting alcohol-based handrubs

BACKGROUND

To promote improved hand hygiene among personnel, a hospital installed dispensers for an alcohol-based hand rinse throughout the facility. Soon after installation, dispensers began to malfunction and continued to do so despite efforts to rectify the problem.

METHODS

Sixteen months after installation, dispensers in all patient rooms were examined, and surveyors recorded the condition of dispensers, the number of times the dispenser lever was pressed to obtain product, how the product was delivered onto the hand, and a qualitative estimate of the volume delivered.

RESULTS

Of 166 dispensers, 2% were broken, 7% had no product container, 5% had an empty product container, 9% contained product but were totally obstructed, and 77% were functional. Of the 128 functional dispensers, 65% delivered product after a single stroke of the lever, 13% after 2 strokes, 9% after 3 strokes, and 13% after 4 or more strokes. Seventeen percent delivered a small volume onto the hand, and 16% squirted the product onto the wall or floor.

CONCLUSION

Evaluation of alcohol-based handrubs should consider not only product characteristics, user acceptability, skin tolerance, and cost but also the design and function of the dispensers that will ultimately be installed.

Definition of a correlation between microbiological and physical particulate barrier performances for porous medical packaging materials

An experimental set up, assembled principally from components of commercially available filter test equipment, has allowed assessment of physical particulate barrier performance of porous materials. Employing twelve specially made papers with graded and widely different barrier properties, a physical particulate/microbiological correlation has been derived covering the 50,000 fold range of microbiological barrier performances seen in commercial porous medical packaging materials. The derived correlation has been shown to be independent of sheet structure and is applicable to the diverse structures that comprise commercial materials. A simple measurement of particle penetration is proposed as a means of assessing microbial barrier properties of such materials.

The antibacterial activity of triclosan-impregnated storage boxes against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Bacillus cereus and Shewanella putrefaciens in conditions simulating domestic use

Antimicrobial resistance has increased over the past decade causing concern for public health. Domestic antimicrobial products containing triclosan (2,4,4'-trichloro-2'-hydroxydiphenylether), a broad-spectrum antibacterial agent, were introduced in 1997 and have become popular among consumers. Cross-resistance to other antibacterial agents has been suggested as a possible consequence of their widespread use. Triclosan-impregnated plastic storage boxes were tested for activity against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Bacillus cereus and Shewanella putrefaciens in various conditions, including some designed to simulate usual storage conditions. Results showed inhibition up to a factor of 106 of bacteria grown in direct contact with triclosan-impregnated plastic at 30 and 22 degrees C, but not at 4 degrees C. Triclosan resistance was not found to increase after repeated exposure in triclosan-impregnated boxes. Further investigation into the effect of triclosan-impregnated products on bacteria will increase understanding of domestic antimicrobial products and implications of their overuse.

Validating the packaging process using factorial designs

The development of an effective process requires a comprehensive understanding of two factors: the variables that can affect the process and the ability of the process to control those variables. This article examines the application of factorial designs in the qualification and validation of packaging systems. Using a case study to illustrate the concept, it describes a three-step approach that allows a reduction in the quantity of sampling compared with other experimental methods.

Market report. Packaging

Medical Device Technology's second annual packaging study looks at the materials and methods used by its readers throughout Europe. Rises in the level of use of some materials and certain packaging requirements are indicated and subcontracting shows increased demand.