WHO calls for worldwide use of smart syringe

Use of the same syringe or needle to give injections to more than one person is driving the spread of a number of deadly infectious diseases worldwide. Millions of people could be protected from infections acquired through unsafe injections if all healthcare programmes switched to syringes that cannot be used more than once. For these reasons, the World Health Organisation (WHO) is launching a new policy on injection safety to help all countries tackle the pervasive issue of unsafe injections.

A 2014 study sponsored by WHO, which focused on the most recent available data, estimated that in 2010, up to 1.7 million people were infected with hepatitis B virus, up to 315,000 with hepatitis C virus and as many as 33,800 with HIV through an unsafe injection. New WHO injection safety guidelines and policy released provide detailed recommendations highlighting the value of safety features for syringes, including devices that protect health workers against accidental needle injury and consequent exposure to infection.

The study, "Evolution of the Global Burden of Viral Infections from Unsafe Medical Injections, 2000–2010", was authored by J Pépin et al.

WHO stresses the need to reduce the number of unnecessary injections as a critical way of reducing risk. There are 16 billion injections administered every year. Around 5% of these injections are for immunising children and adults, and 5% are for other procedures like blood transfusions and injectable contraceptives. The remaining 90% of injections are given into muscle (intramuscular route) or skin (subcutaneous or intradermal route) to administer medicines. In many cases these injections are unnecessary or could be replaced by oral medication.

Transmission of infection through an unsafe injection occurs all over the world. The new smart syringes WHO recommends for injections into the muscle or skin have features that prevent re-use. Some models include a weak spot in the plunger that causes it to break if the user attempts to pull back on the plunger after the injection. Others have a metal clip that blocks the plunger so it cannot be moved back, while in others the needle retracts into the syringe barrel at the end of the injection.

Syringes are also being engineered with features to protect health workers from "needle stick" injuries and resulting infections. A sheath or hood slides over the needle after the injection is completed to protect the user from being injured accidentally by the needle and potentially exposed to an infection.

WHO is urging countries to transition, by 2020, to the exclusive use of the new smart syringes, except in a few circumstances in which a syringe that blocks after a single use would interfere with the procedure. One example is when a person is on an intravenous pump that uses a syringe.

The organisation is also calling for policies and standards for procurement, safe use and safe disposal of syringes that have the potential for re-use in situations where they remain necessary, including in syringe programmes for people who inject drugs. Continued training of health workers on injection safety – which has been supported by WHO for decades – is another key recommended strategy.

Source: World Health Organisation