Search Results (63)

The extensive use of plastic-based materials in healthcare services has raised concerns about micro- and nanoplastic contamination in hospital environments, with potential implications for occupational health, environmental health, and public health nursing. This scoping review aimed to map the available evidence on occupational exposure to micro- and nanoplastics in healthcare settings, identifying exposure sources, pathways, potential health implications, and knowledge gaps, with particular attention to healthcare workers and nursing professionals. It was conducted following JBI methodology and reported according to PRISMA-ScR. Searches were performed in PubMed/MEDLINE, Scopus, Embase, LILACS, and SciELO for original studies published between January 2015 and December 2025 in English, Portuguese, or Spanish. Of 759 records identified, six studies met the eligibility criteria. Evidence was derived mainly from high-complexity healthcare settings, including operating theatres, anaesthetic rooms, laboratories, emergency departments, physiotherapy units, intensive care units, blood banks, and clinical areas. Indoor air, settled dust, disposable medical devices, plastic packaging, personal protective equipment, and plasticised materials were identified as potential exposure sources. Inhalation was the most frequently reported/inferred pathway, followed by dermal contact and indirect ingestion. Current evidence remains limited and heterogeneous, with scarce direct biomonitoring of micro- and nanoplastic particles and limited epidemiological data. Hospital environments may represent under-recognised settings for occupational exposure to micro- and nanoplastics, requiring standardised exposure assessment, environmental surveillance, biomonitoring, and preventive strategies aligned with occupational and public health nursing. Full article

Durable medical devices (DMD) are essential healthcare assets, yet their management in public hospitals is constrained by fragmentation, limited traceability, reactive maintenance, and weak lifecycle integration. This study proposes a framework for digitally enabled, sustainable, and circular DMD management. A mixed-methods design integrated a literature review, expert consultation using the Best–Worst Method, weighted technology nominations, and case-based process mapping in Brazilian hospitals. Eleven experts assessed the criteria guiding Industry 4.0 technology selection for DMD management and the technologies best responding to these priorities; nine consistent judgments were aggregated. Patient-Centered Care, Operational Efficiency, and Resource Efficiency and Cost Reduction emerged as the leading influences on technology selection. Big Data and Analytics, Artificial Intelligence, the Internet of Things, Cloud Computing, Cyber-Physical Systems, Smart Sensors, and Machine Learning formed the priority portfolio, accounting for 84% of the weighted score. The cases contextualized these priorities by revealing discontinuous information flows, limited asset visibility, corrective maintenance, fragmented governance, and weak end-of-life practices. By connecting decision priorities and technological capabilities with observed gaps, the TO-BE framework organizes sustainable procurement, traceable use, predictive maintenance, redeployment, refurbishment, and responsible disposal through material and information flows, providing a pathway for digital and circular transformation in resource-constrained healthcare systems. Full article

Explosive ordnance (EO), including AXO (abandoned explosive ordnance), IEDs (improvised explosives devices), and UXO (unexploded ordnance), are widely recognised for their blast and fragmentation hazards, but they also represent a persistent and under-addressed source of occupational chemical exposure for explosive ordnance disposal (EOD) personnel. EOD core activities liberate mixed metals and energetic chemicals, resulting in exposures that are multi-route (inhalation of dusts and fumes, dermal loading amplified by sweat and glove occlusion, and ingestion via hand-to-mouth transfer during eating, drinking, or smoking) and multi-temporal (repeated low-dose background plus task-driven spikes), as well as chemically complex. Clinically, this can present as syndromic overlap across acute and chronic domains, with symptoms that are easily misattributed to heat stress, dehydration, infection, or fatigue. Acute effects of concern include neurotoxic presentations (headache, dizziness, confusion, tremor, and seizure), respiratory and mucosal irritation following dust or fume events, gastrointestinal symptoms, and patterns suggestive of acute hepatic or renal stress, particularly when high-intensity tasks occur in hot environments that compound physiologic strain. Chronic outcomes relevant to repeatedly exposed EOD personnel include renal function decline, neurocognitive effects that can degrade operational decision making and safety, persistent haematologic abnormalities, and endocrine disruption signals, with long-latency risks requiring cautious interpretation given sparse longitudinal data and confounding co-exposures. This review synthesises the current evidence base through an EOD lens and translates it into pragmatic clinical and programmatic actions: task-based exposure characterisation; tiered biomonitoring and medical surveillance aligned to operational tempo; incident-triggered assessment pathways after high-residue events; and prevention strategies that work under field constraints, including contamination control zones, hygiene enforcement, glove and respiratory protection optimisation, tool and vehicle decontamination, and measures to prevent secondary transfer and take-home exposure. The central takeaway is practical: EOD programs can reduce morbidity and improve readiness by treating explosive ordnance as a chemical mixture exposure problem, adopting mixture-aware clinical triage, and embedding surveillance and controls that match how EOD work is actually performed. Full article

The escalating use of plastic medical products has made medical microplastics (MMPs) contamination an important health concern for specific populations (e.g., patients undergoing medical interventions) and has rendered it a growing focus in global environmental health research. This review systematically summarizes the release characteristics of MMPs throughout their life cycle from device manufacturing and clinical use to waste disposal, and elucidates human exposure pathways. For the general population, environmental exposure and dietary intake are the dominant exposure sources. In patients, however, invasive procedures and intravenous infusions serve as direct, high-concentration routes, enabling MMPs to enter the bloodstream directly. The article focuses on analyzing the molecular mechanisms underlying multisystem pathological effects induced by MMPs, including cardiovascular injury, respiratory dysfunction, digestive disorders, and reproductive toxicity, which involve key pathways such as oxidative stress, inflammatory responses, apoptosis, and dysregulated autophagy. Regarding existing detection technologies, we compare and evaluate the advantages and limitations of microscopic observation, spectral analysis, and chromatography–mass spectrometry in terms of sensitivity, specificity, and applicability, proposing that integrated technical strategies can significantly improve detection reliability. Finally, the review discusses current challenges and future research directions, including the establishment of standardized risk assessment frameworks, the development of highly sensitive in situ detection technologies, and the exploration of targeted intervention strategies. This work provides a theoretical basis for understanding the health risks of MMPs and offers valuable insights for formulating safety management policies for medical plastics. Full article

Despite the implementation of safety-engineered devices (SEDs) in Germany, percutaneous sharps injuries (PSIs) caused by medical devices remain a major occupational risk for healthcare workers. The aim of this study was to analyze the frequency of PSIs and the circumstances of SED-associated PSIs in hospitals, medical practices, and nursing homes. Routine data from a statutory accident insurance provider for 2015–2024 were used to analyze PSI trends (n = 481,575), and survey data from online questionnaires were used to analyze circumstances of PSIs (n = 791). Routine data showed a slight decline (6.1%) in PSIs over the past 10 years across all sectors. Hospitals and medical practices had the highest rates (30.2 and 21.6 PSIs per 1000 full-time equivalents, respectively). The devices most frequently involved were blood collection needles in hospitals and medical practices and insulin pens in nursing homes. Overall, 43.1% of PSIs were related to the improper disposal of used devices. Around 31.1% of PSIs were associated with SEDs. Around 33% of SED-related injuries occurred during disposal. High workload and distraction were the most frequently reported causes of injuries. Regular training should be provided to raise staff awareness of the proper handling and disposal of used devices. Full article

Electrochemical biosensors are becoming increasingly prevalent across medical, food, and bioprocessing industries for monitoring complex biological processes. However, their sensitivity to contamination and exposure to potentially hazardous biological species often necessitates single-use disposal, contributing to the release of high-value, high-demand, and environmentally damaging materials into the environment. This study investigates the feasibility of a closed-loop recycling process for single-use glucose biosensors, with a focus on the recovery and reuse of noble metals silver and gold. Guided by ecodesign principles and using low-impact materials, we developed a silver screen ink, gold syringe ink, and a poly(lactic acid) (PLA) substrate. Sensors were fabricated by additive manufacturing and screen printing—enabling the scalability afforded by screen printing to produce the high-coverage silver layer while also minimising gold ink waste using additive manufacturing. A low-energy recovery method that exploited selective solvent compatibility was developed to reclaim silver and gold. Second-generation devices were then fabricated, demonstrating performance comparable to commercial equivalents while achieving an 80% reduction in material usage, cost, and environmental impact across 16 categories using a life cycle assessment (LCA). Full article

Quantifying e-waste in Sub-Saharan Africa remains constrained by scarce data, weak institutional reporting, and the dominance of informal sector activity. We present the first nationwide assessment of e-waste generation and Random Forest-based national forecasting in Sierra Leone. A mixed-methods survey administered 6000 questionnaires across all 16 districts, targeting households, institutions, enterprises, and informal actors. The study documented devices in use, storage, and disposal across the following six categories: ICT, appliances, lighting, batteries, medical, and other electronics. Population growth and device adoption simulations were combined with lifespan distributions and a Random Forest model trained on survey and simulated historical data to construct e-waste flows and forecast quantities through to 2050, including disposal fate probabilities for repurposing versus discarding. The results showed sharp spatial disparities, with Western Urban (Freetown) averaging about 10 kg per capita compared to 1.8 kg per capita in rural areas. Long-term district patterns were highly concentrated: 50-year annual averages indicated that Western Area Urban contributes 15.3% of national totals, followed by Bo (12.7%) and Western Area Rural (12.1%), with the top five districts contributing 59.1%. By 2050, total national e-waste entering reuse and disposal pathways was projected to reach 23.4 kilo tons per year (kt yr⁻¹) with a 95% uncertainty interval (UI) of 11–42 kt yr⁻¹ (and a 99% interval extending to 50 kt yr⁻¹), corresponding to 0.9–3.4 kg/capita/year. Household appliances dominated total mass, ICT devices exhibited high reuse rates, and batteries showed minimal reuse despite high hazard potential. These findings provide critical evidence for e-waste policy, regulation, and infrastructure planning in data-scarce regions. Full article

Soft actuators are widely explored as movers in various devices, human–machine interfaces, for medical purposes and other biomedical applications. Among them are soft actuators based on a foamed silicone matrix with the working liquid (WL) captured in its pores that undergo the liquid–gas phase transition. For the first time, to gain the actuation strain of such composites, we added, to the WL, a substance that sublimates during the composite actuation. C1–C3 alcohols were tested as WLs, while the sublimation substance (SS) used was benzoic acid dissolved in the WL. It was found that the rejuvenation procedure is able to fill the composite pores with WL + SS solution. The effect of benzoic acid addition was revealed using the two-stage heating mode. The sublimation substance effectively extends the composite strain for methanol and ethanol as WL for about 20%. For C3 propanols, the strain is left nearly unchanged. In the open-air conditions, the high diffusion of WL + SS in silicone allows only a single actuation that makes it a disposable actuator, i.e., a kind of safety switch is proposed. The results obtained in this work pave the way to future, powerful multipurpose “soft safeties” appliances. Full article

Laser- and energy-based device (EBD) treatments in aesthetic medicine pose substantial environmental challenges, including high energy consumption, carbon emissions, and disposable medical waste. Although sustainable healthcare has gained global attention, no competency framework currently exists to guide physicians in integrating environmental sustainability into aesthetic medicine. This study applied McClelland’s (1973) Competency Model Theory (CMT) to develop a sustainability-oriented competency model for physicians specializing in laser and EBD treatments. Using a mixed-methods design, competency-based interviews were conducted to identify the key tasks and sustainability-related competencies, followed by expert panel validation using content validity and Kendall’s coefficient of concordance. The final model consists of 33 competencies across six domains: sustainable operations, regulatory and ethical knowledge, physician patient communication, dermatological science, EBD techniques, and maintenance care. Experts rated most competencies as highly or very highly important and frequently used, and Kendall’s W confirmed significant consensus across domains. The model provides standardized competency benchmarks that can support future curriculum development, professional training, and sustainable healthcare governance. This study extends CMT into the field of environmental sustainability in medicine and offers a structured framework to reduce ecological footprints and promote low-carbon, socially accountable practices. Full article

Recently, the incidence of diabetes has increased across all socioeconomic groups, with a notable increase in developing countries. Although advances in medical devices have enhanced healthcare accessibility, these benefits remain largely out of reach for individuals residing in remote areas. Concurrently, a variety of devices have been created to detect glucose biomarkers. Among these, microfluidic paper-based sensors have received substantial attention due to their affordability, disposability, and ease of production. Research on microfluidic paper-based glucose sensors has become particularly prominent owing to their considerable potential and wide applicability, especially in the integration of artificial intelligence and machine learning in glucose sensor processing. This review aims to examine recent advancements and progress in the development of microfluidic paper-based glucose sensors over the past five years, highlighting their advantages, limitations, and prospects. The sensors combined with artificial intelligence and machine learning have potential for future applications. Full article

The sustainability of the surgical workforce, environmental pollution caused by disposable instruments, and the rising costs of medical care are pressing issues worldwide. This review explores sustainable surgical practices for laparoscopic surgery through the application of surgical AI systems and reusable energy devices. Surgical AI systems enable the precise real-time visualization of organ anatomy, enhance surgical accuracy, and support educational initiatives. The Reusable Energy Device Laparoscopic-Assisted Colectomy (RE-LAC) technique, which employs reusable energy devices, has the potential to reduce medical waste and costs while maintaining safety and quality standards. A comparative analysis of RE-LAC and conventional disposable devices showed no significant differences in operative time or blood loss, suggesting that RE-LAC may be a viable alternative for sustainable surgical practice. These approaches align with the Sustainable Development Goals, contributing to sustainable healthcare by improving workforce efficiency, reducing environmental impacts, and promoting economic feasibility. Further large-scale, multi-institutional studies are necessary to optimize their implementation and maximize their global impact. Full article

The minimal instrumentation of portable medical diagnostic devices for point-of-care applications is facilitated by using chemical heating in place of temperature-regulated electrical heaters. The main applications are for isothermal nucleic acid amplification tests (NAATs) and other enzymatic assays that require elevated, controlled temperatures. In the most common implementation, heat is generated by the exothermic reaction of a metal (e.g., magnesium, calcium, or lithium) with water or air, buffered by a phase-change material that maintains a near-constant temperature to heat the assay reactions. The ability to incubate NAATs electricity-free and to further to detect amplification with minimal instrumentation opens the door for fully disposable, inexpensive molecular diagnostic devices that can be used for pathogen detection as needed in resource-limited areas and during natural disasters, wars, and civil disturbances when access to electricity may be interrupted. Several design approaches are reviewed, including more elaborate schemes for multiple stages of incubation at different temperatures. Full article

Background/Objectives: Abdominal ostomy surgery has a severe impact on individuals’ daily lives. These procedures are typically indicated for conditions such as cancer, inflammatory bowel disease, or traumatic injuries. They involve creating an artificial opening, denominated the stoma, in the abdominal area to divert feces or urine, establishing a connection between the affected organs and the body’s exterior. Thus, specialized products to collect the body fluids are required, being effective and tailored products crucial to enhance the quality of life of such patients. Methods: This paper presents a review of fecal fluid collection devices and advanced technologies designed to assist patients with ostomies. The study aims to identify the known bags/devices and evaluate their attributed performance in enhancing the population’s physical and social quality of life. This review is based on a systematic search conducted between 20 February and 2 March 2024, in the PubMed, Scopus, Web of Science, Google Scholar, and Google Patents databases. Articles published within the last eight years from this period were included in the analysis. Results: The devices found in the study were classified as passive, requiring active monitoring by the user, and active, providing automated assistance. Three main categories were identified, reflecting the most significant concerns of patients: (1) devices that control fluid leakage, reducing peristomal dermatological problems; (2) devices that minimize odors and noise, reducing social embarrassment; and (3) devices that monitor fluid volume, helping with electrolyte balance, especially in patients with ileostomies. Conclusions: This study revealed that the existing devices meet primary collection and disposal needs. However, introducing smart devices could offer greater control and confidence to users, providing real-time information on gas pressure, stool texture, and accumulated volume. Thus, overall, the development of advanced technologies can significantly improve patients’ quality of life, restore social confidence, and enable a more effective management of the condition by sharing information with medical teams. Full article

Nanofibers, with their high surface area-to-volume ratio and unique physical properties, hold significant promise for a wide range of applications, including medical devices, filtration systems, packaging, electronics, and advanced textiles. However, their development and commercialization are hindered by several key challenges and hazards. The main issues are production cost and yield, high voltage, clogging, and toxic materials driven by complex production techniques, which limit their adoption. Additionally, there are environmental and health concerns associated with nanofiber production and disposal, necessitating the development of safer and more sustainable processes and materials. Addressing these challenges requires continued innovation in materials science and industrial practices, as well as a concerted effort to balance production, material, and surrounding condition parameters. This study emphasizes the challenges and hazards associated with nanofiber materials and their production techniques, including electrospinning, centrifugal spinning, solution blow spinning, electro-blown spinning, wet spinning, and melt spinning. It also emphasizes biopolymers and recycling as sustainable and eco-friendly practices to avoid harming the environment and human beings. Full article

The use of plastic products or components in medical equipment and supplies results in challenges in terms of environmental sustainability and waste management for disposable, non-recyclable, and non-biodegradable materials. Medical plastic waste includes items ranging from syringes, tubing, intravenous (IV) bags, packaging, and more. Developing biodegradable replacements to petroleum-based plastics in medical equipment has not yet become an urgent priority, but it is an important endeavor. Examining alternatives involves several key themes, including material selection, testing, validation, and regulatory approval. To date, research includes studies on biodegradable polymers, composite materials, surface modifications, bacterial cellulose, three-dimensional (3D) printing with biodegradable materials, clinical trials and testing, collaboration with industry, regulatory considerations, sustainable packaging for medical devices, and life cycle analysis. The incorporation of bio-based and biodegradable plastics in the healthcare industry holds immense potential for reducing the environmental impact of medical plastic waste. The literature suggests that researchers and industry professionals are actively working towards finding sustainable alternatives that meet the stringent requirements of the medical industry. This paper reviews the efforts made so far to develop biodegradable and sustainable alternatives to plastic in medical equipment using a meta-analysis of resources, which include relevant papers published in English until June 2024. A total of 116 documents were found and screened by three reviewers for relevance. The literature reviewed indicated that various medical uses require plastics due to their unique properties, such as having strength and flexibility; being lightweight; and being able to prevent bacterial contamination. Among the alternatives, polycaprolactone (PCL), polylactic-co-glycolic acid (PLGA), starch-based acid, and polybutyric acid (PBS) have demonstrated favourable outcomes in terms of biocompatibility, safety, and efficacy. Additionally, a set of approaches to overcome these barriers and strategies is discussed alongside potential future solutions. This review aims to catalyze discussions and actions toward a more environmentally sustainable future in the medical industry by providing a comprehensive analysis of the current state, challenges, and prospects of this domain. Full article