A new service for managing waste result from the care of patients undergoing self treatment

Visuel : de gauche à droite : Timothée Perache, Didier Gamerdinger et Caroline Rougaignon-Vernin

Crédit : © Michael Alesi / Direction de la Communication 

Waste produced by patients undergoing self-treatment that involves piercing the skin is hazardous waste that must follow a specific disposal stream to ensure the safety of people in the patient's entourage and the operatives in charge of waste collection and disposal.  This is both an environmental and a health issue. 

Monaco's Prince's Government wished to offer a simple, safe solution for patients undergoing self treatment and has thus added a regulation on waste to Monaco's legal system[1] with regard to the management of waste produced by patients undergoing self treatment that involves piercing the skin. 

The Eco-Organisation DASTRI has been mandated to deploy this system, which has been in place in France since 2013. 

On 28 September, the Prince's Government and DASTRI signed a joint undertaking.  This meeting will mark the launch of this new scheme. 

As from this date, all pharmacies will distribute yellow sharps boxes with green lids free of charge to patients undergoing self treatment (22 conditions are covered**) and to users of home testing kits for the diagnosis of transmissible infectious diseases. 

Once full (or at the end of the treatment), DASTRI sharps boxes must be returned by the patients to one of the 16 Monegasque dispensing chemists, which can be geolocated via the website www.dastri.fr/nous-collectons . 

Collection will be undertaken quarterly by PACADEM, the operator selected by DASTRI.  The waste will then be transported and treated by incineration in France, at the Energy Recovery Unit in Nice. 

Three box formats are available (see visuals):

• 2L box: primarily for sedentary patients who are suffering from chronic illnesses
• 1.5L:  primarily for people with continuous blood glucose meters and users of large injection pens (e. g. with a fixed needle).
• 0.5L box:  primarily for HIV self-test users, people who are travelling (e.g. for holidays), children, and people who have been prescribed short-term treatment

[1] And users of home-testing kits for infectious diseases

² Sovereign Ordinance No. 6.596 of 12 October 2017

A local, free, simple and safe service for the 2,000 or so patients concerned

This scheme is financed in its entirety by the health industries that market the medical devices concerned (which involve piercing the skin), used in self treatment in patients' homes, without any cost repercussions for the patients or for the community.

The involvement of all stakeholders (patients, health professionals, the community, etc.), in association with the eco-organisation, is essential for the smooth running of this scheme. 

About DASTRI 

DASTRI is a health-related eco-organisation, which was given approval for the second time in December 2016.  It is financed entirely by the healthcare industry.  DASTRI provides patients undergoing self treatment and users of diagnostic self tests for transmissible infectious diseases with a simple and safe local solution for the disposal of healthcare sharps waste that is produced in the home and represents a risk to the community.  DASTRI works in partnership with health and institutional stakeholders to reduce environmental impacts.

Further information:  www.dastri.fr  

The 22 conditions concerned and the associated medical devices

• Acromegaly
• Cluster headaches and migraines
• Anaemia secondary to chronic renal failure
• Systemic juvenile idiopathic arthritis
• Gouty arthritis
• Anaphylactic shock
• Immune deficiencies treated with subcutaneous immunoglobulin
• Diabetes
• Organic erectile dysfunction
• Severe A and B haemophilia
• Viral hepatitis
• Hypercholesterolemia
• HIV infection
• Ovarian infertility
• Chronic kidney failure
• Acute adrenal insufficiency
• Parkinson's Disease
• Venous thromboembolic disease
• Autoimmune diseases
• Severe postmenopausal osteoporosis
• Retarded growth in children and growth hormone deficiency
• Hypophosphatasia

Key to Image: 

The 12 Categories of Healthcare Sharps

Lancet and drum-style lancing device;  injection pen;  single needle;  micro-perfusor;  transfer set, bottle adapter, transfer needle, 2-vial mix;  lancing device;  catheter; MID-type all-in-one catheter;  injection pen with fixed needle or retractable needle;  fixed-needle syringe;  IMJECT-type syringe;  applicator