Pharmaniaga Bhd, the sole pharmaceutical product supplier to public hospitals, said it would welcome a move by the Health Ministry to direct all hospitals to use safety syringes but medical experts have mixed opinions about the practicality of such a practice.

On Monday, Yap Chin Kwee - former political secretary of the country's first prime minister, Tunku Abdul Rahman Putra Al-Haj - alerted malaysiakini about the existence of safety syringes ( photo ) and called for a government directive for all public hospitals to use them to avoid needle-stick injuries.

Yap added that o­nly a handful of government hospitals Institut Jantung Negara, Universiti Sains Malaysia hospital and two armed forces hospitals have been using safety syringes for high-risk cases since last year.

Safety syringes are mandatory in the United States after a law was passed late 2000 to protect its medical staff from needle-stick injuries.

The specially designed syringe retracts and locks the needle in an unbreakable shield after it is used ( right, top ). The syringe, which is not reusable, can then be safely disposed of.

This eliminates the possibility of medical staff coming into contact with the needle. Each syringe has a shelf life of three to six years from the date of manufacture.

Not compulsory

Pharmaniaga confirmed that it purchased 457,000 syringes last March but the product was not received well among hospitals.

"We have about 400,000 syringes left.... It is not a compulsory item for the hospitals so they can choose to buy or not to buy them," said supply chain manager Masiah Abu Hassan when contacted.

She said the main reason for the lack of demand was the price of the safety syringe, which is more expensive than the ordinary disposable syringe currently used by most hospitals. ( See box )

Pharmaniaga had earlier forecasted 27 million safety syringes to be used over a period of three years from 2001, "but the forecast was too optimistic," said Masiah.

"We certainly hope that the Health Ministry would direct the hospitals to use the safety syringes. It is for the good of their medical staff," she added.

She denied that Pharmaniaga - a public-listed company controlled by United Engineers (M) Bhd - received any funds from the government for the stock purchase.

The government allocates an annual budget to hospitals which will then decide how the money is spent and what to purchase, Masiah explained.

According to her, another reason why safety syringes are not popular in Malaysia is the lack of awareness among medical practitioners and the public about needle-stick injuries.

Needle-stick accidents

National Institute for Occupational Safety and Health chairperson Lee Lam Thye said his organisation did not monitor needle-stick injuries but had heard about such accidents throughout the years.

Malaysian Medical Association president N Athimulam said he could not comment o­n the safety syringe because his organisation did not have sufficient statistics and facts about the syringe and needle-stick injury.

"It is also a policy matter which is the prerogative of the Health Ministry," he said.

Malaysian Nurses Association president Dayang Anne said the association's members will be asked if they had any problems using the ordinary syringes ( photo ).

Former Health Ministry director-general Abu Bakar Sulaiman said to start using safety syringes for high-risk cases as a "preventive measure" is a "logical thing to do".

"A person who suffers from a needle-stick injury will risk contracting any disease which can be transmitted through blood," he said.

Abu Bakar said the use of safety syringes is essential in ensuring the health of medical staff.

"There is no point curing a disease when you could have prevented it. This is why the safety syringe incurs more cost," he said.

However, assistant director of Hospital Kuala Lumpur Dr Ng Thiew Kim said safety syringes would not help solve the problem of needle-stick injury in Malaysia.

"There is a procedure for the medical staff to follow when they use ordinary syringes now. If they do not follow the procedure, they may still be injured when they are using safety syringes.

"It is like using a hammer - if you are careless, you will knock your fingernail," she said.

Ng said needle-stick injury was not a serious problem as all hospitals adopt a procedure in which used syringes are inserted into a disposal box without having to recap the needles.

She added that needle-stick injury has not resulted in any fatalities or disease infections in her hospital.

Strong lobby

The American Nurses Association (ANA) reported an annual average of 800,000 needle-stick injuries. This resulted in over 2,000 infected cases for Hepatitis C, 400 for Hepatitis B, and 35 for Human Immunodeficiency Virus (HIV).

In 2000, then US President Bill Clinton signed the Needle-stick Safety and Prevention Act in response to strong lobby by ANA for a new legislation that will require all health-care facilities to switch to needleless systems or use needles with engineered protection.

This action came following a 1998 accident in which Karen Daley, Massachusetts Nurses Association president, was confirmed to have contracted HIV and Hepatitis C from a needle-stick injury.