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In health care facilities, pharmaceutical waste is generally discharged down the drain or sent to landfill. Poor knowledge about their potential downstream impacts may be a primary factor for improper disposal behavior. The objective of this study was to determine the impact of an intervention program on knowledge and practice of health care staff regarding pharmaceutical waste management. The study was designed as a pre/posttest intervention study. Total sample size was 530 in the pre-intervention phase, and then a subsample of 69 individuals was selected for the intervention and the post-intervention phases. Paired-sample t test was used to assess the difference between pretest and follow-up test results. A statistically significant improvement in knowledge and practice was achieved (P < 0.001). Poor knowledge and poor practice levels (scores <50%) were found to improve to satisfactory levels (scores ≥75%). Therefore, educational programs could be considered as an effective tool for changing health care staff practice in pharmaceutical waste management.Implications: In health care facilities, pharmaceutical waste is generally discharged down the drain or sent to landfill. A lack of knowledge about the potential impacts of this type of waste may be a leading factor in improper disposal behavior. Following an educational program, statistically significant improvement in knowledge and practice of health care staff as regards to pharmaceutical waste management (PWM) was achieved. It is thus recommended that authorities implement training-of-trainers (TOT) programs to educate health care staff on PWM and organize refreshment workshops regularly.PAPER HISTORY

Background:The Corniche is the main road that runs along Alexandria's coastline. Since 1998, certain developmental activities have been undertaken along this road, aiming at widening it in order to overcome the traffic congestion and to compensate for the erosion of some beaches. Objectives: to assess the impact of such developmental activities on the Mediterranean Sea water quality. Methods: During the period from July 2011 to March 2012, a single water sample was collected monthly during summer and winter seasons from four chosen beaches. Sea water samples were subjected to physical, chemical and microbiological examination. Wilcoxon signed-rank test was used to determine the variation in sea water quality following Corniche Road Widening Project. Besides, an assessment of the quality of sea water in the selected beaches was carried out by comparing different measured characteristics with national and/or international standards. Results: Results of the study revealed that Corniche Road Widening Project did not cause any statistically significant difference in any physicochemical characteristic of sea water in both Sidi-Bishr and Cleopatra beaches. As for Stanly beach, dissolved oxygen (DO) and nitrate increased significantly (to 7.7 ml O 2 /L and 3.9µmole/L respectively) and, in Shatby, DO increased while turbidity and alkalinity decreased significantly. They were found to be 7.7 ml O 2 /L, 0.045 NTU, and 1.6mEq/L respectively. Concerning the biological characteristics of sea water, there was a statistically significant difference in four parameters measured in Shatby beach. With respect to sea water quality, beaches under study were all complying with Egyptian guidelines, WHO and USEPA as regards physicochemical properties. Concerning microbiological quality, all samples were complying with WHO and EPA levels for enterococci except in August. Conclusion:The study recommends the use of best management practices for all construction projects with possible impacts on water bodies, and emphasizes the importance of environmental impact assessment studies and continuous monitoring of sea water quality for public health protection.

End-of-life tires constitute one of the biggest environmental concerns in terms of environmental pollution and resources conservation. This study aims to determine the best proportion of reclaimed rubber and crumb rubber to be added as part of the constituents used in the manufacturing of three different tire parts (tread, side wall, and inner liner) in order to produce standard products from a mix of both recycled and original ingredients. Batches were prepared into which reclaimed rubber and crumb rubber were added to the formulation of three different tire parts, in addition to one batch as reference according to the original formulation. Batches were analyzed according to national and international standards to select the optimum percentage that can be introduced in new tire formulation preparations. Results revealed that reclaimed rubber could be used as 15 parts per hundred rubber (phr) in radial tread compound and as 25 phr in either radial side wall or radial inner liner compounds. As for crumb rubber, results showed that it could be used as 10, 20 and 25 phr in radial tread, radial side wall or radial inner liner compounds respectively. Incorporating higher amounts of either reclaimed or crumb rubber would lead to violating the standards specified in vulcanized rubber tension property test and in oscillating disk cure meter test. Savings in raw material and in energy resulting from the use of reclaimed rubber was calculated: As concerns raw materials, adding 15 phr reclaimed rubber to the tread formulation would save about 7.7% of each of Styrene Butadiene Rubber (SBR), Polybutadiene and carbon black. Adding 25 phr reclaimed rubber to the side wall formulation would save about 12.8% of each of natural rubber, Polybutadiene and carbon black. Adding 25 phr reclaimed rubber to the inner liner formulation would save about 13% of each of natural rubber, SBR and carbon black. Regarding energy conservation, use of reclaimed rubber in new tires would result in a total energy conservation of 6393GJ/year. In addition to the raw material and energy conservation, the process was found to be cost-effective.

Health-care-associated infections (HAI) cause severe loss in health sector resources worldwide. Application of appropriate environmental health standards within the health care setting (HCS) can significantly reduce the transmission of these infections. This study were conducted in Alexandria with the objective of assessing the environmental health standards in some HCS in order to identify the degree of compliance with the guidelines set by the World Health Organization (WHO) and with the infection control measures set by the Ministry of Health (MOH), for the purpose of identifying major areas that require improvement within the health care sector. Ten hospitals were randomly selected in Alexandria Governorate to constitute the study sample: five hospitals were belonging to the private sector and five were public ones. Data collection were conducted using an assessment checklist pre-designed by the WHO, in addition to the chemical and bacteriological analysis of 30 water samples collected from the 10 hospitals. Results of the study revealed the absence of a water quality monitoring system within the HCS, poor maintenance in the plumbing system, lack of sufficient handwashing facilities, absence of suitable puncture-proof containers for sharp waste collection, inadequate laundry and catering services, absence of a High Efficiency Particulate Air (HEPA) filter, and a pressure gradient in all operating theaters and poor vector control especially in public hospitals. According to the WHO checklist, scores for hospital water supply (quality and quantity), water facilities, excreta disposal, health care waste management, laundry, food storage and preparation, vector control and the HCS construction and management were 69%, 62.5%, 63%, 72%, 64%, 89%, 78%, 63% and 44%, respectively. It is worth mentioning that at 95% level of significance, there was no statistical difference between the scores obtained by private hospitals and those obtained by public ones. Consequently, the study concluded that improvement is required in all hospitals and recommended some corrective measures.