Patients’Knowledge, Attitude and Practices on Disposal Methods of Expired and Unused Medicines: Implication for Creation of Drug Take-Back Program

Background: Handling of medicines is a day-to-day activity by patients and many health care providers. However, multiple studies have brought to light inappropriate disposal methods for expired and unused medication (EUM). Improper disposal of expired and unused medicines is hazardous both to humans and the environment. Objective: This sought to measure patients’ knowledge, attitude, and practices on disposal methods of EUM. Methods: A cross-sectional study was carried out among 384 patients at three outpatient pharmacies at the University Teaching Hospitals (UTHs). The structured questionnaire was used to collect data and STAT version 15.1 was used to analyse the data. Results: 384 respondents participated in this study and, at some point, had EUM. In this study, 356 (92.7%) of the participants reported that they had never heard of a drug take-back system. Most of the participants 285 (74.2%) and 239 (62.2%) kept and donated their unused medicine, respectively. Additionally, 244 (63.5%), 212 (55.2%), and 176 (44.8%) of the participants disposed of expired medicines in the bin or garbage, flushed them in toilets or sinks, or burned them, respectively. Occupation was significantly associated with unsafe disposal of unused medicine [P-value = 0.019]. Conclusion and Relevance: Knowledge of safe disposal methods for EUM was good amongst most participants. However, used unsafe disposal methods. The majority of the participants exhibited positive attitude concerning safe disposal methods. This study highlights the need for drug-take-back program creation in Zambia.

Study of the Management and Disposal Practices of Unused or Out-of-Date Medicines by Households in the Municipality of Ouagadougou, Burkina Faso

Introduction: Not all medicines that pass-through consumers’ hands are used, and some often expire in households. These health products can be sources of accidental risks and pollution when they are not properly disposed of. In Burkina Faso, there are as yet no guidelines for the disposal of unused medicines in households. The aim of this study was to estimate the extent of household possession of unused or expired medicines, and to describe attitudes and disposal practices. Methods: This was a descriptive cross-sectional study covering households in the Ouagadougou commune conducted from June to August 2021. Two-stage stratified sampling was used: selection of Enumeration Zones (EZs) and selection of households, with each EZ comprising several households. Data collection was based on direct interviews using a structured questionnaire. Data were processed using Epi Info software version 7.2.4.0. Results: In total, 417 household residents were surveyed out of the planned 423 households, corresponding to a completion rate of 98.58% compared with the initial sample. Among the respondents, 79.62% had unused and/or expired medicines in their household. A total of 2562 drug packaging units were counted, for a total weight of 121.90 kg. Nearly 75% were aware that improper disposal was a danger to the environment. Some respondents kept their unused medicines at home until they expired (43.41%), and disposed of them mainly by throwing them in the household garbage (75.58%). The majority (79%) were in favor of the government setting up a take-back program for these medicines. Conclusion: The introduction of a take-back program for unused or out-of-date medicines will ensure safer disposal of medicines, and better protection for households and the environment.

Perceptions on the risk and management of unused pharmaceuticals toward the creation of guidelines on handling and disposal

The increased usage of pharmaceuticals, its introduction to and accumulation in the environment are growing environmental and health concerns and have been a topic of interests for several years now. Active Pharmaceutical Ingredients (API) were developed and used because of their biological activity. It is this very nature of medicines that they may also have an untoward effect on animals and microorganisms and to the environment and an indirect effect on public health.

Assessment of Knowledge, Attitude and Practices towards the Disposal of Unused and Expired Medications among Students of Private Medical Universities in Lusaka, Zambia

Background: The disposal of unused and expired medications has been a concern in many countries in that, the pharmaceutical waste enters the ecosystem and eventually causes a negative impact on human health and environment. Aim: To assess the knowledge, attitude and disposal practices of unused and expired medicines by students in the private medical universities in Lusaka of Zambia. Method: A cross-sectional survey was conducted over a period of 8 weeks among 391 respondents from three private universities in Lusaka. Respondents were polled using semi structured questions that focused on their knowledge, attitudes, and disposal practices for unused and expired drugs. In order to analyze data, the statistical package for social sciences (SPSS) version 20 was utilized. Results: The mean age of the participants was 23 years (SD: ±3). Out of the 391 participants, 320 (81.8%) knew about medicine waste and 391 (100.0%) responded that unsafe disposal of unused and expired medicine poses a threat to human health and can harm the environment. The drug-take-back system was unknown to a vast percentage of the respondent 371 (94.9%). The majority 274 (70.1%) of respondents had unused medicine stored at home, with antibiotics 215 (56.0%) and analgesia 111 (28.4%) being the most prevalent types of drugs kept in the households. The most commonly used disposal practice for unused 126 (32.2%) and expired medicines 274 (70.1%) was throwing them in household garbage. Only 27 (6.9%) and 30 (7.7%) reported returning unused and expired medicines to the nearest pharmacy respectively. The majority of respondents believed the risk stemmed from the presence of an undesired drug in the home, the potential for harm to children, a lack of proper information on safe disposal practices, and the necessity for a take-back program. Conclusions: The majority of the study participants used unsafe methods to dispose of unused and expired medicine. However, most of the participants acknowledged that unsafe disposal of unused and expired medicines is a public health problem and proposed the need to introduce drug take-back programs in the communities.

Land cover change and eco-environmental quality response of different geomorphic units on the Chinese Loess Plateau

Land cover in the Chinese Loess Plateau has undergone dramatic changes since the late 1980s.Revealing the trend in land cover change and eco-environmental quality response of different geomorphic units in this stage is a realistic requirement for promoting sustainable development of the Chinese Loess Plateau.Based on the data of geomorphic units and land cover in 1990,2000,2010 and 2018 of the Chinese Loess Plateau,we studied the trend of land cover change and eco-environmental quality response of different geomorphic units by using a significance index of land cover change,a proportion index of land cover change and an eco-environmental response model.The results indicated that from 1990 to 2018,the areas of forestland and construction land substantially increased,whereas those of cropland,grassland,wetland and unused land considerably decreased.Land cover change exhibited large geomorphic differences,and the main conversion of land cover was from cropland into other land types.Unstable trend of land cover change in the loess tablelands and sandy loess hills declined,whereas the unstable trends in the other geomorphic units enhanced.Eco-environmental quality varied among different geomorphic units.The expansion of construction land and degradation of forestland,grassland and wetland resulted in the deterioration of eco-environmental quality.The conversion of cropland and unused land into forestland and grassland,and the conversion of grassland into forestland were the main factors that drove the improvement of eco-environmental quality.The findings of this study may provide theoretical reference and support decision making for the optimization of land use structure and the improvement of eco-environmental quality on the Chinese Loess Plateau.

Cultivation of <i>Erianthus</i>and Napier Grass at an Abandoned Mine in Lampung, Indonesia

The production of cellulosic bioethanol from non-edible plants is drawing increasing attention, as it potentially avoids food-fuel competition. Because growing such plants on farmland indirectly reduces food availability, the plants should be grown on marginal, non-arable lands. In this study, we evaluated the growth of cellulosic energy crops at a former mining site in Indonesia. This mine was abandoned because it contained few mineral deposits, and exposed subsoils rather than toxic soils prevented revegetation. In the first trial, growths of two energy plant species Erianthus spp. and Napier grass (Pennisetum purpureum) were compared with that of maize (Zea mays) at the mine site and a nearby degraded farm. Erianthus and Napier grass produced 11.7 and 22.5 t·ha-1 of shoot dry matter at 8 months after planting (MAP) in the farm respectively while maize plants failed to establish, but none of the three species grew at the mine. In the second trial, two-week-old seedlings of Erianthus and Napier grass rather than stem cuttings as used in the first trial were planted at the mine site. Erianthus and Napier grass produced 16.3 and 24.0 t·ha-1 of shoot dry matter over the course of 18 months, respectively. Application of organic fertilizer significantly increased shoot dry matter to 18.9 and 39.6 t·ha-1 in Erianthus and Napier grass, respectively. During the 18-month growth period, both of the energy plants significantly increased soil carbon at the 0 - 0.3 m depth from 0.33% to 1.15% - 1.23% when chemical fertilizer was applied and to 0.67% - 0.69% when both chemical and organic fertilizers were applied. From 0 - 5 MAP, soil surface level dropped by 28.0 - 34.7 mm in plots without plants due to soil erosion. In contrast, both of the energy plants significantly reduced the drop of soil surface level to 16.0 - 19.3 mm in plots with chemical fertilizer alone and to 18.0 - 20.7 mm in plots with chemical and organic fertilizers. Proportions of small soil particles, that would be easily detached and transported by water flow compared with large particles, were larger in the planted plots than the no-plant plots at 16 MAP. The results suggest that successful cultivation of energy plants on abandoned mine sites is possible, particularly if seedlings are transplanted and the crops are fertilized with organic fertilizer. In addition, the cultivation of Erianthus and Napier grass has positive impacts on soil quality that may contribute to their sustainability as crops and to the conservation of the local ecosystem.

Carbon sequestration benefits of the grain for Green Program in the hilly red soil region of southern China

Soil erosion disturbs not only the global carbon cycle,but it is a complex environmental problem.Revegetation could reduce carbon emission by controlling soil erosion and increase carbon sequestration and accumulation by fixing carbon in vegetation and soil.The Grain for Green Program(GFGP)of China is the largest ecological restoration program in the world closely related to land-use/land-cover change(LUCC).Systematically assessing the carbon sequestration benefit of GFGP is crucial for a better understanding of the effects of implementing GFGP and providing reasonable vegetation management.Therefore,we selected the hilly red soil region(HRSR)of southern China as a study area,which is one of the main ecologically vulnerable areas in China.We assessed the carbon sequestration in the GFGP area of the HRSR using the InVEST(Integrated Valuation of Environmental Services and Tradeoffs)model based on land-use/land-cover datasets during 2000e2015.Our results show that implementing GFGP is conducive to the enhancement of carbon sequestration services.Total carbon sequestration showed an increasing trend at a rate of 15.43%from 2000 to 2015.The most significant change mainly happened in Hunan Province with the shortest implementation time.The carbon sequestration of each carbon pool(namely aboveground biomass,belowground biomass,soil,and dead organic matter)also increased slightly.Additionally,for carbon sequestration,unused land converted to forest land is the most effective LUCC.This study can provide scientific support for the management and implementation of GFGP in the HRSR of China.

Identifying potential field sites for production of cellulosic energy plants in Asia

Cellulosic bioethanol produced from non-edible plants avoids food-fuel competition.Growing such plants on marginal non-arable lands also avoids the use of farmland.In this study,attempts were made to identify potential field sites for cellulosic bioethanol production in Asia.In this study,GIS databases containing information about requirements such as land use,landform,and climate were superimposed.Areas with terrestrial constraints were then removed from the candidate field sites using a terrain slope database.The remaining lands were evaluated using a net primary production(NPP)database.Of these areas,southern and eastern India,northeastern Thailand,and southern Sumatra(Indonesia)had high NPP.In the 2nd phase,local information regarding infrastructure,and agriculture were analyzed.Field-establishment feasibility was high for eastern India and southern Sumatra.Potential field sites were then located in satellite images of these two areas.In the 3rd phase,soils around potential sites were evaluated.Local residents were interviewed to estimate the cost of producing plants for biomass energy.Sites selected using this simple method are suitable for biomass production.