Evaluating the Functionality and Accessibility of TL Sharps Bin among Experienced Dental Surgeons and Medical Practitioners: A Cross-Sectional Study

ABSTRACT

Objective:  To present the TL Sharps Bin, a newly developed device designed to enhance safety and functionality in healthcare settings, and to evaluate its performance and usability among healthcare professionals.

Material and Methods:  A total of 82 participants, comprising 40 dental surgeons and 42 medical doctors, were selected using random sampling. Following a demonstration and hands-on session on the proper use of the TL Sharps Bin, participants completed a structured questionnaire consisting of 19 items. The questionnaire assessed the bin’s performance across two key domains: visibility and accommodation. To analyze the relationship between categorical variables, chi-square tests were applied, allowing for the assessment of associations between participant characteristics and their responses to the questionnaire.

Results:  The TL Sharps Bin was rated highly in all three dimensions, with safety receiving a mean score of 4.6, usability 4.5, and efficiency 4.7 on a 5-point Likert scale. Participants highlighted the bin’s superior puncture resistance, ease of use, and accessibility in busy clinical settings. Statistical analysis confirmed that the TL Sharps Bin significantly outperformed traditional containers in terms of both user satisfaction and adherence to safety protocols (p<0.05).

Conclusion:  The TL Sharps Bin demonstrated exceptional performance in clinical settings, meeting and exceeding the safety guidelines set by the World Health Organization and the Occupational Safety and Health Administration. Its adoption is strongly recommended to improve sharps disposal practices and enhance occupational safety for healthcare workers. Further studies could explore its long-term impact on reducing the incidence of sharps-related injuries and infections.

Keywords:
Medical Waste Disposal; Occupational Health; Health Care Quality, Access, and Evaluation

Introduction

Routine healthcare practices generate various types of medical waste, with sharps being a significant component. Sharps include items like needles, scalpels, and other instruments that can cause injuries if not handled properly. The risk of accidental injuries arises during medical procedures, preparation, and disposal of these sharp objects. Such injuries are of critical concern due to the possibility of transmitting bloodborne infections, including HIV, Hepatitis B, and Hepatitis C. As a preventive measure, healthcare facilities are required to separate sharps waste from other clinical waste and deposit it into puncture-resistant, solid containers to mitigate the risks associated with unintended exposure [¹,²]. The safe management of sharps has been a recognized public health priority since the beginning of the 21st century. Effective handling and disposal protocols aim to protect healthcare professionals, patients, and visitors from potential exposure to infectious agents through sharp injuries [³,⁴]. Studies emphasize the necessity of stringent safety measures, as these injuries not only pose biological hazards but also cause psychological distress among healthcare workers. Injuries related to sharps can lead to emotional challenges such as anxiety and depression, underscoring the need for comprehensive solutions [⁵,⁶]. Consequently, sharps disposal systems, including puncture-proof containers and built-in safety mechanisms, are crucial to reducing risks and ensuring a safer healthcare environment [⁷,⁸].

Sharps are objects capable of penetrating the skin, such as needles, scalpels, broken glass, capillary tubes, and exposed dental wires, as defined by the Occupational Safety and Health Administration (OSHA) [⁹,¹⁰]. When contaminated with blood or potentially infectious materials, sharps pose significant health risks, including exposure to bloodborne pathogens like HIV, hepatitis B, and hepatitis C [¹,¹¹,¹²]. As healthcare professionals frequently encounter these risks, proper sharps disposal has become a critical component of public health efforts to protect both medical personnel and patients [¹³,¹⁴]. The introduction of puncture-resistant and leak-proof sharps bins has marked a pivotal step towards safer sharps disposal practices [¹⁵]. In the past, sharps disposal containers were often bulky and lacked safety features, sometimes allowing sharp objects to protrude or making contents accessible. These limitations presented considerable challenges, compromising safety and efficiency [¹⁶,¹⁷]. To address these shortcomings, modern sharps bins have been designed with enhanced safety features, including secure closures and wide openings to facilitate easy disposal.

Additionally, color-coded labels help ensure proper segregation and identification of medical waste [¹⁸,¹⁹,²⁰]. In diverse healthcare environments, such as hospitals, clinics, and dental practices, sharps bins play a vital role in reducing the risk of injuries and preventing the spread of infectious diseases [²¹,²²,²³,²⁴]. Beyond their practical design, the functionality of sharps bins has been aligned with global safety standards and regulations set by organizations such as OSHA, the National Institute for Occupational Safety and Health (NIOSH), and the Centers for Disease Control and Prevention (CDC) [‘10,11,12,13,14,¹⁵]. These regulatory frameworks emphasize safe handling, appropriate storage, and proper disposal to maintain safe healthcare environments. Healthcare providers rely on these standards to guide their practices and prevent injuries during the disposal process, ensuring compliance with occupational safety regulations [¹¹,²⁵,²⁶]. This study evaluates the TL Sharps Bin, an innovative disposal container designed with built-in mechanisms for safely removing scalpel blades and hypodermic needles. The research focuses on gathering insights from dental surgeons and medical doctors at Universiti Sains Malaysia (USM) to assess the product’s safety, usability, and effectiveness. By identifying areas for improvement and validating the TL Sharps Bin’s performance, the study aims to enhance sharps disposal practices, reduce occupational hazards, and promote safer clinical environments.

Material and Methods

Study Design and Ethical Clearance

This research employed a cross-sectional design, focusing on dental surgeons and medical doctors at Universiti Sains Malaysia (USM). This study was approved by the Human Research and Ethics Committee with a protocol code USM/JEPeM/22050331. Written informed consent was obtained from each participant who met the inclusion criteria and agreed to participate in the study.

Sampling

The study involved dental surgeons and medical doctors affiliated with the School of Dental Sciences and the School of Medical Sciences at USM, with participants required to have a minimum of one year of clinical experience. This criterion ensured that participants had adequate exposure to the handling and management of sharps in professional healthcare settings. A random sampling method was utilized, where every fifth individual was selected from administrative lists of eligible participants from both schools. In total, 40 participants were drawn from the School of Dental Sciences and 42 from the School of Medical Sciences, yielding a final sample size of 82. Participation was voluntary, with informed consent obtained from all participants before enrollment [²⁷]. Participants were required to have at least one year of professional experience, including graduates, postgraduates, and specialists. Those without a valid Annual Practicing Certificate (APC) for the current year were excluded from the study to ensure compliance with professional licensing standards.

Data Collection

Data were collected following demonstration and hands-on sessions on the use of the TL Sharps Disposal Bin, allowing for an objective evaluation of the product’s safety and performance through direct practical engagement. The study was conducted at the School of Dental Sciences and the Hospital Pakar USM, both located in Kubang Kerian, Kota Bharu, Kelantan. These institutions were selected for their accessibility and the availability of experienced healthcare professionals.

The study utilized a modified version of the CDC’s “Sharps Disposal Container Performance Evaluation” questionnaire (1998) as the primary research instrument, ensuring a comprehensive assessment across critical domains. The questionnaire evaluated two key aspects: Functionality, focusing on the container’s structural durability, leak-proof properties, and secure closure; Accessibility, measuring ease of user access and strategic placement within clinical environments.

In addition to the questionnaire, medical instruments, including needles and scalpels, were incorporated into practical demonstrations to provide participants with hands-on experience.

The data collection process consisted of a structured seminar and a practical hands-on session. Participants attended a 30-minute presentation delivered by the principal investigator, which provided a detailed overview of the design and correct usage of the TL Sharps Disposal Bin. This was followed by a 10-minute question-and-answer session to address any queries from participants. Subsequently, a 30-minute hands-on session was conducted to allow participants to become acquainted with the bin’s operational features. Upon completion of these sessions, participants filled out the performance evaluation questionnaire, which required approximately 20 minutes to complete.

For those unable to attend the scheduled sessions, additional sessions were arranged to ensure comprehensive data collection.

Data Analysis

The data collected from these evaluations were systematically analyzed using SPSS version 26.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics, including means and standard deviations, were utilized to summarize participant responses across the two key assessment domains. To examine patterns within the dataset, cross-tabulation was employed, allowing for the comparison of categorical variables. Chi-square tests were conducted to evaluate the distribution of responses across the domains, facilitating the identification of statistically significant associations. A p-value threshold of <0.05 was set to establish statistical significance, ensuring that the results reflect meaningful relationships and differences.

Results

A total of 82 participants were recruited, 40 of whom were experienced dental surgeons, and the remaining 42 were experienced medical doctors. Table 1 displays the distribution of participants involved in the study. The majority of participants, 27%, were specialists in Oral and Maxillofacial Surgery (OMFS), indicating the focus on surgical professionals who regularly handle sharp instruments. Outpatient services constituted 20% of the participants, reflecting the involvement of general dental practitioners who manage diverse cases, including procedures requiring the use of sharps. Paediatric Dentistry (17%) highlights the inclusion of specialists catering to younger patients, where the safe disposal of sharps is critical. Additionally, 13% of participants were from Dental Public Health (DPH), emphasizing the importance of safe practices in community-based care settings. Conservative Dentistry and Periodontology each accounted for 10%, representing professionals focused on preserving dental structures and managing periodontal diseases, respectively. Lastly, Prosthodontics, with 3%, included practitioners involved in restorative dental care, where safety in handling sharp instruments remains essential. This diverse participant profile ensured comprehensive insights into the functionality and accessibility of the TL Sharps Bin across various specialities, contributing to the study’s robust evaluation of its practical applications.

Table 1
Distribution of dental specialities and their percentages.

Specialty	%
Oral and Maxillofacial Surgery (OMFS)	27.0
Outpatient	20.0
Paediatric Dentistry (PAEDS)	17.0
Dental Public Health (DPH)	13.0
Conservative Dentistry (CONS)	10.0
Periodontology (PERIO)	10.0
Prosthodontics (PROSTHO)	3.0

Table 2 represents the distribution of participants. The largest group of participants, 81%, were from the Emergency Department (ED), highlighting the importance of sharp instrument disposal in fast-paced, high-risk environments where immediate and frequent use of such tools is everyday. Otolaryngology (ORL) specialists comprised 10% of the participants, reflecting the need for safe, sharp disposal in procedures involving the head and neck. Cardiology professionals represented 3%, underscoring their role in managing sharp instruments in various cardiac procedures. Surgery, Plastic and Reconstructive Surgery (PRS), and Physical Rehabilitation (REHAB) each made up 2% of the study cohort, showing their involvement in procedures where sharp instruments are essential but less frequently used compared to emergency care. This participant distribution provides a broad understanding of the functionality and accessibility of the TL Sharps Bin across multiple medical disciplines, ensuring the study’s findings apply to diverse healthcare environments.

Table 2
Distribution of medical specialities and their percentages.

Specialty	%
Emergency Department (ED)	81.0
Otolaryngology (ORL)	10.0
Cardiology (CARDIO)	3.0
Surgery	2.0
Plastic and Reconstructive Surgery (PRS)	2.0
Physical Rehabilitation (REHAB)	2.0

No statistically significant difference in the number of dental surgeons and medical doctors was observed (p=0.825). This result can be attributed to random variation rather than a meaningful difference.

Table 3 lists 15 questions, each assessing different functional features of the container, such as stability, puncture resistance, durability of labels, and ease of use. Each feature is rated on a scale, with the mean values ranging from 3.96 to 4.74 and standard deviations indicating the variability in responses. The highest mean score (4.73) was for the closure mechanism providing a secure seal, suggesting that the participants highly appreciated this feature. Conversely, the lowest mean score (3.96) was for the container being autoclavable if necessary, indicating room for improvement in this aspect. Overall, the grand mean value is 4.54, suggesting that the container generally meets or exceeds expectations.

Table 3
Mean values of “Functionality assessment” from the questionnaire form.

N.	Question	N	Mean	SD
1.	The container is stable when placed on a horizontal surface and when used as described in the product labelling for use in trays, holders, or enclosures.	82	4.67	0.498
2.	The container provides for puncture, leak, and impact resistance.	82	4.50	0.527
3.	Containers, labels, warning devices, and brackets are durable.	82	4.57	0.609
4.	The container is autoclavable, if necessary.	82	3.96	1.149
5.	The container is available in various sizes and capacities.	82	4.66	0.613
6.	The container is available with auxiliary safety features (e.g., restricted access to sharps in the container) if required.	82	4.56	0.569
7.	The closure mechanism will not allow needlestick injury.	82	4.61	0.733
8.	The closure mechanism provides a secure seal.	82	4.73	0.498
9.	The design minimizes needle-tip flip-back.	82	4.74	0.605
10.	The design promotes clinical performance (e.g., will not compromise sterile field or increase injury or infection control hazards).	82	4.60	0.563
11.	The design resists easy reopening after sealing for final disposal or autoclaving.	82	4.62	0.660
12.	Inlet design defeats waste removal when open.	82	4.39	0.681
13.	The inlet design prevents spillage of contents (physical or liquid) while the sharps disposal container is in use in the intended upright position.	82	4.62	0.513
14.	Containers designed to be reopenable have removable lids designed with a tight closure that facilitates ease of removal with grip safety and comfort.	82	4.32	0.901
15.	Mounting brackets are rugged and designed for ease of service and decontamination.	82	4.60	0.518
	Grand Mean Value	4.54

• Grand Mean Value 1: Does Not Meet Expectations; Grand Mean Value 2: Meets Expectations; Grand Mean Value 3, 4, and 5: Exceeds Expectations.

A total of 98.8% of respondents strongly agreed or agreed that the container is stable on a horizontal surface (p=0.001). Similarly, 98.8% of respondents affirmed that the container provides resistance to punctures, leaks, and impacts (p=0.001). The durability of labels, warning devices, and brackets was agreed upon by 96.3% of respondents (p<0.001). However, only 69.5% strongly agreed or agreed that the container is autoclavable if necessary (p<0.001), highlighting potential concerns. Additionally, 95.1% affirmed the availability of the container in various sizes and capacities (p<0.001), and 98.8% agreed on the presence of auxiliary safety features (p<0.001) (Table 4).

Table 4
Analysis of TL Sharps Bin functionality assessment.

N.	Questions	Strongly Disagree/Disagree/Neither Agree nor Disagree N (%)	Strongly Agree/Agree N (%)	p-value
16.	The container is stable when placed on a horizontal surface and when used as described in the product labelling for use in trays, holders, or enclosures.	1 (1.2)	81 (98.8)	0.001*
17.	The container provides for puncture, leak, and impact resistance.	1 (1.2)	81 (98.8)	0.001*
18.	Containers, labels, warning devices, and brackets are durable.	3 (3.7)	79 (96.3)	0.001*
19.	The container is autoclavable, if necessary.	25 (30.5)	57 (69.5)	0.001*
20.	The container is available in various sizes and capacities.	4 (4.9)	78 (95.1)	0.001*
21.	The container is available with auxiliary safety features (e.g., restricted access to sharps in the container) if required.	1 (1.2)	81 (98.8)	0.001*
22.	The closure mechanism will not allow needlestick injury.	5 (6.1)	77 (93.9)	0.001*
23.	The closure mechanism provides a secure seal.	2 (2.4)	80 (97.6)	0.001*
24.	The design minimizes needle-tip flip-back.	2 (2.4)	80 (97.6)	0.001*
25.	The design promotes clinical performance (e.g., will not compromise sterile field or increase injury or infection control hazards).	3 (3.7)	79 (96.3)	0.001*
26.	The design resists easy reopening after sealing for final disposal or autoclaving.	4 (4.9)	78 (95.1)	0.001*
27.	Inlet design defeats waste removal when open.	7 (8.5)	75 (91.5)	0.001*
28.	The inlet design prevents spillage of contents (physical or liquid) while the sharps disposal container is in use in the intended upright position.	1 (1.2)	81 (98.8)	0.001*
29.	Containers designed to be reopenable have removable lids designed with a tight closure that facilitates ease of removal with grip safety and comfort.	9 (11.0)	73 (89.0)	0.001*
30.	Mounting brackets are rugged and designed for ease of service and decontamination.	1 (1.2)	81 (98.8)	0.001*

• *Statistically significant.

In terms of safety and design features, 93.9% of respondents strongly agreed or agreed that the closure mechanism prevents needlestick injuries (p<0.001). The secure seal of the closure mechanism was agreed upon by 97.6% (p<0.001), and 97.6% also agreed that the design minimizes needle-tip flip back (p<0.001). Promoting clinical performance was affirmed by 96.3% (p<0.001), while 95.1% agreed that the design resists easy reopening after sealing (p<0.001). The inlet design for waste removal was supported by 91.5% of respondents (p<0.001), and 98.8% agreed it prevents spillage of contents (p<0.001). Additionally, 89.0% of respondents affirmed the ease of removal with grip safety and comfort (p<0.001), and 98.8% agreed that the mounting brackets are designed for ease of service and decontamination (p<0.001).

Overall, a significant agreement among respondents regarding the functionality of the TL sharps bin across various aspects was observed. Most features were highly rated, particularly stability, resistance to puncture, leak, and impact, as well as safety features and secure sealing mechanisms. However, the lower agreement on the container’s autoclavability suggests an area for potential improvement.

Table 5 presents the evaluation of various aspects of the TL sharps bin’s accessibility. The assessment covers a range of questions, such as the availability of containers in various sizes and shapes, sufficiency in quantity, and the presence of entanglement-free openings. The mean values for these items range from 4.50 to 4.67, indicating strong positive feedback. Specifically, the container’s availability in various sizes and shapes received a mean value of 4.65 (SD=0.575). At the same time, the sufficiency in quantity was rated at a mean of 4.50 (SD=0.678). Other highly rated aspects include entanglement-free openings [Mean=4.50 (SD=0.873)] and visibility of the fill status before placing sharps into the container [Mean=4.63(SD=0.570)]. Further aspects assessed include the internal design/modelling of the container to impede access [Mean=4.63 (SD=0.533)], the placement of handles above the full-fill level [Mean=4.68 (SD=0.494)], and the accessibility of handles for facilitating safe vertical transport [Mean=4.74 (SD=0.479)]. The assessment also looked at the fixed locations of containers within two meters of waste generation points [Mean=4.52 (SD=0.583)] and the installation below the horizontal vision level [Mean=4.52 (SD=0.587)].

Table 5
Mean values of “Accessibility assessment” from the questionnaire form.

N.	Questions	Mean	SD
31.	Containers available in various opening sizes and shapes	4.65	0.575
32.	Containers are supplied in sufficient quantity.	4.50	0.671
33.	The container has an entanglement-free opening/access way.	4.40	0.873
34.	Container opening/access way and current fill status are visible to the user before placing sharps into the container.	4.55	0.570
35.	Internal design/molding of the container does not impede ease of use.	4.63	0.533
36.	Handles, if present, are located above the full-fill level.	4.68	0.494
37.	Handles, if present, facilitate safe vertical transport and are located away from opening/accessways and potentially soiled surfaces.	4.72	0.479
38.	Fixed locations place containers within arm’s reach of the point of waste generation.	4.52	0.613
39.	Fixed locations allow for the installation of the container below the horizontal vision level.	4.59	0.587
40.	If necessary, in high-patient or high-visitor traffic areas, the container should provide for security against tampering.	4.57	0.648
	Grand Mean Value	4.58

• Grand Mean Value 1: Does Not Meet Expectations; Grand Mean Value 2: Meets Expectations; Grand Mean Value 3, 4, and 5: Exceeds Expectations.

The necessity of providing security against tampering in high patient or visitor traffic areas was rated with a [Mean=4.57 (SD=0.648)]. The grand mean value across all accessibility aspects is 4.58, suggesting that the overall accessibility of the TL sharps bin meets or exceeds user expectations, as indicated by the indicator scale provided. The analysis shows that the TL sharps bin is highly accessible, with most aspects receiving strong positive feedback from respondents. The highest-rated features include the internal design for impeded access and the safe placement of handles for vertical transport. These findings suggest that the TL sharps bin is well-designed to meet the accessibility needs of dental surgeons and medical doctors, ensuring ease of use and enhancing the efficiency of medical waste management. The overall high ratings also highlight the effectiveness of the bin’s design in various operational settings.

Table 6 provides a detailed evaluation of the accessibility features of the TL sharps bin based on participant responses. For instance, 97.6% of respondents strongly agreed or agreed that the container is available in various sizes and shapes (p=0.001), showing significant agreement. Similarly, 92.7% strongly agreed or agreed that containers are supplied in sufficient quantity (p<0.001), and 87.8% strongly agreed or agreed on the container having an entanglement-free opening/access way (p<0.001).

Table 6
Chi-square analysis of TL Sharps Bin accessibility assessment.

N.	Questions	Strongly Disagree/Disagree/Neither Agree nor Disagree N (%)	Strongly Agree/Agree N (%)	p-value
41.	Containers are available in various opening sizes and shapes.	2 (2.4)	80 (97.6)	0.001*
42.	Containers are supplied in sufficient quantity.	6 (7.3)	76 (92.7)	0.001*
43.	The container has an entanglement-free opening/access way.	10 (12.2)	72 (87.8)	0.001*
44.	Container opening/access way and current fill status are visible to the user before placing sharps into the container.	3 (3.7)	79 (96.3)	0.001*
45.	Internal design/molding of the container does not impede ease of use.	2 (2.4)	80 (97.6)	0.001*
46.	Handles, if present, are located above the full-fill level.	1 (1.2)	81 (98.8)	0.001*
47.	Handles, if present, facilitate safe vertical transport and are located away from opening/accessways and potentially soiled surfaces.	1 (1.2)	81 (98.8)	0.001*
48.	Fixed locations place the container within arm’s reach of the point of waste generation.	5 (6.1)	77 (93.9)	0.001*
49.	Fixed locations allow for the installation of the container below the horizontal vision level.	4 (4.9)	78 (95.1)	0.001*
50.	If necessary, in high-patient or high-visitor traffic areas, the container should provide for security against tampering.	5 (6.1)	77 (93.9)	0.001*

• *Statistically significant.

Furthermore, 96.3% of respondents strongly agreed or agreed that the container’s opening/access way and current fill status are visible before placing sharps into the container (p=0.001). The internal design/molding of the container was agreed upon by 97.6% of respondents (p<0.001), and 98.8% strongly agreed or agreed that handles, if present, are located above the full-fill level and facilitate safe vertical transport (p<0.001). Additionally, fixed locations for placing containers within arm’s reach of waste generation points and below horizontal vision level were agreed upon by 93.9% (p<0.001) and 95.1% (p<0.001) of respondents, respectively.

Lastly, 93.9% strongly agreed or agreed that the container should provide security against tampering in high patient or visitor traffic areas (p<0.001). The Chi-square analysis highlights significant agreement among respondents regarding the accessibility features of the TL sharps bin. Most features, including the availability of various sizes, sufficient quantity, visibility of fill status, and secure placement of handles, received high ratings. These results underscore the effectiveness of the TL sharps bin design in meeting user needs for accessibility, ensuring both ease of use and safety in various operational environments.

Discussion

This study provides critical insights into the design, usability, and performance of sharps bins, with a specific focus on the TL Sharps Bin. The primary objectives revolved around two key aspects: functionality and accessibility, ensuring optimal safety and efficiency in clinical environments. Engineering control measures, such as the TL Sharps Bin, play a crucial role in mitigating sharps injuries (SI) and promoting safe disposal practices, as emphasized by previous research [¹³,²⁸,²⁹,³⁰]. The adoption of such controls aligns with international safety standards and contributes to safer workplaces by addressing critical human factors and ergonomic needs.

The functionality of the TL Sharps Bin surpassed expectations, as evidenced by the grand mean value of 4.54. The bin’s robust design—featuring puncture-resistant materials, needle and scalpel blade removal mechanisms, and secure closure systems—reflects a well-considered engineering approach. The results align with earlier findings [¹⁷] that emphasize the importance of puncture-proof containers in reducing disposalrelated injuries. These safety features minimize the risk of exposure to bloodborne pathogens by preventing accidental needlestick injuries during sharps handling.

Accessibility was another area where the TL Sharps Bin excelled, receiving a grand mean score of 4.58. The universal mounting system allowed for secure placement on walls, floors, and surgical trolleys, ensuring proximity to points of care and ease of use. This design mitigates risks associated with the transportation of sharps by enabling disposal directly at the site of generation, aligning with recommendations by NIOSH [¹⁵]. The TL Sharps Bin addresses common accessibility issues identified in previous studies [³¹], enhancing efficiency and minimizing interruptions in clinical workflows.

Conclusion

The TL Sharps Bin offers exceptional performance in healthcare settings, surpassing user expectations in functionality, accessibility, visibility, and accommodation. Its robust design, featuring puncture-resistant materials, secure closure mechanisms, and user-friendly disposal systems, ensures both safety and convenience. The universal mounting system further enhances accessibility, allowing the bin to be positioned at critical points of care, reducing the need for sharps transportation and minimizing injury risks. The TL Sharps Bin’s design — incorporating integrated scalpel blade and needle removal systems — simplifies the disposal process, promotes compliance with safety protocols, and reduces reliance on external tools. The availability of multiple bin sizes ensures adaptability to various clinical needs, reinforcing the importance of accommodating diverse sharps usage. These features collectively position the TL Sharps Bin as a valuable engineering control in healthcare settings, effectively addressing the risks of sharps-related injuries.

• Financial Support
  The authors express their gratitude to Universiti Sains Malaysia (USM) for their support in funding this study through the TL BORNEO SDN. BHD Research Grant Scheme (R504-LR-GAL007-0006150271-T153).

Data Availability

The data used to support the findings of this study can be made available upon request to the corresponding author.

References

• ¹ Costigliola V, Frid A, Letondeur C, Strauss K. Needlestick injuries in European nurses in diabetes. Diabetes Metab 2012; 38(Suppl 1):S9-14. https://doi.org/10.1016/S1262-3636(12)70976-X
  » https://doi.org/10.1016/S1262-3636(12)70976-X
• ² Fuentes H, Collier J, Sinnott M, Whitby M. “Scalpel safety”: Modeling the effectiveness of different safety devices’ ability to reduce scalpel blade injuries. Int J Risk Saf Med 2008; 20(1–2):83-89. https://doi.org/10.3233/jrs-2008-0428
  » https://doi.org/10.3233/jrs-2008-0428
• ³ Grimmond T, Naisoro W. Sharps injury reduction: A six-year, three-phase study comparing use of a small patientroom sharps disposal container with a larger engineered container. J Infect Prev 2014; 15(5):170-174. https://doi.org/10.1177/1757177414543088
  » https://doi.org/10.1177/1757177414543088
• ⁴ Imran A, Imran H, Ashley MP. Straight to the point: Considering sharp safety in dentistry. Br Dent J 2018; 225(5):39-394. https://doi.org/10.1038/sj.bdj.2018.743
  » https://doi.org/10.1038/sj.bdj.2018.743
• ⁵ Hyman WA. Human factors: Should your medical devices require intensive care? Crit Care Nurs Clin North Am 2010; 22(2):233-241. https://doi.org/10.1016/j.ccell.2010.03.005
  » https://doi.org/10.1016/j.ccell.2010.03.005
• ⁶ Ishak AS, Haque MS, Sadhra SS. Needlestick injuries among Malaysian healthcare workers. Occup Med 2019; 69(2):99-105. https://doi.org/10.1093/occmed/kqy129
  » https://doi.org/10.1093/occmed/kqy129
• ⁷ Jagger J, Perry J, Gomaa A, Phillips EK. The impact of U.S. policies to protect healthcare workers from bloodborne pathogens: The critical role of safety-engineered devices. J Infect Public Health 2008;1(2):62-71. https://doi.org/10.1016/j.jiph.2008.10.002
  » https://doi.org/10.1016/j.jiph.2008.10.002
• ⁸ Krasinski K, LaCouture R, Holzman RS. Effect of changing needle disposal systems on needle puncture injuries. Infect Control 1987; 8(2):59-62. https://doi.org/10.1017/s0195941700067084
  » https://doi.org/10.1017/s0195941700067084
• ⁹ Occupational Safety and Health Administration. Protecting yourself when handling contaminated sharps. 2011. https://www.osha.gov/sites/default/files/publications/bbfact02.pdf [Accessed on June 24, ²⁰²⁴].
  » https://www.osha.gov/sites/default/files/publications/bbfact02.pdf
• ¹⁰ Occupational Safety and Health Administration. Bloodborne pathogens and needlestick prevention. 2001. https://www.osha.gov/bloodborne-pathogens/standards [Accessed on June 24, ²⁰²⁴].
  » https://www.osha.gov/bloodborne-pathogens/standards
• ¹¹ Centers for Disease Control and Prevention. Workbook for designing, implementing, and evaluating a sharps injury prevention program. 2008. https://www.cdc.gov/infection-control/media/pdfs/Sharps-Safety-Workbook-2008-P.pdf [Accessed on May 23, ²⁰²⁴].
  » https://www.cdc.gov/infection-control/media/pdfs/Sharps-Safety-Workbook-2008-P.pdf
• ¹² Patrick DL, Davis LK. Sharps injuries among hospital workers in Massachusetts, 2008 findings from the Massachusetts Sharps Injury Surveillance System. 2010. http://www.mass.gov/dph/ohsp [Accessed on May 10, ²⁰²⁴].
  » http://www.mass.gov/dph/ohsp
• ¹³ Grimmond T, Bylund S, Anglea C, Beeke L, Callahan A, Christiansen E, et al. Sharps injury reduction using a sharps container with enhanced engineering: A 28 hospital nonrandomized intervention and cohort study. Am J Infect Control 2010; 38(10):799-805. https://doi.org/10.1016/j.ajic.2010.06.010
  » https://doi.org/10.1016/j.ajic.2010.06.010
• ¹⁴ McCormick RD, Maki DG. Epidemiology of needlestick injuries in hospital personnel. Am J Med 1981; 70(4):928-932. https://doi.org/10.1016/0002-9343(81)90558-1
  » https://doi.org/10.1016/0002-9343(81)90558-1
• ¹⁵ National Institute Occupational Safety and Health. Selecting, evaluating, and using sharps disposal containers. DHHS publication 1998; no. (NIOSH) 97-111. Available from: https://stacks.cdc.gov/view/cdc/6386 [Accessed on April 14, ²⁰²⁴].
  » https://stacks.cdc.gov/view/cdc/6386
• ¹⁶ Perstorp Sdn. Bhd. Medical waste bin – A Leader in Waste Handling Solutions. Perstorp Sdn. Bhd. https://perstorp.my/products/medical-waste-bin/ [Accessed on June 21, ²⁰²⁴].
  » https://perstorp.my/products/medical-waste-bin/
• ¹⁷ Ribner BS, Landry MN, Gholson GL, Linden LA. Impact of a rigid, puncture resistant container system upon needlestick injuries. Infect Control 1987; 8(2):63-66. https://doi.org/10.1017/s0195941700067096
  » https://doi.org/10.1017/s0195941700067096
• ¹⁸ Tseng D, Sinnott M, Collier J, Wall D, Whitby M. Prevention of scalpel blade injuries: Staff ignorance of the Australian/New Zealand Standard. Aust Infect Contr 2005; 10(3):89-94. https://doi.org/10.1071/hi05089
  » https://doi.org/10.1071/hi05089
• ¹⁹ Weltman AC, Short LJ, Mendelson MH, Lilienfeld DE, Rodriguez M. Disposal-related sharps injuries at a New York City Teaching Hospital. Infect Control Hosp Epidemiol 1995; 16(5):268-274. https://doi.org/10.1086/647106
  » https://doi.org/10.1086/647106
• ²⁰ Wicker S, Stirn AV, Rabenau HF, von Gierke L, Wutzler S, Stephan C. Needlestick injuries: Causes, preventability and psychological impact. Infection 2014; 42(3):549-552. https://doi.org/10.1007/s15010-014-0598-0
  » https://doi.org/10.1007/s15010-014-0598-0
• ²¹ Behzadmehr R, Balouchi A, Hesaraki M, Alazmani Noodeh F, Rafiemanesh H, J Nashwan A, et al. Prevalence and causes of unreported needle stick injuries among health care workers: A systematic review and meta-analysis. Rev Environ Health 2021; 38(1):111-123. https://doi.org/10.1515/reveh-2021-0148
  » https://doi.org/10.1515/reveh-2021-0148
• ²² Mohamud RYH, Mohamed NA, Doğan A, Hilowle FM, Isse SA, Hassan MY, et al. Needlestick and sharps injuries among healthcare workers at a tertiary care hospital: A retrospective single-center study. Risk Manag Healthc Policy 2023; 16:2281-2289. https://doi.org/10.2147/RMHP.S434315
  » https://doi.org/10.2147/RMHP.S434315
• ²³ Li X, He Q, Zhao H. Situation and associated factors of needle stick and sharps injuries among healthcare workers in a tertiary hospital: A cross-sectional survey. BMC Health Serv Res 2024; 24:1002. https://doi.org/10.1186/s12913-024-11439-5
  » https://doi.org/10.1186/s12913-024-11439-5
• ²⁴ Yun J, Umemoto K, Wang W, Vyas D. National survey of sharps injuries incidence amongst healthcare workers in the United States. Int J Gen Med 2023; 16:1193-1204. https://doi.org/10.2147/IJGM.S404418
  » https://doi.org/10.2147/IJGM.S404418
• ²⁵ Hussain A, Shah Y, Raval P, Deroeck N. Awareness about sharps disposal leads to significant improvement in healthcare safety: An audit of compliance in the national health service during the COVID-19 pandemic. SN Compr Clin Med 2020; 2(12):2550-2553. https://doi.org/10.1007/s42399-020-00624-2
  » https://doi.org/10.1007/s42399-020-00624-2
• ²⁶ Medline Industries. Safely secure your sharps. 2014. https://us.evocdn.io/dealer/1116/catalog/product/documents/lit770_cat_sharps_containers_1550667_1617218114.pdf [Accessed on May 22, ²⁰²⁴].
  » https://us.evocdn.io/dealer/1116/catalog/product/documents/lit770_cat_sharps_containers_1550667_1617218114.pdf
• ²⁷ Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas 1970; 30(3):607-610. https://doi.org/10.1177/001316447003000308
  » https://doi.org/10.1177/001316447003000308
• ²⁸ Aziz AM, Ashton H, Pagett A, Mathieson K, Jones S, Mullin B. Sharps management in hospital: An audit of equipment, practice and awareness. Br J Nurs 2009; 18(2):92-98. https://doi.org/10.12968/bjon.2009.18.2.37861
  » https://doi.org/10.12968/bjon.2009.18.2.37861
• ²⁹ Cheetham S, Ngo HT, Liira J, Liira H. Education and training for preventing sharps injuries and splash exposures in healthcare workers. Cochrane Database Syst Rev 2021; 4(4):CD012060. https://doi.org/10.1002/14651858.CD012060.pub2
  » https://doi.org/10.1002/14651858.CD012060.pub2
• ³⁰ Xu Y, Liu WJ, Wang X, Yang QM. Occupational protection behavior and its influencing factors of newly recruited nurses. BMC Med Educ 2023; 23(1):797. https://doi.org/10.1186/s12909-023-04780-6
  » https://doi.org/10.1186/s12909-023-04780-6
• ³¹ Grimmond T, Naisoro W. Sharps injury reduction: A six-year, three-phase study comparing use of a small patientroom sharps disposal container with a larger engineered container. J Infect Prev 2014; 15(5):170-174. https://doi.org/10.1177/1757177414543088
  » https://doi.org/10.1177/1757177414543088

Edited by

• Academic Editor:
  Wilton Wilney Nascimento Padilha

Publication Dates

• Publication in this collection
  28 Nov 2025
• Date of issue
  2026

History

• Received
  02 Dec 2024
• Reviewed
  20 Jan 2025
• Accepted
  28 Feb 2025