Over the past 45 years, the healthcare industry has undergone a radical change in the types of products that it uses and its disposal practices. In the 1980s, concern about the spread of blood-borne diseases prompted a large-scale change to the use of disposable products, rather than the traditional washing, sterilisation and re-use. (p. 01) This reduction in the requirement for local sterilisation created a negative feedback loop whereby sterilisation units were closed and centralised, causing a shortage of sterilisation facilities, which in turn further encouraged the change to disposable products.
The iatrogenic acquisition of blood-borne disease from sterilised instrument seems to be a very small risk. One of the primary instigators of the change to disposable instruments was fear of Creutzfeldt-Jacob disease in Neurosurgery. Despite the continued use of mostly reusable instruments in this speciality, there has been no record of infection by the CJD prion relating to surgery in over 30 years. (p. 02)