Medical Packaging: A Personal Retrospective
When first leaving University, I worked in a retail pharmacy bottling vinegar, packaging moss-peat, and delivering prescriptions for patients in surrounding villages.
My employer, the pharmacist, was very demanding. Many new employees were dismissed after a couple of weeks of employment because he considered them to work too slowly -- this was despite us all being pressured into taking one or two "purple heart" tablets each morning to make us "liven up" and work harder.
The main activity at this business was making up doctors' prescriptions. Surgical instruments, OTC medicines, cosmetics, household and gardening products were also supplied. Prescription medicines were made up for walk-in customers; other prescriptions were dispensed for delivery, either to doctors' surgeries or direct to a patient's home. The patient did not need to take a prescription to the pharmacy if the doctor gave the information directly to the dispenser.
In those days, there weren't many cars on the road. Drug theft was almost unknown, which allowed some doctors to keep an unlocked hatch in their outside wall where we would deposit medicines for collection by patients. For those patients unable to arrange collection from their doctor or the pharmacy, we delivered to their home.
One of the services provided to the arthritic was to slacken the caps on screw-top bottles. The more dextrous were shown how to clamp the bottle cap in a door jamb and rotate the bottle.
In 1960, the term "Medical Device" was not used in the pharmacy; devices were identified by their individual names: forceps, syringes, stethoscopes, bone-saws, ostomy pouches, etc. I first came across "Medical Device" when I read an advertisement for a "Medical Device Packaging Engineer" in 1975.
Medicine bottles were glass, and many were returned to the pharmacy where they were cleaned and disinfected before reuse. Ground glass stoppers were cleaned and re-used; corks were replaced, as was the liner within the cap of screw-topped bottles. Circular containers made from light-weight cardboard were generally used for prescription tablets. Patients' name and dosage were typed onto labels and applied by hand.
Elastoplasts were packaged in metal boxes with metal lids, as were condoms and cough drops. Medical Instruments were packaged in the style of box now used for presentation of jewellery. Hypodermic Syringes were a re-usable medical device, as were the needles. The words "sterile" and "traceability" had yet to enter my vocabulary. And the idea of "medical packaging" was non-existent.
There have been many changes over the past half-century, for example:
- Home delivery has ceased.
- Syringes and needles are now marketed sterile and disposable; they use up precious resources and create a waste-handling challenge.
- Washable, recyclable glass bottles have largely been replaced by disposable plastic bottles, thus creating more waste and using more irreplaceable oil resources.
- Pill boxes and bottles have been replaced by child-resistant packaging, which also defeats arthritic fingers.
- Recyclable metal boxes have been replaced by flexible pouches and cartons. At least the cartons can go in the recycling bin.
- Finally, I would expect any modern employer pressuring his staff to take a stimulant such as "purple hearts" to end up in gaol.
Have these changes benefited the European community?
I sympathise with the isolated elderly now that home delivery has gone and child-resistant packaging has further to go before it becomes arthritic friendly. However, I recognise that children face less risk of poisoning.
The wholesale changeover to single-use disposables may have been a short-sighted policy. I sometimes wonder how much oil would have been saved if the device industry had concentrated on making all instruments easy to decontaminate, and at the same time, developed convenient sterilisation methods for hospital use.
Unfortunately, there is no turning back, but I admire the processing industry for reducing the number of devices that go to land fill. I worry that use of reprocessed devices may increase the risk for patients.
Moving from glass bottles and metal boxes to lightweight plastics has facilitated automated packaging and reduced price escalation. We should be happy. Right?
Rolande Hall, FIMMM Pkg Prof