Thanks Steve K for your post. Yes, suction bulbs should be single use, but in practice this is not always the case - I am talking about very poor remote settings (village level of health care=midwives, traditional birth attendants, and/or family members) in places like Bangladesh, India, Uganda, Vietnam, etc. At the district level they may have hand-operated manual suction units like the Laerdal V-Vac, but not at the level I am referrring to - nor would there be any emergency services to assist. Thanks so much for confirming the contents of ISO 10079-2:1999! It's good to know that this is indeed the only applicable (somewhat) standard.