It is estimated that that between eight and nine million people usesyringes at home, generating two to three billion used needles each yearin the United States. About two-thirds of the needle users are injecting formedicinal purposes like diabetes.
The majority of those needles, however, are being discarded inhousehold trash, posing a critical public health concern.
EPA Revises Recommendations for Needle Disposal
In December 2004, the U.S. Environmental ProtectionAgency (EPA) introduced new recommendations for disposal ofsyringes used by people who inject outside of a healthcare setting. TheEPA no longer recommends that patients use a sturdy householdcontainer and throw that in the trash when it is full. Instead, the EPAsuggests participating in one of two programs:
- A community program (such as a community drop-off center, household hazardous waste facility, residential “special waste” pickup service or syringe exchange program); or
- A national disposal program (such as a “sharps” mail-back program or at-home needle-destruction devices).
Household waste is regulated at the state or municipal level; therefore, themajority of states have not adopted the new EPA recommendationsand still allow needles to be thrown directly into the garbage. Theseneedles end up in recycling and solid-waste disposal systems, posinga serious threat of needle-stick injuries to family members, wasteworkers, janitorial workers and others in the community.
Everyone Has Access to Disposal Programs
While few states offer community programs, all individuals haveaccess to national programs, at a cost. These include needle mail-backprograms or at-home needle destruction devices. The at-homeneedle-destruction devices typically last three or more years and destroythe needle, so the syringe can be thrown away after the needle isremoved and destroyed. The mail-back containers are purchased onlineor from participating pharmacies and provide a “sharps” container along with a mail-back container, postage and shipping instructions.
To help cover the cost of these needle-disposal products, a bill (HR2841) was introduced this summer by Representative Mike Ferguson(R-NJ) and Ted Strickland (D-OH). This bill will provide coverage ofsupplies associated with injecting insulin, home needle-destructiondevices and needle and lancet disposal through a sharps-by-mail orsimilar program under Part D of the Medicare Program. The effective datefor this bill is January 2007.
“This is a great first step,” says Ben Hoffman, MD, board president of the Coalition for Safe Community Needle Disposal. “By including coverage of needle disposal under Part D of the new Medicare program, a large percentage of home needle users will be offered safer solutions at an affordable price.”
Some States Get Sharp About Needle Disposal
Some states have already addressed the issueof safe needle disposal and offer communityprograms for residents:
Wisconsin: All medical waste is treated thesame; it doesn’t matter if it is generated athome or in hospitals. Wisconsin has more than1,000 community programs throughout thestate, making it convenient for residents todispose of used needles.
California: In January 2005 the governorsigned a bill that encourages all householdhazardous waste programs in the state to acceptused needles. Residents should call their countysolid-waste department and find out when,where and how needles can be collected in theircommunity.
New York: By law, all New York hospitals andnursing homes are required to accept used“sharps” from the community. More than 1,000hospitals and nursing homes currently acceptneedles. For a list of facilities in your area, callthe New York Department of Public Health at(800) 541-2437.
Florida: Nearly one-half of the counties inFlorida have a community drop-off programthat accepts used sharps. Call your county publichealth department to find out if your countyhas one.
Coalition Working for Safer Conditions
The nonprofit Coalition for Safe CommunityNeedle Disposal is working to inform states andlocal communities that needle-stick injuries area preventable health risk as well as to encouragethem to provide safe, convenient disposaloptions to home needle users. We recognizethat changing used-needle disposal methods isa great challenge, but we believe the Coalitioncan help states and communities to offer safeneedle-disposal solutions. Bringing communityand state leaders together to determine thebest solution for that state is the only way thatdisposal rules and practices will change.
To find out if a needle-disposal program isavailable in your community, log on to www.safeneedledisposal.org to access theCoalition database of existing nationwideprograms, or call your local county or city publichealth department or solid-waste division.
See the “Syringe Reference Guide”.