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Safe Community Needle Disposal

AlabamaAlabama Public Health Laws and Regulations: Impact on the Safe Disposal of Used Syringes by Individuals in the Community

Content Verified on: October 29, 2003


Summary

Regulatory Environment

  • Sharps generated from homes are not regulated and may be disposed in the household trash.
  • Individuals should never label household containers filled with used sharps with the terms “medical waste” or “infectious waste” because those terms apply only to containers used by health care professionals. Containers with these labels may not be accepted for disposal by a landfill.
  • Community syringe collection sites such as pharmacies or fire stations must comply with state medical waste disposal rules.

Identified Community-based Disposal Initiatives

  • No community-based disposal initiatives were identified, although this does not mean that none operate in Alabama.

Introduction

Disposing of contaminated medical waste, including needles, syringes, and other “sharps,” has become an important issue in public health policy. Waste generated in the health care system is highly regulated at the state and federal level. Hospitals and other health care facilities must follow special procedures for handling, transporting, and disposing of medical waste, including used needles that may contain blood. Facilities also have instituted strict safeguards to protect health care workers, housekeeping staff, sanitation workers, and waste haulers from needlesticks because of the risk of contracting HIV, hepatitis B and C, and other bloodborne infections.

Less attention has been paid to safe disposal of used syringes that come from individuals living in the community. However, as many as 3 billion syringes are used each year outside health care facilities: It is estimated that between 0.9 and 1.68 billion insulin injections and up to 1 billion illegal drug injections occur each year in the United States. After being used and discarded, most of these syringes end up in the public solid waste system. This presents a risk of needlestick injury and infection, mostly to solid waste workers. A much smaller number are discarded in public areas, such as parks, presenting a risk to the public.

This section of CDC’s Community Syringe Disposal, Laws and Regulations, and the Public Health web site looks at the public health dimensions of this problem. It describes this state’s solid and infectious waste laws and regulations as they relate to syringe disposal. It provides background information on several key disposal options currently used in the U.S. and describes the impact of this state’s laws and regulations on the way that individuals may use these options. It also includes brief descriptions of some safe disposal programs in the state and provides contact information for the state’s public health and environmental management agencies.

This web site is designed primarily for individuals and communities who are working to build safe syringe disposal programs and improve public understanding of this important issue. We hope that the information and tools provided here will help communities move closer to the ultimate goal of “no syringes discarded in the trash or in public locations such as parks, buildings, or the streets.”


Current Published Guidance for Individuals

The Alabama Department of Environmental Management (ADEM) publishes a brochure entitled “Handling and Disposal of Medical Waste – A Household Guide for Alabamians.” The guidance recommends that:

  • Home generated needles, syringes, lancets, and other sharp objects should be placed in a hard plastic container such as a liquid soap, bleach, or fabric-softener bottle or metal container with a screw-on (or tightly secured) lid. Sharps should not be placed in glass or clear-plastic containers.
  • The lid should be reinforced with heavy-duty tape.
  • Sharp objects should not be placed in any container that will be recycled or returned to a store.
  • Containers should be marked “Not For Recycling.” Containers should never be labeled with the terms “medical waste” or “infectious waste” because those terms only apply to health care professionals.
  • Containers used to dispose of sharp objects should be kept away from young children and pets.
  • Filled containers should be disposed of as frequently as other garbage

Solid and Infectious Waste Policies

1. Alabama Solid Waste Law and Regulation

Summary
Residential sharps not regulated – Individuals who use sharps, live in single-family homes, and who are not health care professionals are excluded from the requirements of Alabama’s solid waste laws.

Sharps container collection sites not specifically addressed by medical waste rule – The law sets requirements for large and small facilities that generate medical waste. Although sharps container collection sites, such as pharmacies, are not specifically addressed by the rule, they must still follow the requirements of Alabama’s medical waste rule.

Landfills must screen incoming loads for regulated medical waste - Landfill operators must screen incoming loads of garbage for medical waste, and refuse disposal if found.

Law
The Code of Alabama, Title 22 [Health, Mental Health and Environmental Control], Chapter 27 [Solid Waste], Article 1 [Solid Waste Disposal Act], Sections 22-27-1 – 22-27-7 [Ref 1]

Regulation
Division 13 [Solid Waste Program], Chapter 335-13-1, General Provisions, ADEM Admin Code R. 335-13-1-.03 [Definitions];Chapter 335-13-6, Inspection of Facilities, ADEM Admin Code R. 335-13-6-.01(2) [Inspection of Solid Waste Disposal Facilities]; and Chapter 335-13-7, Medical Waste, ADEM Admin Code R. 335-13-7.01 – .10 [Medical Waste] [Ref 2]

Responsible Agency
Alabama Department of Environmental Management


Bloodborne Pathogen Standards

Summary
Federal bloodborne pathogen rule applies – Alabama has not established its own state plan for regulating bloodborne pathogens. Therefore, the federal Occupational Safety and Health Administration (OSHA) standards apply.

Sets requirements for collection sites when employees handle the sharps containers – Operators of sharps container collection sites in which employees physically accept and handle filled sharps containers from customers are required to meet the OSHA bloodborne pathogen standards. This involves developing a written Exposure Control Plan that identifies the frequency of exposure and the tasks and procedures in which exposure may occur. The Plan also must address methods of compliance, hepatitis B vaccination, hazard communication to employees, recordkeeping, and methods to evaluate exposure incidents.

Sets requirements for collection sites when employees do not handle the sharps containers – Operators of sharps container collection sites in which customers place filled sharps containers into a collection container are not subject to the bloodborne pathogen standard. In this situation, employees must not handle the sharps containers. Those involved with removing the sharps containers from the collection container must meet the standard.

Law
29 CFR Part 1910.1030 [Ref 3]

Responsible Agency
US Occupational Safety and Health Administration
Regional Office (Responsible for administrative activities in Region 4)
Area Office (Responsible for OSHA compliance in Alabama)


Selected Community Syringe Disposal Options

Container Collection Sites

Background

How This Option Works
An individual brings filled sharps containers to a collection site such as a pharmacy, medical facility (for example, a hospital or public health clinic), or non-medical facility (for example, a fire station) for safe disposal. Other sites have sharps collection drop boxes (a kiosk, mailbox-type receptacle, or other secured collection bin). This is a viable option that can capture many of the syringes generated in the community. Successful syringe container collection programs feature:

  • minimal regulatory constraints placed on collection sites;
  • easy access provided through numerous and well-publicized collection locations; and
  • minimal costs to users through subsidized costs of containers and disposal.

Even if a community does not have collection site programs, an individual may be able to develop an informal relationship with a local pharmacy or other facility that will accept and safely dispose of filled syringe containers.

Advantages and Disadvantages
Sharps container collection programs have two key advantages:
• Used syringes are kept out of the regular solid waste stream, which reduces the risk of needlestick injuries to waste and recycling workers (see Disposal in the Trash for more information).
• Syringes collected through these programs are disposed of safely as medical waste. This involves special disinfection to destroy germs and destruction or burial to ensure that the needle points cannot injure anyone.

Facilities and individuals may perceive some disadvantages:

  • Individuals may feel that bringing sharps containers to a collection site is inconvenient and reduces their privacy because it identifies them as a syringe user.
  • Collection sites may have to comply with state bloodborne pathogen standards and medical waste disposal requirements, and they must carefully maintain the collection bins or kiosks.

Effect of Alabama’s Laws and Regulations
Community syringe collection sites, such as pharmacies or fire stations, must comply with Alabama’s medical waste disposal rules and the OSHA bloodborne pathogen standard.

Container Mailback Programs

Background

How This Option Works
Sharps containers are distributed to customers and, when full, are mailed back to a syringe disposal company for safe disposal. This is a viable option that can capture some of the used syringes generated in the community.

Advantages and Disadvantages
Syringe mailback programs have the same advantages as syringe container collection sites:

  • Used syringes are kept out of the regular solid waste stream, which reduces the risk of needlestick injuries to waste and recycling workers (see Disposal in the Trash for more information).
  • Syringes collected through these programs are disposed of safely as medical waste. This involves special disinfection to destroy germs and destruction or burial to ensure that the needle points cannot injure anyone.

The cost of mailing the container to the disposal company varies. The cost may be too high for some individuals, and may be considered a disadvantage.

Effect of Alabama’s Laws and Regulations
Sharps container mailback programs are not addressed by Alabama’s medical waste rule. However, sharps container collection programs are regulated under the U.S. Postal Service (USPS) when syringes are mailed [Ref 4]. The USPS regulations establish specific packaging, labeling, and tracking requirements for these syringes.

Disposal in the Trash

Background

How This Option Works
Individuals place their used syringes in the household trash, either loose or in a puncture-resistant container. Some individuals remove the needle from the syringe and put it in a container using a special device. The syringe and contained needle are then disposed of in the household trash.

Advantages and Disadvantages
The main advantages of this option are convenience and low cost.

This option has one important disadvantage – it places people at risk of being stuck by a needle and increases their chances of contracting a bloodborne infection:

  • Placing unprotected syringes into the household trash puts waste collectors at risk [Ref 5].
  • Placing used needles in a puncture-resistant container may help protect trash collectors from being stuck. Even so, most containers disposed of in the trash shatter in the garbage truck and release their contents. This places other waste workers at risk.
  • Bottles or cans used as puncture-resistant containers may be recycled by mistake. This puts waste recyclers at risk.

Effect of Alabama’s Laws and Regulations
Sharps generated from homes are not regulated and may be put in the household trash.


How Might Alabama Ensure Safe Syringe Disposal by Individuals in the Community?

The state legislature and individual communities may wish to more actively encourage individuals to safely dispose of used syringes and make it easier for them to do so. Many options for state and local action exist. They range from gathering data, to developing community collection site programs and education efforts, to creating partnerships with interested groups, to considering amending laws and regulations. All will help Alabama move toward the goal of “no syringes discarded in the trash or public locations.”


Current Identified Community Syringe Disposal Programs in Alabama Go to Top

No community syringe disposal programs were identified in Alabama. However, this does not mean that no programs operate in the state.


Responsible Agencies in Alabama

Links below will open in a new browser window.

Alabama Department of Environmental Management
Northeast Unit
Land Division
Alabama Department of Environmental Management
PO Box 301463
Montgomery, Alabama 36130-1463

Contact: James L. Bryant, Chief
Telephone: (334) 271-7771
Fax: (334) 279-2050
Email: jlb@adem.state.al.us

OSHA Regional Office (Region 4)
Regional Office
61 Forsyth Street, SW
Atlanta, Georgia 30303
(404) 562-2300
(404) 562-2295 FAX

OSHA Area Office
Birmingham Area Office
2047 Canyon Road
Birmingham, AL 35216-1981
(205) 731-1534
(205) 731-0504 FAX

Mobile Area Office
3737 Government Blvd., Suite 100
Mobile, AL 36693-4309
(251) 441-6131
(251) 441-6396 FAX


References

Links below will open in a new browser window.

1. The Code of Alabama, Title 22 [Health, Mental Health and Environmental Control], Chapter 27 [Solid Waste], Article 1 [Solid Waste Disposal Act], Sections 22-27-1 – 22-27-7

2. Division 13 [Solid Waste Program], Chapter 335-13-1, General Provisions, ADEM Admin. Code R. 335-13-1-.03 [Definitions];Chapter 335-13-6, Inspection of Facilities, ADEM Admin Code R. 335-13-6-.01(2) [Inspection of Solid Waste Disposal Facilities]; and Chapter 335-13-7, Medical Waste, ADEM Admin Code R. 335-13-7.01 – .10 [Medical Waste] [Scroll down to “Division 13” and select “Word File”]

3. OSHA Bloodborne Pathogen Standards – 29 CFR Part 1910.1030.

4. USPS Domestic Mail Manual [Click on “DMM Subject Index” then scroll to and click on “Sharps, CO23.85”]

5. Turnberg WL, Frost F. Survey of occupational exposure of waste industry workers to infectious waste in Washington State. American Journal of Public Health 1990;80(10):1262-1264.



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