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Safe Community Needle Disposal

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

Content Verified on: February 7, 2003


Summary

Regulatory Environment

  • The Arizona Department of Environmental Quality regulates biohazardous medical waste.
  • Household generated syringes are exempt from the biohazardous medical waste standards and may be disposed of in the trash.

Identified Community-based Disposal Initiatives

  • The state has created disposal guidance for individuals.

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 Arizona Department of Environmental Quality (DEQ) has developed a fact sheet entitled “Waste Programs Division: Solid Waste: AZ Disposal Guidelines for Home Generated Medical Sharps.”This fact sheet provides guidance to residents on how to safely dispose of household-generated syringes.

The guidance includes these recommendations:

  • Medical sharps should be placed in either a medical sharps container purchased from a pharmacy or health care provider, or in a heavy-plastic or metal container.
  • The container should be puncture-proof with a tight-fitting lid.
  • Household containers, such as plastic detergent bottles, can be used if heavy duty tape is used to secure the lid to the container and the words “Not Recyclable” are written on the container with a black indelible marker.

The guidance includes these warnings:

  • Do not use a clear or glass container.
  • Do not over-fill the containers (fill only to approximately ¾ full).
  • Keep container out of reach of children and pets.
  • Always wash your hands after handling or touching medical sharps.

Solid and Infectious Waste Policies

1. Arizona’s Biohazardous Medical Waste Rule

Summary
Defines biohazardous medical waste – Sharps (syringes and hypodermic needles) is defined as biohazardous medical waste.

Establishes requirements for handling sharps - The medical waste rule establishes packaging, transportation, treatment, and disposal requirements for generators and facilities that handle this waste.

Does not regulate community sharps – Persons who generate biohazardous medical waste within the household are exempt from the requirements of the rule.

Rule
Title 18, Chapter 13, Article 14 of the Arizona Administrative Code [Ref 1]

Responsible Agency
Arizona Department of Environmental Quality


Bloodborne Pathogen Standards

Summary
Adopts federal bloodborne pathogen rule – Arizona’s bloodborne pathogen rule was adopted by reference from the federal standard. The state operates its own program under an U.S. Occupational Safety and Health Administration (OSHA)-approved state plan.

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 2]

Responsible Agency
Industrial Commission of Arizona
Arizona Division of Occupational Safety and Health


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 Arizona’s Laws and Regulations
Community syringe collection sites are not specifically addressed in Arizona’s biohazardous medical waste regulations.

A collection facility would be required to comply with regulations set forth by Arizona’s Biohazardous Medical Waste Rule [Ref 1].

This rule regulates the handling of medical sharps. It requires a generator, or a collection facility, that is shipping biohazardous medical waste offsite for treatment to place medical sharps in a medical sharps container and to follow the transportation and packaging requirements. If a collection facility treats the medical sharps on-site, the sharps must be either encapsulated or processed in some way that prevents a possible needlestick hazard.

Collection site operators may also be subject to meeting bloodborne pathogen standards, depending on how the sharps containers are collected and handled.

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 Arizona’s Laws and Regulations
The Arizona Administrative Code specifically exempts persons who send used medical sharps to a treatment facility through the United States Postal Service or private shipping agent from the requirements of Arizona’s Biomedical Waste Rule [Ref 1].

The Arizona Administrative Code also requires generators that ship biohazardous medical waste off-site for treatment to package and send medical sharps according to the instructions provided by the mail-back system operator.

Sharps container collection programs are regulated under the U.S. Postal Service (USPS) when syringes are mailed [Ref 3]. 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 4].
  • 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 Arizona’s Laws and Regulations
The Arizona Administrative Code [Ref 1] specifically exempts generators of household biohazardous medical waste from handling and disposal requirements. Therefore, syringes that are generated within the home are exempt from these requirements and may be disposed of in the trash.


How Might Arizona 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 Arizona move toward the goal of “no syringes discarded in the trash or public locations.”


Current Identified Community Syringe Disposal Programs in Arizona Go to Top

No community syringe disposal programs have been identified in Arizona. However, this does not mean that no programs operate in the state.


Responsible Agencies in Arkansas

Links below will open in a new browser window.

Arizona Department of Environmental Quality
Solid Waste SectionLink to a non-CDC site
1110 West Washington Street
Phoenix, AZ 85007

For more information:
Peggy Guichard-Watters, Section Manager
Telephone: 602/207-7771
Email: guichard-watters.peggy@ev.state.az.us

Industrial Commission of ArizonaLink to a non-CDC site
Arizona Division of Occupational Safety and Health
Phoenix Office
800 W. Washington Street
Phoenix, AZ 85007
Telephone: 602/542-5795
Fax: 602/542-1614


References

Links below will open in a new browser window.

1. Arizona’s Biohazardous Medical Waste RuleLink to a non-CDC site - Arizona Administrative Code, Title 18 [Environmental Quality], Chapter 13 [Department of Environmental Quality – Solid Waste Management], Article 14 [Biohazardous Medical Waste and Discarded Drugs]

2. OSHA Bloodborne Pathogen StandardsLink to a non-CDC site – 29 CFR Part 1910.1030.

3. USPS Domestic Mail ManualLink to a non-CDC site [Click on “DMM Subject Index” then scroll to and click on “Sharps, CO23.85”]

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

 



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