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Safe Community Needle Disposal

MarylandDistrict of Columbia’s Public Health Laws and Regulations: Impact on the Safe Disposal of Used Syringes by Individuals in the Community

Content Verified on: March 7, 2003


Summary

Regulatory Environment

  • The District of Columbia has not developed management standards or regulations on disposing of used hypodermic needles or syringes.
  • The District of Columbia is currently creating medical waste regulations.

Identified Community-based Disposal Initiatives

  • No syringe container collection programs were identified. However, that does not mean that no such programs operate in the District of Columbia.
  • The District of Columbia has one privately-funded harm reduction program that offers syringe exchange services. Participants receive sterile syringes, harm reduction kits, needle-bleaching kits, harm reduction education, on-site OraSure HIV test with pre- and post-testing counseling, and harm reduction counseling.

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 District of Columbia does not provide guidance on safe disposal for individuals who use syringes at home. Representatives from the Department of Health’s Bureau of Hazardous Materials and Toxic Substances recommend that individuals contact their local hospital, medical doctor, or provider for potential syringe collection services or for information on how to safely dispose of used syringes.


Solid and Infectious Waste Policies

1. Solid Waste Statute

Summary
Defines infectious waste – Hypodermic needles and syringes are classified as a form of infectious waste.

Establishes the solid waste management policy for the District of Columbia – The statute requires the mayor to create a solid waste management plan every two years for approval by the Council of the District of Columbia.

Establishes regulations for solid waste facilities – The solid waste statute provides regulations and requirements for solid waste facilities operating in the District. The statute specifically states that solid waste facilities are prohibited from accepting infectious wastes.

Statute
Subtitle B, Chapter 10 of the District of Columbia Code, Division 1, Title 8 [Ref 1]

2. Hazardous Waste Statute

Summary
Establishes the hazardous waste management policy for the District of Columbia – The statute requires the mayor to create a hazardous waste management plan and gives the mayor authority to enforce the plan, as well as any hazardous waste rules and regulations.

Establishes a definition – Infectious wastes are classified as a form of hazardous waste.

Statute
Subtitle C, Chapter 13 of the District of Columbia Code Division 1, Title 8 [Ref 2]

Responsible Agency
District of Columbia Department of Health
Environmental Health Administration
Hazardous Waste Division


Bloodborne Pathogen Standards

Summary
Federal bloodborne pathogen rule applies – The District of Columbia 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
U.S. Occupational Safety and Health Administration
Regional Office (Responsible for administrative activities in Region 3)
Area Office (Responsible for OSHA compliance in the Baltimore/Washington, DC area)


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 the District of Columbia’s Laws and Regulations on Container Collection Sites
The District of Columbia laws and regulations do not specifically address sharps container collection sites. According to representatives from the Department of Health’s Hazardous Waste Division, a collection site would be required to comply with the hazardous waste regulations and may be required to register with the Environmental Protection Agency.

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 the District of Columbia’s Laws and Regulations on Container Mailback Programs
Sharps container mailback programs are not addressed by the District of Columbia’s laws and regulations. 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 the District of Columbia’s Laws and Regulations on Disposal in the Trash
Currently, the District of Columbia has no regulations prohibiting individuals from disposing of used syringes or hypodermic needles in the trash. However, representatives from the Department of Health’s Bureau of Hazardous Materials and Toxic Substances, advise persons not to put their used syringes into the trash and recommend contacting local hospitals, medical doctors, or providers for potential syringe collection services or for information on how to properly dispose of syringes.


How Might the District of Columbia Ensure Safe Syringe Disposal by Individuals in the Community?

The state legislature and individual communities may wish to 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 The District of Columbia move toward the goal of “no syringes discarded in the trash or public locations.”


Current Identified Community Syringe Disposal Programs in the District of Columbia Go to Top

No syringe container collection programs were identified. However, that does not mean that no such programs operate in the District of Columbia.

Prevention Works! is a privately-funded harm reduction program that offers syringe exchange services in the District of Columbia. The program uses a van to visit 11 “exchange sites” located throughout the city. Participants receive sterile syringes, harm reduction kits, needle-bleaching kits, harm reduction education, on-site OraSure HIV test with pre- and post-testing counseling, and harm reduction counseling. The harm reduction counseling includes “assessment of the problems they experience in relation to their drug use, individualized problem-solving, and active referrals to an array of appropriate services, including drug treatment, medical care, and other community-based support services.


Responsible Agencies in the District of Columbia

Links below will open in a new browser window.

District of Columbia Department of HealthLink to a non-CDC site
Environmental Health AdministrationLink to a non-CDC site
Hazardous Waste DivisionLink to a non-CDC site
51 N Street, NE, 3rd Floor
Washington, DC 20002
Tel: (202) 535-2270

U.S. Occupational Safety and Health Administration (OSHA)Link to a non-CDC site
Regional Office
U.S. Department of Labor/OSHA
The Curtis Center-Suite 740 West
170 S. Independence Mall West
Philadelphia, PA 19106-3309
Tel: (215) 861-4900
Fax: (215) 861-4904

Baltimore/Washington Area Office
1099 Winterson Road
Suite 140
Linthicum, Maryland 21090
Tel: (410) 865-2055/2056
Fax: (410) 865-2068


References

Links below will open in a new browser window.

1. District of Columbia Code, Division 1 [Government of District], Title 8 [Environmental and Animal Control & Protection], Subtitle B [Waste Disposal and Management], Chapter 10Link to a non-CDC site [Solid Waste Management and Multi-Material Recycling] (Scroll to and click on “Division 1”, then scroll to and click on “Title 8”, then scroll to and click on “Subtitle B”)

2. District of Columbia Code, Division 1Link to a non-CDC site [Government of District], Title 8 [Environmental and Animal Control & Protection], Subtitle C [Hazardous Waste and Materials Disposal and Management], Chapter 13 [Hazardous Waste Management] (Scroll to and click on “Division 1”, then scroll to and click on “Title 8”, then scroll to and click on “Subtitle C”)

3. OSHA Bloodborne Pathogen StandardsLink to a non-CDC site – 29 CFR Part 1910.1030. [Scroll to and click on “1910.1030 – Bloodborne pathogens”]

4. USPS Domestic Mail ManualLink to a non-CDC site [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.Link to a non-CDC site American Journal of Public Health 1990;80(10):1262-1264.



Disclaimer

The materials provided on this web site are for general information purposes only. They do not constitute legal or policy advice or opinion. Access to these materials, their transmission, or receipt is not privileged and does not create any relationship with the provider.

CDC has attempted to make the information in this website accurate. However, CDC makes no guarantees about the accuracy, currency, or completeness of the information provided. We are not responsible for any errors or omissions, or for results obtained from the use of the information. If legal advice or other expert assistance is required, the services of a professional should be sought.

This CDC Web site is no longer being reviewed or updated and thus is no longer kept current. This site remains to assist researchers or others needing historical content.

   
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