Infectious waste standards are established
for segregating, containing, treating, transporting, and disposing
of medical waste. Community sharps collection sites are not specifically
addressed, but may fall within these standards.
Individuals may dispose of used syringes
in the trash.
Syringes from public health agencies
must be properly packaged and may be disposed of at a hospital if
the public health agency is in a county with a population of less
than 40,000.
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.”
Infectious Waste –
Disposing of Household “Sharps”
Environmental Concerns
More than a billion needles are thrown out each year by
diabetics who self-administer insulin. This high number
of sharps in the garbage, along with a growing number of
home health care patients, creates a hazard to sanitation
workers. This fact sheet outlines some of the options for
safely disposing of used sharps from the home.
Managing Household Sharps
Even though household sharps can legally be put into the
trash, the Minnesota Pollution Control Agency (MPCA) encourages
citizens to dispose of used sharps in a specific way. These
disposal methods will help protect sanitation workers at
composting facilities, waste incinerators, recycling facilities,
and landfills. Also, some of the local ordinances may prohibit
household sharps from being disposed of with the regular
household garbage.
Collection or Drop-off Options Option One: First, see if there are any
household sharps collection or drop-off sites in your area.
Your county health department or
environmental services department may know if a local
collection program is available for household sharps.
Residents may bring their sharps to a drop-off site after
they have properly packaged and labeled the sharps. The
containers are then disposed of by the local government
with the regular solid waste or hauled away by a registered
infectious waste transporter.
Ask your doctor, local clinic,
hospital, fire department, or neighborhood pharmacy about
programs to accept household sharps.
Contact your waste hauler to see
if it collects household sharps.
Option Two: If you
can’t find a collection or drop-off option, sharps
may be put into your garbage. Follow these guidelines to
help keep sanitation workers safe:
Place sharps in clear, plastic
containers with secure screw-on caps only, such as a soda
pop bottle. A study performed in the state of Washington
showed that two-liter plastic pop bottles actually withstood
the solid waste disposal process and compaction better
than other containers, particularly when they were filled
only halfway.
Label the container “SHARPS”.
When a container is one-half full,
tightly seal, label it, and place it with the garbage.
(Do not place these bottles in a recycling bin.)
Inform your garbage hauler that
your trash will include a container with household sharps.
The hauler should let you know if the container should
be bagged and placed with the other trash, or if it should
be placed alongside or on top of the regular garbage.
If you place your garbage in an area where rummaging may
occur, conceal the container in a bag and place it in
the rest of the garbage just prior to collection. Your
hauler should be willing to work with you to arrange for
the most efficient and safest way to handle household
sharps.
The guidance identifies contact phone numbers for
more information. Contact numbers are provided for the nearest MPCA
regional office, and the Minnesota Department of Health AIDS Line.
2. The Minnesota Department of Health,
AIDS/STD Prevention Services Section publishes a brochure entitled “Safe
Disposal of Needles and Syringes Brochure.” The guidance recommends
that individuals:
Find a hard plastic container with
a lid or cap.
Label with a piece of tape stating:
DO NOT RECYCLE: HOUSEHOLD SHARPS.
Keep container close by when using
needles.
Put needles into the container
point first.
When the container is half-filled,
placed the sealed container in your garbage bag and seal.
The guidance also presents a series of “Safe
Reminders” that include:
Don’t leave syringes in public
places or anywhere – always put them into the hard
plastic container.
Don’t place them in beer
or pop cans, glass bottles, coffee cans, or metal cans.
Make sure the container is labeled,
and never place into recycle bins.
Some hospitals, clinics, pharmacies,
HIV street outreach programs may accept contained syringes
for disposal – call the MN AIDS Project AIDSline
for more information.
Some pharmacies and sanitation
companies sell disposal boxes and kits – call the
nearest facility or the MN AIDS Project AIDSline for more
information.
Learn more about syringe access
and disposal by calling the Minnesota AIDS Project AIDSline
(phone numbers are provided).
The guidance is not available on the web.
Copies of the brochure may be obtained from:
Minnesota AIDS Project AIDSLine
Tel: (800) 248-AIDS
Metro Area – (612) 373-AIDS
Summary Establishes medical waste generator requirements – The
law and rule establish standards for segregating, containing, treating,
transporting, and disposing of medical waste.
Exempts community-generated sharps from definition
of sharps generator –
The law and rule exclude from the definition
of “generator” a person who uses syringe to administer
medication to him/herself.
Also excluded are public health agencies, such
as eligible boards of health, community health boards, and public
health nursing agencies.
Establishes limited sharps disposal requirements
for public health agencies – Sharps from public health agencies
must be properly packaged and may be disposed of at a hospital if the
agency is in a county with a population of less than 40,000.
Allows sharps from households to be disposed
unpackaged in the trash – The law and rule also exclude sharps
generated from households from packaging requirements, and allows them
to be disposed in the trash.
Exempts commercial transporters that are participating
in Minnesota’s household sharps collection feasibility study from
registration requirements – Persons who provide collection
and transportation for sharps from households as part of the feasibility
study required by Laws 1989, chapter 337, section 10 are do not have
to register as a commercial transporter.
Does not address community sharps collection
sites – Neither the law or rule directly addresses community
sharps collection sites.
Law
Minnesota Statutes, Chapter 116 [Pollution Control Agency], Sections
116.75 – 116.83 [Collectively referred to as the Infectious Waste
Control Act] [Ref 1]
Summary Adopts federal bloodborne pathogen rule – Minnesota’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.
State Rule
Minnesota Administrative Code, Chapter 5205, Section 5205.0010 [Adoption
of federal occupational safety and health standards by reference] [Ref
3]
Federal Rule
OSHA Bloodborne Pathogen Standards – 29 CFR Part 1910.1030 [Ref
4]
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 Minnesota’s Laws and Regulations
Community sharps container collection sites are not directly addressed
by Minnesota’s infectious waste law or rule. As a result, they
may be regulated as infectious waste generators, such as a hospital
or other medical facility, and this may discourage facilities from becoming
community collection sites.
However, the Minnesota
Syringe Access Initiative encourages pharmacies to participate in
safe disposal activities, including becoming a sharps container distribution
and collection site.
Minnesota’s bloodborne pathogen standard
discourages programs in which employees handle filled sharps containers
from customers, and encourages programs in which employees do not have
to handle filled containers because customers place them directly into
a collection container.
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 Minnesota’s Laws and Regulations
Sharps container mailback programs are not addressed by Minnesota’s
infectious waste rule. However, sharps container collection programs
are regulated under the U.S. Postal Service (USPS) when syringes are
mailed [Ref 5]. 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
6].
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 Minnesota’s Laws and Regulations
Used syringes from households may be legally disposed in the trash.
This is likely to lessen participation in community sharps collection
programs.
How
Might Minnesota 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 Minnesota move toward the goal of
“no syringes discarded in the trash or public locations.”
Current
Identified Community Syringe Disposal Programs in Minnesota
1. Minnesota Pharmacy Syringe/Needle Access
Initiative
In 1997, the Minnesota Legislature passed an act permitting the sale
and possession of up to 10 syringes without a medical prescription.
The primary goal of this legislation, which took effect July 1, 1998,
was to reduce the transmission of HIV among injecting drug users. In
order to sell syringe without a prescription, pharmacies must certify
to the Minnesota Department of Health that they will participate in
at least one activity that supports safe syringe disposal. Such activities
may include:
distributing of educational materials about
safe disposal of syringes;
participating in a sharps container distribution
and collection program;
refering of customers to a medical facility
that accepts sharps from individuals;
refering of customers to the Minnesota AIDS
Project AIDSLine to identify syringe exchange programs for proper
syringe disposal; and
collecting of used syringes from customers.
For more information, contact the Minnesota
AIDS Project
AIDS Project AIDSLine telephone contacts:
(612) 373-AIDS (metro)
(800) 248-AIDS (statewide)
(612) 373-2465 (metro TTY)
(888) 820-2437 (statewide TTY)
2. Identified Syringe Exchange Programs
in Minnesota
MINNESOTA
AIDS PROJECT
Minnesota AIDS Project
1400 Park Ave. S
Minneapolis MN 55404
Tel: (612) 373-2437
Toll-free: (800) 248-2437
TTY: (612) 373-2465
TTY Toll-free: (888) 820-2437
Fax: (612)341-4057
Email: mapaidsline@mnaidsproject.org
ACCESS
WORKS
11 W 15th St.
Nicollet Ave. and 15th St.
Minneapolis MN 55403
Tel: (612) 870-1830
Fax: (612) 870-9646
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Minnesota Public Health Laws and Regulations: Impact
on the Safe Disposal of Used Syringes by Individuals in the Community
