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Safe Community Needle Disposal

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

Content Verified on: November 4, 2003


Summary

Regulatory Environment

  • 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.

Identified Community-based Disposal Initiatives

  • Minnesota Pharmacy Syringe/Needle Access Initiative

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

1. The Minnesota Pollution Control Agency publishes a two-page guidance on the web entitled "Infectious Waste – Disposing of Household "Sharps".PDF IconLink to a non-CDC site

The guidance states:

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:

  1. Find a hard plastic container with a lid or cap.
  2. Label with a piece of tape stating: DO NOT RECYCLE: HOUSEHOLD SHARPS.
  3. Keep container close by when using needles.
  4. Put needles into the container point first.
  5. 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


Solid and Infectious Waste Policies

1. Infectious Waste Law and Rule

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]

Rule
Minnesota Administrative Code, Chapter 7035 [Solid Waste], Sections 7035.9100 to 7035.9150 [Addressing a comprehensive infectious waste management program] [Ref 2]

Responsible Agency
Minnesota Pollution Control Agency


Bloodborne Pathogen Standards

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]

Responsible Agency
Minnesota Department of Labor and Industry


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 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 Go to Top

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 ProjectLink to a non-CDC site
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 PROJECTLink to a non-CDC site
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 WORKSLink to a non-CDC site
11 W 15th St.
Nicollet Ave. and 15th St.
Minneapolis MN 55403
Tel: (612) 870-1830
Fax: (612) 870-9646


Responsible Agencies in Minnesota

Links below will open in a new browser window.

Infectious Waste Issues
Minnesota Pollution Control AgencyLink to a non-CDC site
520 Lafayette Road
St. Paul, MN 55155-4194
Tel #1 – (651) 296-6300
Tel #2 – (800) 657-3864

Contact:
John Ikeda
Tel: (651) 296-6300
Email – john.ikeda@pca.state.mn.us

Bloodborne Pathogen IssuesLink to a non-CDC site
Minnesota Department of Labor and Industry
443 Lafayette Road
St. Paul, MN 55155
Tel: (651) 296-2342


References

Links below will open in a new browser window.

1. Minnesota Infectious Waste Law – Minnesota Statutes, Chapter 116 [Pollution Control Agency], Sections 116.75 – 116.83 [Collectively referred to as the Infectious Waste Control Act]Link to a non-CDC site (Scroll to and click on each of Sections 116.75 – 116.83)

2. Minnesota Administrative Code, Chapter 7035 [Solid Waste]Link to a non-CDC site, Sections 7035.9100 to 7035.9150 [Addressing a comprehensive infectious waste management program] (Scroll to and click on each of Sections 7035.9100 – 7035.9150)

3. Minnesota Administrative Code, Chapter 5205, Section 5205.0010Link to a non-CDC site [Adoption of federal occupational safety and health standards by reference] (Click on Section 5205.0010)

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

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

6. 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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