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Safe Community Needle Disposal

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

Content Verified on: October 23, 2003


Summary

Regulatory Environment

  • Montana requires the Department of Environmental Quality to create and administer a state solid waste management plan. Local authorities have the ability to adopt the plan and propose changes or create a solid waste disposal plan in accordance with the rules.
  • Syringes are classified as a form of infectious waste.
  • Montana’s infectious waste regulations do not address syringes that are used inwithin the home.
  • Montana does not provide written guidance for community syringe disposal.

Identified Community-based Disposal Initiatives

  • No community syringe disposal programs were identified in Montana. However, that does not mean that none operate in the state.

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

Montana does not provide written guidance for community syringe disposal.

However, representatives from the state’s Department of Environmental Quality,Link to a non-CDC site Community Services Bureau, recommend that individuals place used syringes in sharps containers purchased from pharmacies and check with their local health department to determine a safe means of disposal.


Solid and Infectious Waste Policies

1. Solid Waste Law

Summary
Establishes rule-making authority – Montana requires the Department of Environmental Quality to create and administer a state solid waste management plan. Local authorities have the ability to adopt the plan and propose changes or create a solid waste disposal plan in accordance with the rules.

Law
Chapter 10 of the Montana Code Annotated, Title 75 [Ref 1]

2. Infectious Waste Management Act

Summary
Establishes definition – “Sharps” (hypodermic needles and syringes) are defined as a form of infectious waste.

Establishes storage and labeling requirements – Infectious waste must be separated from other wastes at the point of origin, stored in separate containers until rendered noninfectious, and labeled with a biohazard warning. . Infectious wastes must not be compacted and untreated infectious waste must be stored in a secured area.

Establishes packaging requirements – Sharps must be packaged in leak-proof, rigid, puncture-resistant containers that are taped closed or securely capped.

Establishes treatment requirements – Infectious wastes can be treated by incineration, steam sterilization, chemical sterilization or any other technique that has been approved by state and federal authorities. The waste must be labeled to identify that it has been treated and may then be disposed of in the regular solid waste stream or at a licensed landfill.

Establishes requirements for infectious waste facilities – The Act establishes training requirements for employees who handle infectious waste as well as permit and fee requirements for all persons who operate treatment, storage, or disposal facilities and for persons who generate and transport infectious waste.

Act
Part 10 of Montana Code Annotated, Title 75, Chapter 10 [Ref 2]

3. Infectious Waste Management Rules

Summary
Establishes disposal requirements for infectious waste generated by medical facilities – Infectious waste from a hospital or medical facility that has been rendered non-infectious is classified as “Group II Waste.” The rules require this type of waste to be disposed at a licensed “Class II” disposal facility.

Establishes disposal facility requirements – The rules establish requirements for the location and design of disposal facilities, license applications, and standards for operation and maintenance plans.

Rule
Sub-Chapter 5 of the Administrative Rules of Montana Title 17, Chapter 50 [Ref 3]

Responsible Agency
Montana Department of Environmental Quality


Bloodborne Pathogen Standards

Summary
Federal bloodborne pathogen rule applies – Montana 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 4]

Responsible Agency
U.S. Occupational Safety and Health AdministrationLink to a non-CDC site
Regional OfficeLink to a non-CDC site (Responsible for administrative activities in Region 8)
Area Office (Responsible for OSHA compliance in Montana)


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 Montana’s Laws and Regulations on Container Collection Sites
Community sharps container collection sites are not specifically addressed in Montana’s Infectious Waste Management Act. Collection sites may be required to comply with Montana’s infectious waste regulations.

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 Montana’s Laws and Regulations on Container Mailback Programs
Sharps container mailback programs are not addressed by Wisconsin’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 Montana’s Laws and Regulations on Disposal in the Trash
Montana’s regulations do not address syringes that are generated within the home. Therefore, home users of syringes may dispose of their syringes in the trash.


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


Current Identified Community Syringe Disposal Programs in Montana Go to Top

No community syringe disposal programs were identified in Montana. However, that does not mean that none operate in the state.


Responsible Agencies in Montana

Links below will open in a new browser window.

Montana Department of Environmental QualityLink to a non-CDC site
Permitting and Compliance DivisionLink to a non-CDC site
Community Services BureauLink to a non-CDC site
Tel: (406) 444-4400
Fax: (406) 444-1374
Contact: Mike DaSilva
Tel: (406) 444-9879
Email: mdasilve@state.mt.us

U.S. Occupational Safety and Health AdministrationLink to a non-CDC site
Regional OfficeLink to a non-CDC site
1999 Broadway, Suite 1690
P.O. Box 46550
Denver, Colorado 80201-6550
Tel: (303) 844-1600
Fax: (303) 844-1616

Billings Area Office
2900 4th Avenue North, Suite 303
Billings, Montana 59101
Tel: (406) 247-7494
Toll free: 1-800-488-7087
Fax: (406) 247-7499


References

Links below will open in a new browser window.

1. Montana Code Annotated, Title 75 [Environmental Protection], Chapter 10Link to a non-CDC site [Waste and Litter Control]

2. Montana Code Annotated, Title 75 [Environmental Protection], Chapter 10 [Waste and Litter Control], Part 10Link to a non-CDC site [Infectious Waste Management Act]

3. Administrative Rules of MontanaPDF IconLink to a non-CDC site (ARM), Title 17 [Environmental Quality], Chapter 50 [Solid Waste Management], Sub-Chapter 5 [Refuse Disposal]

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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