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Safe Community Needle Disposal

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

Content Verified on: July 2, 2003


Summary

Regulatory Environment

  • The Nebraska Department of Environmental Quality (DEQ) establishes the rules for the management of solid waste.
  • Used sharps (hypodermic needles and syringes) are classified as a form of infectious medical waste and are considered “special waste.”
  • Nebraska specifically exempts hosehold infectious wast from the solid waste management regulations.
  • Nebraska offers guidance on the disposal of syringes through a fact sheet created by the DEQ entitled Handling Household Medical Waste.

Identified Community-based Disposal Initiatives

  • No sharps container collection sites were identified operating in Nebraska. However, this does not mean that no such programs 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

In 2000, the Waste Management Division of the Nebraska Department of Environmental Quality (DEQ) developed a fact sheet entitled Handling Household Medical WasteLink to a non-CDC site [Click on "Publications/Forms" - "Integrated Waste Management" - "Fact Sheets" - "Handling Household Medical Waste"]. This fact sheet provides guidance to residents on how to safely dispose of household-generated “infectious waste," including syringes. The DEQ defines infectious waste as “"any medical waste that is capable of causing disease in another human being if that person comes into contact with the waste."

The guidance includes these recommendations:

  • Place the waste in a rigid or semi-rigid, puncture resistant and leak-proof container.
  • Mark the container prominently with the universal bio-hazard symbol.
  • Label the container "Infectious Waste" or "biohazard waste."
  • Seal the container.
  • Ensure that the outside of the container is free from contamination.

DEQ also recommends that any type of sharp medical waste such as needles or lancets, should be sealed in a puncture resistant container whether it is infectious or not. This will protect family members and waste handlers from possible cuts or punctures."


Solid and Infectious Waste Policies

1. Solid Waste Statute

Summary
Establishes rule-writing authority – The statute gives the Nebraska Environmental Quality Council rule-writing authority for the management of solid waste.

Statute
Section 81-1505 of the Nebraska Statutes, Section 81-1505 [Ref 1]

2. Solid Waste Management Regulations

Summary
Establishes a definition –“Sharps” (hypodermic needles and syringes) are considered a form of infectious waste. The regulations define infectious waste as a special waste.

Establishes disposal requirements – Special wastes must be disposed of in a permitted solid waste disposal area that operates according to regulations set forth by the Department of Environmental Quality. The regulations require infectious wastes to be rendered non-infectious by incineration, autoclaving, or other treatment method, before disposal.

Exempts household-generated infectious waste – The Department of Environmental Quality specifically exempts syringes used at home from the solid waste regulations.

Statute
Chapters 1-16 of the Nebraska Administrative Code, Title 132 [Ref 2]

Responsible Agency
Nebraska Department of Environmental Quality


Bloodborne Pathogen Standards

Summary
Federal bloodborne pathogen rule applies – Nebraska 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 7)
Area Office (Responsible for OSHA compliance in Nebraska)


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 Nebraska’s Laws and Regulations on Container Collection Sites
Sharps container collection sites are not specifically addressed in Nebraska’s solid waste regulations. In Nebraska, syringes are classified as a form of infectious waste. The regulations require infectious waste to be rendered non-infectious by autoclaving, incineration or other treatment method before it can be disposed in a permitted municipal solid waste landfill. Based on a conservative interpretation of the regulations, a collection site operator may be required to have all collected sharps treated prior to disposal.

According to representatives from the Department of Environmental Quality, household syringes retain their exemption from solid waste regulations no matter how they are collected.

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 Nebraska’s Laws and Regulations on Container Mailback Programs
Sharps container mailback programs are not addressed by Nebraska’s solid waste management 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 Nebraska’s Laws and Regulations on Disposal in the Trash
In Nebraska, infectious waste generated in the home is exempt from the solid waste regulations. Therefore, persons who use syringes at home are not required to comply with the regulations and can dispose of their syringes in the trash.


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


Current Identified Community Syringe Disposal Programs in Nebraska Go to Top

No sharps container collection sites were identified operating in Nebraska. However, this does not mean that no such programs operate in the state.


Responsible Agencies in Nebraska

Links below will open in a new browser window.

Nebraska Department of Environmental QualityLink to a non-CDC site
Waste Management Division
P.O.Box 98922
Lincoln, NE 68509-8922
Contact: Mark Podany
Tel: (402) 471-4210
Email: mark.podany@ndeq.state.ne.us

U.S. Occupational Safety and Health AdministrationLink to a non-CDC site (OSHA)
Omaha Area Office
Overland-Wolf Building
6910 Pacific Street, Room 100
Omaha, Nebraska 68106
Tel: (402) 221-3182
Fax: (402) 221-3188
Toll Free {Nebraska Residents Only}: 1-800-642-8963


References

Links below will open in a new browser window.

1. Nebraska Statutes, Section 81-1505Link to a non-CDC site [Council; rules and regulations; standards of air, land, and water quality]

2. Nebraska Administrative Code, Title 132Link to a non-CDC site [Integrated Solid Waste Management Regulations], Chapters 1-16. (Go to “Rules and Regulations”, “Title 132”) )

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

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.



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