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Safe Community Needle Disposal

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

Content Verified on: August 26, 2003


Summary

Regulatory Environment

  • New Hampshire’s solid and infectious waste programs are administered by the New Hampshire Department of Environmental Services.
  • Used sharps (hypodermic needles and syringes) are classified as a form of infectious waste.
  • Syinges used at home must be placed in a rigid, puncture-resistant container; sealed and labeled “not for recycling”; and disposed at an authorized facility.

Identified Community-based Disposal Initiatives

  • The New Hampshire Syringe Access Initiative is sponsored by the New Hampshire Department of Health and Human Services (DHHS), STD/HIV Section and encourages pharmacies to provide individuals with information about safe disposal when they buy syringes. They have developed a brochure that contains recommendations for safe syringe disposal as well as a listing of medical facilities that will accept properly contained syringes from individuals.
  • The New Hampshire SHARPS Program has been created to help individuals safely dispose of needles, syringes, and lancets. The program requires home users of syringes to place their sharps in a sharps container, liquid laundry detergent bottle, or fabric softener bottle. These containers may then be brought in for disposal during SHARPS Program hours.

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. New Hampshire Syringe Access Initiative Brochure

The New Hampshire Department of Health and Human Services provides written guidance on safe syringe disposal in a brochure describing the New Hampshire Syringe Access Initiative.

The guidance contains these recommendations:

  • Recap needle or disable tips (Note: not appropriate if the needle was used by or on someone other than yourself).
  • Place used syringes in a heavy, leak-proof, puncture-resistant container like a liquid laundry detergent container.
  • Put lid on container tightly.
  • Keep the container out of the reach of children.
  • Dispose of the container legally.

The brochure also provides phone numbers for several hospitals that accept properly packaged needles from community members for disposal.

The brochure also recommends that individuals call their solid waste disposal department of their city or town or the NH AIDS Hotline (1-800-752-AIDS) for more information.

Copies of the brochure are available by contacting:

David Ayotte
New Hampshire Department of Health and Human Services
Public Health Services Division
STD/HIV Section
6 Hazen Drive
Concord, NH 03301
Tel: (603) 271-4502
Fax: (603) 271-4934
Email: dayotte@dhhs.state.nh.us

2. SHARPS Program Pamphlet

In New Hampshire, local authorities may adopt and enforce infectious waste regulations provided they are equivalent or more stringent than current state regulations. The City of Nashua has created an ordinance that prohibits the disposal of syringes and needles in household trash or landfills. A program and pamphlet have been created by the Southern New Hampshire Medical Center and St. Joseph Hospital entitled The SHARPS Program: Store Household Sharps and Return them Properly. The pamphlet offers guidance on how to safely dispose of syringes that are used in the home.

The pamphlet provides these recommendations:

  • Use a home sharps container or a liquid laundry detergent bottle. No other container is acceptable.
  • Place the used needles, syringes and lancets into the container needle first. When the container is ¾ full, close the lid and seal it securely.
  • Call HEALTHMATCH at Southern New Hampshire Medical Center or MED-CALL at St. Joseph Hospital to obtain the schedules for when the containers may be brought in for disposal. Please do not bring in your containers except during the SHARPS Program hours.

The pamphlet provides these warnings:

  • No other container is acceptable. Coffee cans and soda bottles do not have plastic that is thick enough to contain these sharp items reliably and may place someone at risk for accidental needlesticks.
  • Store your sharps container in a safe place in your home where children cannot play with it.

For more information about the SHARPS PROGRAM call HEALTHMATCH at Southern New Hampshire Medical Center: 1-800-628-8070 or call MED-CALL at St. Joseph Hospital: 1-800-210-9000.


Solid and Infectious Waste Policies

1. Solid Waste Management Statute

Summary
Establishes rulemaking authority: The statute provides the Commissioner of the Department of Environmental Services with authority to make solid waste rules.

Establishes permit requirements: Solid waste facilities are required to obtain a permit from the Department of Environmental Services before operating.

Statute
Chapter 149-M of the New Hampshire Revised Statutes Annotated (RSA), Title X [Ref 1]

2. Infectious Waste Rules

Summary
Establishes a definition – Used Sharps (hypodermic needles and syringes) are classified as a form of infectious waste.

Establishes storage requirements – Infectious waste must be stored in pre-designated locations that provide adequate protection and placed in containerssufficiently strong.

Establishes storage requirements for sharps – Sharps must be placed in puncture-resistant, rigid containers before being double bagged in non-permeable, 3 mil polyethylene.

Establishes labeling requirements – Storage containers must be labeled with the words “infectious waste,” “biohazard waste,” or with the biohazard symbol.

Establishes transportation requirements: Infectious waste must be transported in accordance with the United States Department of Transportation Hazardous Materials Regulations.

Establishes treatment requirements – New Hampshire requires all infectious waste to be treated before it can be disposed of at an authorized facility that has been notified by the transporter. Untreated waste must be double-bagged in non-permeable, 3 mil polyethylene and appropriately labeled.

Exempts household infectious waste – New Hampshire specifically exempts syringes used at home from its infectious wastes regulations provided that: (1) syringes are enclosed inside rigid, puncture-resistant containers; (2) the containers encasing the syringes are sealed and labeled “not for recycling”; and (3) the waste is disposed of at an authorized facility.

Rule
Part Env-Wm 2604 of the New Hampshire Code of Administrative Rules [Ref 2]

Responsible Agency
New Hampshire Department of Environmental Services


Bloodborne Pathogen Standards

Summary
Federal bloodborne pathogen rule applies – New Hampshire 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 1)
Area Office (Responsible for OSHA compliance in New Hampshire)


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 New Hampshire’s Laws and Regulations on Container Collection Sites
Container collection sites are not specifically addressed in New Hampshire’s laws and regulations. Collection sites may be required to comply with New Hampshire’s infectious waste rules.

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 New Hampshire’s Laws and Regulations on Container Mailback Programs
Sharps container mailback programs are not addressed by New Hampshire’s infectious waste rule. 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 New Hampshire’s Laws and Regulations on Disposal in the Trash
New Hampshire specifically exempts syringes used at home from its infectious waste rule provided that: (1) sharps are placed in a rigid, puncture-resistant container; (2) sealed and labeled “not for recycling”; and (3) disposed at an authorized facility.


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


Current Identified Community Syringe Disposal Programs in New Hampshire Go to Top

New Hampshire Syringe Access Initiative
The New Hampshire Department of Health and Human Services (DHHS), STD/HIV Section sponsors an outreach program for safe syringe disposal in New Hampshire. Under this program, pharmacies are encouraged to provide individuals with information about safe disposal when they buy syringes. This information should include the location of local disposal sites or a telephone number to call for such information.

DHHS has also developed an educational brochure that contains recommendations for safe syringe disposal as well as a listing of medical facilities that will accept properly contained syringes from the community.

The following medical facilities are identified on a New Hampshire Syringe Access Initiative brochure as community syringe collection locations:

Frisbie Memorial (Rochester ) (603) 332-5211
Lakes Region General (Laconia) (603) 524-3211
New London Hospital (N. London) (603) 526-2911
Parkland Medical Center (Derry) (603) 432-1500
Southern NH Medical Center (Nashua) (603) 577-2547
St. Joseph Healthcare (Nashua) (603) 882-3000
Upper Connecticut Valley Hospital (Colebrook) (603) 237-4971
Weeks Medical Center (Lancasster) (603) 788-4911

For more information, contact:
David Ayotte
New Hampshire Department of Health and Human Services
Public Health Services Division
STD/HIV Section
6 Hazen Drive
Concord, NH 03301
Tel: (603) 271-4502
Fax: (603) 271-4934
Email: dayotte@dhhs.state.nh.us

The SHARPS Program: Store Household Sharps and Return them Properly
In cooperation with the City of Nashua, the Southern New Hampshire Medical Center and St. Joseph Hospital have created the SHARPS Program to help individuals safely dispose of needles, syringes, and lancets. The program requires home users of syringes to place their sharps in a sharps container, liquid laundry detergent bottle, or fabric softener bottle. These containers may then be brought in for disposal during SHARPS Program hours.

For more information, contact:
HEALTHMATCH
Southern New Hampshire Medical Center
Tel: (800) 628-8070

MED-CALL
St. Joseph Hospital
Tel: (800) 210-9000


Responsible Agencies in New Hampshire

Links below will open in a new browser window.

New Hampshire Department of Environmental ServicesLink to a non-CDC site
Waste Management Division
Solid Waste Management Bureau
6 Hazen Drive
PO Box 95
Concord, NH 03302-0095
Tel: (603) 271-2925
Fax: (603) 271-2456

U.S. Occupational Safety and Health Administration (OSHA)Link to a non-CDC site
Concord Area Office
279 Pleasant Street, Suite 201
Concord, NH 03301
Tel: (603) 225-1629
Fax: (603) 225-1580


References

Links below will open in a new browser window.

1. New Hampshire Revised Statutes AnnotatedLink to a non-CDC site (RSA), Title X [Public Health], Chapter 149-M [Solid Waste Management]

2. The New Hampshire Code of Administrative Rules, Part Env-Wm 2604Link to a non-CDC site [Infectious Waste]

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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