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Safe Community Needle Disposal

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

Content Verified on: April 22, 2003


Summary

Regulatory Environment

  • Nevada specifically exempts syringes used in households from its definition of medical waste. Therefore, home users of syringes are not required to comply with Nevada’s medical waste regulations and may dispose of their syringes in the household trash.

Identified Community-based Disposal Initiatives

  • No community disposal initiatives were identified but this does not mean that no 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

Nevada does not currently provide written guidance on community syringe disposal.


Solid and Infectious Waste Policies

1. Nevada Medical Waste Law and Regulation

Summary
Adopts federal definition – Nevada has adopted the U.S. Department of Transportation definition of medical waste. Used syringes are classified as a form of medical waste.

Establishes disposal standards – The Nevada Administrative Code (NAC) allows medical waste to be placed in a disposal site so long as the solid waste management authority approves. However, the waste must be separated from other waste and stored within corrosive-resistant, watertight, cleanable containers that are clearly labeled, tightly covered, lined with material approved by the solid waste management authority, and placed in a secured area.

Exempts home users of syringes – The definition of medical waste used in Nevada specifically exempts syringes used in the home. Therefore, individuals are not required to comply with Nevada’s medical waste regulations and may dispose of syringes in the trash. However, medical waste generated by a health care provider and taken outside of the home is subject to the medical waste regulations.

Regulation
Nevada Administrative Code (NAC), Chapter 444 [Sanitation], Section 444.570 to 444.7499 [Solid Waste] [Ref 1]

Responsible Agency
Nevada Department of Conservation and Natural Resources, Division of Environmental Protection


Bloodborne Pathogen Standards

Summary
Adopts federal bloodborne pathogen rule – Nevada’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.

Law
29 CFR Part 1910.1030 [Ref 2]

Responsible Agency
Nevada Department of Business and Industry
Occupational Safety and Health Enforcement Section (OSHES)


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 Nevada’s Laws and Regulations
Although sharps container collection sites are not specifically addressed in Nevada’s solid waste laws and regulations, a collection site must comply with state requirements for storing, labeling, segregating, and transporting of medical wastes.

Local governments can adopt more stringent requirements for handling medical waste. For example, Washoe County has created standards for managing medical waste treatment. Facilities that are considering becoming a collection site should contact their local health department to find out what additional requirements may apply to them.

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 Nevada’s Laws and Regulations
Sharps container mailback programs are not addressed by Nevada’s infectious waste rule. However, sharps container collection programs are regulated under the U.S. Postal Service (USPS) when syringes are mailed [Ref 3]. 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 4].
  • 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 Nevada’s Laws and Regulations
The state’s definition of medical waste specifically exempts household waste. Therefore, home users of syringes are not required to comply with Nevada’s medical waste regulations and may dispose of used syringes in the trash.

However, local governments can adopt additional requirements for medical waste. Individuals should contact their local health department to find out whether any requirements apply to medical waste disposal in their community.


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


Current Identified Community Syringe Disposal Programs in Nevada Go to Top

No community disposal initiatives were identified but this does not mean that no programs operate in the state.


Responsible Agencies in Nevada

Links below will open in a new browser window.

Nevada Department of Conservation and Natural ResourcesLink to a non-CDC site
Division of Environmental ProtectionLink to a non-CDC site
Solid Waste Branch
333 W. Nye Lane
Carson City, Nevada 89706
Contact: Les Gould, Supervisor
Telephone: (775) 687-4670
Email: lgould@ndep.state.nv.us

Nevada Department of Business and IndustryLink to a non-CDC site
Division of Industrial RelationsLink to a non-CDC site
400 West King Street
Carson City, Nevada 89710
Roger Bremner, Administrator
John Laxalt, Assistant Administrator
Telephone: (775) 687-3032
Fax: (775) 687-6305

Occupational Safety and Health Enforcement SectionLink to a non-CDC site (OSHES)
1301 N. Green Valley Parkway - Suite 200
Henderson, Nevada 89074
Tom Czehowski, Chief Administrative Officer
[Las Vegas] Telephone: 702/486-9168; Fax: 702/990-0358
[Carson City] Telephone: 775/687-5240; Fax: 775/687-6150

Washoe County District Health Department
PO Box 11130
Reno, NV 89520
Contact: Jeanne Rucker
Telephone: (775)328-2423
Email: jrucker@mail.co.washoe.nv.us).

Clark County Health District
PO Box 3092
Las Vegas, NV 89127
Contact: Doug Joslin
Telephone: (702)383-1274
Email: joslin@cchd.org).


References

Links below will open in a new browser window.

1. Nevada Administrative Code (NAC), Chapter 444 [Sanitation], Section 444.570 to 444.7499 [Solid Waste]Link to a non-CDC site

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

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

4. 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.



Disclaimer

The materials provided on this web site are for general information purposes only. They do not constitute legal or policy advice or opinion. Access to these materials, their transmission, or receipt is not privileged and does not create any relationship with the provider.

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This CDC Web site is no longer being reviewed or updated and thus is no longer kept current. This site remains to assist researchers or others needing historical content.

   
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