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Safe Community Needle Disposal

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

Content Verified on: February 14, 2003


Summary

Regulatory Environment

• Hospitals and nursing homes must by law accept filled sharps containers from the public. Individual facilities can determine their own hours of operation, types of required containers, and labeling requirements.

• Syringes used in the home may be disposed of in the trash. However, state guidance recommends that individuals put used syringes in punchture-resistant containers and bring filled containers to a community syringe collection site for safe handling and disposal as medical waste.

Identified Community-based Disposal Initiatives

• New York’s Expanded Syringe Access Demonstration Program (ESAP) provides public education, establishes syringe collection kiosks at pharmacies and health care facilities, and promotes safe disposal community coalitions.


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 syringes that are used by individuals living in the community. However, billions of 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 of syringes are discarded in public areas, such as parks, and this presents 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

Two New York state agencies publish the same guidance on community syringe disposal:

1. New York State Department of Health, Expanded Syringe Access Program (ESAP) – “Household Sharps: Dispose of Them Safely

2. New York Department of Environmental Conservation – “Household Sharps: Dispose of Them Safely

The guidance states:

Millions of individuals with serious health conditions manage their care at home. For example, people with diabetes use syringes and needles to inject their own insulin, and lancets to test their blood glucose every day.

These syringes, needles and lancets are called "household sharps." Household sharps must be properly contained and discarded to protect trash handlers and waste treatment workers against disease or injury. Careful disposal also prevents re-use of syringes that can transmit the human immunodeficiency virus (HIV), or hepatitis B or hepatitis C. In New York State, all hospitals and nursing homes must accept household sharps. Contact local hospitals and nursing homes for days and hours of acceptance, location of sharps collection sites and type of containers that will be accepted.

Containment

Contain the used sharps safely in your own home:

  • Use a puncture-resistant, plastic container with a tight-fitting screw top. A plastic soda bottle or bleach bottle will work. Some pharmacies sell small, plastic sharps disposal containers. Don’t use glass because it can break. Coffee cans are not recommended because the plastic lids come off too easily and may leak.
  • Label the container clearly. Write "Contains Sharps" with a waterproof marker directly on the container or on masking tape that is placed on the container.
  • Put used syringes, needles or lancets immediately into your container. Screw on the top.
  • Don’t clip, bend or recap the syringes, needles or lancets because you could injure yourself.
  • If you are away from home or there are no sharps containers available, carefully recap all syringes, needles or lancets and place them in a plastic bag to carry home or to a sharps collection site.

The person who uses the syringes, needles or lancets should place them directly into a container.
Keep the container away from children!

When the container is three-quarters full, screw on the cap tightly. Seal it with heavy-duty tape to be extra-safe.

Disposal

There are different options for getting rid of sharps. Some cities and towns have more options than others. Here are the best bets for safety, health and protection of the environment.

  • Call your health care provider, pharmacy or clinic to find local hospitals or nursing homes that accept properly contained sharps for disposal. The hospital or nursing home receiving such containers must dispose of the sharps properly.
  • Ask your diabetes educator or local American Diabetes Association chapter about sharps collection programs in your area.
  • Call your local public works department or trash collector. (Check the blue pages of the telephone book for their numbers.) Some communities have special household medical waste collection or drop-off days.
  • Call your local health department and ask for the health educator. Ask about sharps collection programs in your county.

New York State law allows disposal of household sharps with household trash. Local laws, however, may prohibit this. Consult your local public works department, sanitation department or trash collector for information about laws that apply in your area.

Do Not Put the Sharps Container out with the Recyclable Plastics.
Sharps Are Not Recyclable.


Solid and Infectious Waste Policies

1. New York Regulated Medical Waste Law and Regulation

Summary
Requirements for generators – The law defines medical waste and sets requirements on generating, storing, containing, treating, and disposing of waste, and transferring it to off-site treatment and disposal facilities.

Medical waste from homes not regulated – Used sharps generated in the home are not subject to the New York regulated medical waste law and may be disposed of in the trash.

Regulations are out of date; interim guideline is available – New York’s regulated medical waste regulations have not yet been revised to meet amendments to the law made in 1993. The state’s Department of Health has developed a guideline to address these gaps. The guideline provides guidance on interpreting Subsection 1389-dd (4), under a subsection entitled “sharps collection from private residences.”

Hospitals and nursing homes must accept home-generated sharps – Subsection 1389-dd (4) of the Public Health Law requires that hospitals and residential health care facilities accept home-generated sharps. Individual facilities can determine specifics, such as schedules, types of containers, and labeling requirements.

Law
New York State Consolidated Laws, Public Health, Article 13 [Nuisances and Sanitation], Title 13 [Storage, Treatment And Disposal Of Regulated Medical Waste], Sections 1389 [AA – HH] [Ref 1]

Regulation
New York State Codes, Rules and Regulations (NYCRR), Title 10, Part 70 [Regulated Medical Waste] [Ref 2]

Guideline
Managing Regulated Medical Waste Guidelines, Sharps Collection from Private Residences [Ref 3]

Responsible Agencies
New York State Department of Health
New York Department of Environmental Conservation

2. New York Solid Waste Law and Regulation

Summary
Transportation requirements defined; medical waste tracking program established – The law addresses transportation of regulated medical waste, and is applied to persons engaged in storing, containing, treating, disposing, or transferring regulated medical waste destined for off-site treatment and disposal. The law establishes the regulated medical waste tracking program in New York.

Regulations are out of date; interim guideline is available – The regulations have not yet been revised to meet 1993 revisions to the regulated medical waste statutes. The state’s Department of Environmental Conservation has developed a guideline to address these gaps.

Consolidated household-generated medical waste regulated – If medical waste generated in the home is combined with medical waste collected from other sites, it is considered “regulated medical waste” and must be packaged, labeled, and transported according to appropriate law and regulation.

Law
New York State Consolidated Laws, Environmental Conservation, Article 27 [Collection, Treatment and Disposal of Refuse and Other Solid Waste], Title 15 [Storage, Treatment, and Disposal of Infectious Waste] [Ref 4]

Regulation
Title 6 NYCRR, Chapter 4 [Quality Services], Subchapter B [Solid Wastes], Subparts 360-10, 360-17 and 364-9 [Ref 5]

Guideline
Guidance for Regulated Medical Waste Treatment, Storage, Containment, Transport and Disposal [Ref 6]

Responsible Agency
New York Department of Environmental Conservation


Bloodborne Pathogen Standards

Summary
Adopts federal bloodborne pathogen rule – New York’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.

Rule
29 CFR Part 1910.1030 [Ref 7]

Responsible Agency
New York Department of Labor


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 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 York's Laws and Regulations
Community syringe collection sites, such as pharmacies, must comply with state and local laws regarding the disposal of regulated medical waste.

Hospitals and nursing homes are required to collect home-generated sharps. Facilities can set requirements for containing the needles and can determine the hours during which they will accept needles and syringes from the public. Some facilities are reported to have set limited hours, such as early Sunday mornings, which discourages participation.

New York’s bloodborne pathogen standard discourages programs that require employees to handle filled sharps containers from customers, and encourages programs in which customers place their filled containers directly into a collection container without employee involvement.

Under New York’s syringe prescription law and rule, eligible providers of syringes must register with the health department to sell or furnish syringes without a prescription, or to accept needles and/or syringes for disposal. Pharmacies, clinics, and health care practitioners that wish to accept household sharps under the Expanded Syringe Access Demonstration Program must register for this program component. Hospitals and nursing homes are already required to accept household sharps.

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 this may be considered disadvantage.

Effect of New York’s Laws and Regulations
Sharps container mailback programs are not addressed by New York’s infectious waste rule. However, sharps container collection programs are regulated under the U.S. Postal Service (USPS) when syringes are mailed [Ref 8]. 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 9].
  • 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 York’s Laws and Regulations
New York law does not consider individuals who use syringes at home to be “generators” of regulated medical waste. Therefore, individuals using syringes in their homes are not subject to the requirements of the law and they may dispose of their syringes in the trash.

Although the law allows disposal in the trash, New York’s Department of Health and Department of Environmental Quality recommend that people put used sharps in appropriate containers and take filled containers to a community syringe collection site.


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


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

Expanded Syringe Access Demonstration Program (ESAP)
This New York State Department of Health program, designed to prevent bloodborne pathogen transmission, allows persons 18 years and older to obtain up to 10 syringes at a time without a prescription [Ref 10]. In early 2003, the New York state Legislature extended ESAP through September, 2007. Safe disposal of syringes is a key component of ESAP. To participate in ESAP, pharmacies, health care facilities, and health care practitioners must cooperate in efforts to ensure safe disposal of used hypodermic needles or syringes.

Expanded Syringe Acess Demonstration Program has developed safe disposal information for consumers and encouraged the formation of community-based syringe access and safe disposal demonstration projects, which foster coalitions among a wide range of community players. The program also has promoted the use of sharps collection “kiosks” in settings such as pharmacies, community health centers, community-based organizations, and substance abuse treatment programs.

A detailed document entitled NY State Department of Health Guidelines for Pharmacies Interested in Accepting Hypodermic Needles, Syringes, and Other Sharps Used Outside of Health Care Settings for Safe Disposal (March 2002) has been developed to help pharmacies establish community syringe collection programs [Ref 11].

Information for consumers – Additional information about the ESAP program is provided on the NY Department of Health website [Click on “Search” / Type “ESAP”]. This information includes:

Required ESAP Safety Insert – “Expanded Syringe Access Demonstration Program Safety Insert”
Household Sharps – Dispose of Them Safely” guidance information

"New York State Directory of ESAP Providers & Community Sharps Disposal Sites." This listing of community disposal sites for household sharps, organized by county, identifies locations where individuals can bring needles, syringes, lancets and other sharps for safe disposal.

For more information and copies of program brochures, contact:
ESAP Division of HIV Prevention
AIDS Institute
New York State Department of Health (In the search box, type “ESAP”).
Corning Tower, Rm. 308
Albany, NY 12237-0684
Tel: (518) 473-4229
Fax: (518) 486-6888
Email: sjk06@health.state.ny.us.


Responsible Agencies in New York

Links below will open in a new browser window.

New York Department of Health
Corning Tower, Rm. 308
Albany, NY 12237-0684

ESAP
Division of HIV Prevention
AIDS Institute
Tel: (518) 473-4229
Fax: (518) 486-6888
Email: sjk06@health.state.ny.us

Household Sharps Program
Contact: Delton Courtney
Tel: (518) 402-1003
Email: dxc04@health.state.ny.us

New York Department of Environmental Conservation
Division of Solid & Hazardous Materials
Regulated Medical Waste

625 Broadway
Albany, NY 12233-7258
Contact: Alan G. Woodard, Ph.D.
Supervisor, Regulated Medical Waste Program
Tel: (518)402-8693
Fax: (518)402-8654
E-mail: agwoodar@gw.dec.state.ny.us

New York Department of Labor
Division of Safety and Health
W. Averell Harriman State Office
Building – 12, Room 500
Albany, NY 12240
Telephone: 518/457-2741


References

Links below will open in a new browser window.

1. New York State Consolidated Laws, Public Health, Article 13 [Nuisances and Sanitation], Title 13 [Storage, Treatment and Disposal of Regulated Medical Waste], Sections 1389 [AA – HH][New York Consolidated Laws]; [Title 13]

2. New York Regulated Medical Waste Rule - NY State Codes, Rules and Regulations (NYCRR), Title 10, Part 70 [Regulated Medical Waste] (Please make all in underlined blue the link)[Click on “Search Title 10.” In the “search” box, type in “Part 70.” Click on “Part 70, Regulated Medical Waste.” Click on “Part 70-1.”]

3. New York Department of Health Guidelines - Managing Regulated Medical Waste Guidelines. [Type “managing regulated medical waste” in the “Search” box]

4. New York Solid and Infectious Waste Law - New York State Consolidated Laws, Environmental Conservation, Article 27 [Collection, Treatment and Disposal of Refuse and Other Solid Waste], Title 15 [Storage, Treatment, and Disposal of Infectious Waste]

5. New York Solid Waste Rule - Title 6 NYCRR, Chapter 4 [Quality Services], Subchapter B [Solid Wastes], Subparts 360-10, 360-17 and 364-9. [Click on “Chapter IV,” scroll to Subchapter B, click on Part 360, click on Subparts 360-10, 360-17, and 364-9]

6. New York Department of Environmental Conservation Guidance - Guidance for Regulated Medical Waste Treatment, Storage, Containment, Transport and Disposal.

7. Federal Bloodborne Pathogen Standard – 29 CFR Part 1910.1030 [Scroll to and click on “Part 1910.1030 – Bloodborne pathogens.”]

8. US Postal Service Sharps Mailback Requirements - USPS Domestic Mail Manual [Under the heading “Domestic Mail”, click on “DMM Subject Index” scroll to and click on “Sharps, C023.85”]

9. Turnberg WL, Frost F. Survey of occupational exposure of waste industry workers to infectious waste in Washington State (Abstract). American Journal of Public Health 1990;80(10):1262-1264.

10. Klein SJ, Estel GR, Candelas AR, Plavin HA. Promoting safe syringe disposal goes "hand in hand" with expanded syringe access in New York State. Supplement to the Journal of the American Pharmaceutical Association 2002; 42(6):5105-5107.

11. NY State Department of Health Guidelines for Pharmacies Interested in Accepting Hypodermic Needles, Syringes, and Other “SharpsPDF IconLink to a non-CDC site.



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