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Archival Content: 1999-2005
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Archival Content: 1999-2005 |
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Archive
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Content Verified on: February 14, 2003
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.
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.”
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:
1. New York Regulated Medical Waste Law and Regulation Summary 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 Regulation Guideline Responsible Agencies 2. New York Solid Waste Law and Regulation Summary 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 Regulation Guideline Responsible Agency
Summary 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 Responsible Agency
Effect of New York's Laws and Regulations 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.
Effect of New York’s Laws and Regulations
Effect of New York’s Laws and Regulations 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.
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.”
Expanded Syringe
Access Demonstration Program (ESAP) 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” "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:
Links below will open in a new browser window. New
York Department of Health ESAP Household Sharps Program New
York Department of Environmental Conservation New York Department of Labor
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 “Sharps 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. CDC has attempted to make the information in this website accurate. However, CDC makes no guarantees about the accuracy, currency, or completeness of the information provided. We are not responsible for any errors or omissions, or for results obtained from the use of the information. If legal advice or other expert assistance is required, the services of a professional should be sought. 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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Privacy Policy | Accessibility
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New York Public Health Laws and Regulations: Impact
on the Safe Disposal of Used Syringes by Individuals in the Community
