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Safe Community Needle Disposal

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

Content Verified on: May 1, 2003


Summary

Regulatory Environment

  • Individuals may legally dispose of used syringes in the trash.
  • Individuals may transport used sharps to a hospital without having to meet infectious waste transportation standards.
  • Infectious waste generators must follow the standards of Ohio’s infectious waste law and rule.
  • Community sharps container collection sites are not specifically addressed by the rule. However, any facility that accepts sharps is considered a large infectious waste generator under the Ohio standards.
  • Facilities that generate fewer than 50 pounds of infectious waste each month such as a physician’s office or a sharps collection site may dispose of their sharps in the trash, once properly contained and labeled.

Identified Community-based Disposal Initiatives

  • No community-based disposal initiatives were identified, although this does not mean that none operate in Ohio.

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

The Ohio Environmental Protection Agency (EPA) publishes guidance on its infectious waste web site under the heading “Home generated infectious waste disposal options.”

The guidance recommends:

A person who generates sharp wastes ("sharps" include lancets, hypodermic needles, syringes, scalpel blades, and non-household glass articles that have been broken) for the purpose of their own care or treatment in their home is considered a home sharps user. For example, an insulin dependent diabetic or a terminally ill person being cared for by family members and given injections. Disposing of loose needles and syringes into the household waste poses a risk to family members and solid waste workers who must handle the waste. While Ohio law allows the disposal of sharps used by an individual for purposes of his/her own care or treatment in their home into the solid waste stream, it is important to recognize the hazard they pose to solid waste workers. Solid waste workers handle waste containers without knowledge of the contents.

It is recommended that home generated sharps be packaged into a rigid container and marked with the wording sharps prior to disposal into the solid waste stream. Common household containers which meet the description of rigid are: liquid detergent & bleach bottles, 2 liter pop bottles, and coffee cans if the lid is securely taped to the can. In addition, the person may contact their local health department or hospital to inquire if they would accept the home generated sharps.

The Ohio EPA also publishes a fact sheet that expands upon its published guidance. “Disposal Tips for Household Generated SharpsPDF IconLink to a non-CDC site provides information under the following headings.

  • What are sharps?
  • Who are home sharp users?
  • What are my alternatives to a purchased sharps container?
  • What are some other disposal alternatives for sharps?
  • Can I put “sharps” into the trash?
  • Why is it allowable to throw “sharps” into the trash and not properly package them?
  • If I choose to package my “sharps” in a plastic bottle, will the bottle get recycled?

 

Solid and Infectious Waste Policies

1. Infectious Waste Law and Rule

Summary
Establishes infectious waste generator requirements – The rule establishes standards for segregating, containing, treating, transporting, and disposing of infectious waste.

Exempts individual and single families – Ohio’s infectious waste standards specifically exempt single family residences and any infectious waste, including used syringes , generated by individuals for their own care or treatment.

Exempts individuals from meeting infectious waste transportation standards – Individuals may take their used sharps to a hospital without having to meet infectious waste transportation standards.

Does not address community sharps container collection sites – Community sharps container collection sites are not specifically addressed by the rule. However, any facility that accepts sharps is considered an infectious waste generator under the Ohio standards.

Allows small quantity generators to dispose of sharps in the trash – Facilities that generate fewer than 50 pounds of infectious waste per month (e.g., a physician’s office) must properly contain and label sharps in rigid, tightly-closed, puncture-resistant containers with the word “sharps” and the international biohazard symbol on the container. Once contained and labeled, they may be disposed in the trash. This practice may be restricted by local regulations.

Law
Revised Code of Ohio, Title 37 [Health – Safety – Morals], Chapter 3734 [Solid and Hazardous Waste] [Ref 1]

Rule
Ohio Administrative Code, Chapter 3745 [Environmental Protection Agency – Administration and Director], Chapter 3745-27 [Solid and Infectious Waste Regulations] [Ref 2]

Responsible Agency
Ohio Environmental Protection Agency


Bloodborne Pathogen Standards

Summary
Federal bloodborne pathogen rule applies – Ohio 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
US Occupational Safety and Health Administration
Regional Office (Responsible for administrative activities in Region 5)
Area Office (Responsible for OSHA compliance in Ohio)


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 Ohio’s Laws and Regulations
Community sharps container collections sites, such as pharmacies or fire stations, must follow the standards of Ohio’s infectious waste law and rule. This may discourage some facilities from establishing community sharps collection programs.

The federal OSHA bloodborne pathogen standard discourages programs in which employees handle filled sharps containers from customers, and encourages programs in which employees do not have to handle filled containers because customers place them directly into a collection container.

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 Ohio’s Laws and Regulations
Sharps container mailback programs are not addressed by Ohio’s infectious waste law or 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 Ohio’s Laws and Regulations
Individuals may dispose of their used syringes in the trash. This is likely to lessen participation in community sharps container collection programs.

Facilities that generate fewer than 50 pounds of infectious waste each month such as a physician’s office or a sharps collection site may dispose of their sharps in the trash, once properly contained and labeled. This is contrary to the purpose of collecting sharps for proper and safe disposal.


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


Current Identified Community Syringe Disposal Programs in Ohio Go to Top

Identified Sharps Container Collection Site Programs

No sharps container collection site programs were identified in Ohio, although this does not mean that none exist in the state.

Identified Syringe Exchange Programs [Ref 6]

Free Clinic of Greater Cleveland
12201 Euclid Avenue
Cleveland, Ohio 44106
Tel: (216) 721-4010
Fax: (216) 721-2431

David House
PO Box 391
Toledo, OH 43697-0391
Tel: (419) 244-6682
Tel: (800) 519-4479
Email: davidshouse@davidshouse.com


Responsible Agencies in Ohio

Links below will open in a new browser window.

Infectious Waste Issues

Ohio Environmental Protection Agency
Division of Solid and Infectious Waste Management
Infectious Waste Program
P. O. Box 1049
Columbus, Ohio 43216-1049
Tel: (614) 644-2621
Fax: (614) 728-5315

Contact:
Alison Shockley, Supervisor
Infectious Waste and Composting Unit
Tel: (614) 728-5335
Fax: (614) 728-5315
Email: alison.shockley@epa.state.oh.us

Bloodborne Pathogen Issues

U.S. Occupational Safety and Health Administration (OSHA)
OSHA Regional Office
230 South Dearborn Street, Room 3244
Chicago, Illinois 60604
(312) 353-2220
(312) 353-7774 FAX

OSHA Area Office
Cincinnati Area Office
36 Triangle Park Drive
Cincinnati, Ohio 45246
(513) 841-4132
(513) 841-4114 FAX

Cleveland Area Office
Federal Office Building
1240 East 9th Street, Room 899
Cleveland, Ohio 44199
(216) 522-3818
(216) 771-6148 FAX

Columbus Area Office
Federal Office Building
200 North High Street, Room 620
Columbus, Ohio 43215
(614) 469-5582
(614) 469-6791 FAX

Toledo Area Office
Ohio Building
420 Madison Avenue, Suite 600
Toledo, Ohio 43604
(419) 259-7542
(419) 259-6355 FAX


References

Links below will open in a new browser window.

1. Ohio Solid and Hazardous (Infectious) Waste Laws – Revised Code of Ohio, Title 37 [Health – Safety – Morals], Chapter 3734 [Solid and Hazardous Waste] [On the left side of the screen, scroll to and click on “Title 37.” Scroll to and click on “Chapter 3734.”]

2. Ohio Solid and Infectious Waste Regulations – Ohio Administrative Code, Chapter 3745 [Environmental Protection Agency – Administration and Director], Chapter 3745-27 [Solid and Infectious Waste Regulations] [On the left side of the screen, scroll to and click on “Chapter 3745.” Scroll to and click on “Chapter 3745-27”.]

3. OSHA Bloodborne Pathogen Standards – 29 CFR Part 1910.1030.

4. USPS Domestic Mail Manual [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. American Journal of Public Health 1990;80(10):1262-1264.

6. North American Needle Exchange Network. [Click on "Needle Exchange Program Links" and select Ohio from teh U.S. map]



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