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Safe Community Needle Disposal

South CarolinaSouth Carolina Public Health Laws and Regulations: Impact on the Safe Disposal of Used Syringes by Individuals in the Community

Content Verified on: February 12, 2003


Summary

Regulatory Environment

  • State agencies manage infectious waste generated and handled in the state. Community syringe disposal is not directly addressed.
  • Sharps generated from homes are exempt from South Carolina’s infectious waste regulations and may be disposed of in the trash.

Identified Community-based Disposal Initiatives

  • State-level disposal guidance for individuals has been published.

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 South Carolina Department of Health and Environmental Control has developed a “Get the PointLink to a non-CDC site program that provides guidance on safely disposing of used syringes at home.

The guidance provides these recommendations:

  • Sticker – Label an empty two-liter soda bottle with the warning “DO NOT RECYCLE” using either a “pre-made” warning sticker or one that you make.
  • Store – Carefully put each of your used syringes into the bottle.
  • Seal – Put tape over the closed bottle cap when the bottle is full.
  • Safe Disposal – Dispose of the filled bottle in your household trash.

Now your syringes are safely held in a container that protects people from needle sticks and is unlikely to break open on its way to the landfill.”

The guidance includes these warnings:

Remember -

  • Keep your container out of reach of small children and pets!
  • Never flush your syringes down the toilet!
  • Don’t fill your container to the top! Allow two to three inches between the syringes and the neck of the soda bottle.
  • Put a lid on it! After you use a syringe or lancet, put it directly into a two-liter soda bottle with a tight cap.
  • Pitch in! When the soda bottle is full and tightly sealed, throw it out in the trash.

Solid and Infectious Waste Policies

1. South Carolina Infectious Waste Law

Summary
Defines infectious waste – Sharps are included as a form of infectious waste.

Establishes authority – South Carolina’s Department of Health and Environmental Control has the authority to carry out the state’s Infectious Waste Management Act. The Act covers the storage and transportation of infectious waste and other matters related to generator registration, permit requirements, enforcement, and fee provisions.

Law
Title 44 [Health], Chapter 93 [Infectious Waste Management], Sections 44-93-10 to 44-93-240 [Ref 1]

Responsible Agency
South Carolina Department of Health and Environmental Control

2. South Carolina Infectious Waste Rule

Summary
Establishes an infectious waste management program – This program carries out the provisions of the South Carolina Infectious Waste Management Act. The rule applies to infectious waste that is generated, stored, contained, transferred, transported, treated, destroyed, disposed, or otherwise managed within South Carolina.

Community sharps collection sites excluded from regulation – Community sharps collection sites are not specifically addressed by South Carolina’s infectious waste rule, therefore, the regulations do not apply to such sites.

Rule
R.61.105 [Ref 2]

Responsible Agency
South Carolina Department of Health and Environmental Control


Bloodborne Pathogen Standards

Summary
Adopts federal bloodborne pathogen rule – South Carolina’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 3]

Responsible Agency
South Carolina Department of Labor, Licensing and Regulation


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 South Carolina’s Laws and Regulations
The South Carolina Infectious Waste statute and rule do not directly address sharps collection sites for syringes generated outside of the health care system. By a conservative rule interpretation, community sharps collection sites could be classified as “generators” and subject to the state’s infectious waste standards. However, according to guidance developed by the state’s Department of Health and Environmental Control, an infectious waste generator is a person or facility producing infectious waste in a health care community. This does not include waste produced in a private residence. Therefore, by policy, the Department does not regulate sharps collection sites.

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 South Carolina’s Laws and Regulations
Sharps container mailback programs are not addressed by South Carolina’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 South Carolina’s Laws and Regulations
Individuals using syringes at home may dispose of them in the trash. South Carolina law does not consider individuals who use syringes at home to be “generators” of infectious waste. Therefore, individuals using syringes in their homes are not subject to the requirements of the infectious waste law and they may dispose of their syringes in the trash.


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


Current Identified Community Syringe Disposal Programs in South Carolina Go to Top

No community syringe disposal programs were identified in South Carolina. However, this does not mean that no programs operate in the state.


Responsible Agencies in South Carolina

Links below will open in a new browser window.

South Carolina Department of Health and Environmental Control
Bureau of Land and Waste ManagementLink to a non-CDC site
Infectious Waste Management Program
2600 Bull Street
Columbia, SC 29201
Telephone: 803/898-3432

Contact
Phil Morris, Program Manager
Infectious Waste Management Section
Telephone: 803/896-4173
Email: morrispr@dhec.sc.gov

South Carolina Department of Labor, Licensing and RegulationLink to a non-CDC site
SC OSHA OfficeLink to a non-CDC site
PO Box 11329
Columbia, SC 29211-1329

Attn: Bloodborne Pathogens Section
Telephone: 803/896-4300


References

Links below will open in a new browser window.

1. South Carolina Code of Laws, Title 44Link to a non-CDC site (Health), Chapter 93 (Infectious Waste Management), Sections 44-93-10 to 44-93-240 [SC Code of Laws]; http://www.lpitr.state.sc.us/code/titl44.htmLink to a non-CDC site [Title 44 - Health]; [Chapter 93 - Infectious Waste Management]

2. South Carolina R.61.105Link to a non-CDC site (Infectious Waste Management Regulation) [Go to “Waste Management” / Go to “Infectious Waste”]

3. OSHA Bloodborne Pathogen Standards – 29 CFR Part 1910.1030.Link to a non-CDC site

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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