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Safe Community Needle Disposal

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

Content Verified on: June 26, 2003


Summary

Regulatory Environment

  • The South Dakota Department of Environment and Natural Resources enforces the laws and regulations relating to medical waste and provides management standards for its treatment and disposal.
  • Sharps (hypodermic needles and syringes) are contained within South Dakota’s definition of regulated medical waste and are therefore subject to its regulations.
  • South Dakota specifically exempts household-generated medical waste from current medical waste regulations.

Identified Community-based Disposal Initiatives

  • The Sioux Falls City Health Department operates a syringe container collection program in collaboration with Lewis Drug Stores and the Veterans Administration (VA) Medical Center.

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

South Dakota has not published guidance for individuals on safely disposing of used syringes. However, the state’s Department of Environment and Natural Resources encourages individuals to disinfect used sharps before placing them into a rigid, puncture-resistant container and disposing of them in the household trash.


Solid and Infectious Waste Policies

1. Solid Waste Management Statute

Summary
Establishes authority – The solid waste management statute requires the within South Dakota’s Department of Environmental Protection, Board of Minerals and Environment, to adopt a statewide comprehensive solid waste management plan.

Law
Section 34A-6 of the South Dakota Codified Laws (SDCL) [Ref 1]

2. Medical Waste Rules

Summary
Establishes a definition – “Sharps” (hypodermic needles and syringes) are contained within South Dakota’s definition of regulated medical waste.

Establishes regulations for medical waste facilities – The rules require facilities that treat medical waste to obtain all appropriate local, state, and federal permits; maintain appropriate records; treat medical waste by an approved method; meet standards, perform tests and monitor for certain chemical emissions; and regulate incinerators.

Establishes storage requirements for sharps – Untreated sharps must be placed in a rigid, puncture-resistant and leak resistant container.

Establishes labeling requirements – All medical waste containers must have a water-resistant label that includes the words “Medical Waste” or “Infectious Waste” or displays the universal biohazard symbol. The container must also be marked with a water-resistant identification tag that contains the generator’s name and address; transporter’s name and address; date of shipment; and identification of the contents as medical waste prior to transport and disposal.

Establishes treatment requirements – Regulated medical waste must be treated with a Department-approved method before disposal.

Exempts household generated medical waste – Syringes used in household are specifically exempt from the medical waste rules.

Law
Chapter 74:35:01 of the Administrative Rules of South Dakota (ARSD) [Ref 2]

Responsible Agency
South Dakota Department of Environment and Natural Resources


Bloodborne Pathogen Standards

Summary
Federal bloodborne pathogen rule applies
– South Dakota 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
U.S. Occupational Safety and Health Administration
Regional Office (Responsible for administrative activities in Region 8)
Area Office (Responsible for OSHA compliance in South Dakota)


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 Dakota’s Laws and Regulations on Container Collection Sites
Community syringe container collection sites are not specifically addressed in South Dakota’s solid waste regulations. Based on a conservative interpretation of South Dakota law and rule, a collection site would be seen as a facility that handles regulated medical waste and would therefore be subject to the requirements of the law.

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 Dakota’s Laws and Regulations on Container Mailback Programs
Sharps container mailback programs are not addressed by South Dakota’s medical 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 6].
  • 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 Dakota’s Laws and Regulations on Disposal in the Trash
The Administrative Rules of South Dakota (ARSD) exclude household waste from the definition of regulated medical waste. Therefore, persons who use syringes in the home are not required to comply with the regulations and standards set forth by ARSD and can dispose of their syringes with their household trash. However, the Department of Environment and Natural Resources recommends that sharps be disinfected and then placed into a rigid, puncture-resistant container before disposal in the household trash.


How Might South Dakota Ensure Safe Syringe Disposal by Individuals in the Community?

The state legislature and individual communities may wish to 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 Dakota move toward the goal of “no syringes discarded in the trash or public locations.”


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

Sioux Falls Syringe Container Collection Program

The Sioux Falls City Health Department operates a syringe container collection program in collaboration with Lewis Drug Stores and the Veterans Administration (VA) Medical Center. The program was started in 1999 in response to questions from the community about syringe disposal in local landfills.

Individuals may get free sharps containers from Lewis Drug Stores. When the containers are filled with used syringes individuals can bring them to a Lewis drug store, where the syringes will be placed into another syringe container by pharmacy workers trained in accordance with OSHA standards. The containers are then transported to the Veterans Administration Hospital, where they are documented, sterilized, and transported to a landfill for disposal.

Funding for this program comes from “tipping” fees paid by garbage haulers that dump or “tip” their garbage at local landfills. The Health Department estimates that about 2,250 containers are collected per year.

For more information, contact:
Morris Forsting
Sioux Falls Health Department
132 N. Dakota Avenue
Sioux Falls, South Dakota 57102
Tel: (605) 367-8760


Responsible Agencies in South Dakota

Links below will open in a new browser window.

South Dakota Department of Environment and Natural ResourcesLink to a non-CDC site
Waste Management Program
523 East Capitol
Pierre, South Dakota 57501-3182
Tel: (605) 773-3153
Fax: (605) 773-6035
Contact: Jim Wendte
Natural Resources Engineering Director
Tel: (605)773-3153
Email: jim.wendte@state.sd.us

South Dakota Department of HealthLink to a non-CDC site
Office of Licensure & Certification
615 East 4th St.
Pierre, South Dakota 57501
Tel: (605) 773 3356
Contact: Toye Thelen, RN
QMRP Public Health Advisor
Email: toye.thelen@state.sd.us

U.S. Occupational Safety and Health AdministrationLink to a non-CDC site
Regional OfficeLink to a non-CDC site
1999 Broadway, Suite 1690
PO Box 46550
Denver, Colorado 80201-6550
Tel: (303) 844-1600
Fax: (303) 844-1616


References

Links below will open in a new browser window.

1. South Dakota Codified LawsLink to a non-CDC site (SDCL), Section 34A-6 [Solid Waste Management]

2. Administrative Rules of South DakotaLink to a non-CDC site (ARSD), Chapter 74:35:01 [Disposal of Medical Waste]

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

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.



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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