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Safe Community Needle Disposal

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

Content Verified on: November 10, 2003


Summary

Regulatory Environment

  • The Virginia Waste Management Board controls waste management activities in Virginia.
  • Virginia requires all sharps to be placed in an opaque container that is highly puncture resistant before they are mixed with other wastes or disposed in the trash

Identified Community-based Disposal Initiatives

  • Virginia’s Safe Sharps Disposal Program distributes free syringe containers to residents of the state. Individuals can call 1-800-603-4068, visit any Good Neighbor or Eckerd Pharmacy, or visit any area health department to get a home sharps container. To date, approximately 10,000 sharps containers have been distributed.

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

Virginia has no published guidance for individuals on safe disposal of syringes used at home.

Solid and Infectious Waste Policies

1. Waste Management Law

Summary
Establishes authority – The law gives the Virginia Waste Management Board the authority to supervise and control waste management activities in Virginia. The law also allows the board to develop state waste management plans and provide technical assistance, advice, and other aid for the development and implementation of local and regional waste management plans.

Law
Chapter 14 of the Code of Virginia, Title 10.1 [Ref 1]

2. Regulated Medical Waste Management Regulations (RMWMR)

Summary
Establishes definition – “Sharps” are classified as a form of regulated medical waste.

Establishes regulations for managing of medical waste – The regulations establish permit requirements for the storage, treatment and disposal of regulated medical waste (RMW) as well as rules for how it is packaged, labeled, and transported.

Establishes regulations for household generated sharps used in the home – Sharps that are used in single- or multiple-family residences must be placed in an opaque container that is highly puncture-resistant and labeled with the words “Do Not Recycle, Medical Waste” before they are mixed with other wastes or disposed.

Establishes regulations for health care professionals – Health professionals who deliver care in the private home of a patient are required to package sharps in rigid, highly leak resistant and puncture resistant containers that are properly labeled in accord with the regulations. Before the containers are filled to capacity they must be delivered to a permitted regulated medical waste treatment or storage facility.

Law
Chapter 20 of the Virginia Administrative Code, Title 9, Agency 20 [Ref 2]

Responsible Agency
Virginia Department of Environmental Quality


Bloodborne Pathogen Standards

Summary
Adopts federal bloodborne pathogen rule – Virginia’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
Virginia Department of Labor and Industry


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 Virginia’s Laws and Regulations on Container Collection Sites
Community syringe collection sites are not specifically addressed in Virginia’s Regulated Medical Waste Management Regulations (RMWMR). However, the regulations require all persons who treat, store, or dispose of regulated medical waste to obtain a permit from the Department of Environmental Quality and comply with all applicable packaging, labeling, storage, transport, and disposal requirements.

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 Virginia’s Laws and Regulations on Container Mailback Programs
Sharps container mailback programs are not addressed by Virginia’s medical waste regulations. 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 Virginia’s Laws and Regulations on Disposal in the Trash
In Virginia, medical sharps that are used in single-or multiple-family residences must be placed in an opaque container that is highly puncture resistant before they are mixed with other wastes or disposed in the trash.


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


Current Identified Community Syringe Disposal Programs in Virginia Go to Top

Virginia has established the Safe Sharps Disposal ProgramLink to a non-CDC site
to distribute free syringe containers to residents of the state. Individuals can call 1-800-603-4068, visit any Good Neighbor or Eckerd Pharmacy, or visit any area health department to get a home sharps container. To date, approximately 10,000 sharps containers have been distributed.

Partners in the Safe Sharps Disposal Program include:

  • Southeastern Public Service Authority (SPSA)
  • American Diabetes Association (ADA)
  • Eastern Virginia Association of Diabetes Educators (EVADE)
  • Senior Services of Southeastern Virginia (SEVAMP)
  • Eckerd, Inc.
  • Good Neighbor Pharmacy Program
  • Cox Communications Cable Network
  • Virginia Peninsula’s Public Service Authority
  • City of Norfolk, Public Works Division
  • Virginia Beach Health Department
  • Bon Secours OCCU MED

For more information about the Safe Sharps Disposal Program, call: 1-800-603-4068.


Responsible Agencies in Virginia

Links below will open in a new browser window.

Virginia Department of Environmental QualityLink to a non-CDC site
Office of Waste Programs
P.O. Box 10009
Richmond, Virginia 23240
Contact: Michael J. Dieter
Regulation and Program Consultant
Tel: (804) 698-4146
Email: mjdieter@deq.state.va.us

Virginia Department of Labor and IndustryLink to a non-CDC site
Powers-Taylor Building
13 South 13th Street
Richmond, Virginia 23219

Contacts:
C. Raymond Davenport, Commissioner
Tel: (804) 786-2377
Fax: (804) 371-6524

Jay Withrow, Director, Office of Legal Support
Tel: (804) 786-9873
Fax: (804) 786-8418

Glenn Cox, Director, Safety Compliance, VOSHA
Tel: (804) 786-2391
Fax: (804) 371-6524


References

Links below will open in a new browser window.

1. Code of Virginia, Title 10.1Link to a non-CDC site [Conservation], Chapter 14 [Virginia Waste Management Act]

2. The Virginia Administrative Code, Title 9 [Environment], Agency 20 [Virginia Waste Management Board], Chapter 20 [Regulated Medical Waste Management Regulations]Link to a non-CDC site

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.



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