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Safe Community Needle Disposal

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

Content Verified on: February 4, 2003


Summary

Regulatory Environment

  • Local governments are authorized to manage syringe collection and disposal programs.
  • Syringe disposal in trash is prohibited in communities where garbage companies provide special residential collection services for used syringes. Companies offering this service must also provide information about proper disposal methods. No such services have been identified to date.

Identified Community-based Disposal Initiatives

  • Several pharmacy-based syringe container collection programs.
  • No state-level disposal guidance for individuals.
  • Several syringe exchange programs exist.

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 state of Washington has not published any state-level guidance for individuals on how to safely dispose of used syringes.


Solid and Infectious Waste Policies

1. Washington Biomedical Waste Law

Summary
Establishes definition – “Sharps waste” (hypodermic needles, syringes with needles attached, and lancets) is defined as a form of biomedical waste.

Prohibits sharps in recycling containers – Disposing of used sharps into recycling bins or at a recycling facility is prohibited unless the facility has been designated by a local health department as a sharps collection site.

Conditionally prohibits sharps in trash – Disposing of used sharps in the trash is permitted except in areas of the state that have a residential sharps collection service (no such services have been identified). Local health jurisdictions are responsible for enforcing these requirements.

Some areas of the state, including Seattle, send their solid waste to an Oregon landfill. These areas must comply with Oregon’s law prohibiting disposal of used syringes in the trash.

Permits special residential sharps collection services – If a garbage haulers wishes to offer separate residential sharps collection, it must notify the public in writing that the service is available. Notification must provide details on how to properly dispose of residential sharps waste, how to obtain waste containers, the cost of the program, options to home collection of sharps waste, and the legal requirements of residential waste disposal.

Law
Chapter 70.95K of the Revised Code of Washington (RCW) [Ref 1]

Responsible Agency
Local health departments and districts
For further information, contact: Washington State Department of Health

2. Washington Solid Waste Law

Summary
Excludes pharmacies from solid waste regulations – Pharmacies that offer sharps collection do not have to meet the state’s solid waste facility requirements. They also do not need to obtain a solid waste handling permit.

Requires pharmacy registration – Pharmacies offering sharps collection must register at no cost with the Washington State Department of Ecology. The Department of Ecology is required to share the name and location of registered pharmacies with local health jurisdictions and local solid waste management officials.

Law
RCW 70.95.715 [Ref 2]

Responsible Agency
Washington State Department of Ecology

3. Washington Biomedical Waste Transportation Rule

Summary
Establishes standards for transporters – Registered biomedical waste transporters must meet specific requirements related to operation, training, packaging, containment, transfer to off-site treatment and disposal facilities, and waste tracking.

Establishes standards for sharps collection programs – Operators of community sharps collection programs using transporter services must meet specified transportation packaging and labeling requirements.

Regulation
Chapter 480-70 of the Washington Administrative Code (WAC), Part 9 [Ref 3]

Responsible Agency
Washington Utilities and Transportation Commission


Bloodborne Pathogen Standards

Summary
Adopts federal bloodborne pathogen rule – Washington’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
Chapter 296-62 WAC, Part J [Ref 4]

Responsible Agency
Washington Department of Labor and Industries


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 Washington’s Laws and Regulations
Washington’s solid waste law encourages pharmacies to become collection sites because participating pharmacies do not have to meet the state’s solid waste facility standards and permitting requirements. Pharmacies must register with the state, but registration is free.

Washington’s 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.

Pharmacies that choose to use a registered biomedical waste transporter must meet sharps container packaging and labeling requirements of the state’s biomedical waste transportation regulation.

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 Washington’s Laws and Regulations
Sharps container mailback programs are not addressed by Washington’s biomedical waste law. However, sharps container collection programs are regulated under the U.S. Postal Service (USPS) when syringes are mailed [Ref 5]. 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 Washington’s Laws and Regulations
Individuals may dispose of used sharps in the trash except in areas where a residential sharps collection service is available. No such services have been identified in Washington, so it appears that sharps can be legally disposed in the trash in most parts of the state.

Some regions of the state, such as the City of Seattle, send their solid waste to a landfill in Oregon and must meet Oregon’s law prohibiting sharps in the trash. Local restrictions may also apply.


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


Current Identified Community Syringe Disposal Programs in Washington Go to Top

Pharmacy Sharps Container Collection Program
As of January 3, 2002, more than 90 pharmacies have registered to participate in Washington’s pharmacy sharps container collection program. This represents approximately 9% of the pharmacies in the state.

To obtain a list of participating pharmacies, contact:
Randy Martin
Washington State Department of Ecology
Solid Waste and Financial Assistance Program
PO Box 47600
Olympia, WA 98504-7600
Tel: (360) 407-6316
Fax: (360) 407-6102
Email: rama461@ecy.wa.gov

Sharps Container Distribution/Collection-Site Program
The Tacoma/Pierce County health department has been operating a sharps container distribution and collection program since April 25, 1994. This free program targets anyone using sharps in the community.

The health department obtains funding, orders sharps containers, and distributes them. Each empty container comes with a information brochure entitled “Sharps Disposal Program,” and has a warning sticker that users apply to it when they begin to fill it with used sharps.

Sharps containers can be picked up at three Pierce County public health offices, the River Falls Area Hospital, and any local pharmacy in Pierce County. Users bring filled containers to the public health offices or the River Falls Area Hospital Emergency Room for biohazard disposal and then get a clean new container.

Reasons for starting the program – The public health department realized the need through its homecare program. People with diabetes had no safe way of collecting or disposing of lancets and needles. There also had been incidents of syringes and needles washing up on beaches and waste handlers being stuck by sharps.

Funding – The Kinnickinnic Valley Health and Education Foundation and the Pierce County Solid Waste Department funding the program. The program costs approximately $1,896/year. The public health director requests funding annually.

Program impact – Although the Public Health Department does not collect data on the program, it appears that fewer syringes are disposed of improperly in the community.

Program barriers – Initially, funding was a barrier. However, the Kinnickinnic Foundation and Pierce County Solid Waste Department see the merit of having such a program and continue to fund it for now.

For more information about the program or to obtain the “Sharps Disposal Program” brochure, contact:
Dorothy Beix
Pierce County Public Health Department
PO Box 238, 412 West Kinne
Ellsworth, WA 54011
Tel: (715) 273-6755
Fax: (715) 273-6854
Email: ddbeix@hagertelecom.net

Bartell Drugs Sharps Container Distribution/Collection Site Program
Bartell Drugs serves an area with approximately 1.3 million residents. In this program a customer purchases an approved Becton-Dickinson (BD) sharps container, which holds about 100 sharps, for $2.99 and pays an additional $1.50 disposing fee. After the container is full, the customer returns it to any of the 50 Bartell Drug stores operating in the Greater Puget Sound area.

The pharmacy puts the filled sharps container into a SteriTub, a sharps storage container provided by Stericycle (a large medical waste disposal company). A SteriTub holds 28 BD containers. Once the SteriTub is full, Stericycle picks it up and provides the pharmacy with an empty SteriTub. The Washington State Utilities and Transportation Commission sets the cost for delivery and pick-up by Stericycle at $35.16.

Reasons for starting the program – The program was started in response to the Washington state statute that makes it illegal to dispose of syringes in the household trash in areas of the state that have a residential sharps collection service [Ref 1].

Funding – The program is funded by a combination of the retail sales of the sharps containers and disposal fees. The pharmacies pay for the contract and pick-up fees charged by Stericycle.

Program statistics – Bartell Drugs does not collect statistics on its program. The program does not appear to be heavily used.

Regulations – To meet the Washington State Department of Labor and Industries OSHA bloodborne pathogen requirements, Bartell Drugs has developed an exposure plan and training/methodology document for employees who collect the sharps containers.

Literature – Bartell Drugs has developed a two-page document entitled “Bartell Drugs Sharps Return Program.” This document provides a program description, and the Exposure Plan and Training/Methodology protocols to meet Washington State’s bloodborne pathogen standards.

For more information, contact:
Michelle Thomas
Bartell Drugs
4727 Denver Avenue South
Seattle, WA 98134
Tel: (206) 767-1375
Email: michelle@bartelldrugs.com


Responsible Agencies in Washington

Links below will open in a new browser window.

Washington State Department of EcologyLink to a non-CDC site
Olympia, WA
Telephone: 360/407-6000

For more information:
Randy Martin
Washington State Department of Ecology
Telephone: 360/407-6316
Email: rama461@ecy.wa.gov

Washington Utilities and Transportation CommissionLink to a non-CDC site
1300 S. Evergreen Park Drive SW
Olympia WA 98504-7250
Telephone: 360/664-1160

For more information
Cathie Anderson
Washington Utilities and Transportation Commission
1300 S. Evergreen Park Drive SW
Olympia, WA 98504-7250
mailto:webmaster@wutc.wa.gov
Telephone: 360/664-1254
Fax: 360/586-1150
Email: canderso@wutc.wa.gov

Washington Department of Labor and Industries
Olympia, WA 98504-4001
Telephone: 360/902-4200
For more information
Mary Miller
Telephone: 360/902-5666
Email: mmar235@Ini.wa.gov


References

Links below will open in a new browser window.

1. WA Biomedical Waste Law – Chapter 70.95K RCWLink to a non-CDC site [Biomedical Waste]

2. WA Solid Waste Law – RCW 70.95.715Link to a non-CDC site [Sharps waste – Drop off sites – Pharmacy return program]

3. WA Biomedical Waste Transportation Rule – Washington Administrative Code, Chapter 480-70 WAC, Part 9Link to a non-CDC site

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

5. USPS Domestic Mail ManualLink to a non-CDC site [Click on “DMM Subject Index” then scroll to and click on “Sharps, CO23.85”]

6. 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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