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Safe Community Needle Disposal

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

Content Verified on: August 5, 2002


Summary

Regulatory Environment

  • The West Virginia Department of Health and Human Resources regulates infectious medical waste.
  • Individuals are allowed to dispose of syringes and other sharps in the trash if they are first placed in a puncture-resistant container.

Identified Community-based Disposal Initiatives

  • The state has published disposal guidance for individuals.

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 West Virginia Department of Health and Human Resources, Public Health Sanitation Division, provides management guidelines for disposing of household generated syringes in a brochure entitled “A Household Guide for the Proper Disposal of Syringes and SharpsLink to a non-CDC site Click on Public Health Sanitation Division, Infectious Medical Waste, Proper Disposal of Household Infectious Waste, Disposal of Household Infectious Waste).

The guidance includes these recommendations:

  • Place syringes and needles in hard plastic or metal containers that have screw on caps or tightly fitting lids (Examples include: liquid detergent bottles, bleach bottles, or coffee cans. If a coffee can is used, reinforce the lid with heavy duty tape.)
  • Place the container in close proximity to where you will be using the syringes.
  • Place the sharps directly into the container immediately after use.
  • When the container is nearly full, add a sanitizing solution made by adding one teaspoon of 5.25% bleach to one pint of water and then seal the container.
  • Label the container, “Not Recyclable Treated Sharps” with a permanent marker.
  • Place the container in a plastic bag and seal the bag with tape.
  • Place the bag in the garbage.

The guidance includes these warnings:

  • Do not place syringes in clear plastic or glass containers.
  • Be sure to store the containers in a secure location that is both child and animal proof.
  • Do not recap, remove, bend or break the needle.

Solid and Infectious Waste Policies

1. West Virginia Medical Waste Act

Summary
Establishes authority - The Department of Health and Human Resources manages state infectious medical waste. The Medical Waste Act covers the generation, storage, handling, management, treatment, transportation, and disposal of infectious medical waste within the state.

Law
Chapter 20 Article 5J of the West Virginia Code [Ref 1]

2. West Virginia Infectious Medical Waste Regulation

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

Exempts household generated sharps – Sharps that are generated within a household are specifically exempt from West Virginia infectious medical waste regulations so long as people place sharps in a puncture-resistant container before disposing of the container in the trash.
Establishes permit requirements – Facilities that handle infectious medical waste are required to obtain appropriate permits.

Establishes standards for sharps packaging – Facilities that handle sharps are required to package them in containers that are rigid, leak-proof, and puncture-resistant. Containers must be labeled as infectious medical waste and they must not be completely filled.

Sharps containers that are brought off-site for treatment or storage must be placed inside a leak-proof, red or orange plastic bag of certifiable strength. Orange colored bags are used if the infectious medical waste is being treated with steam. The open end of the bag must be gathered and taped closed.

Establishes labeling standards for sharps packages – Before treatment, facilities should label all bags “infectious medical waste”, “biomedical waste”, “biohazard”, or “regulated medical waste” and marked with the universal biohazard symbol.

Establishes standards for transportation of sharps – Facilities that transport infectious waste off-site must package it in “double-wall corrugated fiberboard boxes or equivalent rigid containers. The boxes or containers shall be leak-resistant or lined with a tear-resistant leak-proof plastic bag.” The outer layer of packaging must contain a label that provides information from all persons who manage the infectious waste from that point forward as well as a certification of treatment, if that waste has been treated.

Infectious waste can only be transported to permitted infectious medical waste management facilities.

Establishes treatment methods for sharps – Methods for treating sharps include: incineration, stream treatment, discharge to a sanitary sewer, or any other method approved by the Department.

Establishes storage standards for sharps – Facilities must store infectious medical waste in a secure, designated area.

Law
Title 64 Series 56 of the West Virginia Code of State Rules (WV CSR) [Ref 2]

Responsible Agency:
West Virginia Department of Health and Human Resources
Office of Environmental Health Services


Bloodborne Pathogen Standards

Federal bloodborne pathogen rule applies – West Virginia 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 3)
Area Office (Responsible for OSHA compliance in West Virginia)


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 West Virginia’s Laws and Regulations
Sharps collection container sites are not specifically mentioned in West Virginia’s laws and regulations.

Collection sites may be subject to meeting West Virginia’s infectious medical waste regulations as well as the federal 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 West Virginia’s Laws and Regulations
The West Virginia Code of State Rules [Ref 2] allows infectious medical waste to be transported through the United States Postal Service provided the federal requirements are met.

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 West Virginia’s Laws and Regulations
The West Virginia Code of State Rules [Ref 2] specifically exempts infectious medical waste generated within a household from the infectious medical waste requirements, provided persons place sharps in a puncture-resistant container before disposing of the container in the trash.


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


Current Identified Community Syringe Disposal Programs in West Virginia Go to Top

No community syringe disposal programs have been identified in West Virginia. However, this does not mean that no programs operate in the state.


Responsible Agencies in West Virginia

Links below will open in a new browser window.

WV Department of Health and Human Resources
Bureau of Public Health
Office of Environmental Services
Public Health Sanitation Division
Infectious Medical Waste Program
815 Quarrier Street, Suite 418
Charleston, West Virginia 25301
Telephone: 304/558-2981 or 1-800-368-4358

West Virginia Department of Health and Human Resources
Office of Environmental Health ServicesLink to a non-CDC site
Public Health Sanitation Division
815 Quarrier Street, Suite 418
Charleston, West Virginia 25301-2616
Telephone: 304/558-2981 or 800-ENV-HELT

Contact –
Joseph A. Wyatt
Telephone: 304/558-6730
Email: jwyatt@wvdhhr.org

US Occupational Safety and Health Administration
Regional Office (Responsible for administrative activities in Region 3)
The Curtis Center – Suite 740 West
170 S. Independence Mall West
Philadelphia, PA 19106-3309
(215) 861-4900
(215) 861-4904 FAX

Area Office (Responsible for OSHA compliance in West Virginia)
Charleston Area Office
405 Capitol Street
Suite 407
Charleston, WV 25301-1727
(304) 347-5937
(304) 347-5275 FAX


References

Links below will open in a new browser window.

1. West Virginia Medical Waste Act - West Virginia Code Chapter 20Link to a non-CDC site [Natural Resources], Article 5J [Medical Waste Act] [Click on “WV Code”, then click on “State Code”, and then type in “[medical waste]” in the Search box]

2. West Virginia Infectious Medical Waste Regulation - West Virginia Code of State RulesLink to a non-CDC site (WV CSR), Title 64 [Legislative Rule, Division of Health, Department of Health and Human Resources], Series 56 [Infectious 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.



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