Needling Change

Alice P. Jacobsohn

An unexpected encounter with a used syringe, needle or other sharp object at a collection site, transfer station or landfill can provoke intense fears of life-threatening infections. If an injury involves a needle, costs can be significant. Unfortunately, options for safe disposal often are limited and poorly understood. Therefore, in June, the Coalition for Safe Community Needle Disposal met in Washington, D.C., to resolve this serious healthcare issue.

The problem begins with the generator community but trickles down to the waste industry because needles are used by self-injectors and individuals with diabetes, allergies or other diseases, then are placed into the municipal solid waste (MSW) stream. Although needle injuries at collection sites, transfer stations and landfills are low, a dramatic reduction or complete elimination of needles and other sharps from MSW is the most effective approach to protect workers.

Every year, self-injectors use more than 2 billion needles and syringes. Home healthcare also is a rapidly increasing source of used needles. Illicit drug users, who annually make about 1 billion injections, add to the waste stream.

Used needles can transmit bloodborne pathogens, such as the viruses that cause hepatitis B and C and AIDS. Despite potential injuries, there are no federal regulations for safe needle disposal at nontraditional healthcare settings because they fall outside the regulated medical waste definition, are not considered infectious or enforcement is viewed as impractical. Some state and local governments have developed disposal guidelines, laws and regulations, but many are ineffective or confusing to self-injectors. Often, self-injectors avoid safe disposal to protect their privacy or to avoid syringe and drug paraphernalia laws. Also, safe disposal can be costly.

The nonprofit coalition was formed following a January 2001 meeting held at the American Pharmaceutical Association, Washington, D.C., where 30 attendees from organizations discussed the public health implications of unsafe disposal. The coalition states that needle disposal programs must include:

To ensure that such programs exist, the coalition first will garner support from stakeholders, such as state agencies, trade associations and healthcare groups. Fundraising will be an ongoing component, particularly because the coalition's goals are long-term. Comprehensive data collection will be necessary through studies that accomplish the following:

Call the coalition toll-free at (800) 643-1643 or visit www.safeneedledisposal.org.

Alice Jacobsohn is NSWMA's public affairs and industry research director. E-mail: [email protected].