By Melanie R. Margolis
My dog suffers from diabetes. I have administered two insulin injections to him every day for the past year and a half. His twice daily insulin injections result in a large number of used syringes, and I confess: I have been at a loss as to what to do with them.
I have discovered that home sharps containers are difficult to find and are very expensive. Once found and paid for, they are small and fill quickly. I inquired at the veterinarian’s office, and they suggested using empty bleach bottles. A friend showed me how her diabetic mother recaps the syringes after use and breaks the needle off, discarding the syringe and placing only the capped needle in a sharps container, which takes up much less room than the entire syringe. I had been told by the veterinarian, however, never to recap a syringe.
Then, the question arises as to what should be done with the sharps container (or the bleach bottle or other makeshift holder) when it becomes full. I was sure that hospitals did not just toss sharps containers out with the regular trash. It seemed that I should not either. The label on the sharps container said the container must be disposed of in accordance with applicable law. I did not know what the law said on this matter. I was certain that many others did not know either. I was just pleased to discover eventually that my veterinarian’s office was willing to dispose of the sharps container for me. Veterinarians, as well as providers of human health care, have the means to dispose safely of used sharps, as they are required to do by Texas regulations governing solid waste. See 30 TAC § 330.1004 (2003) (Texas Commission on Environmental Quality, Municipal Solid Waste).
The rules concerning the disposal of sharps outside the health care setting are actually very simple: no Texas regulations govern it. In fact, the Texas solid waste regulations governing medical waste specifically exempt “single or multi-family dwellings.” Id. Thus, sharps used outside the health care setting are generally discarded into the public solid waste system, where they pose risk of injury and infection to solid waste workers and others who come across them. These discarded sharps can transmit blood-borne pathogens, including HIV and hepatitis B and C.
How big is this problem? Estimates indicate that more than 2 billion needles are used annually by self-injectors outside of traditional health care settings, according to the Coalition for Safe Community Needle Disposal web site, accessible at http://www.safeneedledisposal.org. Some needle users are diabetic, some self-administer allergy shots, and others are users of illicit drugs. The rise in home health care has also contributed to the use of sharps in the community.
Concerns about the disposal of used needles outside of health care settings brought about the formation in 2002 of the Coalition for Safe Community Needle Disposal. It was established to address the problem of limited options available for disposal of used needles and other sharps in the community. The following organizations comprise the Coalition’s advisory council: the American Association of Diabetes Educators, the American Diabetes Association, the American Medical Association, the American Pharmaceutical Association, the Association of State and Territorial Health Officials, and the National Alliance of State and Territorial AIDS Directors. The Coalition seeks to provide resources to help community and state efforts to develop programs for safe disposal of used needles and other sharps. For more information, see http://www.safeneedledisposal.org.
Most individuals who dispose of sharps at home would like to have some guidance on how to do so safely, and certainly the public would benefit greatly from the proper disposal of sharps. After all, it may be easier than you think to find a discarded hypodermic needle in a public place. Unfortunately, it is no longer like looking for a needle in a haystack, and this needle may carry blood-borne pathogens.