Background Information
Needle Use
Individuals who inject themselves as a treatment for diabetes, allergies or other diseases are known as "self-injectors."
Every year, more than 2 billion needles and syringes are used by self-injectors in the community outside traditional health care settings, most by people with diabetes to administer insulin.
Home health care is a rapidly increasing source of used sharps.
Injection drug users (IDUs), who annually make about one billion injections of illicit drugs, are also self-injectors.
The Problem
Most sharps are discarded into the public solid waste system, posing risk or injury and infection to anyone who encounters them.
In addition to causing injuries, used needles can transmit blood-borne pathogens such as the viruses that causes AIDS (HIV), hepatitis B and C.
Despite the growing problems associated with improper disposal of sharps produced and generated outside health facilities, there currently are no federal regulations for their safe disposal.
While some states and local governments have their own disposal guidelines, laws and regulations, many are ineffective, unclear or even conflicting, creating confusion among self-injectors.
IDUs often avoid safe disposal because of syringe and drug paraphernalia laws. Possession of syringes by IDUs carries a high risk of arrest, fines or imprisonment.
Barriers encountered in finding safe alternatives include cost, confidentiality, convenience, bias, a federal ban on funding syringe-exchange programs, and a lack of public awareness.
Definitive data are lacking on the incidence of injuries and infections sustained by workers and the public from used sharps outside health care facilities.
There is a critical need for appropriate alternatives for self-injectors who continue to place used sharps in the municipal waste system.
The Solution
A January 2001 meeting on "Safe Community Syringe Disposal: Understanding the Barriers and Creating Solutions" at the American Pharmacists Association in Washington, DC. sparked creation of a national effort.
Thirty attendees from organizations with a stake in this issue identified public health implications of unsafe sharps disposal and described as inadequate current community efforts to promote the safe disposal of used needles.
The group concluded that unsafe sharps disposal is widespread and that the populations most at risk are sanitation workers, waste employees, hospitality employees and children.
Public attitudes about needle disposal need to change to reflect the belief that placing needles in the trash is unacceptable, much like current attitudes about recycling.
Above all, we need to create effective, inexpensive and widely available methods for people to dispose of needles and sharps without putting them in their communities’ solid waste systems.
The Coalition
Sparked by the January 2001 meeting, the Coalition for Safe Community Needle Disposal was established in Houston in 2002 to assume a nationwide role in promoting the safe disposal of used needles and syringes.
Start-up funding for the not-for-profit coalition was provided by Waste Management, Inc. and Becton, Dickinson and Company.
Advisory Council members include: American Association of Diabetes Educators, American Diabetes Association, American Medical Association, American Pharmacists Association, Environmental Industry Association, National Alliance of State and Territorial AIDS Directors, National Association of County and City Health Officials, National Association of Chain Drug Stores, National Association of Home Care, National Recycling Coalition, and U.S. Conference of Mayors.