Coalition launches national campaign for cut infection risk from improperly disposed needles
2002-08-20Policy void leaves workers, general public at risk:
AMA, ADA, AADE, APhA, ASTHO, NASTAD
August 20, 2002, HOUSTON - Improper disposal of used hypodermic needles and other "sharps" outside healthcare facilities poses a potentially serious risk of infection or injury to thousands of Americans, according to the American Medical Association and five other leading public health organizations.
"Used, improperly discarded needles pose a serious risk of injury and even infection to unsuspecting workers, families, and pets across the U.S. in their homes, workplaces and public areas," said AnneBurns of the American Pharmacists Association, the national professional society of pharmacists. "Current practices, regulations and resources are often incomplete, inconsistent and misleading, resulting in an unintended public safety hazard," she added.
U.S. residents use needles and syringes to inject themselves more than 3 billion times each year. One out of 12 households includes someone who uses hypodermic needles and syringes. Most used needles end up in the solid waste system, where they pose a grave health risk to anyone encountering them through the course of their work, spills or other accidents. Used needles can transmit numerous blood-borne pathogens, including HIV, the virus that causes AIDS, as well as hepatitis B and C.
To address this risk, six organizations - the American Medical Association, American Diabetes Association, American Association of Diabetes Educators, American Pharmacists Association, Association of State and Territorial Health Officials, and National Alliance of State and Territorial AIDS Directors - have agreed to serve as an advisory council to the newly-formed Coalition for Safe Community Needle Disposal and have issued a national call to action for their members to initiate new safe needle disposal practices in urban, suburban and rural communities nationwide. Start-up funding was provided by The Waste Management Charitable Foundation, Inc., and BD (Becton, Dickinson and Company) (NYSE: BDX).
"The AMA is concerned about any behavior that puts patients and the public at risk," said Patricia L. Turner, M.D., the resident member of the American Medical Association's Council on Scientific Affairs. "We have studied this problem carefully, and feel that we need clear guidelines for the safe disposal of needles outside the healthcare setting. This is why the AMA has agreed to participate in this important process by becoming a member of the Coalition."
Regulations and procedures exist in medical facilities and other workplaces handling infectious materials to protect healthcare professionals and other workers from potentially dangerous needle sticks; its time to extend a similar level of protection to individuals in their homes, neighborhoods and public facilities," Dr. Turner added.
The Environmental Protection Agency (EPA) and the Occupational Safety and Health Administration (OSHA) are two federal entities that currently provide guidelines for used needle disposal. However, the EPA's website guidelines fall short of the ideal and OSHA's regulations apply only to workplaces under OSHA's jurisdiction.
"We are pleased that both the EPA and OSHA have indicated a commitment to working with the Coalition to identify better, safer and more practicable ways for the nation to dispose of used needles," said Burns.
The Coalition will work to educate individuals and policy makers about alternatives and options available to communities to assure safe needle disposal. In addition, the Coalition will use advocacy and education to support guidelines that may be used by federal, state and local officials to develop locally tailored programs for safe community disposal of used sharps.
The Coalition supports the development of disposal programs that are:
Accessible. Safe sharps collection and disposal options should be easily accessible to all members of the community and conveniently available in terms of location, days, and hours to ensure maximum utilization.
Affordable. Programs should be within reach of people at all income levels, including through reimbursement or subsidy when necessary.
Confidential. Individuals should be able to dispose of sharps privately.
Distinct. Disposal programs should consider directing sharps into a waste stream separate from the standard public waste stream.
Safe. Programs should assure the safe collection and disposal of used sharps and comply fully with any pertinent federal, state or local requirements.
Well-publicized. Information on disposal programs should be available to (and through) physicians, diabetes educators, nurses, pharmacists, substance abuse counselors, veterinarians and other health professionals who come into contact with those who use sharps.
Inclusive. Solutions should address the needs of all individuals in the community who use sharps.
Supported by the community. To be effective, solutions should have broad-based community support.
Several different types of programs currently operating in the U.S. fulfill these principles, including:
Community drop-off sites, such as pharmacists, police and fire departments, and public drop boxes.
Syringe exchange programs.
Municipal waste pick-up programs.
Mailback programs. Home users place sharps in a special container and return by U.S. Mail to a collection point where they are incinerated.
According to the Coalition, national statistics indicate that home needle use will continue to increase in coming years as diabetes and other chronic diseases that require self-administration of injectible medicines become more prevalent, as baby boomers age, as health care relies more heavily on out-patient procedures and as more people enter home health care:
There are 8 million in-home syringe users, approximately 3 percent of the U.S. population.
Of those 8 million, some 3.4 million people with diabetes require an estimated 1-2 billion injections each year. Each year injection drug users (IDUs) will administer approximately 1 billion injections of illicit drugs.
An unknown number of injections will be given for infertility, allergies, multiple sclerosis and other home health treatments, as well as to pets.
Needle stick injuries cost approximately $3,000 per injury for follow-up tests and care if no infection is incurred. Costs soar if there is a serious infection.
The Coalition for Safe Community Needle Disposal is a 501(c)3 organization available to provide technical and other assistance.