Sharps Container Disposal

[MSdetective]

Congratulations to my husband on six months of Avonex. Honey, you win a nifty red sharps container full of old syringes. And apparently it's yours to keep...

I have called the doctor, the pharmacy, the health department...

The doctor won't take it because they pay a service to remove theirs.

The pharmacy won't take it back, but happily sent a fresh one (yay, now we'll have a set by Christmas!)

The health department, no joke, told me to use a milk jug and duct tape it shut, and put it in the regular trash. How on earth is that legal, safe, or sanitary? I don't think so.

Thoughts or helpful hints?

TIA,
Holly

[NHE]

Hi MSDetective,
You will have to check your local county regulations on household sharps disposal. I looked into it a bit and here's what my county had to say.

What do I do with...?
Medical Sharps Generated in the Home

Putting sharps into the garbage is a health risk for solid waste workers; a loose needle could injure and possibly infect a worker. There are a number of safe options for disposal of home-generated sharps waste:

• Ask your doctor or other health care provider if you can return used sharps to his/her office or clinic.
• Check with your local pharmacy or waste collection company to see if they offer a sharps management program.
• Some pharmacies will take back full containers of sharps for proper disposal. They all require sharps to be in an approved container for drop-off, but only a few require that you have purchased the container from them. Check with your local pharmacy to see if they offer this service and if there are any fees. For example: sharps containers can be purchased at and returned to Bartell drug stores. See the Bartell Drugs Web site (external) for store location and contact information.
• You can manage your sharps using a sharps mail-in program. In these programs, you purchase a puncture-proof and leak-resistant plastic container. When the plastic container is full, you place it in a pre-addressed cardboard box and mail it. Search on "sharps mail in programs" on the internet for a list of mail-in programs.
• If you live on ______ Island, you can take full 2-liter pop bottles of medical sharps to the ______ Transfer Station, where they will be kept separate from the rest of the waste. To do this, you must first obtain a waste clearance decision.
• For ______ County residents in the ______ area, the ______ Recycling and Transfer Station has a drop-off box for deposit of used household sharps in approved sharps containers.
• For City of ______ residents, the North and South transfer Stations take sharps for free. See the City of ______ Web site (external) for details and other options.
• Although it is the least preferred option, it is still legal to place sharps in a two-liter pop bottle and dispose the bottle in your garbage can. The bottle must be marked, "SHARPS - DO NOT RECYCLE." Two-liter pop bottles have been shown not to crack or break open as often as other containers. This option poses a risk of puncture to solid waste workers. Both the federal Centers for Disease Control and the federal Environmental Protection Agency no longer support this method as preferred due to the risk to solid waste workers.

In addition, I also discovered that my local Public Health Centers will take household sharps in a special sharps disposal drop box.

Can I bring used sharps to Public Health Centers?

Only home-generated sharps may be disposed of at Public Health Centers. Several sites have secure outdoor drop boxes that are available 24 hours a day. This service is available at no charge to Public Health Center patients and to people who inject illegal drugs. The drop boxes are part of Public Health’s disease control program.

Disposal drop boxes are NOT for general medical, dental, veterinary, pharmacy or other commercial or business use.

All commercial and business generators of used sharps and syringes must dispose of them through a licensed biomedical waste transporter or approved treatment method.

• The drop boxes will accept used sharps packaged in safe containers and sharps that are loose. But, it's safer for everybody if you put your sharps and syringes in an approved container, so:
• First: Put your used sharps and syringes in a manufactured sharps container or a 2-liter P.E.T. plastic pop bottle. Make sure the lid fits tightly, then tape it shut for added safety. If you use a plastic pop bottle, label it with the warning: "SHARPS, DO NOT RECYCLE."
• Then: Bring your full container to the drop box site. You are responsible for putting your sharps in the drop box at the site. Your sharps container will not be returned to you.
• If your container is bigger than a 2-liter pop bottle or if the drop box is full, DO NOT cram more stuff into it and DO NOT leave containers or loose syringes sitting out next to the drop box. These practices put others at risk for injury. If your items will not fit in the drop box, please bring them inside to the Health Clinic’s reception desk. If you encounter this problem when the clinic is closed, you may need to return to the clinic and dispose of your sharps during normal business hours in order to assure safety for all.

Regulations on sharps disposal likely vary by both state and county, so you will have to check your county's website for information specific to your location.

By the way, with regards to the above information about using a 2-liter plastic pop bottle, I would imagine that if you just have a small amount of sharps, then a 16 oz bottle might be ok as well.

NHE

[patientx]

Holly,

NHE has some good advice. In addition, when I started injecting, I found a local hospital that would take used syringes as part of their diabetes program (they were willing to take the syringes for my MS medicine).

The health department, no joke, told me to use a milk jug and duct tape it shut, and put it in the regular trash. How on earth is that legal, safe, or sanitary? I don't think so.

Sadly, the nurse told me the same thing. I just can't bring myself to do this, though.

Also, I noticed this older post:

The latest shipments are coming through Medco Accredo. These syringes look and feel different. The needle size is the same, but these latest syringes have a visible white line around the base of the needle. Additionally, the cap is soooo difficult to get off the needle.....

Don't know if you're still having problems, but a while back, I noticed the weekly IM shots I was getting had changed. (It's been a while, so I can't even remember what the old ones looked like.) The new ones have a 2-piece white cap on the syringe that you break off, and then put the needle on. Is this what your new ones look like? If so, I noticed that the needle actually twists onto the syringe, like the cap on a soda bottle. Once I figured this out (rather than pushing the needle onto the syringe), I didn't have any problems with the needle coming off.

[MSdetective]

Thanks for the suggestions... here's what I have learned:

The disposal of sharps by home users varies by state. Only in California and Wisconsin is it illegal for home users to discard used syringes in the regular trash. In other states, that is legal, though not necessarily safe or responsible in my opinion.

The manufacturer of the sharps container we have is BD. The BD website (BD Diabetes) is geared for home users and gives a decent breakdown by state.

My state allows home users to discard their sharps in a plastic container or metal cannister (coffee can, milk jug, laundry detergent bottle), secure the lid and put it in the regular trash.

However my local authority differs and the county specifically says there is to be no medical or biohazard waste included in home trash. However, they do not offer an alternative solution.

Addtional tips/instructions from BD indicate that you are not to re-cap your syringe before disposal. You are supposed to deposit the uncapped needle into the container and then add bleach to the container when it's full and ready for disposal. Presumably this is to sterilize the needles should someone get stuck. Sorry, that doesn't make me feel any better.

The mailback sharps containers are probably best for my situation-- that is I can't conscientously put these out on the curb in a neighborhood full of kids. However the mailback service is expensive, not covered by insurance and not FSA eligible. But, until there is a better solution, that is probably what we are going to do.

In the meantime, MY allergist (not my husband's neuro) agreed to take the container for us and lauded me for trying to do the right thing -- although that's going to cost him money. Doctors typically won't take them back because they pay by the container for sharps disposal.

I'm appalled by the lack of regulation in this area. I'm surprised the garbage collectors don't demand safer conditions. In our area, they have just started strictly enforcing recycling laws. I don't want someone well-meaning to mistakenly take that container from the trash and put it into the recycling. Nor do I want to leave these on the curb. The whole thing is just.... wrong.

The insurance company's mail order pharmacy provides a regular 1.5 quart BD sharps container (costs about $5). Compare that to the same size container in a heavier plastic wth mailback privileges at a cost of $40 out of my pocket. Wrong.

Avonex might want to consider a program for patients to establish a program to address this. I'd be more grateful for this service than all the marketing tchotchkes.

I hope this helps another newbie out there:

http://www.bd.com/us/diabetes/page.aspx ... 2&id=10284

http://www.bd.com/us/diabetes/page.aspx ... 02&id=7415

Unfortunately the clips container shown (a good idea) is not compatible with the size needles on the Avonex syringes.

http://www.safeneedledisposal.org/resslaws.html

I am definitely bringing this to the attention of my local and state officials.

thanks again!
Holly

[Vii]

Check with your city or county Fire stations. Some will accept and properly dispose of your full sharps containers.
Vii