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Sharps Disposal: Will Pharmacies End Up Footing the Bill?


Aug 14, 2012

Sharps Disposal: Will Pharmacies End Up Footing the Bill?

As CEO of a company that manufactures insulin syringes and pen needles for the US and Canadian markets, I have been closely monitoring the regulations and trends pertaining to the safe disposal of the products we produce. Surveys indicate that less than five percent of the over three billion sharps devices sold in the US annually are disposed of in some type of closed container. Most of the remaining 95 percent are deposited, unprotected, in the household trash. Significant changes may be pending with regard to the disposal of used sharps devices, and it's likely that pharmacists will be affected by these changes.

The most influential group promoting safe sharps disposal regulations comprises the companies that handle household trash. These waste companies report that they incur millions of dollars in annual expenses when their workers are accidentally stuck with a used needle. They claim that each needle stick creates over $3,000 in testing and sick leave expense, not to mention the fact that some needle sticks cause serious illness.  The incidence of needle stick injuries at transfer stations has risen with the increased use of sorting lines, where workers hand-sort waste as it rapidly moves down conveyer belts. These workers wear protective gloves, but the incidence of needle stick injuries is still very high.  Because of this problem, the companies that handle waste have been lobbying intensely to remove used sharps devices from the household waste stream.

The world environmental movement has also been actively involved in promoting the safe disposal of hazardous products, including medical sharps devices such as syringes and pen needles.  A growing number of countries have enacted rules regulating the disposal of home-generated sharps waste.

Many of the hazardous waste disposal regulations used around the world incorporate the concept of "extended producer responsibility" or EPR.  Also called "product stewardship," EPR encourages manufacturers to design environmentally friendly products by holding them liable for the cost of managing those products at the end of their useful life. The purpose of EPR is to relieve governments of the cost of managing hazardous waste.  

The US currently has no national laws pertaining to the safe disposal of sharps waste.  However, the EPA has published new "guidelines" for the disposal of home-generated sharps waste.  The purpose of the EPA guidelines is to encourage the removal of sharps waste from the normal household waste stream.

The EPA recommends six disposal options, all of which include the use of sharps containers. These guidelines have become the default position for most states and local communities in the US.  Some states now require the storage and transport of used syringes and pen needles in sharps containers.  An example of this type of legislation is California's SB 1305, which was passed in July 2006.

Unfortunately, the effect of SB 1305 has been negligible. Industry observers believe that it has been ineffective because it omits the two most critical components of successful programs that have high compliance rates:  free sharps containers and convenient authorized collection points.

There are a few examples of successful sharps waste collection programs in the US.  Two of the most cited are Sioux Falls, South Dakota, and San Luis Obispo, California.  Both incorporate the two critical components listed above.  A large part of the funding for these programs comes from local government.

Another option, which is prevalent in Canada, is for pharmacies to pay for the disposal of home sharps.  Pharmacy payment in Canada started when some pharmacies tried to attract diabetic customers by offering free sharps containers and disposal.  When other Canadian pharmacies realized that they were losing their valued diabetic customers to this tactic, they countered with their own programs.  It soon became common practice throughout the entire country.  It's noteworthy that some provinces in Canada are considering legislation to move to an EPR model, which would transfer the cost from pharmacies to the sharps manufacturers.

The next few years will be interesting as political pressure and EPA guidelines provoke the 50 states to enact home sharps collection legislation. Undoubtedly, the most controversial issue surrounding such legislation will be who is going to foot the bill. There are three alternatives:

-       The Canadian model, in which pharmacies pay
-       The Sioux Falls and San Luis Obispo models, in which government pays
-       The EPR model, in which sharps manufacturers pay for the safe disposal of their products

It will be interesting to see which of the three options the 50 state legislatures take.


Categories: Diabetes, Diabetes Health, Diabetic, Hazardous Material, Insulin, Pen Needles, Sharps Waste, Syringes



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Comments

Posted by Anonymous on 16 August 2012

In New York, all hospitals and nursing homes must accept sharps for disposal. Special containers do not have to be used, but the containers and their lids must be puncture proof and unbreakable. Diabetes educators teach their clients that laundry detergent, bleach and prescription bottles that fit this criteria maybe used. It is encouraged that the user write "sharps" on the container and dispose of at a local nursing home or hospital. It is unfortunate that many persons who use sharps at home are not aware of this arrangement. Perhaps if more hospital employees and doctors offices were aware we could reduce the number of unnecessary finger stick injuries at waste-disposal treatment centers? Instructions for sharps disposal directions for most states can be found at the CDC website: http://www.cdc.gov/needledisposal/
Laurie P.

Posted by Anonymous on 16 August 2012

I live in San Diego, CA and we are mandated to use sharps containers but no free service for disposal. Since I pay an enormous amount of $ for my supplies, I find it annoying that I'm expected to pay to dispose as well. All of my sharps containers are lined up in my garage, waiting for the day I die so someone else can pick up the tab. Hopefully the government.

Posted by Anonymous on 16 August 2012

Some common sense should also reign in this issue. When disposing of my sharps, I take the safety cap from the new sharp I am putting in the pen and stick on the tip of the old one that then goes into a large container marked "sharps" DO NOT RECYCLE. By covering the end, the risk of anyone getting stuck with a used needle is minimal. Come on folks, take a little time to be safe and reduce risk to others!!

Posted by Anonymous on 16 August 2012

Maybe if the pharmacies would make sure they stock the containers, then more people might actually dispose of sharps properly. I have been diabetic since 3/98 and only twice was I able to purchase sharps containers from any of the local pharmacies. Many said they didn't stock them and, like I said, I was only able to purchase 2 over the past 14 years and I always look for them, so its not like they are just out of them. The two times I did get them there was only 1 on the shelf. So if pharmacies don't want to foot the bill, then they need to be well stocked at all times and EDUCATE their patients.

Posted by fatherbill on 16 August 2012

NO regs in OHIO. I use pen needles that are covered. I accumulate sharps & BG strips in a fairly heavy weight container from Acetic Acid [vinegar]. Have container marked "SHARPS." Will take about 3 years or more to fill. Have asked local hospitals/clinics if I could leave my sharps with them as they have so much. Answer is always "NO."

Posted by bongobuzz on 16 August 2012

I use a small BD gadget that cuts off the needle and encloses it in a chamber that keeps the needles away from sticking others. I then dispose of the syringe in the rubbish. I dispose of the full chamber in the regular trash. I believe this is legal in my locality.

Posted by Anonymous on 16 August 2012

Put a free BD Safe-Clip Needle Clipping and Storage Device in each box of needles and the problem is solved

Posted by Florian on 17 August 2012

I'm in the camp of those who believe that the manufacturer's should be responsible for the cost of disposal.

Posted by Anonymous on 17 August 2012

I clip off the end of my disposible syringe using an approved clipping device the put the recapped syringe into a used liquid detergent bottle, then seal the bottle with duct tape when full. I didn't realize that I could drop this off at a local hospital or nursing home in NY, so it went out with my household trash (we sort recycles separately). Thanks for the tip on where proper diosal locations.

Posted by Anonymous on 17 August 2012

At present, Medicare does not cover sharps containers, deeming them out-of-pocket expenses. Prepaid shipping sharps containers are cost-prohibitive, costing five to ten times more. The solutions should include free sharps containers, convenient disposal locations, and a sharing of the cost between insurers, manufacturers and governmental agencies. It is a public health cost and a public health hazard. Type 1 for 42 years, I am very aware of the issues.

Posted by Anonymous on 18 August 2012

It's too bad that more people do not know about needle destruction devices. We never liked to put used sharps into home trash based on concern about whether they would could get loose in the trash and injure someone, and purchased sharps containers are expensive for 5-syringes-per-day use. Several months ago, we purchased a "Disintegrator Insulin Needle Destruction Device" from Amazon for $50.(Other types are available, elsewhere, I believe) This device has a hole for the syringe needle, where the metal shaft touches 2 contacts attached to the device's internal battery. Push the destruct button on the device, and the needle becomes a tiny blob of melted metal and falls off the syringe into an internal collector. Very cool! The syringe is no longer a sharp, cannot stick us when we go to put the cap back on, and can go into the household trash without any precautions at all. This device has worked for us and made home use of syringes much less dangerous than when we used needle clippers, ect. I realize that not everyone can afford choices like this, but if you can, it's a nice option...

Posted by Anonymous on 26 March 2013

Frankly, the cost of Sharps containers should be picked up by Medicare or other insurance. Moreover, the Sharps container should be designed to lock shut after use.

I am tired of having to pay a large portion of my diabetes related costs out of my pocket.


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