Injecting Precaution

EACH YEAR, PEOPLE ADMINISTER an estimated 3 billion to 4 billion injections outside traditional health care settings. Two-thirds, or at least 2 billion injections, are given by patients managing their, or a loved one's, home-based health care. And the numbers likely will continue to rise.

Last year, drug manufacturers introduced four at-home medications to treat HIV, arthritis, osteoporosis and psoriasis. These drugs join the list of medications already being used at home to treat diabetes, migraines, infertility, allergies, multiple sclerosis, and Hepatitis B and C. There is also a growing number of individuals who vaccinate and treat their pets at home.

Needles and other sharps used in hospitals, clinics and doctors' offices are treated as medical waste and disposed of in a meticulously safe fashion. But what happens to needles used by individuals in their homes?

Waste industry workers have reported a steady increase in hypodermic syringes, lancets and other sharps found at recycling centers, materials recovery facilities and landfills. Janitors and other public waste collectors also are at risk of being pricked by potentially infected needles while collecting trash in airports, hotels, restaurants, parks and office buildings.

The U.S. Environmental Protection Agency (EPA), Washington, D.C., is taking a critical first step in addressing this growing public health and environmental concern by changing its current recommendations for safe home needle disposal. The new guidelines, to be issued this summer, will recommend five safe disposal options. One EPA brochure will target individual sharps users, while another will provide resources for communities and municipalities interested in identifying and implementing safer disposal options for their residents.

To create the guidelines, the EPA has partnered with the Coalition for Safe Community Needle Disposal, a nonprofit collaboration of businesses, community groups, nonprofit associations, and local, state and federal government entities. The coalition, which includes the National Solid Wastes Management Association, Washington, D.C., and the EPA have identified five types of safe needle disposal options for individuals and communities:

  • Drop box or supervised container collection points. Sharps users can take their own puncture-proof sharps containers filled with used needles to collection sites, which will be located in doctors' offices, pharmacies, hospitals, health departments, fire stations, medical waste facilities and household hazardous waste drop-off sites.

  • Residential special waste pickup service: Home users place used sharps in a special container and set it outside, much like a recycling container, for pickup by special waste handlers.

  • Syringe exchange programs: These enable injection-drug users to exchange used syringes for new ones. Some state and local governments, as well as many nonprofit organizations, fund these programs for users of illicit drugs to inhibit the spread of infectious diseases through needle sharing.

  • Mail-back programs: Home users place used needles in a special “sharps” container and mail it to a collection site to be disposed of properly.

  • In-home individual disposal products: A range of products is available for “at-home” injectors, including retractable safety needles, devices that sever or burn the needle, portable and transportable sharps containers, and mail-back containers.

“The Coalition is available to help communities of all sizes and demographics design programs tailored to meet their specific needs and available resources,” says Susan Eppes, safety and health director for the Coalition for Safe Community Needle Disposal. “Hundreds of communities nationwide already have such programs in place, and we can help communities benefit from what they have learned.”

For more information on implementing a community-based sharps disposal program, call the Coalition for Safe Community Needle Disposal at (713) 980-3120 or (800) 643-1643. Web site:

Jenny Schumann is the director of the Safe Community Needle Disposal Coalition, Houston.