Public Safety

The Sharps Proliferation Crisis

Used Sharps Create Health And Safety Hazard

According to the U.S. EPA, over 9 million people use injectible substances outside of healthcare facilities and an estimated 3 billion medical sharps (used needles, used syringes and discarded lancets) enter the municiap waste stream annually. Although the institutional use and disposal of these instruments are subject to governmental control, regulatory agencies until recently did not forsee the exponential growth of home-use injectible medications nor the burden home-generated medical waste disposal has placed on the municipal waste system.

Current research concludes that over 9 million Americans use disposable syringes daily for health maintenance. Over 8% of all U.S. households has a resident who generates used needles regularly. Of these, two-thirds receive the medications and syringes from a pharmacist under recommendation of a medical doctor. And of these 9 million users, only 43% use any sharps container at all, instead simply throwing out the used needles and other medical waste in the trash along with their regular household garbage. Only 20% of users dispose of their used sharps in a marked medical sharps container, while the rest use a variety of containers ranging from thin-walled soda bottles to bleach containers and coffee cans or even simply wrapping the used sharps in a plastic or paper bag.

These controlled medical instruments invariably end up in the municipal waste stream comingled with regular trash, posing a hazard to sanitation workers, sewage and water treatment personnel and law-enforcement officers. But the danger is not limited to people whose jobs require contact with solid waste. Friends, family, and children of medical sharps users as well as housecleaning staff are all at risk of accidental needlesticks through improperly stored and unsecured sharps.

Fear And Stress Follow Needlestick Injuries

Concerns Of Secondary Infection Linger

For victims of accidental needlesticks, the emotional damage continues long after the physical injury has healed. Anxiety and stress about secondary infection from used needles can have lingering psychological effects for victims. In most cases the source of the used needle cannot be traced, nor can it be determined whether pathogens were active at the time of the injury. The fact that some pathogens like HIV and Hepatitis can remain dormant for long periods before showing symptoms results in a drawn-out waiting game, sometimes with multiple cycles of testing and indetermine outcomes.

Accidental needlestick injuries bring economic consequences as well as emotional trauma. Each needlestick injury requires a palette of diagnostic tests for secondary infection in addition to prophylactic antibiotic treatment of the primary injury. If secondary infection by viral agents such as Hepatitis or HIV are detected, lifelong care and disease management is required. And even if no secondary infection is determined, costly lawsuits and insurance payments are often the result.

According to the American Hospital Association, needlestick injuries can result in direct costs for medical evaluation and follow-up ranging from $200 - $1200 while total costs for treating accidental needlesticks exceeded $3 billion in the U.S. Since most needlesticks, especially in non-occupational environments, go unreported, the real cost in terms of secondary infection and psychological impact is estimated to be much greater. And since economic evaluation studies do not include economic factors such as lost work time or legal and litigation costs, the real economic impact of accidental needlestick injuries in non-occupational settings may never be known.

Self-Injection Enters Mainstream

Changing Attitudes Add To Disposal Crisis

In decades past, the 'sharps problem' was limited to a small percentage of illicit drugs users discarding their syringes in parks and alleyways. Although this problem persists in many major cities, the sharps disposal problem has arrived on Main Street. Injectible medications are prescribed by doctors and dispensed by pharmacies for an increasing number of conditions:

- Arthritis

- Diabetes

- Hepatitis C & B


- Infertility

- Migraine

- Multiple Sclerosis

- Osteoporosis

- Psoriasis

Needles and syringes are also distributed to administer other substances such as a variety of growth hormones, B12 supplements and other home-use drugs. Self-injection can no longer be viewed as an act performed only by illicit drug users and heroin addicts. Users of home-injectibles now span all demographric groups and reflect the face of the general population.

But people are not the only ones benefiting from injectible medications. Just like their human owners, American pets are seeing an increase in obesity and a corresponding increase in the incidence of diabetes, requiring pet owners to administer insulin injections regularly from home. Although no statistics on home-use injectibles for pets are yet available, the number of units entering the waste stream is significant, and many vets now provide sharps containers and information on responsible sharps disposal to their clients.