SB 1305 Sharps

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SB 1305Sharps
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Jim Cropper(916) 323-3416jcropper_at_ciwmb.ca.gov

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Home-Generated Sharps Waste

• Hypodermic Needles,
• Pen Needles,
• Intravenous Needles,
• Lancets, and
• Devices Used to Penetrate the Skin for the
  Delivery of Medications.

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Sharps Usage in CA

• 40 Million People
• 7.6 are Diabetic
• 16 Inject Insulin
• 486,000 Self-Inject Insulin/Day
• 2 Syringes Used Per Day/Person
• 180 Million Home-Generated Sharps Just for
  Self-Injecting Diabetics in CA Per Year
• Only 30 of Self-Injectors are Self-Injecting
  Diabetics
• Could be 1/2 Billion Sharps Per Year in CA

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What Else Are Sharps Used For?

• Allergies
• Cancer
• Hepatitis
• Infertility
• Multiple Sclerosis
• Psoriasis
• Arthritis
• Diabetes
• HIV/AIDS
• Migraines
• Osteoporosis

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What Do People Do With the Sharps?

• Flush Down Toilet
• Discard in MSW
• Leave in a Public Place
• N.Y City -1988-83 of Self-Injectors Dispose of
  Needles in Trash
• Atlanta-93 Self-Injectors Dispose of Sharps in
  Trash
• 35 Who Discarded in Trash, Made No Effort to
  Contain Them, 54 Did Break the Needles

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Whos At Risk

• Custodial or Hospitality Workers
• Waste Haulers
• Recycling Facility Personnel
• Anyone Working Around Landfills

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Dangers of Getting Stuck with Sharps

• Needlestick Injuries-Could Get Hep C, Hep B, HIV
• Become Lodged in Equipment
• Painful If You Get Stuck
• Costs- Post-Injury Testing and Counseling
• 600 Blood Tests
• 100,000s if positive
• Disease Prevention Measures (Protective Clothing)

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Amounts of Sharps Collected 2006-07
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SB 1305-New Amendments to the Health and Safety
Code

• Added the Definition of Home-Generated Sharps
  Waste
• Home-Generated Sharps are not Medical Waste
• Requires Special Handling and Disposal

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Effective September 1, 2008

• Create Prohibitions for Disposal
• Create Container Requirements
• Create Management and Disposal Requirements for
  Home-Generated Sharps Waste

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Prohibitions for Home-Generated Sharps Waste

• Cannot be Placed in the Following Containers
• Solid Waste,
• Recyclable Materials, and
• Greenwaste.

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Enforcement

• Only Done Locally.
• Cant Be Enforced Under the MWMA, because
• Home-generated sharps waste are not medical
  waste.

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Disposal Options for Home-Generated Sharps Waste

• HHW Facility,
• Home-Generated Sharps Consolidation Point,
• Hospital, Clinic, Etc.
• Mail-back Container.

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Consolidation Point

• Obtain a one time written approval from the Local
  Enforcement Agency
• Accept waste in containers that meet the
  definition of a sharps container and
• Ensure that the waste is handled, stored and
  transported as a medical waste after receipt.

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Kiosks as Consolidation Points
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Disposal Options

• Medical Waste Mail-Back Container

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Source Reduction Products

• Clipper
• Voyager
• Melt
• Cost-89-180

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Where Can the Public Find Out Where to Take
Sharps?

• Contact Local HHW Facility or LEA
• Look for a location on www.Earth911.org
• Look for a location at safeneedledisposal.org
• www.ciwmb.ca.gov/HHW/Sharps/Collection
• CDPH-www.cdph.ca.gov

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Components of a Successful Sharps Collection
Program

• Accessible
• Financially Viable
• Inclusive
• Affordable
• Confidential
• Safe
• Well-Publicized
• Supported by the Community
• Safe

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Setting Up a Sharps Program

• Guidelines for Establishing a Collection and
  Disposal Program-Safe Needle Disposal
• Build a Team-
• Public Health Officials, Diabetes Educators, HIV
  Departments, Waste Officials, Health Industry
  (AMA,AADE, MS, Hep Groups)
• Monitor Program
• Participation, Community Supporting Program,
  Serving Population, How to Expand

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Costs

• San Bernardino-Drop Off-6,000/Year
• Mail Back Programs-
• 50,000 Residents - 8,022
• 100,000 Residents - 16,044
• 250,000 Residents 440,110
• San Francisco- 30 Drop Off Pharmacies 231,395
  -1.52 yr/Resident or 13 Cents per Month

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Costs-Los Angeles

• Containers - 6.25 /Container (Container, Collecti
  on, Transportation, and Disposal. 
• Total Cost (75,000 X 6.25 468,750)
• Mail Back Program 27.50. 
• Total cost (10,000 X 27.50 275,000)  
• How is the program paid for?
• HHW Funds Generated from Stormwater Program and
  Wastewater Program to cover the cost.  

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Other Resources

• California Dept of Public Health-www.cdph.ca.gov
• Medical Waste Management Act
• Alternative Treatment Technology List
• Registered Transporter List
• Consolidation Points
• CIWMB-www.ciwmb.ca.gov/HHW/Sharps
• SLO Ordinance
• Diabetes Cost Calculator
• Safe Needle Disposal
• Product Stewardship Institute-productstewardship.u
  s
• SWANA-Training Materials

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• 2007 Sharps Survey of
• Individuals,
• Home Health Care Providers, and
• Hospice Care Providers

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Survey of Individuals

• 33 Obtain Their Sharps Online (33) and a
  Smaller Number Obtain Their Sharps from Chain
  Stores (18).

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Survey of Individuals
Most Respondents to the Survey Dispose of Their
Sharps in a Strong Container (34) and at a
Household Hazardous Waste Facility (21).
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Survey of Individuals
This Graph Shows That the Major Barrier to Proper
Disposal of Sharps is Not Knowing Where to Take
the Sharps (31)
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Survey of Individuals
This Graph Shows That 72 of the Respondents
Insurance Doesnt Pay for Disposal of Their
Sharps.
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Survey of Individuals
This Graph Shows That the Majority of People Get
Information About Sharps Disposal From the
Internet (24) and from Their Doctor (20).
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Survey of Individuals
Best Method to Dispose of Sharps Was a Brochure
at the Purchase Point (26) followed by
Information From a Non-Profit Organization (18).
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What is the CIWMB Doing Regarding Sharps?

• Web Page
• Law
• Where to Dispose of Sharps-Searchable Database
• Summary of Local Programs
• Listserv
• Notes and Presentations from Stakeholder Meeting
• Survey Information
• Poster, Brochure, Mailer to Pharmacies

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Resources

• Jim Cropper - [phone] jcropper_at_ciwmb.ca.gov
  
• 50,000-Promotional Program
• Brochure, Poster, Mailer Requesting to Be
  Consolidation Point
• Listserv-www.ciwmb.ca.gov/Listservs/
• Form 303 Information
• HHW Grants-Retail Take-Back and EPR Programs ,
  Including Sharps
• CDPH Staff and Web Page
• Diabetes Calculator

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Strategy

• Catalog Consolidation Points and Obtain New Ones
  by Mailer
• Provide Brochure to Pharmacies, Doctor Offices
• Work with Diabetes Educators-12 Chapters and
  1,000 Educators
• Contact Non-Diabetic Illness Organizations, such
  as MS
• Press Release on New Law and LEA Advisory
• Promote Searchable Database

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(No Transcript)
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Brochure
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• Questions?
• Comments?
• Suggestions?