Coalition for Safe Community Needle Disposal

1
Coalition for Safe Community Needle Disposal

• Product Stewardship Institute
• SAFE COMMUNITY NEEDLE DISPOSAL
• Stakeholders Conference

2
History of Coalition

• Bloodborne Pathogens Standard- In 1990, OSHA
  issued a standard designed to prevent health care
  (and other) workers from being exposed to
  bloodborne pathogens such as Hepatitis B, Hep C
  and HIV
• Multiple OSHA enforcement actions and threshold
  question of whether waste workers were reasonably
  anticipated to be exposed
• WM wanted to move towards primary prevention eg
  segregate sharps from municipal solid
  waste(MSWhousehold trash) similar to HHW
• CDC engaged WM in dialogue in 2000

3
Sharps Statistics

• 9 million Americans self-inject prescription
  drugs.
• 1 in 12 homes in the U.S. houses a self-injector.
• 3 billion needle injections occur yearly outside
  of medical facilities (at home, work, while
  traveling).
• 2 billion injections are self-administered by
  patients using prescription drugs to treat
  chronic illnesses.
• 1 billion injections are attributed to individual
  injection drug users (IDUs) using illicit drugs.

4
Why Billions of Needles?

• Increasing U.S. population, average life span.
• Increase in incidence of chronic illnesses
• Incidence of obesity and diabetes growing
  rapidly-21 million have DM currently and
  growing
• Patient care pushed out of medical facilities.
• Pharmaceutical industry pipeline of injectable
  drugs developed and marketed to treat chronic
  illnesses.

5
And The Problem Will Only Get Worse
Unchecked, a number of factors will conspire to
exponentially increase needle use/waste/sticks
and their personal/social/economic consequences.
4x
3x
Needle Users ? Needles ? Waste ? Sticks
2x

• Demographics
• Diseases
• Self-Injectable Treatments

1x
Today
10-20 Years
Unless We Work Together on Solutions
6
Coalition First 2 Years

• January 2001 Safe Community Syringe Disposal
  Understanding the Barriers and Creating Solutions
  was held in Washington, D.C. Hosted by Dr. Steve
  Jones, CDC
• January 2002 Similar Meeting. BD and WM agreed
  to provide start-up funding for Coalition. SCI
  was third Board member
• April 2002 Coalition Officially Launched
  (founding members Included ADA, AMA, APhA,
  NASTAD, AADE, NASTHO, BD, WM, SCI
• February 2003 New Members Join the Coalition
  (US Conf. Of Mayor, NACDS, NSWMA, NAHC, NACCHO,
  NRC)

7
Coalition Agenda

• Call to Action letter
• Advocate to EPA to re-write Federal guidelines
  for at-home needle disposal (completed 12/04)
  http//www.epa.gov/epaoswer/other/medical/sharp
  s.htm
• Advocate to individual States to create
  legislation re-writing non-regulated medical
  waste regulations to ban sharps from MSW
• Advocate to pharmaceutical and medical device
  industries to develop sharps disposal solutions
  for all self-injecting drugs
• Assist communities to develop needle disposal
  programs
• Advocate for development of reimbursement
  strategies

8
Coalition Past 4 Years

• February 2004 CA Introduces Bill Encouraging
  HHHW Facilities to Accept Sharps (Passed
  Implemented 2005)
• September 2004 NJ Introduces Syringe Access
  Bill with Needle Disposal Component (Did not Pass
  Reintroduced next session)
• December 2004 EPA Issues New Recommendations on
  Safe Needle Disposal
• June 2005 HR 2841 (Medicare Bill) Introduced in
  House by Ferguson/Strickland (Did not pass)
• February 2006 CA Introduced Bill Making it
  Unlawful to Throw Needles in Household Trash
  (July 2006 Passed Have until Sept. 2008 to
  Comply)

9
Coalition Past 6 Years

• June 2006 S 3604 (Medicare Bill) Introduced in
  Senate by Isakson (did not pass)
• July 2006 MA Passed Syringe Access Bill that
  Includes New Needle Disposal Component
• December 2006 NJ Passes Syringe Exchange Bill
  with Needle Disposal Component
• February 2007 CA Introduces AB 501- a Bill that
  Requires All Pre-filled Syringes Provide Needle
  Disposal Solution by Pharma
• 2007 on-going discussions with retailers

10
Coalition Past 6 Years

• Summer 2007 Louisiana passes legislation S 224
  making it unlawful to throw syringes/needles in
  household waste
• July 2007 Senator Isakson and Representative
  Ferguson re-introduce Medicare Bill for needle
  disposal reimbursement
• September 2007 Began working with PSI
• January 2008 NH Introduces legislation to
  remove needles from the household garbage and
• January 2008 Novo Nordisk (Pat Quinn) joins the
  Coalition Board of Directors
• February 2008 MS introduces legislation to
  remove needles from household garbage (currently
  waiting for Governors signature)

11
Problem Improper Disposal of Needles

• U. S. Survey on People With Diabetes indicates
• 93 of responding self-injectors dispose of their
  used syringes in the trash
• 4 placed syringes in puncture-resistant
  containers
• 3 flushed syringes down the toilet
• Most sharps end up in municipal solid
  waste!

12
Problem Impact Accidental Needle Sticks

• Household residents
• (family members, guests, pets)
• General population in public venues
• (airports, casinos, hotels, parks, restaurants,
  stadiums, stores)
• Workers in various service industries
• Environmental Services (janitorial, recycling,
  waste disposal, water treatment)
• Hospitality (hotels, theme parks, stadiums,
  casinos, airports)
• Retail (stores, restaurants)

13
Improper Disposal Many Forms/Locations
Improper Disposal In Many Forms/Locations
14
Cost Impact of Accidental Needle Sticks

• Physical/emotional trauma to individual
• Cost of diagnostic testing and preventive
  treatment regimens (500-10,000 per incident)
• Transmission of pathogenic diseases (HIV, HEP B
  C, etc.) leading to preventable morbidity and
  mortality
• Life-long utilization of medical care and need
  for income replacement
• Lawsuits, litigation and settlements

15
Types of Needle Disposal Programs

• Community-Centric Needle Disposal Programs
• - Drop Box Collection Sites
• - Residential Special Waste Pick-Up
• - Household Hazardous Waste Programs
• - Syringe Exchange Programs
• Patient-Centric Needle Disposal Programs
• - Disposal by Mail Programs
• - In-Home Individual Disposal Products
  (needle destruction devices)