Sunday, December 8, 2013
When people who self-inject insulin or other medication in their homes, the needles they throw in the trash sometimes jab family members and the workers handling their trash, leading to infection, tetanus and the transmission of disease.
Don Simoneau of Fayette advocates for patients to use approved containers, like the one he is holding, when disposing of needles.
David Leaming/Staff Photographer
TACKLING THE PROBLEM
RITE AID and sharps manufacturer Becton, Dickinson and Co. worked with the Department of Environmental Protection to launch a public education campaign in September.
The department will distribute 40,000 brochures and 3,000 needle clipping devices to Mainers using sharps through pharmacies, grocery stores and community groups.
It encourages Mainers to put sharps into laundry detergent bottles and to use needle clipping devices. The devices, which are also manufactured by the company, retail for about $6 and hold up to 1,500 needle tips.
ATTEMPT AT LEGISLATION
MAINE AND many other states have few requirements for the disposal of household sharps.
Don Simoneau, a 60-year-old veteran from Fayette, has been active in the needle disposal issue for five years.
"I think the state of Maine has ducked the issue," he said.
He said he knows people who use needles who have infections and other illnesses. "It didn't seem right to me."
Simoneau said a dangerous double standard exists.
"You wouldn't do that with hospital waste," he said.
Partly because of Simoneau's efforts, state legislators crafted a bill, sponsored by state Rep. Melissa Walsh Innes, D-Yarmouth, that would have required manufacturers of sharps to be responsible for disposal.
The sharps bill was declared dead in January after the state Environment and Resources Committee voted it down. Innes said it failed because of industry opposition.
Becton, Dickinson and Co., a company Innes said manufactures about 85 percent of the sharps used in Maine, was one of those that opposed the bill.
"Industry said they didn't think it was needed," she said.
Calls to the company's corporate communications office were not returned.
Medical facilities must observe legally mandated disposal requirements for biohazardous waste, including needles, but those same needles are often simply tossed in the trash by the estimated 40,000 Mainers who use millions of needles at home a year.
The lawmaker who sponsored a state bill that would have required manufacturers to establish a program addressing the issue said the bill died in January after needle manufacturers lobbied against it.
Instead, the state has launched a public education campaign that targets consumer behavior. Public safety advocates like Don Simoneau, a 60-year-old veteran from Fayette, say the education campaign will help but still falls short of what is needed to prevent waste management workers and others from getting stabbed.
On Tuesday, Simoneau, who has been diabetic for 12 years, wrote a letter to state legislators on the Environment and Natural Resources Committee.
"Needles don't belong in the household trash, nor does any medical waste," he wrote. "How many dirty needle sticks will it take to change the law? It shouldn't take any. This is a public health concern."
WORKERS AT RISK
Tom Erickson, chief executive officer of UltiMed, a Minnesota-based company that manufactures sharp medical objects, or "sharps," has lobbied on behalf of stricter laws in several states.
Unlike some companies in the industry, UltiMed is in favor of making manufacturers responsible for the hazards created by their products.
Family members who handle the trash are one group at risk of being stabbed by a wayward needle, but Erickson said the biggest losers in the battle over needle sharps are those in the waste management industry.
"Waste management companies have been the largest proponents of keeping these things out of the trash stream," Erickson said. "They have literally tens of millions of dollars every year in claims from employees."
While the vast majority of those who are stuck with needles don't contract any type of infectious disease, every incident requires preventive treatment in a hospital setting, which Erickson said costs about $3,000 per injury.
"Every time you get stuck, it's like getting bit by a bat or a skunk," he said. "You have to go through the precautions even though it might not have rabies."
Mickey Wing, owner of Central Maine Disposal in Fairfield, said he knows of people in the industry who have had to go to the hospital for treatment after being stuck with a needle.
"We're handling bags all the time," Wing said. "When they're doing curbside pickup, they grab the bags and put them in the back of the truck. They're all aware of the possibility of being stuck."
Wing said employees are also at risk when they perform maintenance and clean a truck. Cracks and seams in the compactor areas accumulate small items, including needles.
Wing said the hazard is unnecessary.
"I don't think they should be in the waste stream at all," Wing said. "My feeling is they should be handled like medical waste. They should be put in a sharps container and there should be a depot or something, maybe at the pharmacy where they purchased the needles."
Some needle users put their sharps in specially designed containers that have been approved by the Food and Drug Administration. Others put them in household laundry detergent bottles or other hard plastic containers.
Erickson said that approved containers are better than detergent bottles because they are harder to break.
A collection container that will safely hold 100 needles retails for about $4.50, but he said even that relatively low cost is too much of an obstacle.
"They might see the sense of it but they just don't want to spend the extra money because of their financial situation," Erickson said.
Needles that are packaged can be put into the solid waste stream or taken to collection centers that send them to proper medical waste disposal sites.
Although detergent bottles can burst and leave needles in the crevices of garbage trucks, Erickson said using them is better than nothing.
"There have been surveys that show 95 percent of needles don't go in any kind of container," he said. "I guess it's just too convenient to just throw them in the trash."
Some household sharps find their way into hospitals for disposal, but that is becoming less common in Maine, according to state Rep. Melissa Walsh Innes, D-Yarmouth, who sponsored legislation that would regulate needle disposal.
"Hospitals and medical facilities, they properly dispose of them," Innes said. "Some will take them from customers, but they don't want everyone to do it. They have to pay for that."
THE FUTURE OF SHARPS
While many local collection programs fail because people just don't use them, when there are free containers and convenient collection points, a local program can be hugely successful, Erickson said.
He said that only 5 percent of needles go into containers in most places, but a few model programs have achieved compliance rates of up to 90 percent.
Erickson also said that manufacturers can take it upon themselves to make a difference, even if they're not compelled to do so by legislation.
He said his company, UltiMed, is smaller and privately owned, so "We can make decisions that are a little more out of the mainstream of maximizing the profit for the next quarter."
UltiMed packages include a tray that allows used needles to be disposed of in the same package.
Erickson said the added functionality is well worth the cost to the company, which amounts to less than a dollar per container.
"Frankly, I don't think that the other companies want the expense of providing a sharps container," he said. "It's our responsibility as a manufacturer to supply at least the free sharps container. We've tried to encourage the competition to do it as well, with little success."
Innes said that while the sharps bill didn't pass in Maine this year, when Democrats return to power next year, the issue will probably come back up.
"I'll certainly be asking whoever is chair to invite industry back in to hear what they've done to help people dispose of them properly," she said.
Staff Writer Matt Hongoltz-Hetling can be contacted at 861-9287 or at: