Sharps 101: Understanding Sharps Waste and Proper Needle Disposal

Occupational Safety and Health Administration (OSHA) standards state that a sharp is a contaminated object that can penetrate the skin. In healthcare, sharps are a form of biohazardous waste generated during the provision of care, treatment and services. There are many kinds of sharps found in healthcare organizations, including:

• Hypodermic needles
• Syringes, such as insulin syringes for diabetic patients
• Scalpels
• Lancets
• Wires, including dental wires

When a contaminated sharp penetrates the skin, such as through a puncture or cut, there is a risk of bloodborne pathogen transmission. A bloodborne pathogen is a microorganism, such as a virus, bacteria or fungi, which may be present in blood or other body fluids, and can lead to serious illness like hepatitis, AIDS or other bloodborne diseases.

If a sharps injury is not immediately addressed, the injured person could become very sick.

The best way to limit the likelihood of bloodborne pathogen transmission is to reduce the chances of sharps injuries. Proper sharps waste disposal is a key strategy for curbing these events. By preventing sharps injuries, healthcare organizations not only safeguard workers but avoid the costs of investigation and treatment, which can cost about $3,000 per needlestick and lead to more than $1 billion in unnecessary costs for the industry.

Sharps should be placed in a specially designed sharps container after use. Containers that have Federal Drug Administration (FDA)-marked clearance are recommended. These receptacles are made of either hard plastic or cardboard and are designed to prevent punctures, leaks and overfilling that objects such as needles can cause. They are also clearly labeled as biohazardous to ensure proper handling.

Healthcare organizations should place sharps waste disposal containers in areas where sharps are used, including exam rooms, laboratories, pharmacies and nurses’ stations. They should be positioned as close as possible to the point of use and be installed at the National Institute for Occupational Safety and Health (NIOSH)-recommended height for easy employee access.

Organizations may opt to use reusable sharps containers to help meet organizational sustainability goals. Reusable containers are made of hard plastic and reduce the number of receptacles ending up in landfills.

Once a sharps container is full, it should be removed from the healthcare facility and transported and disposal by a medical waste management expert. Some states allow organizations 30 days to correctly dispose of sharps waste.

Those organizations that do not generate a large volume of sharps waste may opt to use mail back sharps containers. These are disposable sharps containers that are shipped to the healthcare facility with easy-to-follow instructions and a prepaid return-shipping box. These types of containers can also be made available to patients who wish to dispose of diabetic syringes or other sharps used for medication self-administration at home.

Sharps containers are reserved for those items that are contaminated and that could puncture the skin. Proper training can help ensure staff are fully aware of what can and cannot be disposed in a sharps container.

Things that should not be thrown in a sharps container include:

• Tape, paper, bandages/gauze, exam gloves, alcohol preps
• Medication and medication wrappers
• Aerosols or inhalers
• Garbage or liquids of any kind
• Batteries of any type
• Cauterizers
• Fluorescein
• Hazardous, chemical, radioactive or red bag waste (non-sharps regulated medical waste)
• Fixatives and preservatives

As mentioned before, sharps waste should be treated in a medical waste management facility. There are two common treatment methods. The most frequent method for treating sharps is autoclaving, which uses a timed, high-temperature, high-pressure steaming process to neutralize any infectious agents. The resulting “clean” waste can then be sent to a landfill or waste-to-energy facility.

In certain cases, such as when sharps are contaminated with trace chemotherapeutic waste, incineration is required. This involves subjecting the waste to high temperatures that promote combustion or burning. The remaining ash is then sent to a landfill for disposal.

Several federal bodies regulate various aspects of sharps waste management. For example, the Environmental Protection Agency (EPA) governs the impacts of hazardous waste on the environment. The Department of Transportation (DOT) oversees how sharps waste is transported. The Occupational Safety and Health Administration (OSHA) addresses the worker safety implications regarding bloodborne pathogen transmission. OSHA regulations cover topics like proper waste containers, staff training, and injury reporting.

At the state level, other regulatory authorities have further rules relating to sharps waste. When developing or refining a sharps waste management program, be sure to check state regulations first and then examine the federal ones to make certain a program is in full compliance.