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 garbage, leading to infection, tetanus and the transmission of disease.
Medical facilities have 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 medical 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 amounts to 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 the truck. Cracks and seams in the compactor areas accumulate small items, including grit, glass and needles.
“The danger is spreading disease,” said Wing.
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.
“Even though you can go to the local pharmacy and buy them, they sell extremely slowly,” he said.
He said that many of those who need to self-inject medication are elderly or poor.
“They might see the sense of it but they just don’t want to spend the extra money because of their financial situation,” he said.
Needles that are packaged can be put into the solid waste stream or taken to collection centers that send them on to proper medical waste disposal sites.
While detergent bottles can burst and leave needles in the crevices of garbage trucks, Erickson said using them is better than nothing.
The real problem, he said, is that most needle users don’t do anything at all.
“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, but that is becoming more rare 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.”
Franklin Memorial Hospital in Farmington used to accept sharps from the public, but stopped in May.
“It’s basically because in most towns you can just dispose of them there,” said Jill Gray, spokeswoman for the hospital. “We have provided our patients with DEP guidelines on safe disposal.”
Inland Hospital in Waterville also does not collect sharps, and recommends that its patients contact their town offices about how to best dispose of biohazards in their communities, hospital spokeswoman Sara Dyer said.
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.”
Erickson said that a group of influential shareholders at UltiMed were concerned about being involved with a company whose products could harm people. As a result, the company has been proactive, not only by trying to make its own products safer but by lobbying for stricter laws around the country.
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.
Matt Hongoltz-Hetling — 861-9287