By Juan Landeros

 The transport and disposal of solid and hazardous waste is

regulated by the Resource Conservation and Recovery
Act
 It wasn’t until the Medical Waste Tracking Act of 1988 that
medical waste was specifically included in the Resource
Conservation and Recovery Act, through the creation of
Title J
 After Title J Expired in 1991, the burden of regulation of
medical waste fell on the states, with each state setting
up its own guidelines (EPA 2017)
 In California, home generated medical waste has
regulations set up through the Medical Waste
Management Act which sets up guidelines for the
transport and disposal of Sharps waste (no guidelines
for other home generated medical waste)
 Medical waste can be transported in sharps
containers, and sometimes in hard plastic bottles
(depends on county).
 They can be disposed of by turning in sharps
containers to hospitals, pharmacies and local
household hazardous waste programs (MWMA 2017)
 According to the Centers for Disease Control and
Prevention there are over 13 million needles and syringes
used per day by diabetic patients (CDC 2012)
 According to a study conducted amongst diabetic
patients, over 85% reported improperly disposing of sharp
 7% reported flushing their used sharps down the toilet (Costello
2013)
A Baltimore study that focused on intravenous drug users
found that most participants disposed of used needles in
the trash
 17% reported disposing of sharps in toilet or sewer system
 9% gave or sold their used sharps to other people (McNeely
2006)
 There are many expected risks to exposure with
improperly disposed sharps waste
 A study in Brazil on the prevalence of Hepatitis C amongst
recyclable waste collectors found that, although these
individuals were very likely to experience a needle stick
injury, the rate of Hepatitis C was no different than in the
general public (Marinho 2013)
 They did find that the longer a person worked at a recyclable
waste center, the more likely they were to have hepatitis C
 A study involving people in A study amongst
Georgia who experienced
needle stick injuries outside diabetic patients
of a medical setting found done through the
that the risk of contracting U.S. Department of
Hepatitis B from these
sharps injuries was very low Veterans Affairs
(Butsashvili 2013) found that 3.5% of
 Half of the participants were amputations could
children exposed while
playing outside be traced back to
 20% were people who
stepped on a used needle
accidental needle
at the beach sticks (Costello 2013)
 The Medical Waste Tracking Act expired in 1991, after 10
years the EPA stated that risk of communicable disease is
worst at the point of creation, and tapers off with time
 A high rate of home generated sharps were disposed of
incorrectly
 Actual risks associated with improperly disposed sharps
were stepping on a needle, and with diabetes patients,
having that lead amputation
 Medical Waste. (2017, November 07). Retrieved May 15, 2018, from https://www.epa.gov/rcra/medical-
waste#history
 Medical Waste Management Act 2017 - CDPH Home. (n.d.). Retrieved May 15, 2018, from
https://www.cdph.ca.gov/Programs/CEH/DRSEM/CDPH%20Document%20Library/EMB/MedicalWaste/Medic
alWasteManagementAct.pdf
 Age-Adjusted Percentage of Adults with Diabetes Using Diabetes Medication, by Type of Medication, United
States, 1997–2011. (2012, November 20). Retrieved May 15, 2018, from
https://www.cdc.gov/diabetes/statistics/meduse/fig2.htm
 Costello, J., & Parikh, A. (2013). The Sticking Point: Diabetic Sharps Disposal Practices in the Community.
Journal of General Internal Medicine, 28(7), 868-869. Doi: 10.1007/s11606-013-2350-3
 Mcneely, J., Arnsten, J., Gourevitch, M. (2006) Sterile Syringe Access and Disposal Among Injection Drug Users
Newly Enrolled in Methadone Maintenance Treatment: A Cross-sectional Survey. Harm Reduction Journal,
doi:10.1186/1477-7517-3-8
 Marinho, T. A., Lopes, C. L., Teles, S. A., Reis, N. R., Carneiro, M. A., Andrade, A. A., & Martins, R. M. (2013).
Prevalence of hepatitis C virus infection among recyclable waste collectors in Central-West Brazil. Memórias
Do Instituto Oswaldo Cruz,108(4), 519-522. doi:10.1590/s0074-02762013000400021
 Butsashvili, M., Kamkamidze, G., Kajaia, M., Kandelaki, G., & Zhorzholadze, N. (2011). Circumstances
Surrounding the Community Needle-Stick Injuries in Georgia. Journal of Community Health,36(6), 1050-1052.
doi:10.1007/s10900-011-9408-0