In the United States today, more than three percent of the population are self-injectors. Eight percent of residences have a self-injector in them. These percentages are on the increase as the use of sharps-the medical term for hypodermic needles, lancets and anything that can penetrate the skin-shifts from the hospital to the home.

In Alameda County many groups in the community are impacted by the lack of a safe needle disposal program. Waste pick-up route drivers, landfill workers, recycling center workers, employees of hotels, health clubs, parks and recreation departments, transportation departments (Caltrans, BART, airlines and airports), janitorial workers, police departments, restaurants and laundry facilities often are confronted with needles in the workplace. The public has the same problem in that it is not uncommon to find used needles and syringes in parks, schoolyards and other public areas. Needle exchange programs take care of a subset of the self-injecting population but do not directly serve the needs of those who self-inject for medical reasons in the home, while traveling, exercising or eating out. - e.g.: those individuals with diabetes mellitus (DM).

Until very recently, disposal of home-generated sharps - that is, any object used for medical reasons that are exposed to an individual's blood or body fluids; examples include needles, lancets, infusion sets - was unregulated by any state or county agency. Self-injectors could place used needles in plastic containers or directly into the trash if they don't have an appropriate container. Many people are unaware of the change in the law and will continue to throw their sharps away. The waste pick-up route drivers and the workers at the Materials Recovery Facilities (MERF) have a great risk of needle exposure. At these facilities garbage is received and sorted. Sanitation workers sort through the waste before it enters the landfill. "Once a staff person from the State Environmental Management Branch measured how frequently he saw needles on the MERF conveyor belt. In 20 minutes he saw two exposed needles; this is 'like dodging 6 bullets an hour'."

• Approximately 3% of the U.S. population self-injects; this means approximately 8% of homes in the U.S. include people who self-inject some type of medication
• Some 3.7 to 4.6 million patients with diabetes self-inject daily
• An additional 3.5 to 4.1 million patients with diabetes use lancets each day to check blood sugar levels
• Approximately 1.2 million people have hepatitis B - 10% become chronic carriers who will treat themselves by injecting interferon for four months or longer
• Approximately 3.9 million people have hepatitis C - 70% become chronic carriers who will need three injections of interferon a week for 18 to 24 months
• Intravenous drug use accounts for more than 13,000 new AIDS cases each year
• Other reasons to self-inject include multiple sclerosis, infertility, migraines, allergies, hemophilia, medications for pets, illegal drug users

• When sharps are disposed of improperly - tossed in the trash or placed in plastic containers and then thrown away - they can cause physical injury. These injuries can lead to the transmission of infectious diseases, which may result in death.
• Inside a trash can or bag, loose or containerized sharps can injure family members or inappropriately fall into the hands of children or people with substance abuse problems.
• Syringes flushed down the sewer system may end up on a beach or shore.
• Children who find syringes are at great risk of hurting themselves. They may not realize the consequences of a needle stick and fail to tell an adult of the injury.
• Millions of hepatitis B, hepatitis C and HIV infections have occurred to date from re-use of syringe needles. Many of these infections could be avoided if syringes were disposed of safely.
• Although the risk of actually contracting a disease from a contaminated needle may be low, needle sticks can be painful and inevitably cause a great deal of anxiety. Follow-up blood tests and prophylactic treatment are costly. Needle stick injuries can cost approximately $3,000 per sharps injury for follow-up tests and care even if no infection occurs, and up to $1 million in a case of serious infection.
• Among those who regularly encounter sharps disposal issues are: airlines, ambulance service, blood donor clinics, casinos, correctional facilities, dentists, diabetics, doctors, factories, fire and police departments, health nurses, home health care, hospices, hotels, industrial facilities, laboratories, nursing homes, paramedics, piercing studios, research labs, restaurants, convenience stores, schools, tattoo artists, veterinarians, home self-injectors.

The Solution New steps must be taken because many states (including California) have made it illegal for health care providers to dispose of needles and lancets in the trash. The solution lies in removing sharps from the solid waste stream entirely, but the cooperation of the pharmaceutical industry (who produces these injectible medications) is needed. That's why the Coalition, along with our partners in Alameda County are supporting SB 486 authored by California Senator Joe Simitian. For more information about SB 486, please call our Coalition Chair, Lara Sim at 415-948-5674 or email her at larabice@hotmail.com.