by Matt Prindiville, NRCM Clean Production Project Director
Senator Saviello, Representative Hamper and members of the Committee. My name is Matt Prindiville and I’m the Clean Production Project Director for the Natural Resources Council of Maine. We support LD 1412, and thank Representative Innes for bringing this issue to the attention of the Committee.
In the United States, more than 3 billion medical sharps are disposed of annually by people managing their own health care at home, as well as intravenous drug users (1). Over 40,000 people in Maine use medical sharps to manage disease, the vast majority of which are people living with diabetes (2). Maine DEP reports that “people using medical sharps routinely discard them in the trash at home or in public setting, or down the toilet. Many sharps users dispose of their needles in the trash because they are not aware of, or can’t afford or conveniently access other disposal options.” (3) And it’s not just at home, sharps are also often disposed of in trash containers in public places as well, and in other public settings such as hotel rooms, air ports, and recycling bins (4). Also, as self-injection of medications becomes an increasingly popular mechanism for drug delivery, the number of home medical sharps is expected to increase significantly.
Because of this, there is potential for injury or transmission of infectious diseases to anyone who comes in contact with used sharps, including homeowners, sewage treatment plant operators, and waste management personnel. When I posted this issue to the Product Stewardship Working Group List Serve, three local government officials immediately wrote back and reported that their employees were getting stuck by hypodermic needles in household trash. When this happens the costs of dealing with the problem are exorbitant. According to Maine DEP, societal costs associated with needle-caused injuries include and estimated $6,300 for initial testing and care, and up to hundreds of thousands of dollars if a disease is contracted (5).
And it’s just direct contact from improperly disposed sharps in the trash that are the chief concern. Sharps are also routinely released into environment through combined sewer overflow in storm events in Maine, leading to these items washing up on beaches, riverfronts and shore land all over the coast.
Maine biomedical rules require that used sharps be put in a rigid plastic container prior to disposal, but these containers are routinely crushed and the sharps released in waste management operations. Unfortunately, “voluntary” collection programs in Maine are very limited and vulnerable to budget constraints of the sponsoring medical or community sponsor.
So what can we do about this problem? In 2009, the Product Stewardship Institute convened a stakeholder dialogue with representatives from industry, government, diabetes organizations and waste management. They could not be here today, but I believe they’re submitting written testimony and may be here for the work session. I’m going to quote directly from their memo, “There was agreement at the first meeting that sharps should not be disposed of in the waste stream…” As I understand it, much of the discussion revolved around providing free, convenient drop-off locations for sharps users. The discussions broke down around financing although PSI recommends in their memo that “primary funding for the solution should come from the pharmaceutical companies” that put insulin into the sharps.
The Maine Product Stewardship Working Group has had one meeting focused on medical sharps. We learned that the Maine Hospital Association owns a biomedical waste facility in Pittsfield, operated by Oxus Environmental LLC. Oxus routinely visits up to 500 health care facilities throughout the state to pick up biomedical waste. This could be the viable infrastructure needed to set up a sharps product stewardship program. There are currently 3 manufacturers that make up the majority of the market for medical sharps sold into Maine as insulin for people living with diabetes. While it is difficult to get good estimates, it is also our understanding that a sharps product stewardship program utilizing the existing infrastructure would not cost a tremendous amount of money. I recall a representative at our Product Stewardship Working Group Meeting suggesting that this may cost only $200,0000 annually.
Now we’ve heard that the industry may be moving toward greater utilization of retractable sharps. While this is to be commended and certainly makes sharps safer, without a viable collection program, these sharps will still end up in the waste stream or in municipal wastewater facilities. In both these scenarios, the retractable sharps can be crushed in trash trucks, compactors and wastewater facilities, re-exposing the sharp and whatever pathogenic material may be present.
We urge the committee to consider the benefits of such a program, make revisions to the bill as necessary and provide a viable statewide solution for sharps collection in Maine.
Thank you and I would be happy to answer any questions you may have.
1 “Product Stewardship Action Plan for Medical Sharps.” Product Stewardship Institute. June 27, 2008.
2 “Implementing Product Stewardship in Maine.” Maine DEP. December 2010.
4 “Product Stewardship Action Plan for Medical Sharps.” Product Stewardship Institute. June 27, 2008.
5 “Implementing Product Stewardship in Maine.” Maine DEP. December 2010.