Editor’s Note: Our friends at the Product Stewardship Institute recently helped the state of Oklahoma solve its medical sharps disposal dilemma. They graciously agreed to share their lessons learned and actions you can take to handle medical sharps safely in your community.

Medical sharps, such as needles and syringes, are convenient devices used by millions to safely self-inject medications outside of healthcare settings, often to treat conditions like diabetes. More than 8 million US residents are prescribed self-injecting medications, generating as many as 3 billion needles per year.

Although medical sharps are life-saving devices for millions of Americans, when needles are flushed or trashed, they pose grave health and safety risks to residents, sanitation workers, sewage treatment plant operators, waste management personnel, and hospitality workers.

Finding proper disposal options for medical sharps can be challenging. In most states, household sharps are advised to be placed in plastic containers and disposed of in household trash. However, this method poses risks, especially for waste management workers who may encounter loose sharps.

Patrick Riley, from the Solid Waste and Sustainability Unit at Oklahoma Department of Environmental Quality (DEQ), explains that, in Oklahoma, “the solid waste rules are pretty vague when it comes to… household sharps. They direct people to put it in a plastic container, label it and put it in the household trash. But other than that, there aren’t a lot of options for people to dispose of sharps.”

The Oklahoma Meds and Sharps Disposal Committee (OMSDC)

Prompted by concerns from waste management companies about work injuries from needle sticks, the Oklahoma DEQ sought non regulatory solutions to safe handle medical sharps. To address this problem, the Product Stewardship Institute (PSI), which has led the national movement for proper sharps management since 2008, was elected to facilitate the Oklahoma Meds and Sharps Disposal Coalition (OMSDC) with support from the DEQ.

The OMSDC originated not only from a need to address the inadequate disposal options for medical sharps, but for various difficult-to-dispose-of waste streams in Oklahoma, such as pharmaceuticals and mercury thermostats. The group has worked to expand safe waste disposal options for over a decade.

Recognizing the diverse stakeholders involved, the OMSDC includes waste haulers, medical professionals, and harm reduction organizations. Many of these organizations provide on-the-ground assistance, including identifying potential collection locations and promoting programs in related organizations and events across the state.

In 2016, PSI and DEQ launched a drug take-back pilot in Oklahoma with participation from the Oklahoma State Department of Health, the Oklahoma Bureau of Narcotics & Dangerous Drugs Control, Oklahoma State University’s Cooperative Extension Program, Reworld (formerly Covanta) Tulsa, Tulsa Master Recyclers, and the Ithaca (NY) Area Wastewater Treatment Facility.

In 2021, the Oklahoma law was amended to allow sharps collection which led to the first sharps collection pilot: a six-month program to collect medical sharps from residents free of charge, developed and implemented by PSI and the OMSDC, with grant support from DEQ.

In 2022, the OMSDC and PSI partnered with the Choctaw Nation, Indian Health Services, the Iowa Tribe of Oklahoma, and Reworld Waste to further expand sharps take-back infrastructure in the state. Through the program, 15 participating health clinics provided sharps users with easy-to-use containers that let them drop off or mail in their used sharps, protecting people and the environment.

In addition to increasing available drop off locations, Riley explains how the OMSDC hosts collection events “for folks to bring in all the stuff that they’ve collected in their garage, like motor oil, antifreeze, electronics, sharps, and pharmaceuticals. It’s a one-stop shop for bringing all these things in, all the things that people have a hard time getting rid of or for which there needs to be a better option than just putting it all into a residential container and rolling into the curb.”

Over the years, initiatives like takeback pilots have helped raise awareness and demonstrate effective strategies for waste management in Oklahoma. This led PSI to develop a how-to guide: Establishing Community Medical Sharps Programs: A Guide for Municipalities, Pharmacies, Health Clinics, and Nonprofits in Oklahoma. This guide contains information on the need for safe disposal options, the different types of programs available, criteria for designing a program, cost estimates, vendor information, and best practice recommendations.

As a result of this work, there are now 49 sharps disposal sites in Oklahoma in addition to regular sharps take-back events. Our progress underscores the significance of collaborative efforts and importance of community engagement to build community resources and advocate for improved waste management services.

Extended Producer Responsibility for Medical Sharps

Extended producer responsibility (EPR) for medical sharps, which is a mandatory type of product stewardship required by law, is a viable solution for safely and effectively managing used needles. Currently, California is the only state with an EPR law for medical sharps. However, In France, DASTRI – the producer responsibility organization that operates sharps take-back programs – safely manages 83% of sharps waste. The programs are funded by manufacturers of sharps and medical devices, who are DASTRI members.

In the U.S., PSI has led the movement for sharps EPR since 2008, when the organization first convened the public and private sectors in dialogue to develop a national solution which laid the groundwork California’s medical sharps EPR program as well as the programs in nine local jurisdictions.

Voluntary initiatives are effective for managing medical sharps waste, and often a great place to begin improving disposal options at a local or state level. However, EPR is an effective solution for ensuring safe, mandatory medical sharps management.

What can you do?

Start by looking at the disposal options in your area and state. Here are steps you can take to find available options:

  • Reach out to your local government or solid waste management team to inquire about existing disposal programs and resources.
  • Utilize online resources and databases to locate drop-off locations or events.
  • Start a sharps collection program in your own community!
  • Learn more about EPR for medical sharps

Medical sharps disposal is a pressing issue that requires collective action and community engagement. By building coalitions like the OMSDC and advocating for safer disposal methods in your state, you can make a tangible difference in improving waste management practices, protecting public health and the environment.

If you’re interested in starting a coalition, or have questions about this work, you can contact PSI at: info@productstewardship.us. By taking proactive steps to advocate for better disposal options, we can create safer and healthier communities for all. Let’s work together to ensure that everyone has access to safe and convenient options for disposing of medical sharps and medications.

Need to dispose of medical sharps near you? Add your ZIP Code to this search to check Earth911 for local options.

By Hanz Atia

Hanz Atia, MPH, is an Associate for Policy and Programs at the Product Stewardship Institute (PSI) where they conduct research, create educational materials and campaigns, and design and implement infrastructure development initiatives to advance product stewardship for pharmaceuticals and medical sharps. Learn more about PSI at http://www.productstewardship.us/