WASHINGTON, DC—As VA and other health systems embrace telehealth and other care options that allow patients to administer some of their own treatment at home, the problem of safe medical waste disposal moves from the hospital setting to a new venue. Approximately 9 million people in the US self-inject at home or outside of the traditional healthcare setting to treat diseases such as diabetes, arthritis, and other conditions. This results in as many as 3 billion syringes that are frequently just thrown in the trash with other household waste.

Until December 2004, the EPA guidelines advised home-injectors to dispose of needles in their household trash. However, that year EPA updated its guidance, naming disposal by mail a possible solution. Government-approved disposal by mail systems include a medical waste container, prepaid postage return shipping box with barcode, protective liner, detailed instructions, and a simple manifest tracking form. When the container is full, it is placed in the prepaid postage return box and delivered via the USPS to a permitted treatment facility for documentation, weighing, and destruction of each package and its contents. Proof of destruction is available through an online manifest tracking program.

’There are as many as 800,000 needlestick injuries among healthcare, laundry, and housekeeping employees each year, creating risk of infection from hepatitis and HIV,” explained Burton Kunik, MD, chairman of Sharps Compliance Corp, a provider of medical waste disposal solutions.

’For example,” he continued, ’Cathedral City, CA became the first city in the nation to offer a free and confidential disposal by mail program to help residents safely dispose of used hypodermic needles, syringes, and lancets. In the last four years the program has resulted in an estimated 1,400 participating residents who self-administer injections to treat diabetes, allergies, HIV, and other medical conditions; and has prevented more than 480,000 used needles and syringes from disposal in local landfills.”

As more patients self-inject—there are half a million diabetes patients in VA alone—and as vaccine administration becomes widespread in remote areas, disposal by mail offers a viable solution.

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