Hepatitis C Information Central

HOUSTON, July 23 /PRNewswire/ -- An unsuspecting child is stuck by a used syringe while retrieving a ball that bounced into the neighbor's trash. A trash collector is cut by a used syringe while transferring a load into the truck. A hotel housekeeper reaches under the mattress to change the bed and sticks her hand on a used syringe. Or a homecare nurse drives her family around for the weekend with a sharps container full of used patient syringes in the back seat of her vehicle.

The problem? Unregulated disposal and transportation of home and self-care generated medical waste.

Thousands of people improperly dispose and unsafely transport needles and blood contaminated materials (i.e. medical waste) everyday, putting a significant number of people at risk. More than one million accidental needlesticks are reported each year, and it is estimated that an additional 66 percent per year also go unreported. These incidents can directly expose people to many different infectious agents, including hepatitis and AIDS.

Until the Environmental Protection Agency (EPA) has federal authority to issue federal standards on medical waste disposal or states improve their current medical waste regulations, providers of home health care, consumers and hospitality services must take responsibility to protect their employees, the public and the environment.

The chance for a needle to be contaminated with infectious viruses and bacteria agents can be high. For example, there are an estimated 1.25 million hepatitis B carriers and close to 4 million hepatitis C carriers in the country. Should any of these people generate contaminated medical waste, people could be at risk because of improper medical waste disposal.

Medical waste is generated in a variety of forms and in any number of places, for example, in homes of chronically ill patients who dispose of their used syringes in their household garbage, in a restaurant where a waiter cuts himself on a broken glass or in a hotel room where an insulin dependent diabetic guest places a used lancet in the trash.

"People are acutely aware of the danger of AIDS, but there is a greater threat when it comes to diseases spread through potentially infectious medical waste," says Janet Emmerman, national consultant and expert in medical waste industry. "It is hepatitis B. The hepatitis B virus accounts for approximately 300,000 of the new hepatitis cases a year. Approximately 40,000 of these patients die annually. By comparison, AIDS infects about 35,000 people a year with approximately 10 percent of the patients dying of the disease annually. An extremely hearty virus, hepatitis B can survive on surfaces for seven to ten days."

Today, while employers in the hospitality and homecare industries must comply with Occupational and Safety Hazard Association (OSHA) regulations which has some medical waste regulations that protect employees, the EPA has no current authority to issue any other federal regulations on the treatment and disposal of medical waste. In November 1988, President Ronald Reagan, in response to a rash of beach wash ups and improperly disposed medical waste, signed into law the Medical Waste Tracking Act, establishing a two-year demonstration program to track medical waste from cradle to grave. Once the program expired, Congress did not extend or expand the law because medical waste problems quieted as most states took action and implemented their own regulations.

As a result, regulations vary from state to state. Many states have tough regulations on medical waste while others have none. Those states that do regulate medical waste have exempted waste produced in the home from the regulations, similarly to the exemptions to hazardous chemical waste. However, unlike chemicals, items such as syringes with needles and lancets can not be diluted. They can still stick someone no matter how much they are mixed with trash. States also often exempt the medical waste removed from a single home by a home health care company based on the weight of the material generated. The reasons for exemption are because of the difficulty in enforcing stricter regulations concerning home generated waste and the relatively small percentage of the material when compared to that generated in more traditional health care settings.

Due to recent changes in health care, a significant amount of health care has been shifted to the home setting and there has been an explosion of the use of injectable drugs used at the home. According to Emmerman, the number of patients, procedures and homecare agencies have increased dramatically in last ten years. For example, indigent patients alone accounted for approximately 2 million home care clients in 1990; this number doubled to 4 million in 1997. This increase is of concern when one realizes that the level of care at home has intensified and with it the generation of medical waste.

Solutions do exist. One developed by a Houston-based medical waste disposal company Sharps Compliance Inc. (OTC Bulletin Board: SCOM) (Sharps), is a mail-back medical waste disposal system called Sharps Disposal By Mail. The system is available to small generators of medical waste and includes U.S. Postal approved sharps containers, prepaid U.S. postage and destruction costs of the waste that is in strict compliance with all regulatory requirements.

In this medical waste disposal system, the homecare company or hotel manager orders the system, completes the tracking form and delivers the system to the patient or caregiver in the case of homecare, or to the cleaning staff in the case of the hospitality industry. When the sharps container is full or no longer needed, the container is placed in the pre-paid U.S. postage return box and given to the U.S. Postal Service. The Postal Service then delivers the package directly to a medical waste incinerator. When the waste materials have been destroyed, proof of destruction is mailed back to the purchaser using the tracking form.

The advantages to the Sharps Disposal By Mail System are numerous. "The system reduces the risks of our neighbors, workers or others being injured in the disposal transportation of medical waste," says Burt Kunik, president and CEO, Sharps Compliance Inc. "The system also offers easy compliance with JCAHO, OSHA, federal, state and municipal regulations with its tracking ability."

In addition to providing a safe means for the disposal and transportation of medical waste, the Sharps Disposal By Mail system reduces the hidden costs such as workers compensation claims for accidental sticks or civil litigation from customers receiving an accidental stick.

According to studies, the estimated cost of a needle stick to a company is approximately $6,000. If a disease is contracted, that could be increased to $200,000 or more.

Larry Box, director of pharmacy, field and clinical services of Apria Home Care, is currently using the mail-back system in approximately 30 of his offices nationwide. Box states the Sharps mail-back system reduces the incidence rate at which his workers are injured or exposed to medical waste during the disposal and transportation stage. "The process is smooth and easy. The medical waste goes from point A to point B -- from the patient to the incinerator and we receive the confirmation."

OSHA has given the mandate to protect employees in the work place. According to OSHA's bloodborne pathogen standard, employers must have a written exposure control plan that outlines how to eliminate and minimize exposure, have adequate numbers of sharps containers located as close as possible to the immediate area where sharps are likely to be found, and have a procedure in place for handling sharps containers. This is well known in the health care industry, however, Dr. Kunik adds that staff and guests in the hospitality industry are not aware of the impact of improper disposal of waste.

"Typically, hospitality managers will say 'we only find a few syringes a year' but often these are the ones that have caused a problem'" adds Dr. Kunik. "The reason is they have no disposal system in place, so most items are discarded into the solid waste, transferring the danger to the waste handler. This increases liability to hotels , motels and the like with risk to the public as well as to OSHA fines. Also, commingling even one sharp into the solid waste can cause the entire dumpster to be considered medical waste. The whole practice is an unnecessary risk."

Sharps Compliance Inc., based in Houston, Texas provides a convenient, cost effective and environmentally sound system to be used for home medical care which generates medical waste. Sharps distributes its products nationally to several industries including home health care, hospitality medical and dental practices and diabetics.

SOURCE Sharps Compliance, Inc.

table Of Contents