Community sharps are needles and syringes that are generated by community members through self-administered healthcare or injecting drug use. Under the Protection of the Environment Operations Act, community sharps are specified as 'municipal waste'. While it is best to put community sharps in personal sharps waste containers, or designated sharps containers provided as part of a commercial or community service, it is not illegal to put community sharps in domestic waste.
Pen needles—often used instead of syringes by people with insulin-requiring diabetes—also pose a risk if inappropriately disposed of. Unlike pen needles, finger prick lancets used to measure blood glucose levels do not have a hollow core but because lancets have contact with blood and can cause a penetrating injury they should also be disposed of safely.
People who inject illicit drugs are often perceived as the main offenders whenever unsafe disposal of community sharps becomes an issue. Yet there are many medical conditions that involve regular self-injection in the home. These include diabetes, multiple sclerosis (MS), renal failure, infertility, allergies and vitamin deficiencies. Increasingly, community sharps are also generated in livestock and pet management.
Insulin treatment for diabetes accounts for a large proportion of community sharps, with the number of Australian adults with diabetes increasing rapidly in the past 20 years. Each year in NSW, the National Diabetes Services Scheme distributes over 36.5 million insulin pen needles and 2.5 million syringes for personal use. The NSW Needle and Syringe Program annually distributes approximately 10.5 million syringes through public outlets and participating pharmacies.
The management of community sharps is a shared responsibility across government, council and other organisations.
A significant number of councils have successfully addressed and responded to community sharps management. This is beneficial to communities while at the same time addressing community service and statutory obligations.
State government is responsible for developing, implementing and evaluating public health and waste management policies. NSW Ministry of Health has a demonstrated commitment to the management of community sharps through:
Local health districts support the safe disposal of community sharps by:
promotes safe disposal of sharps, and educates people with diabetes on the importance of correct disposal. Diabetes NSW also:
Aboriginal owned lands are private property and are rateable, so councils provide waste services just like any other private property. However, some Aboriginal communities are well within the boundaries of the property, and council legally doesn't have a right to enter. Council is reliant on either the community bringing waste to the boundary or they may have some arrangement with the Aboriginal Land Council to allow council onto the property to collect the waste. In this latter scenario, council would also manage community sharps disposal in the event a sharps disposal bin has been approved and installed.
Councils are responsible for managing community sharps waste and the potential workplace and public health risks resulting from inappropriately discarded community sharps on council owned or managed properties.
Council staff are not allowed by law to enter onto private property without the invitation of the land owner.
Sharps discarded on social housing common property are the responsibility of the property managers (Housing NSW). How this is managed varies from site to site.
Transport for NSW has clear guidelines for staff and contractors managing sharps that have been inappropriately discarded on roads and other land they manage. Staff are trained in safe handling.
Government agencies that have to collect and dispose of community sharps, have Safe Work Method Statements and workplace policies.
Your local health district can provide useful data and links to other key stakeholders, including health practitioners. They also provide community sharps disposal services and can help promote new bins and raise awareness of safe disposal practices with their clients.
Aboriginal Medical Services are able to provide statistics for an area and help identify a suitable location and promote awareness of the bins
Diabetes NSW is able to provide statistics for an area and help promote the bins location
Who self-inject to treat a medical condition may not believe that their equipment represents a risk to others and may think that safe disposal information does not apply to them. They may not know where to deposit their sharps or may have limited understanding of workplace health and safety and public safety reasons for disposing of community sharps safely. Involve your community in where to locate disposal bins so that they are accessible and convenient.
Pharmacies can be a convenient site for community sharps bins, and can help raise awareness of safe disposal and collection.
Access to bins for residents is a key issue, particularly for those with limited transport options.
Other stakeholders can provide councils with advice and assistance on where to locate bins, so broader consultation prior to finalising a location is recommended. Informants could include sharps contractors to ascertain whether any current bins are being under/over utilised, NSP staff who perform localised sweep of hotspots, and who educate their clients about safe disposal, Diabetes NSW, local pharmacies and affected communities.
Some councils install bins in all public toilets for all sharps users.
To address domestic waste, consider larger sized bins at community disposal facilities, community centres, pharmacies, medical centres and other publically accessible locations.
Clinical waste contractors can vary, depending on their capacity and whether they have other services operating in your area. A large community sharps bin (240 litre) that is serviced weekly should cost you no more than $250 per month. Large capacity bins more often than not require servicing each fortnight unless large containers are being disposed of each week.
Here is a guide to pricing per service:
Prices will vary depending on the geographical location of the council area, so please contact your clinical waste contractor.
This price includes the removal of sharps waste, the replacement of a new sharps container inside the sharps cabinet, the transportation of the waste and the destruction of the waste.
Bins get emptied according to how much they are used and their size. Small bins such as 1.4 litre bins inside public toilets can get jammed, so even if they are not used frequently, it is a good idea to have them serviced fortnightly or at least monthly. Make sure you place clear instructions on the bins so that people know how to report a full or damaged bin. If the bin gets full between servicing more than twice in a row, it may be time to consider increasing services. Remember that service providers often charge more for unscheduled services, so it is better to get the frequency right. If you find that bins are empty upon servicing, it is time to decrease service.
Ask your service provider to provide reports on the numbers of sharps in the bins so you can ensure your servicing frequency is appropriate.
The Pharmacy Guild of Australia is long-time supporter of the National Drug Strategy and its harm minimisation components.
Community pharmacy, representing more than fifty per cent of Needle and Syringe Program outlets around the country has made a significant contribution to the prevention of blood borne diseases among people who inject drugs and within the wider community by making sterile injecting equipment available through the Fitpack® scheme.
The Fitpack® scheme, which is fully funded by the NSW Ministry of Health, allows people who inject drugs to obtain a free Fitpack® in exchange for a used Fitpack® from a participating NSP pharmacy. In NSW, 60% of Fitpacks® obtained from community pharmacy are returned to be disposed of responsibly, using the safe disposal systems operating within community pharmacy. The used Fitpacks® are placed in a sharps container to be collected and destroyed by a licensed contractor.
The Pharmacy Guild uses funding from NSW Ministry of Health (Centre for Population Health) to pay for the contractors who collect used Fitpacks® from NSP pharmacies. This funding is dedicated for stopping the spread of Blood Borne Viruses by people who inject drugs.
The Needle and Syringe Program (NSP) is an evidence-based public health program that aims to reduce the transmission of infections such as HIV and hepatitis C among people who inject drugs. In Australia the NSP is the single most important and cost effective strategy in reducing drug-related harms among people who inject drugs and the wider community. There is no evidence that Needle and Syringe Programs increase the prevalence of illicit drug use in areas in which they are sited. All NSPs provide sharps disposal facilities.
Councils employ and contract a significant number of workers whose activities may involve exposure to community sharps. As well as cleaning, waste and parks staff, councils employ people in other public locations, such as community centres and libraries.
While councils may have little or no control over the behaviour of groups or individuals in public places, they are required to take all reasonable precautions to minimise risks to employees, volunteers and the public arising from inappropriately discarded community sharps.
As is the case for all employers, compliance with workplace health and safety regulations by councils presupposes that the risk of needle stick injury in the workplace has been identified, assessed, and either eliminated or the risk of harm controlled to the lowest possible level.
In the case of needle stick injury, clear procedures for responding and reporting incidents should be attached to a safe work method statement (SWMS).
Needle and Syringe Programs (NSPs) are provided in areas where injecting drug use is already occurring. No study has ever found that the introduction of an NSP contributed to increased levels of injecting drug use. In fact, studies have reported a decrease in drug use following the introduction of NSP because they act as a referral and education point for clients wanting to begin drug treatment.
Some drug users inject in public places like toilets because they are young, homeless, or are very dependent on drugs and inject immediately after buying them. Drug users may also throw their injecting equipment away because they fear the police could use this equipment as evidence of drug use and arrest them.
However, just as the vast majority of people do not litter, most people who inject drugs dispose of their used needles and syringes safely, particularly when there are accessible disposal facilities available.
NSPs help reduce the number of needles and syringes that are discarded inappropriately by providing disposal bins and personal containers, educating clients about safe disposal and by cleaning up hotspots where injecting equipment has been discarded.
NSPs collect used injecting equipment and often visit known hotspots to collect discarded equipment. Councils and others who have issues with discarded injecting equipment should inform their local NSP, or the NSW Needle Clean-up Hotline on 1800 633 353, who will assist with the clean-up.
All NSPs accept needle and syringes from the public, regardless of whether or not they are NSP clients. This means people with diabetes and other medical conditions are entitled to dispose of their community sharps at NSP programs.
All public hospitals and community health centres in NSW provide disposal bins for the public. Some councils provide community sharps bins in public places. Some pharmacies provide a disposal service. Diabetes NSW Resource centres have sharps disposal facilities.
People with diabetes can access free needles and syringes as part of the National Diabetic Services Scheme. Diabetes NSW are able to inform people with diabetes where they can dispose of their used needles and syringes. If people with diabetes and other medical conditions do not have access to disposal facilities through Diabetes NSW, community pharmacies or local councils, they can dispose of used needles and syringes at Needle and Syringe Programs.
Blue (ultraviolet) lighting is not recommended as a response to injecting use in toilets, as the low level lighting increases the risk of needle stick injury to council staff and members of the public, and may result in increased injection related harms such as blood spills. Blue lighting is also unlikely to conform to Australian lighting standards.
Brisbane City Council's Blue Light Policy states: In theory, blue light makes it difficult for injecting drug users to find a vein to inject into. However, Council does not install blue lights in public toilets because blue monochromatic light:
Sydney City Council Toilet Strategy states:
Ultra violet light should not be used (as a means to reduce illicit behaviour) because such lighting reduces visibility and safety levels for all users.