Disposal of sharps - needles and lancets

Background

The need for a special system of disposal for sharps arises from the damage that can be caused through injury from a used needle. The risks include contracting blood-borne viruses such as Hepatitis B and C and HIV from contaminated blood on needles. Even if a needle is not contaminated the psychological impact of such an injury whilst awaiting test results can be great. The responsibility to dispose of sharps safely and correctly rests with the individual.

Advice

Safety

• Never share syringes or finger-pricking devices.
  
• Keep all your needles and glucose monitoring equipment clean, bloodstain free and out of reach of children at all times.
  
• Never try to retrieve anything once it has been put in the sharps disposal box.

Storage

• Needles, syringes and lancets must not be disposed of in fizzy drinks cans, plastic bottles or similar containers as they are not safe for disposal and could result in injury to others. They are clinical waste and need a special system for disposal
• You can dispose of your needles, syringes and lancets in a sharps disposal box. A clipper, a device that enables you to safely snap off sharps from your syringes/pens, can also be useful as a method of storage. The clipper needs to be disposed of in a sharps disposal box when full in accordance with your local guidelines for clinical waste disposal.
• Sharps disposal boxes and clippers are available on prescription (FP10 prescription form) in all four nations of the UK.
• Lancets cannot be disposed of using clippers as these are not designed to remove the lancet needle.
• Sharps disposal boxes come in a variety of sizes, and clippers are very small. Although Diabetes UK advocates that there should be choice according to need, not all areas offer a choice, or more than one disposal container. Your healthcare provider should be able to prescribe you the correct type of sharps disposal box and provide instructions on how to use it.

Disposal

There are different schemes and arrangements in place for the safe disposal of your sharps disposal box once it is full. Schemes vary from nation to nation and even down to the locality, and your local healthcare provider should have information about local disposal methods. They can range from taking it to GP surgeries or pharmacies for disposal, to having it collected by the local council. Care should be taken to ensure the sharps disposal box is stored safely to prevent it from causing a hazard to others whilst it is being stored or awaiting collection. Here is a breakdown of your rights and the corresponding legislation.

England, Wales, Scotland:

In England and Wales some GP surgeries and pharmacists will collect sharps bins from people with diabetes, but they are not duty bound by the law to do so. However your local council does have a duty to collect your sharps bin, but you need to request this service and they can charge you for this if they choose to. In Scotland guidance appears to currently be made at a local level.

The relevant legislation is the Environmental Protection Act 1990 and the Controlled Waste Regulations 19922.

Northern Ireland:

In Northern Ireland a system of disposing of sharps waste in pharmacies appears to be the norm. This is aided by a centrally set-up and funded system by the Central Services Agency as part of the Department of Health. Pharmacists are able to accept sharps waste and it is collected along with their other waste medicines and sharps at no additional cost to the pharmacist.

The relevant legislation is Controlled Waste Regulations Northern Ireland 2002 and the Waste and Contaminated Land Northern Ireland Order 1997.

Travel

• When travelling by air you can check with your GP to ensure your disposal equipment such as clippers and sharps disposal box are included in your accompanying letter regarding your treatment and equipment.
  
• Information about the guidelines for disposal in the country you are visiting can be sought from the Association for Diabetes in the country you are visiting.

More information can be found in our Travelling with diabetes section.

Advice if no clear systems are in place to enable you to dispose of your sharps in the methods described above

Diabetes UK believes sharps disposal should be a free and efficient service provided by the most appropriate body in the local area.

It is important to try and find out what systems are in place in your area to ensure that sharps are disposed of safely.

If it appears that there are no strategies in place in your locality then the following approaches have demonstrated that awareness of the issue can be raised. In some cases this has brought about a change in the system:

1. Contact your local healthcare trust, group or board. These bodies are responsible for overseeing healthcare within their areas. They are:
   Primary Care Trusts (PCTs) – England
   Local Health Boards (LHBs) – Wales
   Four Health and Social Services Boards (HSSBs) – Northern Ireland
   Health Boards – Scotland
   Your GP surgery should have the details of your relevant local trust/board/group. Alternatively the NHS provides a service finder www.nhs.uk/.
   You could also check our In your Area section.
   It may also be useful to raise the matter with your local Diabetes User Representative/User Reference group (Wales), Diabetes Lead or Diabetes Network Manager. Details of your Diabetes Lead or Network Manager should be available through your local healthcare organisation mentioned above, and the Lead or Network Manager should have details of your User Representative.
2. Where your local authority has a duty to collect your sharps as part of household waste you could raise it with your local council/authority. You need to speak to the waste management department.
   Details of your local council can be found at your local library, online at: www.direct.gov.uk and in local directories.
3. If the matter is still unresolved you can raise it with the patient support services who can advocate on your behalf with healthcare providers.
   In England, you can contact your local Patient Advice and Liaison Service (PALS). Information about PALS should be available at the hospital, your GP practice or on your Trust's website.
   In Scotland, you can approach your local Citizens Advice Bureau. You can find your local bureau at www.cas.org.uk/
   In Northern Ireland, contact your local Health & Social Services Councils, until Spring 2008. After this contact the Patient Client Council.
   In Wales, you can contact your local Community Health Council. www.patienthelp.wales.nhs.uk
4. If there appears to be no satisfactory resolution then asking for your MP's involvement may assist matters.
5. If you are having difficulties within a specific setting such as residential care or school, encouraging discussion between relevant partners such as healthcare providers, community/paediatric nursing staff, school/residential care manager, local authority and social services for example at the care planning stage and getting sharps disposal considered within the care plan, may help resolve any issues more satisfactorily.