Frances Rule District Nurse Frances Rule disposes of a syringe properly in a plastic detergent bottle as home health patient Gertrude Muise looks on. (Photo Lisa Kristoff)

What is household biomedical waste? It is defined by the Department of Environmental Protection, in a household waste management profile, issued in September of 1998, as consisting ``...solely of sharps, usually generated in conjunction with the home treatment of diabetes. The sharps themselves are insulin syringes and lancets, are either self-administered or administered by a family member.''

In the health care community, it came to the attention of Kathy Bean, nurse manager at St. Andrews Home Health, through reports from nurses providing home health care, including District Nurse Frances Rule. Rule has held this position for 27 years and sees 135-155 patients per month. She estimates that 60 percent of these are diabetics. During a visit, Rule will fill their syringes providing enough doses for one full week. Others using syringes in the home are patients receiving vitamin B-12 and a few rare cancer treatment patients.

While in the home, Rule and other health care givers have observed syringes thrown loosely in the wastebasket. Their concern is not so much for the users -- their contact with the syringes was over -- but for other community members who might come into contact with this waste and place themselves at risk. If stuck by a used syringe, an unsuspecting person could contact an illness such as hepatitis. They would then have to begin a series of blood tests and injections for the treatment of hepatitis and other blood-borne pathogens.

The hospital acknowledged the need for public awareness when new patients would come to St. Andrews asking for disposal units and information.

The issue has also been cited by Alison McCrady, Manager of the Transfer Station/Waste Management Facility in Boothbay where improper syringe disposal has been, ``...an ongoing problem for years. As the number of people receiving home care increases, so does the incidence of the problem it created. Every week we will find them loose on the ground after falling out of a trash bag. They have even been discovered in the mixed paper bin!'' McCrady says. ``We do not feel that anyone is doing this maliciously. People just don't know what to do with them. If you have questions, please ask! There are no stupid questions.''

In response to this need for information, Bean, McCrady and Rule held three meetings, beginning on May 11, to discuss the best course of action that would simply and effectively increase patient and community awareness and educate. The result of these meetings was the creation of a pamphlet, ``Tips for Syringe Disposal in the Home.'' The pamphlets are available in physicians' offices, pharmacies and the Waste Management facility. Out-of-area care givers will receive copies of pamphlets with a letter.

Do's and Don'ts

What are the ``do's'' of safe disposal of home use syringes?

They are: DO place needles, syringes and other sharp objects in a hard plastic container -- the laundry detergent variety is preferred by the DEP -- with a tight-fitting lid. The detergent bottle is best because it has a large opening -- and can hold quite a few. (Coffee cans are the second choice, HOWEVER, care must be taken to reinforce the lid with heavy tape.)

DO label a full container with the words: DO NOT RECYCLE. Do check for a tight-fitting lid.

And, finally, DO dispose of it in the regular trash.

Please DO NOT use milk containers which are easily punctured.

A sign of progress was witnessed by District Nurse Rule recently on a new package of syringes that bore a label with the correct disposal information.

And, for all of you confirmed powder detergent users, liquid laundry detergent containers are plentiful at the Waste Management Facility and the District Nurse's office. Stop by and pick one up at the District Nurse's office (located in Attorney Frank Poe's former office in the former Key Bank building) or request one by calling Nurse Rule at 633-5533 -- although you can be sure that when she's making her rounds, she's always ``packin' a spare.''

Finally, as McCrady reminded, whether you are unsure about the proper disposal of syringes or any waste item -- Ask!

For more information, call Alison at the Waste Management Facility at 633-5006 or nurse manager Kathy Bean at St. Andrews Home Health at 633-2121.