Patterns of Sharps Handling and Disposal Among Insulin-Using Patients With Diabetes Mellitus

Abstract

Background: The objective of this study was to assess disposal patterns for “sharps” among a cohort of patients with diabetes mellitus (DM) receiving insulin therapy. Method: A convenience sample of inpatients and outpatients was surveyed about how they disposed of sharps, how often they reused lancets and needles, and what education they had received about proper disposal. Safe disposal was defined as discarding sharps into a formal sharps or sealable container; otherwise, disposal was categorized as unsafe. Results: Of 150 respondents, 56% were men and 75% were white. The mean (SD) age was 56 (15) years; duration of DM, 20 (13) years; and hemoglobin A1c, 8.1% (2.0%). Half the respondents reused a lancet two or more times, and 21% reused an insulin needle two or more times. Thirty-eight percent of respondents discarded lancets unsafely, and 33% discarded insulin needles unsafely, typically by throwing these items into household trash. Most respondents (75%) discarded insulin pens, vials, cartridges, insulin pump supplies, and continuous glucose monitor sensors into household trash. Most (64%) indicated that they had not received education on safe sharps-disposal practices, and 84% had never visited their municipal website for information on medical waste disposal. Conclusion: Approximately one-third of patients unsafely disposed of sharps. Unsafe disposal could cause millions of sharps to appear in the municipal solid waste stream, thereby posing a substantial public health hazard. Point-of-care patient education is important, but a broader public health campaign may be required.

The Diabetes Technology Society Green Diabetes Initiative

“…23 A recent survey study of 150 respondents on insulin therapy revealed that approximately one-third of respondents disposed of their lancets and insulin needles in an unsafe manner noncompliant with the current recommendations. 24 The findings from this study are similar to the limited data from the United States and other countries that indicate many patients with diabetes mellitus (DM) unsafely dispose of their sharps. [25][26][27][28][29][30][31] Sharps disposed of improperly pose a risk to waste industry workers.…”

“…In addition, the majority (87%) indicated they had never visited their municipal website for medical waste disposal. 24 As the incidence of diabetes increases, it becomes even more important to provide patients with education on safe sharps disposal.…”

“…Two examples of the types of topics we will cover at this Summit will be (1) “Patterns of sharps handling and disposal among insulin-using patients with diabetes mellitus,” which is the title of an eye-opening article by Bithika Thompson and Curtiss Cook et al that we published in Journal of Diabetes Science and Technology (JDST) six weeks ago 24 ; and (2) “Diabetes technology and waste: a complex problem piling up,” which is the title of a thoughtful article by Lutz Heinemann and Ed Krisiunas that was published in JDST last year. 40 We will also discuss how to move waste management processes from less preferable to more preferable according to a seven-level hierarchy, as described by the United Nations Global Healthcare Waste Project 41 (see Figure 3).…”

Green Diabetes Summit 2021

“…In a study reported by Montoya et al in 2021 at the Mayo Clinic in Arizona, USA, of 150 respondents with diabetes, 64% indicated that they did not receive proper education on how to dispose of their waste, and around 40% indicated that they disposed their lancets in common household trash. 15 Evidence indicates that this is a global problem. DTS also conducted a study to describe the current landscape of sharps disposal options in commercial airports in California.…”

The Diabetes Technology Society Green Declaration

“…In 2021, Montoya and colleagues reported a study to examine and characterize current issues regarding waste disposal practices for diabetes devices. 2 Of the 150 respondents, 64% indicated that they did not receive proper education on how to dispose of their diabetes-related waste, and around 40% indicated that they disposed of their lancets in common household trash. Many medical products used for diabetes monitoring and therapy contain multiple components, each constructed from a different material.…”