Unsafe Sharps Disposal Among Insulin-Using Patients With Diabetes Mellitus: An Emerging Global Crisis

Abstract

Approximately eight billion therapeutic injections are administered outside of medical treatment facilities annually. The management of diabetes mellitus (DM) includes self-monitoring of blood glucose levels and administration of insulin and injectable non–insulin-related medications. The lancets, needles, and syringes used for DM management are categorized as medical sharps. Improperly discarded medical sharps can cause needlestick injuries in unsuspecting individuals and thereby pose a considerable public health risk. Release of these items into the environment will likely increase with the rising worldwide prevalence of DM, and a public safety crisis will emerge if proper disposal measures are not emphasized. This article reviews the literature from various geopolitical regions and describes how a substantial number of patients with DM improperly discard their sharps. Data support the need to develop multifaceted and innovative approaches to reduce risk associated with improper disposal of DM-related medical sharps into local communities.

Medical sharps in Portugal: a cross-sectional survey of disposal practices among the diabetic population

“…To the best of our knowledge, there was no data available about home disposal practices of medical sharps in the Portuguese diabetic population, as in many other countries 20. We found clear evidence of inadequate disposal of medical sharps among these patients, findings that are corroborated by studies in the same scope conducted in other countries, which reported household bin disposal of medical sharps ranging from 33% to 92%,3 7 8 10 13 15 17 18 21–28 a common problem worldwide 9. Our results show that over two-thirds of diabetic patients discard sharps directly into common household bins.…”

“… 20 We found clear evidence of inadequate disposal of medical sharps among these patients, findings that are corroborated by studies in the same scope conducted in other countries, which reported household bin disposal of medical sharps ranging from 33% to 92%, 3 7 8 10 13 15 17 18 21–28 a common problem worldwide. 9 Our results show that over two-thirds of diabetic patients discard sharps directly into common household bins. Only 19.1% (n=52) of needles/devices with needles and 13.1% (n=104) of lancets were disposed of at healthcare facilities, that is, primary care, hospital or community pharmacy.…”

“…The undifferentiated elimination of these by-products of DM management at home not only leads to environmental pollution, but also represents a major threat to anyone who inadvertently handles ordinary household waste, such as workers at material recovery facilities, but also for landfill workers and those who collect waste from households. 9 10 Approximately 5.2 million people die every year worldwide due to diseases derived from the inadequate management of healthcare waste. 11 12 Improper disposal of sharps carries potential risk of propagation of some diseases, such as hepatitis B, C and HIV, to anyone who comes in contact with these sharps.…”

Conductive Composite Microneedle Sensors Based on Cellulose Acetate Phthalate: Investigating Performance and Biodegradability

“…This again is in marked contrast where current recommendations for the disposal of measurement strips and lancets employed in home glucose monitoring related to dedicated waste containers for incineration. There are long standing issues with compliance with prescribed disposal practices and it has been estimated by Thompson and Cook (2021) that in the UK almost 30% of lancets were placed directly into household waste [1]. Similar numbers have been reported internationally and contribute to a worrisome waste and safety problem [1,2].…”

“…The home glucose market in particular has, at least until recently, been dominated by screen printed electrodes but these still require the use of finger prick testing which can be painful and will inevitably generate considerable waste (strip, lancet, insulin syringe/ needle etc) [1,2]. There is a pressing need to reconsider the design, application and disposal of modern point of care (POC) sensing consumables to provide more sustainable options that avoid the accumulation of waste.…”