[Pharmwaste] Sharps kiosks

Thu Aug 10 10:20:03 EDT 2017

Here is an interesting article I just spotted in  a waste magazine.
http://magazine.wastetodaymagazine.com/article/july-2017/sandwich-fire-department-medical-waste-program.aspx

Is anyone familiar with the sharps disposal unit mentioned?  http://www.sterilismedical.com/

Christine Miller
Recycling Coordinator
Outagamie County Recycling & Solid Waste
1419 Holland Rd Appleton, WI 54911
(920) 968-5721
www.RecycleMoreOutagamie.org <http://www.recyclemoreoutagamie.org/>
[XSM_signature]<http://www.recyclemoreoutagamie.org/> [fb-art] <https://www.facebook.com/OutagamieCountyRecycling/>

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From: Pharmwaste [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Volkman, Jennifer (MPCA)
Sent: Wednesday, August 09, 2017 3:59 PM
To: Jaramillo, Jeanie; pharmwaste at lists.dep.state.fl.us
Subject: Re: [Pharmwaste] Sharps kiosks

Awareness for sure, but it also reflects the fact that more people are injecting various types of drugs at home, mainly insulin, but I think the injectable drugs for arthritis are on the increase as well. I see the pounds increasing with increasing numbers of people self-injecting various drugs.

I've pushed collection a bit here in MN through the SW and HHW programs. Counties are very involved in operating SW facilities of various types and it is in their best interest to organize collection, even if they charge a fee, to prevent sticks. If private SW haulers complain about sharps, I tell them to place a collection bin at their facility or office for use by the public. Sure, people may not drive there, but some will. If everyone with an interest in reducing loose sharps due to worker exposure, providing customer service or overall community concern collected and charged a nominal fee we'd take care of the issue. A nominal fee in Minnesota used to be the amount equal to the cost of a 6 pack of beer. I think we increased that to a 12 pack or a 6 pack of specialty beer. I think that's true for 'Sconny as well. We have a program that charges $5 for any amount and people think they are angels for making it available.

From: Pharmwaste [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Jaramillo, Jeanie
Sent: Wednesday, August 09, 2017 2:53 PM
To: pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Subject: [Pharmwaste] Sharps kiosks

I really like the idea as well (dual pharma/sharps kiosks), Jennifer. Our kiosk liners are pretty sturdy, but I wouldn't trust them to keep a needle on the inside! Then, the carrier reps would be at risk. But, I'm with you in thinking there needs to be a solution. We actually found out recently that the sharps from our one-day event take back program are less expensive to dispose of then our pharmaceuticals...which shocked me! We've always felt it was important to accept sharps (at the events, not at the kiosks) as we are in an area of the country that is behind the times in terms of having sharps disposal options. We've noted that our sharps collections have increased in weight with each event we have - likely as people become aware that we will accept them. This is definitely a need!

Jeanie

From: Volkman, Jennifer (MPCA) [mailto:jennifer.volkman at state.mn.us]
Sent: Wednesday, August 09, 2017 1:36 PM
To: pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Subject: Re: [Pharmwaste] New Stericycle med disposal kiosks

Currently, some sharps waste is autoclaved and landfilled, and some goes through incinerators. We had a medical waste incinerator in Minnesota for a couple of years, so I figured it was an outlet, but you make a good point. Incinerators are not all designed the same way and sharps could gum up the works.

Also, liners are not required to be puncture proof, so that is another barrier. I guess I'm back to the side-by-side concept...

Cheers all!
Jennifer Volkman

From: DeBiasi, Deborah (DEQ) [mailto:Deborah.DeBiasi at deq.virginia.gov]
Sent: Wednesday, August 09, 2017 7:50 AM
To: Volkman, Jennifer (MPCA) <jennifer.volkman at state.mn.us<mailto:jennifer.volkman at state.mn.us>>; pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Cc: mclark at micrometalsinc.com<mailto:mclark at micrometalsinc.com>
Subject: RE: New Stericycle med disposal kiosks

The concern that I have heard about the sharps is that they cause problems for the incinerators, since the needles are still intact after burning.  They get caught in the mechanical parts and then can cause injury to the workers trying to fix it.

From: Pharmwaste [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Volkman, Jennifer (MPCA)
Sent: Tuesday, August 8, 2017 6:28 PM
To: pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Cc: mclark at micrometalsinc.com<mailto:mclark at micrometalsinc.com>
Subject: Re: [Pharmwaste] New Stericycle med disposal kiosks

Why does no one make a combination sharps/pharms container with two doors and two boxes? No market because it would be too large? I have two counties that put one of those bathroom sized sharps containers next to or on top of their pharm container, which cracks me up given the size.

I don't think having sharps mixed in with the pharms is a large deal, since the inner liners are supposed to be puncture proof and it all goes for incineration. Maybe someone can explain to me why adding in sharps is a problem? Is it because it adds too much volume and cost, or is there an operational or process issue? For the average citizen, it would be nice to just bag up everything and toss it in there. Less needles laying around is also a plus for all county/city police, parks, public works type people, so it seems like adding them would be worth it for law enforcement.

From: Ed Gottlieb [mailto:EGottlieb at cityofithaca.org]
Sent: Tuesday, August 08, 2017 3:46 PM
To: Jaramillo, Jeanie <Jeanie.Jaramillo at ttuhsc.edu<mailto:Jeanie.Jaramillo at ttuhsc.edu>>; Volkman, Jennifer (MPCA) <jennifer.volkman at state.mn.us<mailto:jennifer.volkman at state.mn.us>>; MChris Angel <chrisangel at greatlakes-us-cleanwater.org<mailto:chrisangel at greatlakes-us-cleanwater.org>>; pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Cc: mclark at micrometalsinc.com<mailto:mclark at micrometalsinc.com>
Subject: RE: New Stericycle med disposal kiosks

The full service provided by Stericycle, the Yellow Jug Old Drugs Program, and possibly others, is a great service that appeals to many pharmacies.

Having a scale in the box to automatically alert Stericycle to empty it is an interesting innovation.  It isn't a problem if a bunch of (dense) liquids were deposited, causing a premature "full" indication.  I wonder if they ever run into overfill problems when, by chance, a box gets filled only with particularly light items?

Many years ago, the lack of a commercially available, narrow profile drop-box pushed me to partner with a manufacturer to design one.  The solution I came up with to determine the fill level without unlocking the box was to install two frosted Plexiglas windows (roughly 1" x 6") on the back half of the top.  You can shine a flashlight in one and see the level through the other.  The "frosting" prevents details, like personal information on labels, from being readable.  Sorry, the web site doesn't show the view ports.  http://www.takebackexpress.com/slimline-medication-collection-unit/  All but one of our nine law enforcement partners choose this box over the commonly sold ones because it is only 14" deep and fit better in their tight spaces.

Our law enforcement partners empty their bins (that hold 3.5 cubic feet/26 gallons) and transport the inner liners to the Sheriff, who has lots of secure storage space (a trailer we bought for this purpose).  Custody is transferred and the Sheriff holds it until the DEA collection day pick-up.

Ed Gottlieb
Chair, Coalition for Safe Medication Disposal
Board Member, New York Product Stewardship Council
Industrial Pretreatment Coordinator
Ithaca Area Wastewater Treatment Facility
525 3rd Street
Ithaca, NY  14850
(607) 273-8381
fax: (607) 273-8433
________________________________
From: Pharmwaste [pharmwaste-bounces at lists.dep.state.fl.us] on behalf of Jaramillo, Jeanie [Jeanie.Jaramillo at ttuhsc.edu]
Sent: Tuesday, August 08, 2017 3:51 PM
To: Volkman, Jennifer (MPCA); pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Subject: Re: [Pharmwaste] New Stericycle med disposal kiosks
We use a kiosk as well, although we maintain it, empty, affix vendor labels and ship on our own. My unwritten question was whether the technician shipped the liner from the pharmacy/site vs. hauling it away in their truck (can't remember if they can legally do that.) I like that it has a sensor for notification of when it's full, although I don't like the idea of locking the drop drawer until the vendor comes. As you all know, experience has shown that if customers come to dispose of their meds and the bin is locked, they'll simply throw them in the trash on their way out the door.

It would be neat if the bins could electronically communicate directly with the vendor when they're full and pickup could then be "on demand". Otherwise, it seems the vendor would be coming either when the bin is not full yet or well after it's full. We are currently spending about $4,500/year on our bin. Some months we may fill one box, other times two boxes can be filled in one day. It's real sporadic. We still do two community-wide take back events per year and they continue to grow in spite of the presence of 4 disposal bins in our community (1 Walgreens, 2 sheriffs' depts., and us). I'm really hoping for the day that all pharmacies have disposal bins.

Dr. Jeanie Jaramillo-Stametz
Managing Director, Texas Panhandle Poison Center
Asst. Professor, Pharmacy Practice
Director, Medication Cleanout
Texas Tech University Health Sciences Center
School of Pharmacy
jeanie.jaramillo at ttuhsc.edu<mailto:jeanie.jaramillo at ttuhsc.edu>
Office: (806) 414-9402
Voice mail: (806) 414-9299
Mobile: (806) 376-0039

From: Volkman, Jennifer (MPCA) [mailto:jennifer.volkman at state.mn.us]
Sent: Tuesday, August 08, 2017 2:38 PM
To: Jaramillo, Jeanie <Jeanie.Jaramillo at ttuhsc.edu<mailto:Jeanie.Jaramillo at ttuhsc.edu>>; pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Subject: RE: New Stericycle med disposal kiosks

That's how it works. They are permitted by DEA to handle the collected liners, so they replace them, while pharmacy staff watch so everything is above board. I believe they are servicing the Walgreens collection sites here in MN. The Sharps Compliance system operates the same way.

From: Pharmwaste [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Jaramillo, Jeanie
Sent: Tuesday, August 08, 2017 1:41 PM
To: pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Subject: [Pharmwaste] New Stericycle med disposal kiosks

http://drugtopics.modernmedicine.com/drug-topics/news/what-do-your-patients-do-unused-meds?GUID=&rememberme=1&ts=08082017<http://cp.mcafee.com/d/FZsScxMA72hJ5-WqqqdNPVKVJd5x5NMQsCzBZUSCyMyUeLsQsICQQm4n73hOqenPhOrhLtNUQsIf3zhOr4vS4LUhSeGOffG2FPr9QJTEdCVPr9QJTEdCQQmktud7b_nVd5NVYsy_RXBQSmnKpvuuooKzR4kRHFGTohVkffGhBrwqrhdECXYCYqekS7XITodTdw0Q8JApRmBqDaRg-c5vgBqkfVv48JAiYWHiJj8uoFxwDIOW5iVqHsiWSPBY9QbElbJMrFW1tnQa4wA4MQeeq208zWLGAfyHVObgg14W7nuKYDt4sr4vx2jLNUPkYGHI0liuP_BosTgSyCNtwS2NF8Qg0PP1Ew69_6lyRz_d42LE6y12l5GQQYQg5plElErpudZugyg8Ww>

This is interesting. The system is apparently entirely managed by Stericycle. The article indicates a "technician" (i.e. Stericycle rep) will come to empty the kiosk while two people from the pharmacy site are present. It's not crystal clear, but sounds like that technician then ships the liner. The video panel is interesting with the ability to provide directions in different languages.

Dr. Jeanie Jaramillo-Stametz
Managing Director, Texas Panhandle Poison Center
Asst. Professor, Pharmacy Practice
Director, Medication Cleanout
Texas Tech University Health Sciences Center
School of Pharmacy
jeanie.jaramillo at ttuhsc.edu<mailto:jeanie.jaramillo at ttuhsc.edu>
Office: (806) 414-9402
Voice mail: (806) 414-9299
Mobile: (806) 376-0039

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