How do you dispose of lancets

Disposal of syringes

About half of all reported insurance claims in the health service can be traced back to needlestick injuries. The professional association for health and welfare services (BGW) mentions frequent causes such as the fact that instruments such as syringes, needles, cannulas or lancets are not disposed of immediately after use, that there is no suitable waste container or that it is overfilled. Needlestick injuries are particularly problematic when the instruments are contaminated with blood or other body fluids. Because then dangerous viruses such as hepatitis B, hepatitis C or HIV can be transmitted. Waste Manager Medicine summarizes below which regulations exist for the collection and disposal of syringes and other pointed and sharp objects.

Pointed and sharp instruments, the so-called sharps, belong to the waste law category

  • Needles of syringes and infusion systems,
  • Scalpels
  • and items with a similar risk of cuts and stab wounds, e.g. B. acupuncture needles, lancets, surgical wires.

The employer is obliged to ensure protection against injuries caused by these instruments. The exact protective measures are determined on the basis of the risk assessment, which must also include psychological stress such as time pressure and fatigue on the part of the employees due to the increased risk of accidents. In addition to the Biological Agents Ordinance (BioStoffV), the Technical Rule for Biological Agents (TRBA) 250 must be used for this purpose. The classification and disposal of used pointed and sharp objects is described by the Federal / State Working Group on Waste (LAGA) in its notification 18.

Do not return used cannulas to the protective cap

Activities such as puncturing, injecting, taking blood or laying vascular accesses can come into contact with potentially infectious material such as body fluids, excretions or tissue. Therefore, according to TRBA 250, in addition to the minimum protective measures, the protective measures for activities of protection level 2 must be applied. According to point 4.2.5 Prevention of needlestick injuries, the following applies to used cannulas:

  • No recapping: Used cannulas must not be put back into the cannula cover (protective cap). They must also not be bent or kinked, unless this manipulation is used to activate an integrated protective device. The safety mechanism must not be overridden by manipulation.
  • If activities are carried out that require multiple use of the medical instrument (e.g. local anesthesia in dentistry) and in which the cannula has to be inserted back into the cannula cover, this is permissible if a procedure is used that allows the cannula to be safely retracted allowed into the cannula cover with one hand, e.g. B. Use of a protective cap holder. The procedure to be used must be specified in work instructions in accordance with Section 14 (4) numbers 2 and 3 BioStoffV.

Collection, storage and transport in puncture-proof and break-proof containers

Used pointed and sharp medical instruments, whose collection and disposal are not subject to any special requirements from an infection prevention point of view, must be collected, made available and disposed of in accordance with the Waste Catalog Ordinance (AVV) according to waste code 180101. The TRBA 250 explains specifically:

Used pointed and sharp medical instruments, including those with a safety mechanism, must be collected in waste containers immediately after use. The waste containers must safely enclose the waste. The containers should be placed as close as possible to the point of use of the pointed, sharp or fragile medical instruments. They must not be decanted.

The waste containers, also known as waste containers, must be designed as follows:

  • They are tightly closable single-use containers.
  • You enter the content, e.g. B. with pressure, impact, fall, not free.
  • They are resistant to penetration.
  • Their condition is not affected by moisture.
  • The container size and filling opening are tailored to the goods to be disposed of.
  • They do not open when the cannulas are removed.
  • They can be identified clearly and confusedly as waste containers (color, shape, labeling according to AS 180101).
  • The waste containers are tailored to the disposal concept and the syringe systems used (stripping device for various cannula connections).
  • Their maximum filling quantity is indicated, their filling level is recognizable. (For test requirements see also DIN EN ISO 23907)
  • Filled waste containers are to be disposed of safely.

The puncture-proof and break-proof waste containers are available in different sizes. Replacement containers should be available in every practice and clinic. New containers can be ordered from waste disposal companies or on the Internet. When ordering on the Internet, attention must be paid to the legally compliant quality.

Disposal in residual waste?

The following also applies to non-infectious pointed and sharp objects: No transferring, no sorting or pretreatment. Once the syringe containers are full, they must be tightly closed - once closed, they must no longer be able to be opened. Subsequent disposal together with waste from AS 180104 is possible from an epidemic hygienic point of view as long as occupational health and safety issues (especially protection against injuries) are observed. In any case, it must be ensured that all health risks associated with blood contamination are taken into account when handling this waste.

The disposal of closed syringe containers in the residual waste is therefore basically possible. But since many practices, pharmacies and medical facilities are located in apartment buildings and garbage cans are free or at least accessible to other residents, this approach appears problematic. For this reason, many employers decide to use a medical disposal service: Prescribed containers are delivered and filled and picked up again for safe disposal, now even using postal services such as UPS.

Infectious pointed and sharp objects

If, on the other hand, pointed and sharp objects are to be disposed of which are contaminated with notifiable pathogens, the waste code 180103 * for infectious waste must be used:

  • Collection in puncture-proof and break-proof disposable containers
  • Do not transfer or sort
  • Label containers (biohazard)
  • No outside contamination
  • Prevent unauthorized access during storage, transport and disposal
  • Disposal as hazardous waste in approved waste disposal facilities
  • If necessary, disinfection (according to a procedure approved by the Robert Koch Institute), then disposal as per waste code 180104
  • There are special regulations for certain pathogens (transmissible spongiform encephalopathy)

Use the syringe container at home too

Many people have to inject themselves at home. Insulin-dependent diabetics sometimes several times a day. Another example is thrombosis injections after most operations. For safety reasons, all syringes used at home must be collected in the puncture-proof and break-proof waste containers described, which are also used by doctors' surgeries. This also applies to disposable syringes with a protective mechanism, where a protective cover slides over the needle after the injection. The syringe containers can be obtained from clinics and pharmacies or ordered on the Internet.

The tips to be read over and over again in online forums, used syringes can simply be stored in empty jam jars, ice packs, detergent or other plastic bottles, cannot be followed. These containers cannot be closed securely and can therefore quickly become a source of danger - even in the residual waste bin.

Many pharmacies accept full syringe containers. If they are ordered online through specialized companies, free pick-up is usually included.