while hospitals and doctors’ offices often have extensive programs in place to deal with the biohazardous waste they produce, medical waste generated in the home is more difficult to sequester for safe disposal. Often, people aren’t sure what to do with their needles or are simply careless with the way they dispose of them. A rise in heroin use around the country, while harrowing on its own accord, also has not helped matters.
Sandwich, Massachusetts, was dealing with this very issue, and it wasn’t getting any better, according to J.J. Burke, deputy fire chief, Sandwich Fire Department.
About one-third of the city’s population of 20,000 are seniors, many of whom must inject medicine for various health issues. This, combined with reports of dirty needles being found around the community from illicit drug use, was cause for action.
“The initial problem we had was disposal of diabetic needles and B12 injected needles. People weren’t sure what to do with them,” Burke says. “That was kind of the first inkling I had that there was something on the horizon we needed to plan for. Then the heroin epidemic started almost at the same time.”
Needles began appearing in parks and along beaches. Burke says the public works department would drop off bags of needles they had collected to the fire department. After about two years of this, Burke wondered if the department could handle the community’s medical waste as an additional service.
While Burke was teaching a class at Boston University, he talked to a colleague who was aware of a machine that had been developed for treating medical waste.
Burke says, “I thought, this is perfect. This solves so many potential issues. It is affordable. It is compact. You can put it anywhere. I said if I could get my hands on that for six months, I think I could really show the need across multiple levels.”
The department reached out to Bob Winskowicz, CEO of Sterilis LLC, the Boxborough, Massachusetts-based company making the machine. Winskowicz agreed to let the fire department use the device. In September 2015, Winskowicz came out and installed one of the machines in the fire station and showed the firefighters how to use it.
Prior to the installation, the Sandwich Fire Department had begun accepting needles from the community as a designated needle drop center. As part of the arrangement, anyone could bring their used needles to the department with no questions asked. Before the machine was installed, the fire department simply stored the needles in a two-car garage. The county health department would come by once a month and take them away, according to Burke.
With the Sterilis device, the fire department no longer had to store needles. They could be dropped into the machine for shredding and sanitizing before being disposed of with the regular trash.
Another benefit was that the machine could treat the medical waste created from trauma calls to which the department responds. The nearest trauma hospital is about 60 miles away, so the department handles a lot of helicopter transports or calls where a patient needs first aid but does not require hospitalization. Both scenarios can create medical waste in the form of blood soaked gauze. That material, which makes up about 5 percent of what the fire department processes, goes right into the Sterilis machine.
“That ambulance comes back to the station full of blood,” says Burke. Prior to the Sterilis device, that medical waste was stored just like the needles. “Now, we are able just to drop it in the machine, and it’s taken care of. We literally just walk 10 feet, drop it in there and it’s done.”
HOW IT WORKS
The Sterilis machine is designed to reduce the cradle-to-grave liability of waste generators. Winskowicz says that as the health care industry continues to decentralize, many smaller outpatient clinics and offices are opening with limited space. Just as the Sandwich Fire Department did previously, these offices must designate an area where medical waste service providers can pick up the boxed waste for hauling.
“With our machine, we can eliminate all of that tracking, all of that boxing, and reduce the amount of touches it goes through and, lastly, reduce all of the liability,” Winskowicz says. “We’ve developed a machine that can be simply wheeled into a doctor’s office, plugged into the wall and, within 15 minutes, you can take an entire sharps container with all the needles in it or the entire red bag, place it into our machine, touch the keypad as if you were touching your iPhone, press a couple of buttons and within 60 minutes it completely sterilizes it and grinds it up. What comes out is confetti that you now can either throw in a dumpster, or it can be recycled [if it] has a lot of economic value to it.”
He adds, “They can do this right then and there and eliminate all the cradle-to-grave liability for that highly infectious waste to be moved around.”
A PUBLIC SERVICE
Burke says the device has not only been cost-effective for the Sandwich Fire Department, it also has been a public service. He says often people are prescribed a medication without knowing what to do with the waste. Some people were just throwing it in the regular trash stream.
“If you’ve ever seen people that store needles in their house, and they’re in milk cartons and coffee cans, and you give them a way to dispose of them that is environmentally friendly and not going to cause any issues, they jump at the opportunity to do that,” says Burke.
People can bring their needles to the Sandwich Fire Department any hour. “It really served a need and put our department in a great light,” says Burke. The ability to serve the community, he says, “is the part I was most excited about.”
The department used public service announcements, news articles and social media to get the word out. Since the program began, the department went from collecting 100 needles per week to 500. To Burke, that means less of a chance that an animal, child or city worker will come into contact with a discarded needle.
The amount of material being processed in the device is automatically logged online. Prior to the Sterilis system, the department used to keep track of the material it received using a hand-written log. Burke says the cloud-based management of the waste works much better.
The medical waste that goes into the Sterilis machine is sanitized at temperatures of around 270 degrees Fahrenheit (132 degrees Celsius) and ground into what looks like confetti.
“This is the cleanest trash you will handle all day,” Burke says.
He says it takes about 47 minutes to process a load. When a cycle is over, the machine alerts the user via a text message or a call.
The fire department conducted a six-month pilot with the machine in late 2015 and early 2016 and worked out some glitches. “Since we completed the pilot, we are on full cycle with very few issues,” he says. “If there is a problem, the machine automatically notifies a technician. I don’t even have to call them.”
WORKING IN TANDEM
While the Sandwich Fire Department accepts needles, the Sandwich Police Department, next door, provides a drop-off service for oral medications. A receptacle in front of the police station has a design similar to a mailbox.
The two programs have met with an overwhelming response and have kept needles and drugs from getting into the wrong hands, Burke says. “If you have a bunch of Oxycontin pills, you drop off at the police station, and any syringes come to us,” he says.
Burke says some of the area’s “snowbirds” have brought back their used needles from Florida because they know they are disposed of safely in Sandwich.
Pet medications also are accepted and donated to developing nations thanks to a firefighter who knew of a veterinarian involved with the donation program.
Burke says the city’s Public Works Department also has embraced the program. If a worker is mowing the grass at a park and finds a needle, he or she will put on gloves, pick it up, place it in a plastic bottle and take it to the fire department. Burke also recalls a waste hauler who emptied a dumpster outside a medical office and found a bag of prefilled syringes. “He drove his giant truck to the fire station and said, ‘I found these,’” Burke recounts.
Sandwich residents and employees are embracing the program, and it hasn’t taken long for it to catch on. “We’ve only had it for a year and a half, but we’ve changed behavior. I think we’ve made a positive difference in a situation that is not necessarily the best,” Burke says.