A cutting-edge solution for dental sharps

In a story that was widely reported on the Internet, a section of the New Jersey coast in August 2008 experienced medical waste washing up on shore areas used by thousands of vacationers. Ultimately, responsibility for the incident was placed with a Pennsylvania dentist who allegedly took his boat offshore and dumped from it the used needles and similar hazardous waste materials from his dental office. The incident was a graphic illustration of how 20 years after the passage of the Medical Waste Tracking Act, which was meant to protect the public and our environment from the dangers of medical waste, improper disposal by a single dentist can have a huge impact. Regulated wasteOne can only assume why this dentist dumped his medical waste into the ocean. If it was simply to save money, perhaps if he was properly segregating his medical waste from ordinary office trash, and thus reducing his medical waste disposal costs, the idea of improper disposal would not have been so tempting. And equally plausible is the idea that if the dentist actually understood what constituted medical waste, proper disposal would not have seemed like a major challenge.There is a definition of what constitutes the problem. Treatment by-products such as used gloves, masks, gowns, patient bibs, lightly soiled gauze or cotton rolls, and plastic barriers are not typically considered regulated medical waste. According to the Centers for Disease Control and Prevention, only 1% to 2% of dental office waste is actually regulated medical waste, with needles and other medical sharps composing the bulk of that material. Regulated medical waste from a dental office includes:

• Gauze saturated with blood after surgery
• Extracted teeth (without amalgam); and hard and soft tissue
• Contaminated sharps – needles, carpules, broken sharp instruments, dental wires, endo files, scalpel blades, and suture needles.

Disposal standards – workplace and community safetyWhen improperly discarded, sharps can present the risk of injury and disease. The first and foremost risk, one that is closely regulated by workplace safety standards, is to those who work in the dental office itself. Governing workplace safety is OSHA’s (Occupational Safety and Health Administration) Bloodborne Pathogens Standard, which incorporates the requirements of the federal Needlestick Safety and Prevention Act, passed in 2000. After the Medical Waste Tracking Act expired in 1999, individual states began to regulate the disposal of sharps and other medical waste. There are many differences in state medical waste generator regulations, including storage time restrictions, need for generator registration, the establishment of medical waste management plans, and tracking of medical waste disposal. States can also differ on definitions of medical waste, including disposal of teeth and pharmaceuticals. Disposal-by-mail solutionSo how do dental offices deal with the disposal of sharps and other medical waste? To fulfill their responsibilities, many offices still pay for standard monthly or quarterly collection by a state-permitted waste disposal service. However, this is generally expensive (since dental offices generate minimal medical waste) and disruptive (when pickups are missed or office workflow is interrupted by the collection process). A simpler, more effective, and often less expensive method for dental professionals is disposal-by-mail programs for a medical waste disposal “as-needed” approach. Both federal government agencies like the EPA and the CDC, as well as many state regulators, single out disposal-by-mail systems as highly effective. The concept is simple: It involves a specially designed, government-approved system, which includes secure packaging, a mailable sharps container with a protective bag liner, detailed instructions, a manifest tracking form, and prepaid postage for mailing when full. The mailed containers of medical waste and/or sharps are sent to a fully permitted treatment facility where they are responsibly and legally destroyed. A number of state dental associations offer member discounts for using specific disposal-by-mail systems. The cost, time, and safety efficiencies of using disposal-by-mail systems make them an excellent solution to the issue of regulated medical waste disposal in the dental office.