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Can we re-use syringes and needles?

Sharps and medical waste issues are an area that cause confusion because the rules are rarely very clear. One of the most often Can I reuse disposable syringes?” There is usually some qualifier to the question, like, “We only reuse them once,” or “We only use them to dispense medication to clients without a needle attached.”

The simple answer is: There is no rule against it - HOWEVER, reality is rarely that simple. OSHA’s Bloodborne Pathogens Standard (BPS) does not apply to most traditional veterinary practices because animal blood is not covered by the rule. Therefore, there is no specific OSHA regulation dealing with the handling of needles and syringes. When it comes to the disposal regulations, each state or municipality is in charge of setting the waste disposal rules for regular trash as well as medical waste such as syringes and needles.

Worker Safety

OSHA will likely only get involved in this issue at a particular practice as the result of an accident or complaint. If an employee is ever injured while handling a single-use item that is being reused, OSHA can use the General Duty Clause to cite or fine the business.

The General Duty Clause is the section that requires the employer to "provide a workplace free of unnecessary hazards." If the syringe with needle attached is placed in the sink or a bucket to be "processed" by an employee later, OSHA would consider that an "unnecessary" risk. An OSHA inspector would probably still consider it unnecessary handling if the needle were removed from the syringe by the person using it so the syringe can be cleaned and resterilized later or even disposed of in the trash if allowed by local waste rules.

Another issue is one of insurance and liability. A staff member of a veterinary hospital in the southeast stuck a needle in her hand while "processing" syringes for autoclaving. TWO YEARS later the employee was still on disability for the incident and the insurance company has dropped (e.g. declined to renew) the hospital's coverage. Their new worker's compensation insurance is much more expensive than the old coverage since they had such a large claim. It only takes one claim like that to wipe out years of small savings from reuse.

Client Confidence

It would also be pretty easy for an attorney to convince a jury or judge (none of whom will likely have veterinary experience) that a practice acted unprofessionally in reusing disposable materials and that they failed to inform clients of that fact. Similarly, many clients look at the practice as being “cheap” in reusing disposable materials and most feel “cheated” because they believe they paid for new materials to be use don their pets.

Management Practices

Another thing to consider is today’s labor market. The cost of employee time is rarely justified cleaning syringes. Years ago, when plastic syringes were new on the scene (and more expensive,) many practices did wash and re-autoclave them. With the labor market at the time, that process probably cost the practice about three cents. Today the labor cost to clean, sort, reautoclave, and restock them is more than the money that can be saved.

Most practices have a hard time finding enough staff with a national unemployment rate around 5% so it just doesn’t make sense to use “scarce” labor to save “plentiful and cheap” supplies. With practices operating at record low staffing levels, the existing staff members find it hard enough to do all the really necessary things like lab work, client education, dentistries and patient care let alone washing and re-sterilizing syringes.

Proper Disposal

So now the question becomes “What do I do with the used syringe and needle?” Since the disposal of waste is a state-regulated issue, it’s important to check with your state on specifics for non-sharps items, but these guidelines are pretty universal for syringes and needles in a veterinary practice.

The best way to dispose of sharps, including syringes, is to place the used syringe/needle combination directly into a designated sharps container. There should be a sharps container in each area where sharps are used. Similarly, mobile practices should have a sharps container on each vehicle for collecting sharps while in the field.

Sharps containers are available in a number of sizes and styles, including ones that mount in brackets on the wall or in the vehicle. The sharps container for a particular area should be big enough to accommodate the quantity of sharps generated in that area for about 1-3 weeks. The containers should be replaced at least monthly to prevent excessive pathogen growth in the container. These pathogens are released into the work area whenever a device is deposited in the container because a similar amount of air is displaced. Containers should be sealed and collected for disposal according to state guidelines. Remember, OSHA has no regulations dictating the disposal aspect of medical waste - it’s strictly a state or local requirement.

“Makeshift”containers such as milk bottles and laundry detergent containers are normally not appropriate for sharps containers. Used needles and syringes should never be collected in a “temporary” container which is later emptied into another container except for the placement of sealed sharps containers into a transport box.

Recently, there has been a number of devices hit the veterinary market that destroy the needle in some fashion. The manufacturers of these devices often tout the cost savings to the veterinary practice because the syringe can then be disposed of as regular trash. Although this may sound appealing from a financial standpoint, there are several factors that must be considered. For instance, for years the Centers for Disease Prevention & Control and Prevention (CDC) has warned AGAINST cutting or destroying the needle in any manner. Studies have shown an increased risk of aerosolizing the contents of the needle with that process.

Another factor is the quantity and location of the devices. Although it can be argued that having a needle “zapper” in any location where sharps are used can help prevent needlesticks, most veterinary practices won’t purchase enough devices. If only one or two devices are available, the risk of needlestick injuries may INCREASE when the staff member has to recap the needle or travel with an uncapped one to get to the location of a “central” device.

Since all mechanical devices eventually need cleaning and servicing, the practice will need to take steps to protect and train staff members who would be exposed to the inside of those devices.

Finally, some devices emit harmful smoke into the room air as a byproduct of the destruction process. Although a small amount of smoke per needle is not a big concern, the cumulative effects of prolonged use has not yet been determined and is a valid concern of many staff members. It just doesn’t make sense to solve one problem by generating others!

Given all these reasons, it just doesn’t make sense to reuse syringes even though there is no specific regulation against it.

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The information on these pages is excerpted from
The Veterinary Safety & Health Digest,
Copyright 2001 Philip J. Seibert, Jr., CVT  All Rights Reserved
No part of this publication may be reproduced for distribution without prior permission from the publisher.