BLOOMINGTON - After Gayle Gaines gave herself an injection of Byetta, she took the used needle off, placed it in a hard plastic container marked "Used Needles" and resealed the container.

"I'm pretty cautious," said the 49-year-old Bloomington woman, who was diagnosed with diabetes 20 years ago. "I don't want the people who pick up my garbage to get hurt."

Gaines is not alone in giving herself injections at home and in being concerned about what to do with her home medical waste.

"More people are getting shots at home" compared with several years ago as more people are being diagnosed with diabetes and other diseases, said Marvis Custer, registered nurse and diabetes educator with OSF St. Joseph Medical Center. Patients also are being discharged from hospitals earlier, many sent home with wounds that need ongoing treatment and other medical care that must be done in the home.

"People used to stay in the hospital longer and now some of them are self-administering (medical treatment) at home," said Steve Pinneke, BroMenn Healthcare's director of pharmacy.

A result is thousands of used needles, gauze strips and other medical supplies that Central Illinoisans need to dispose of each day without infecting their other family members and refuse haulers.

Here is the consensus from medical professionals about what to do with the two more prevalent home medical wastes:

w Sharps: Used needles and lancets (small needles used in checking blood sugar levels), for example - should be placed in an empty hard plastic container where the sharps can't pierce the container. Examples include empty laundry detergent and coffee containers.

When the container is full, close the lid, seal the lid with duct tape and place the container in your regular garbage bag.

Family members in the home and refuse haulers are protected and the needles are out of site to drug abusers, children and others who may be tempted to play with or use the needles, medical professionals said.

w Dressings: Dressings - such as gauze used to cover wounds - should be placed in two plastic bags, such as those used for groceries. Close the bags with a knot and place them in your regular garbage bag.

Again, the waste is disposed of safely, the refuse hauler is protected and the waste is out of site.

"It's a very good system," Teresa Beland, a field nurse with BroMenn Home Health for 23 years, said of the two approaches. "It's safe and effective."

But not everyone is aware of the recommendations and some people handle their medical waste differently.

"People want to be safe and do the right thing but not all of them are clear on what to do," Custer said.

The two recommendations are consistent with what the Town of Normal recommends, said Mike Hall, Normal's director of public works.

"Waste carriers have been stuck and/or cut by either used needles or other sharp objects," said Hall, who said workers are urged to get hepatitis shots. "Used needles can cause a blood-borne pathogen (that causes disease). So it's an education thing."

The City of Bloomington has a slightly different recommendation for disposal of sharps, said Jim Karch, Bloomington's director of public service.

"We like to see the actual needle portion broken off" so the needle can't be reused by a drug abuser, Karch said. "To break the unit apart so it's unusable is critical."

The needles then may be placed in the hard plastic container and, when it's full, closed and sealed with duct tape.

Bloomington then asks that the container be marked as containing needles or sharps and placed at the curb beside the regular garbage, Karch said. Because the needles have been broken, they can't be reused, he said.

Karch said Bloomington's policy is aimed at keeping used needles from being placed loose in garbage bags, putting refuse haulers at risk. A container marked as containing needles or sharps will be dealt with carefully by refuse haulers, he said.

Pinneke recommends that patients using needles buy a needle clip. A needle clip works like a pill splitter and clips off needles from the syringe so they can't be reused, he said. The used needles then fall into a puncture-proof hard plastic container that can hold as many as 1,500 used needles, he said.

Once the container is full, it may be sealed.

"It's a self-contained system," the doctor of pharmacy said.

A brand name that Pinneke is familiar with is the BD Safe Clip, which costs $4.34 and is available at pharmacies. "It works well," he said.

Patients giving themselves an injection of an anti-coagulant to treat deep vein thrombosis, and people getting injections for multiple sclerosis and severe allergies are among Central Illinoisans with used needles, medical professionals said.

But diabetics may be the largest number of patients. In McLean County alone, there are nearly 11,000 diabetics, according to the American Diabetes Association. Some of those people get injections of insulin or Byetta to help control their blood sugar, Custer said.

Gaines gives herself an injection of Byetta twice each day in her stomach. She also takes three oral medicines, walks for exercise and watches what she eats.

About four times a week, she uses a lancet to poke her finger and draw a little blood to measure her blood sugar level. She places the used lancets in the hard plastic container with the used needles, she said.

While Gaines' doctor has accepted her containers of used needles and lancets for disposal, Gaines knows most doctors don't accept home medical waste.

"Everyone has plastic containers around the house. Just use them and mark them," she said. "It's common sense and it's courteous. You wouldn't want your family member to be cut on anyone else's needles."

---

How area hospitals dispose of their waste

By Paul Swiech | pswiech@pantagraph.com

BLOOMINGTON - Hospitals have strict protocols on how to handle their medical waste.

Three larger categories of medical waste are sharps, red bag waste and chemotherapy waste.

Sharps are used needles and other sharp devices that must be disposed of after each use.

At BroMenn Regional Medical Center in Normal and OSF St. Joseph Medical Center in Bloomington, hard plastic boxes for disposal of sharps are located in treatment rooms not more than five feet from where the sharps are used, said BroMenn safety manager Earl Williams and St. Joseph director of environmental services Scott Hedding.

At BroMenn, when the boxes are full, they are collected by an outside vendor who grinds up the used sharps and sterilizes the substance.

"At that point, it's just sand-size loads of sterilized organic materials that go to a (regular) landfill," Williams said.

At St. Joseph, the full boxes are collected and transported to a location where St. Joseph treats medical waste by using a machine that creates high temperature by injecting steam under pressure, Hedding said. The treatment means that the material is no longer infectious. From there, it is ground up and hauled to a regular landfill, he said.

Red bag waste is waste that goes into red bags in treatment rooms. This waste is anything that has blood on it.

Red bag waste is kept separate from other trash and also is sanitized, ground up and placed in a regular landfill.

Yellow bag waste is waste from chemotherapy and includes needles and bandages. This waste is kept separate from other medical waste because waste from chemotherapy can't be sterilized, Williams said. Instead, it must be incinerated.

Chemotherapy waste is collected by a special vendor who takes the waste to a medical incinerator approved by the Environmental Protection Agency, Williams said. The waste is incinerated at 2,000 degrees Fahrenheit.