Report on the national audit of community needle and syringe disposal facilities: legislation and literature review

Community concerns in respect to needle and syringe disposal

Page last updated: June 2005

According to Thompson (2003), while there can be significant quantities and types of litter discarded in public areas, it is the fear of a needlestick injury from a discarded N&S that causes significant concern. This fear is heightened when the N&S is observed in areas such as playgrounds and schools.

Other factors reported by Kermode (2003), in regards to community concerns over community-acquired needlestick injuries include:

  • Inconvenience.
  • Anxiety and distress for the affected person and family.
  • Costs associated with follow up procedures.
In addition, as reported by Gontasezewski (2003), discarded N&S can come from other sources than IDU such as; pet owners, people with Diabetes and those on home based medications. To a member of the community that has read about the issue of disease transmission, it is logical to assume however, that any injecting equipment is a N&S and that it comes from an IDU.

A survey undertaken of various stakeholders including the general community demonstrated some concern with the establishment of N&S collection boxes to be located in public areas in East Baltimore USA. Following implementation of these boxes, a survey was then re-conducted. This second survey showed greater community support for the boxes as concerns (eg. condoning drug use, loitering), were not realised. In addition, counts of discarded needles reduced in the project areas as compared to control areas (ie., those without boxes installed (Riley 1998).

Research undertaken internationally has demonstrated that there is not an increase of discarded N&S in the community from the establishment of NSPs (MacGowan 1998).

An additional study conducted in America concluded that there was an actual decrease of discarded needles based on an analysis of needles, drug vials and bottles measured prior to the opening of the NSP and during a two year period after. Based on the geographical area studied, there was no difference in the number of discarded needles by distance from the NSP (Doherty 2000). This study was a follow up study of an original one that compared results after two months of the opening of the NSP and arrived at similar conclusions (Doherty 1997).

A review of needle return studies (using predominantly international data), by Ksobiech (2004b), has concluded that concern over the increased availability of contaminated needles in NSP communities appears unfounded. That is the siting of a NSP does not lead to increases in discarded N&S in the locale.
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Kermode (2003), indicates that community concern is inter alia based on a perception that all discarded N&S in the community arises from IDU. However, the true source of these discarded N&S is rarely known. This article also indicates that perceptions associated with discarded N&S and needlestick injuries, and NSP activities threaten the viability of the NSP program(s).

In Kermode's (2003) article, an example of a community driven closure of an NSP resulted from a child receiving a needlestick injury (the source of the N&S was not able to be determined). Based on the studies reported by Kermode (2003), it is the discarded N&S that are more of a concern than the NSP program. This article provides some demonstration of the fragility of community concerns over NSP programs and the absolute need to ensure all N&S are effectively managed to avoid needlestick injuries.

In other factors relating to the communities concerns over NSP (and hence concern over discarded N&S), the following was found:
  • No increase in crime in the areas neighbouring an NSP following its establishment (Strathdee 2004).