There is a lack of pertinent literature both from Australia and internationally on the topic of community needle and syringe disposal issues. The bulk of the literature deals with the use of Needle and Syringe Programs (NSP), in preventing spread of bloodborne pathogens between Injecting Drug Users (IDU), as well as the advantages/successes of NSP.

Needles21 and syringes (N&S), pose a hazard due to the potential to cause penetrating injuries. Many N&S contain pharmaceutical substances, and there is an equal risk that these substances can also be "injected" into a person through an accident. However, with discarded N&S from an IDU, this risk is virtually negligible as the substance is usually fully expended from the syringe (personal communication 2005).

There are several Australian media articles in relation to N&S being found in community areas and the resulting publicity is often emotive. The following reported quote by National Hepatitis Chairman Professor Bob Batey in response to the statement that in the 12 months ending June 2003, almost 1.7 million needles and syringes were issued through the Needle and Syringe Program in Northern New South Wales alone – "so that could mean, yes, there are significant thousands, if not millions of syringes lying around having been disposed of inappropriately". This was on a website providing information on a NBN news special on "The Needlestick Scourge" (NBN 2004).

Several Australian and international authors made mention of the community reactions to discarded N&S and/or the presence of a NSP to increase the actual numbers of N&S discarded. The data from studies (mostly international), does demonstrate that there is not any increase in discarded N&S following the introduction of a NSP – in fact reductions have been recorded. While this is so, some studies did indicate that access to appropriate disposal facilities needs to be improved so that discards do not happen. However, if the wider community perceives that the risk is greater than it actually is, it does not mean that their opinion should be ignored. The perceived risk must be managed as well.

Only one firm conclusion can be drawn from the literature, that there is no conclusive evidence to state with a high degree of certainty as to the presence or the absence of risk(s) to the public, the environment and waste workers in managing and disposal of discarded N&S in public areas. However, based on what information is available and extrapolating data/information from related studies, the risk to the community of bloodborne infections from discarded N&S is extremely low.

In an extensive review of the Australian and international literature on NSPs, Ksobiech (2004a), it was concluded that there were a number of weaknesses in studies reported by authors into NSPs. A number of recommendations were made in regards to NSP studies to improve their outcomes, not just justifying their existence. One difficulty being faced is the lack of consistency in approaches so as to be able to compare data and a broad range of variables.
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NSP programs have been well documented to reduce transmission of bloodborne pathogens between IDU. Stancliff (2003), states that NSPs have been extremely effective in preventing disease. In addition, limited studies have also indicated lowering blood titers of HIV, HBV and HCV in syringes used by IDU. Therefore it can be reasonably concluded that NSP programs are also reducing risks to the community from infection post-needlestick injury.

The following provides an overview of the literature review in respect to the scope of the Australian Department of Health and Ageing "National Audit of Community Needle and Syringe Disposal Facilities".

Footnotes

21 Needles are also referred to as Sharps within the literature.