Fauquier County Environmental Services will be negatively impacted by proposed changes to the Regulated Medical Waste Management chapter of the Virginia Administrative Code, specifically proposed additions contained in 9VAC20-121-10 “Definitions,” 9VAC20-121-90 “Identification of regulated medical waste” and 9VAC20-121-300 “Applicability.”

In September 2018, Fauquier County Environmental Services began implementation of a home sharps collection program, with approval from DEQ Northern Region staff and the local office of the Virginia Department of Health. This program was conceived due to repeated sharps injuries within County staff, particularly recycling sorting staff, caused by improperly disposed home sharps in recycling material at the County’s residential recycling facility.

The program is designed to provide a convenient and accessible way for Fauquier County residents to dispose of home sharps in a safe manner, and keep them out of the larger waste and recycling stream. In order for the program to be affordable to the County, and to prevent an increased financial burden to County taxpayers, the resulting home sharps were allowed by DEQ to be disposed of directly into the working face of Fauquier County’s sanitary MSW landfill, PN 575.

The collection and disposal of home sharps is carried out in an organized and safe fashion, with program specifics previously approved by DEQ.  Fauquier County Environmental Services has also developed and implemented a department-specific Exposure Control Plan in consultation with Katherine West, BSN, MSEd, CIC.  We are only collecting home sharps directly from only Fauquier County residents at our facilities, and in-person screening of each deposit (required by the program) allows us to be certain we are not accepting sharps from business entities. After implementation of the sharps collection program in late 2018, sharps injuries among Environmental Services staff dropped by 50% in 2019, and to zero in 2020. In 2021, Environmental Services had only one possible sharps-related injury, the specific source of injury being undetermined, and there have been zero sharps-related injuries in 2022 to date. There have been no reported hazards to staff or the public related to disposal of collected home sharps in the sanitary landfill’s working face.

Under the proposed additions to the regulations, there is a newly defined “sharps drop box” in the proposed 9VAC20-121-10 “Definitions”, which is “a secure, tamper-proof sharps container for the temporary storage of only household sharps provided for the convenience of individual home generators who choose to transport their own household sharps to the collection point and where collected sharps are packaged, labeled, and managed as regulated medical waste.” Under this definition, the residential collection points operated by Fauquier County Environmental Services would be defined as sharps drop boxes. We have no objection to this definition, save for the last line “where collected sharps are packaged, labeled and managed as regulated medical waste.” This line of the proposed regulation would negatively impact our program, as it would trigger all other requirements of the regulated medical waste regulations in regard to our collection, transport and disposal of home sharps.

The proposed draft of 9VAC20-121-90 “Identification of regulated medical waste” also negatively impacts our program. Previously, home sharps were largely exempt from regulation.  Under this draft of 9VAC20-121-90, both subsection B.2.d. (“This also includes sharps generated through veterinary practice, acupuncture needles, and household sharps collected in a sharps drop box”) and D.2. (“Household sharps centrally collected in a sharps drop box shall be managed as regulated medical waste in accordance with 9VAC20-121-300 E 1”)  home sharps collected in a sharps drop box are specifically designated as regulated medical waste, triggering the requirements outlined in the proposed 9VAC20-121-300 “Applicability.”

The proposed draft of 9VAC20-121-300 “Applicability” also negatively impacts our program. Under 9VAC20-121-300 E.1.a-c, we may collect home sharps in a sharps drop box at our residential collection facilities, but “must comply with the general handling, packaging and labeling, storage, reusable container, spill cleanup, transportation, and Category A waste management requirements for regulated medical waste outlined in Part III (9VAC20-121-100 et seq.) of this chapter,” with the further restriction in that same subsection that “Collected sharps shall be treated or disposed of as regulated medical waste in accordance with this chapter. Untreated sharps shall not be recycled or disposed of in a solid waste landfill or other solid waste management facility.”

The proposed regulations as outlined above will effectively eliminate Fauquier County Environmental Services’ ability to continue operating our home sharps collection program. It will no longer be financially viable, and will place an undue burden on the County’s taxpayers as it would require a significant budget increase to comply with the new requirements. This program has been highly successful in providing a needed resource for residents in a largely rural area with few options for safe home sharps disposal. It has been very effective in reducing sharps injuries amongst our staff.

We believe that our system as currently operating is no less protective of human health and the environment than residents legally disposing of individual or packaged home sharps mixed in household solid wastes. In actuality, we feel that our system is more protective, as we ensure that home sharps are directly disposed of in our landfill’s working face using specific safety procedures, rather than having household sharps interspersed in waste that is collected by widely varying methods, dumped on our MSW transfer station tipping floor, and shipped out to another landfill via public roads. In the view of Fauquier County Environmental Services, this regulatory change will only serve to increase health and safety risks to our staff and others, as unmanaged home sharps are highly likely to be improperly and unsafely disposed.

We would propose several options for changes to the draft regulations in question:

1. Create a separate category for a permitted solid waste facility that would allow it to directly operate sharps drop boxes at such facilities, with the caveat that only home sharps would be disposed of in the associated permitted facility. This should include a permitted sanitary landfill, but could be expanded to include a permitted MSW transfer station should DEQ agree. Our program would not be affected by this expansion, but we can see the potential utility of this for other localities.
2. Eliminate or modify the last line of 9VAC20-121-300 E.1.c. that states “Untreated sharps shall not be recycled or disposed of in a solid waste landfill or other solid waste management facility,” to allow for disposal of home sharps as outlined in the previous bullet point.
3. Provide for a process to apply for an exemption or variance to the proposed regulation that would allow Fauquier County Environmental services or other localities to obtain said exemption/variance, if we are able to show a significant benefit to public health and access to needed services, combined with little to no risk to health or the environment.