Sharps waste is a subset of infectious waste and comprises syringes, needles, lancets, broken glass and any other materials that can pierce the skin. The combination of contamination with pathogens and the ability to break through the skin’s protection make them one of the most dangerous wastes produced in healthcare.

The vast majority of sharps waste is syringes from the 16 billion injections given each year. Vaccinations are essential to prevent disease, but over half of the curative injections are not necessary as they could be replaced by oral medications.

Reuse of syringes causes millions of infections each year, with HIV, hepatitis and bacterial infections. To try to reduce this, WHO recommends use of auto-disable syringes during vaccination programs. However, these can still cause injury and 10-20% of needle stick injuries happen during disposal, making proper management essential. 

Moreover, there is a thriving trade in second hand syringes in several countries, notably in South Asia. These are repacked and sold to unwitting customers. Not only do they do untold harm to patients, but the rag-pickers who search them out get 3-5 needle stick injuries a day.

Needle cutters- also called hub cutters- which cut off the needle and the end of the syringe so that it cannot be used again, can prevent reuse and make treatment and disposal safer and easier. 

Sharps can easily be autoclaved or disinfected with any of the technologies used for infectious waste. In addition, some waste treatment companies provide reusable sharps containers that can be disinfected with their contents and returned to use.

Reusable containers can also be made from aluminium by local metalworkers to suit the needs of each situation.

Finally, syringes are made from high grade plastic and they have been disinfected and made non-reusable via needle removal or shredding, they can often be recycled.

Key resources

• WHO’s Safe Injection Global Network (SIGN Alliance) has lot of information on keeping injections safe: http://www.who.int/injection_safety/sign/en/

• For Proper Disposal: HCWH’s Inventory of alternative treatment technologies lists more suppliers of different waste treatment technologies than any other document. To make it easier to find appropriate technologies, they are listed by company name, by technology, and by the countries where companies operate.

• HCWH (2014) FOR PROPER DISPOSAL: A Global Inventory of Alternative Medical Waste Treatment Technologies. Publ: Health Care Without Harm, 52pp.
• PATH listing of Indian autoclave suppliers. India is home to many manufacturers of autoclaves, especially small scale, low cost, general use models which can be adapted to medical waste use. This document draws together information on a number of them. 
• PATH (2008) Small-Scale Autoclaves to Manage Medical Waste: A buyer’s guide to selecting autoclaves manufactured in India. Publ: PATH, Seattle. 
• Autoclave testing and validation | UNDP autoclave testing procedures. Produced by the UNDP GEF Global Healthcare Waste Project, these guidelines are for regular testing of autoclaves and contain information about biological indicators and how to use them.
• UNDP GEF (2010) Guidance on Microbiological Challenge Testing for Medical Waste Autoclaves. Publ: UNDP GEF Healthcare Waste project, 9pp.