Community-Acquired Needle-Stick Injuries: Rapid and Safe Retrieval of Discarded Needles Is Essential: In Reply

Abstract

We agree with Mr Blenkharn that a timely and coordinated retrieval program for used needles and syringes is part of the solution for preventing community-acquired needlestick injuries (CA-NSIs). However, the cornerstone of CA-NSI prevention is requiring safe disposal of used needles and syringes by the user. We would like to share the successful experience of the Province of Quebec, Canada, as shown by the decrease in CA-NSI incidence observed in pediatric emergency departments in Montreal.1In 2003, the Ministry of Health of the Province of Quebec mandated an advisory committee to review the situation and make recommendations regarding safe recuperation of used needles and syringes. A park clean-up program was put in place that year, and in June 2006, an integrated system for the recuperation of used needles and syringes was launched. As part of this system, the Ministry of Health provides free secure needle-disposal containers (1.4 and 5 L) for individuals who need them. They are distributed by community pharmacies, local service networks, community organizations, and teaching centers for diabetics. Every encounter with individuals known to use needles, syringes, or lancets is used as an opportunity to provide these containers. Once full, the container can be returned to one of the aforementioned participating locations. From there, the containers are then transported to an agreed-on local facility at which they are destroyed safely with other medical waste. Since 2006, 300 000 containers have been distributed, with an estimated 40 million syringes recuperated safely. So far, ∼90% of community pharmacies in the Province of Quebec are participants in this program. Larger containers (50 L) have also been provided to the community pharmacies to enable them to collect used needles and lancets brought back in a nonstandard container.Moreover, educational material2 regarding used needles has been distributed to primary schools and day care centers to increase awareness of children and adults working with children. Outdoor and indoor disposal units have been installed in public places where intravenous drug users gather. Guidelines for safe pick-up of syringes are available to the public.2 The provincial health help line (Info-Santé CLSC), easily accessible by dialing 811, also has a protocol for safe syringe recuperation.