An Important Environmental Risk from
Patients with Diabetes using Insulin:
Disposal of Medical Waste
Emine Kır Biçer*
Department of Medical Nursing, Mustafa Kemal University, Turkey
Submission: April 16, 2018; Published: July 17, 2018
*Corresponding author: Emine Kır Biçer, Assistant Professor, PhD, RN, Department of Medical Nursing, Mustafa Kemal University, School of Health Science, Hatay, Turkey, Tel: +905333266819; Email: email@example.com
How to cite this article: Emine Kir Biçer. An Important Environmental Risk from Patients with Diabetes using Insulin: Disposal of Medical Waste.
Curre Res Diabetes & Obes J. 2018; 7(5): 555725. DOI: 10.19080/CRDOJ.2018.07.555725.
Diabetes mellitus is an escalating global epidemic . In 2015, there were 415 million diabetics in the world it is expected that by 2040 this figure will raise to 642 million . Self-care is crucial for controlling diabetes and maintaining blood glucose at target values. This involves self administration of insulin and/or selfmonitoring of blood glucose (SMBG) .The management of diabetes necessitates frequent assessment of blood sugar levels and the use of oral medications and insulin injections . Insulin is indispensable to the management of DM. Correct insulin injection techniques are essential for better diabetic control [5,6].
Previous research on insulin injection techniques have addressed the importance of insulin pen education, injection techniques, but very little research has been referred the disposal of medical wastes . Proper disposal of sharps is one of the crucial, but oftenneglected components of proper injection techniques  .Incorrect sharp disposal practices among diabetes patients lead to the accumulation of sharps within the household and their improper disposal can potentially result in public health problems, such as personal injury of people in the general community and the propagation of blood borne infections via needle stick injuries . The lancets used for SMBG are often loosely recapped and are vulnerable to breakage/detachment when subjected to even the slightest of force .
Similarly, failure to use puncture proof containers for discarded lancets and insulin syringes is equally hazardous. Needlestickinjuries may lead to epidemics of blood-borne infections such as HIV/AIDS, hepatitis B and hepatitis C. According to the Centre for Disease Control, Atlanta, outbreaks of hepatitis Bdue to improper blood glucose monitoring practices have already been reported in home and assisted living care settings . The disposal of sharps generated in the community has been identified as an area of public health and environmental health
concern. While there is a wealth of literature on sharps disposal practices in healthcare settings, the sharps disposal practices of diabetic patients living at home have been poorly documented . Studies throughout the world have demonstrated that diabetics inappropriately discard medical medical wastes.
In a Nepal study, the most common methods used to dispose of used needles were transferring them into municipal waste disposal vehicles, throwing them in isolated places, and burning them . The Coalition for Safe Community Needle Disposal estimates from data it has collected that there are over 7.5 billion syringes used in households yearly, and the numbers are increasing. Individuals with diabetes constitute the largest user group; however, this number does not reflect the number of lancets used by 25 million diabetics. Moreover, according to the insulin pump management consensus statement released by the American Association of Clinical Endocrinologists, insulin pumps are used by approximately 375,000 Americans.There are approximately 26 million Americans with diabetes, and it is estimated that about 26% (6.5 million Americans) receive 1-4 insulin injections per day. This means that collectively over 13 million needles and syringes are being used per day. This enormous figure highlights the importance of researching the impact on the environment of needles, syringes, and lancets generated by this population .
Supporting the conclusions of previous research, in a study of disposal practices conducted in Southern Ghana, Udofia et al.  found that the majority of unwanted medicines and sharps are discarded in ordinary household garbage.In a study conducted by Govender and Ross in South Africa (2012), it was found that more than 97% of patients discarded their sharps inappropriately . Similarly, most Indian patients throw their used needles and syringes directly into the garbage and public drainage system . Other studies also report improper disposal of used needles [6,7]. A study conducted in Pakistan showed that
the majority of the diabetics in Pakistan use syringes (88.3%) for
insulin administration. Most patients disposed of used devices
(syringes, 92%; pens, 75%; and lancets, 91%) along with other
household waste into the same garbage collection bin. This is a
very common practice among insulin users in Pakistan . The
studies in Turkey showed that patients with diabetes disposed
of their used insulin needle tips inappropriately [15,16].
Studies highlight that needle disposal is a global problem
in both the developed and developing world. No recent studies
were found on safe disposal of sharps by diabetic patients.
Healthcare professionals also should educate patients and their
relatives about the correct use of insulin pens during their first
visit and subsequent follow-ups. They can play a significant role
in the safe and effective use of insulin pens in diabetic patients.
However, there still remains a need for the development of
uniform national guidelines on the disposal of sharps for diabetic
patients living at home.