NIOSH specifies disposal box performance criteria
Four areas targeted to help ensure safety
Noting that no single type of sharps disposal container can meet the needs of every health care setting and procedure, the National Institute for Occupational Safety and Health recommends the following four criteria for selection and use of sharps containers:
· Functionality: Containers should be durable, closable, leak-resistant on sides and bottoms, and puncture-resistant during their entire usage. A sufficient number of containers should be provided. Containers should have adequate volume and safe access to the disposal opening.
- Barrier material performance: Container material should be resistant to chemical or liquid permeation or degradation, punctures, tearing, abrasion, and laceration.
- Closure mechanisms: Once activated, the final closure mechanism should be resistant to manual opening. It should be designed to minimize exposure to contents and hand injury during mechanism engagement and transport within the facility before final disposal.
- Stability: Containers should be stable when placed on a horizontal surface and when used as described in product labeling.
- Size and shape: Containers should be of sufficient size to accommodate the largest sharp used at the work station they serve. They also should be shaped to accommodate the particular type of sharp requiring disposal. At a minimum, one sharps disposal container should be provided at each worksite where sharps are predictably generated or located. Containers should be of sufficient size to accommodate the volume of sharps typically generated at the site between maintenance operations. Overfilling a container would compromise its safe operation.
- Mounting brackets: Container mounting brackets should be rugged and provide for ease of servicing and decontamination.
· Accessibility: Containers should be accessible to workers who use, maintain, or dispose of sharps. Containers should be conveniently placed and (if necessary) portable within the workplace.
- Disposal opening or access mechanism: The disposal opening should prevent spills of contents (objects or liquids) while in use in the intended upright position, during the closure and sealing process, and during transportation within the user facility before final disposal. The design should minimize catching and snagging of sharps during insertion into the container. The opening should be identifiable and accessible and should facilitate one-handed disposal.
In areas of facilities where security is a concern, consider selecting containers with guards that prevent children's hands or fingers from entering. Safety features to restrict child access should not interfere with the worker's vision of the inlet opening.
- Handles: If handles are present to facilitate safe handling of the container, they should be sufficiently sturdy to avoid breaking when the container is in use or during transportation before final disposal. Handles should be placed so the user's hands are not close to the disposal opening when the handles are used, and they should be positioned above the full-fill level.
- General location and placement: Containers should be readily visible and within easy horizontal reach of the user. Placement should comply with any existing state or local regulations or site-specific certification or accreditation licensing requirements. When containers are fixed to walls or other permanent sites, the vertical height should allow the worker to view the opening or access of the container.
Containers should be placed with no furniture or other obstacles between site of use and the container. Placement outside patient rooms also increases the possibility of injury. Examples of inappropriate installation include the corners of rooms, the backs of room doors, under cabinets, inside cabinet doors, under sinks, in areas where people might sit or lie underneath the container, near light switches, near room environmental controls or utility system access ways, near mail boxes, and where containers are subject to impact and dislodgement by pedestrian traffic or swinging doors. Workers should be able to dispose of sharps as soon as possible after use, preferably without having to put down a device and pick it up again.
Special situations may require innovative placement and security approaches. Those might include pediatric and geriatric wards, and mental health or correctional facilities. If necessary, containers should be mounted in a lockable fixture. In the emergency room, containers may need to be mounted on wheels to facilitate the movement of gurneys and monitoring equipment. While some pediatric facilities mount containers high on walls to prevent children's access, placement should not be so high to impair workers' safe access.
- Installation height: The following criteria should be used to determine the optimal range for fixed installation height: user should have a clear view of the inlet opening; the container should be located within arm's reach; fixture height should be below the eye level of 95% of adult female workers. These requirements yield an optimal installation range of 56 to 52 inches at a standing work station, and 42 to 38 inches for a seated work station.
· Visibility: Containers should be plainly visible to the workers who use them. Workers should be able to see the degree to which the container is full, proper warning labels, and color coding. Labels and device colors should imply danger. Sufficient illumination is needed at the container to determine whether any sharp object is protruding, or whether the container is grossly soiled at holding points or opening mechanisms.
· Accommodation: Container designs should be accommodating or convenient for the user and the facility, and they should be environmentally sound (free of heavy metals and composed of recycled materials). Accommodation also includes ease of storage and assembly and simplicity of operation.
Container manufacturers should provide recommended user training information, which could include assembly instructions, safety considerations, maintenance criteria, optimum storage conditions, warranty information, decontamination recommendations, container retirement considerations, bilingual or multilingual material, container disposal considerations, and information for periodic inservice retraining.
Source: Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health. Selecting, Evaluating, and Using Sharps Disposal Containers. DHHS (NIOSH) Publication No. 97-111. Atlanta: NIOSH; 1998.
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