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Household generated needles and sharps have historically been found in residential waste streams, presenting a risk of needlestick injury (NSI) to waste management personnel. Currently, data documenting the extent and rate of needlestick and related injuries is sparse but it has been suggested that NSIs present a notable risk to waste industry workers. This is especially true in Material Recovery Facilities (MRFs), where activities such as picking lines put employees in direct contact with sharps when manually moving or sorting waste materials. There are concerns that NSIs will increase in the coming years due to factors such as an aging population, home management of increasingly prevalent medical conditions (e.g. diabetes, migraine), confusion surrounding proper disposal, and lack of access to take-back programs.

Disposal of loose needles or other sharps in the MSW stream is never considered proper disposal. However, proper disposal is not universally defined. States set individual policy and guidance on accepted methods for needle disposal. Most states allow for the disposal of containerized household needles (CHN) in curbside residential waste. Four states (CA, MA, OR, and WI) have banned the practice.