Blood splashes and smears are common on the external surfaces of sharps bins.

Occurring mostly when sharps attached to a short length of plastic tubing, or an entire infusion set are manouvered into the narrow opening of the sharps bin, blood splashed can be seen on around 40% of sharps bins removed for disposal. Using a forensic technique to aid the visualisation of blood residues this rises to around 65%.

Of great concern are firstly the high incidence of blood splashes detectable in the are where sharps bins had stood, creating an addition challenge for healthcare hygiene and an easy marker for poor performance. Secondly, it is reasonable to assume that there may be a similarly high incidence of splashes with blood or IV infusion fluids containing additional drug residues. These too may be present on the surface of sharps bins and be found more widely in the area where sharps bins had stood.

Current waste management practice dictates bagging of soft wastes to provide a barrier between the contaminated wastes within and those who may come into contact with them. Is it appropriate therefore to bag filled sharps bins when these are removed from the clinical area to improve the safety standards for those who may handle them as they move along the disposal chain?

Though the risk of exposure may be slight – waste handlers should wear gloves – the additional risks of exposure to drug residues, including cytotoxics, has not previously been recognised. Though improved PPE use for waste sector employees may mitigate these risks, at least in part, poor standards of PPE compliance, low standards of hand hygiene and the paucity of hand washing facilities for many waste handlers, together with the limited barrier protection and relative permeability of sharps protection gloves suggest additional bagging may be advantageous.

Study data are being prepared for publication.