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Proposed LA County law would make pharma pay for drug, sharps disposal

Every day at the Burbank recycling center, a steady stream of trucks dumps about 100 tons of recyclables onto the warehouse floor. Workers sort the glass, cardboard, plastics, used batteries and discarded electronics. 

It’s a pretty smooth operation, with one exception, says Kreigh Hampel, the city's recycling coordinator - medical waste.

It's "one of the things we’re completely ill-equipped to take," he says.

The main problem is discarded syringes, needles and lancets – collectively known as sharps. They turn up in Burbank’s mix of recyclables several times a week, forcing a temporary shutdown of the sorting line. 

"We just had one of our biggest days ever just a few months ago where we had almost 27 1/2 pounds of needles come through the line," says Hampel. "The workers up there have leather gloves, but there are no gloves made that can stop a fine, little puncture from a needle."

Such punctures can expose workers to serious blood-borne infections, such as hepatitis and HIV.

A 'take back' law

It's one of the public health risks targeted by a proposed "take back" law scheduled to come before the Los Angeles County Board of Supervisors early next month.

The ordinance would require pharmaceutical companies to design, manage and pay for the collection and disposal of unused prescription medicines and sharps. It would be the largest such program in the nation. 

Five Northern California counties have similar ordinances that are limited to unused medicines; one in Santa Cruz is the first in the nation to include medical sharps.

Santa Monica-based Heal the Bay supports the proposed law; it's concerned with both types of medical waste.

"It’s unfortunately not uncommon to find syringes washed up on the beach," says Rita Kampalath, the group's science and policy director. "We're not exactly sure where they come from, but they do pose a hazard to beachgoers."

But the larger problem stems from the unused prescription drugs that consumers dump into sinks and toilets.

"These are chemicals that are pretty small and a little bit complex," Kampalath says. "And wastewater treatment plants generally aren’t designed to treat them."

That, she says, is bad news for the nation’s waterways, wetlands and wildlife that wind up ingesting these drugs. 

"They can bioaccumulate to higher and higher concentrations," she says. "And of course the fish and the amphibians can’t get away from them."

'Costly and...inefficient'

Public health officials contend the proposed county ordinance would also help save people, by reducing the amount of unused prescription drugs that can be snatched from family medicine cabinets.

"We need to provide an option that we can all say is safe [and] minimizes damage to the environment while getting these potentially harmful substances out of reach of people who would abuse them if they had access to them," says Angelo Bellomo, deputy director for health protection at the L.A. County Department of Public Health. 

Drug makers oppose the proposed ordinance.

"We agree that it’s really vital that consumers dispose of their medicines properly," says Priscilla VanderVeer, spokeswoman for the Pharmaceutical Research and Manufacturers of America, a national trade association.

But "a mandated costly and frankly inefficient take-back program is not the way to do that," she says. "There are cheaper, less burdensome ways to dispose of medicines."

VanderVeer says a mandatory program would force a liability risk onto pharmacies that handle controlled substances. A better option, she says, would be to educate residents about proper disposal and to promote voluntary drug drop-off sites,  such as those offered by the Los Angeles County Sheriff’s Department and some pharmacies.

But there aren’t enough of those programs to handle the medical waste disposed of by all of L.A. County's 10 million residents, argue public health officials.

Drugs, water and kitty litter in a bag

Carol Royce-Wilder agrees.

The Venice resident says she recently tried to dispose of a bag full of unused medications belonging to her and her two dogs. So she headed to a pharmacy that takes back drugs, but was turned away.  

"They said, 'No, we don’t take anything back that we haven’t prescribed.' So I went home and didn’t know what to do with this stuff," says Royce-Wilder. 

 L.A. County's proposal seeks to solve that problem in part by requiring drug makers to offer a network of drop-off kiosks.

But Vanderveer of PhRMA says it would be much easier for consumers to dispose of unused medications at home by dropping them into a plastic bag with water.

"Then you add something like coffee grounds, or kitty litter, sawdust, dirt, whatever, to help dissolve and make that substance unpalatable," she says. "You seal it up and put it in your trash."

But environmentalists don’t like this idea. They point out that sealed baggies can easily tear, causing their contents to leach through landfills and into groundwater.

Still, it's one of the arguments  drug makers are using to lobby against the L.A. County proposal and others springing up nationwide. 

Last May, the U.S. Supreme Court rejected a drug industry challenge to a similar law in Alameda County, which was the nation's first. 

Since then, drug take back ordinances have sprung up in  Marin, Santa Clara, Santa Cruz, San Francisco and San Mateo counties. Massachusetts and King County, Washington have adopted similar laws.