EHJ May 2004, pages 154-155
Each year over 200 adults and children are tested for HIV and hepatitis following injuries from discarded needles. Eibhlin O'Somachain of the British Cleaning Council explains how local authorities can improve safety for the public and street cleaners

Newspaper headlines are regularly warning of the risk to children of being injured by sharps and other drugs-related litter. The fear, of course, is that discarded needles carrying blood infected with hepatitis B, HIV or hepatitis C will spread potentially fatal diseases.

Figures provided by the environmental charity Encams show that over 200 people are injured each year picking up around 20,000 discarded needles. The most recent figures show that 8 per cent of injuries were to children with the workers most vulnerable to injury being cleansing technicians.

This calls in to question the role of cleaners and their important, yet undervalued role in our society. The health and safety of these workers was recently the subject of a national drugs-related litter conference for councils, police, and drugs action teams held in Bristol where views were shared on how to tackle this growing problem.

Delegates heard how 89 per cent of councils are aware of discarded needles on their land, with most finding over 20 needles in any one area. "Sharps" are mostly discovered in parks, playing fields and public toilets.

Some authorities have got a handle on the problem with staff being issued safety equipment, including protective gloves, tongs and bins. Street sweepers, bin men and toilet attendants also receive training on safely dealing with needles. Three quarters of councils have an official procedure for removing discarded needles if found by staff and 70 per cent if discovered by a member of the public.

The Department for the Environment, Food and Rural Affairs has highlighted its commitment to tackling this problem and is calling on councils to deal with drugs litter quickly and effectively. It is also hoping to do more to encourage drug users to dispose of their paraphernalia responsibly. This often poses problems because of the mental state of the users when under the influence of drugs.

The good news is that the current code of practice on litter and refuse is under review, opening up the opportunity for a change in the way we tackle this particularly pernicious kind of litter.

Torbay Council runs a scheme clearing up drugs-related litter. David Vine, cleansing technician for the operational services team, told the conference: "We get a training pack with gloves, disinfectant, and pinchers. If a member of staff gets pricked, they put the needle in to a special container and make their way to hospital. A couple of people have been caught with the needle but thankfully no one has been infected as yet."

Cleaning teams also run the risk of verbal and physical abuse. "We have started to log incidents of violence, such as where a technician is trying to clean up and risks being threatened by a sleeping vagrant for being in their way."

By working with local police, security companies and by using CCTV, the council has been able to provide better protection for staff. Torbay Council's record for collected needles has risen from 500 in 2002 to 2,500. Training of staff and good communications with those at managerial level appears to be a key factor in keeping the staff motivated.

According to the British Cleaning Council, local authorities should be listening more to staff who pick up the waste and heed their advice. Cleaners, like those in Torbay, work around the clock to rid the streets of hazardous litter. In this case, council managers have listened to their views which has even made drug users more sensitive to the problems that cleaners face while doing their job.

Community groups, including the crime prevention community association Crime Concern, are also highlighting the public health risks of sharps. Roger Howard, Crime Concern's chief executive, praised the role of neighbourhood wardens in tackling drug litter and told delegates how his organisation had helped redesign their training.

With the number of addicts increasing from 48,000 in 1994 to  the current estimate of 250,000 and treatment rooms, once used in the 1960s, being phased out, drug users are being forced to use public spaces like toilets. As public lavatories introduce a blue light system to displace users, the problem is moved on - although some ex-users claim that blue lighting is not a deterrent.

Drug action response teams (Dart) are beginning to make a significant difference in tacking problem areas. These are teams of specialist cleaners equipped to handle items that pose a risk of blood infection and used condoms. Kenny Wilkes, from Camden LBC's Dart, is proud of his team's record, having removed 13,000 needles from the area in the first six months of the scheme's launch.

"Initially people thought we were undercover police and staff have been threatened before, despite the good work that they do. However, the scheme is now a clear success and 16,000 items have been collected in the past year with the help of a second Dart vehicle in operation," said Mr Wilkes.

In Scotland, 63 per cent of councils have introduced procedures for recovering needles. Of these, 80 per cent found needles with 11 people suffering injury from sharps over the past three years. Some Scottish councils will recover needles from houses, businesses, schools and colleges, as well as public spaces. Over half of Scotland's street sweepers and refuse collectors are trained to recover needles.

In Northern Ireland, only 6 per cent of councils operate a hotline to report needle sightings compared to 78 per cent in the north west of England. While the drugs litter problem in Northern Ireland is not as big as in the rest of the UK, the problem does exist and councils should recognise this potential threat to the public.

What works for some councils may not for others and so methods of dealing with drugs litter throughout the UK varies. In the west midlands, 80 per cent of councils are involved with drug action agencies, compared with just 33 per cent in Yorkshire. Alternately, all parks personnel in Wales and the north east are provided with sharps kits to dispose of needles, compared to just 25 per cent in areas such as Northern Ireland, the north west and the east midlands.

Paul Pearce, chair of BCC, believes that in order for our communities to properly combat the problem of drugs-related litter, councils need to train cleaners, advise drug users how to dispose of needles properly, and help the public to properly report sightings of needles.

Mr Pearce said: "Ultimately, cleaners need to be respected for their work and properly equipped for their safety. While it is quite right that parents who have to endure months of agony while their children undergo tests for HIV or hepatitis grab the headlines, we also need to highlight the very real dangers our cleaners face out on the streets, picking up the problem. We will not rest until all councils have set procedures, adequate training and provide the sturdiest, safest equipment for their staff - because the thought of a fatality from drugs-related litter is too monstrous to contemplate."