Libre 2 disposal

In my area we have to have a 7l bin and all gubbins including the applicator has to be put in there. I get through about one a year. Provided via my prescription.

KatyAnneH said:

How do you dispose of your libre2 sensors?

The instructions say you shouldn’t dispose of them in domestic waste because of the battery. I got one in the free trial and have bought a few since then but I’m starting to get quite a collection of dead ones :-D

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Neither my integrated care system/integrated care board (the former clinical commissioning group) nor my local council will provide adequately sized sharps bins. The largest sharps bin available to me is one of those flat, squat 1 litre sharps bins (and yes, my ICS/ICB and local council are aware how much product waste the Freestyle Libre system generates).

If you can get hold of a much larger sharps bin, go for it!

I put the sensors in the sharps bin provided, along with blood test strips and lancets.

I also remove very carefully (with a pair of pliers) a needle that is found in the applicator and put that needle in the sharps bin too.

The remainder of the applicator goes in landfill.

N.B.: anyone removing the needle found in the applicator needs to exercise caution. Removing the "white circular disc" from the applicator releases a spring inside the applicator which is used (with the appicator needle) to deploy the sensor filament under the skin. Removing the "white circular disc" from the applicator too vigourously/too suddenly may cause the spring to pop out of the applicator potentially harming someone or something).

Abbott really ought to start a sensor and sensor applicator recycling scheme. I understand Abbott have initiated such schemes in the USA.

I am confused. The OP said the instructions say not to dispose in domestic waste because of the battery and the responses are talking about sharps boxes.
The Libre sensor has no sharp item on it.

In Response said:

I am confused. The OP said the instructions say not to dispose in domestic waste because of the battery and the responses are talking about sharps boxes.
The Libre sensor has no sharp item on it.

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A Libre sensor's "filament" is inserted into the skin. The "filament" has chemicals applied to it that the sensor uses in part to measure the concentration of glucose in the interstitial fluid found under the skin where the sensor is inserted in order to give a glucose reading.

Because the filament is inserted into the body, and has bodily fluids on it, once the sensor is removed it ought to be treated in exactly the same way as a blood glucose test strip. As medical waste.

The  only appropriate way to dispose of a dead sensor which has a filament attached to it which has bodily fluids on it, is to put the sensor in a medical sharps bin.

Regardless of the fact that the sensor contains a battery.

It's not ideal, but until Abbott institute a sensor recycling scheme, that's the best we users can do.

I certainly don't intend spending time dissecting a Libre sensor to remove its battery so I can dispose of that separately in accordance with my local council's battery disposal policy.

All flash and continuous glucose sensors use a filament to obtain a glucose reading, so all sensors ought to be put in a sharps bin when they stop working.

Medical waste isn't treated and disposed of in the same way as general household waste and recycling. At least, it shouldn't be.

Sticky plasters have bodily fluids on them. Finger stick strips have bodily fluids on them. Women's sanitary products have bodily fluids on. None of these items need to go in a sharps bin because they are not sharp.
As the OP mentioned, Abbott advise against putting Libre in domestic waste due to the battery. There is no mention of bodily fluids.

In Response said:

Sticky plasters have bodily fluids on them. Finger stick strips have bodily fluids on them. Women's sanitary products have bodily fluids on. None of these items need to go in a sharps bin because they are not sharp.
As the OP mentioned, Abbott advise against putting Libre in domestic waste due to the battery. There is no mention of bodily fluids.

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I agree with everything you say above.

Nevertheless, in the United Kingdom a used flash or continuous glucose monitor sensor is considered to be potentially infectious medical waste. As such, it should be disposed of by placing it in a sharps bin.

And I say again, in the UK medical waste is not dealt with and disposed of in the same way as general household waste by waste management contractors.

I'm attaching below a link to some information published by NHS England (London) which appears to have been provided to Libre users, CCGs (as they were then known) and local authorities based in London, following discussions with Abbott in 2018 concerning how the component parts of the Freestyle Libre sensor, the applicator and the sensor pack ought to be disposed of.

The clear lid doesn't have any batteries in, hasn't even been near your body so why on earth should that be put in a clinical waste bag. We were told to put it in normal recycling waste at the training by an Abbotts rep, so that's what I've always done.

Hopeful34 said:

The clear lid doesn't have any batteries in, hasn't even been near your body so why on earth should that be put in a clinical waste bag. We were told to put it in normal recycling waste at the training by an Abbotts rep, so that's what I've always done.

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There is no reason why the clear lid needs to go in a biohazard bag (provided it hasn't been touched by any bodily fluids).

Abbott recommend that once the sensor applicator has been used to apply a sensor, the clear lid is screwed back onto the applicator. So it makes sense to dispose of the applicator and the clear screw-on lid in the same way.

I see from the NHS England (London) note (link above) that I need to get hold of some biohazard bags to dispose of the applicators.

The leaflet indicates the sensor is waste electrical equipment. Contact the manufacturer for details. Putting the sensor in a sharps bin does not comply with the waste electrical equipment directive ...

jonathan183 said:

The leaflet indicates the sensor is waste electrical equipment. Contact the manufacturer for details. Putting the sensor in a sharps bin does not comply with the waste electrical equipment directive ...

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Good morning @jonathan183

Forgive me, which leaflet are you referring to that you say indicates a used glucose sensor is considered to be principally "waste electrical equipment"?

The document from NHS England (London) which I linked above does not do so.

Are you suggesting the advice given by NHS England (London) in 2018 to London-based Libre users, ICS's and local authorities following discussions with Abbott is wrong?

I would have expected London local authorities - who dispose of substantial amounts of electrical waste each year - to have pushed back and for the NHS England (London) document to reflect your suggestion.

But the document does not do so.

What is your solution for diabetics wanting to dispose of used glucose monitoring sensors that have bodily fluids on them (and because the filaments which puncture the skin are deemed "sharps" by clinicians) and which are consequently potentially infectious biohazards?

Should non-specialist clinical waste management contractors and their staff be put at potential risk handling and disposing of used sensors?

I do not know, but I would be extremely surprised if waste management contractors who specialise in handling and disposing of clinical waste are unaware that sharps bins may now contain used glucose sensors that have batteries in them. I would also expect such used sensor products placed in sharps bins to be dealt with appropriately by specialist clinical waste contractors.

The leaflet which comes with the sensor which has the fitting instructions.
It includes in a table (waste symbol next to it) the following text:-

This product must not be disposed of via municipal waste collection. Separate collection for electrical and electronic equipment waste per Directive 2012/19/EC in the European Union is required. Contact the manufacturer for details.

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The filament should not be considered sharps, the applicator will contain sharps which are not exposed unless they are dismantled. Putting waste electrical equipment in a sharps bin is the wrong approach.

In Response said:

Sticky plasters have bodily fluids on them. Finger stick strips have bodily fluids on them. Women's sanitary products have bodily fluids on. None of these items need to go in a sharps bin because they are not sharp.
As the OP mentioned, Abbott advise against putting Libre in domestic waste due to the battery. There is no mention of bodily fluids.

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I agree. I think we are somewhat overanalysing things. I can’t see any difference between sticky plasters, test strips or sanitary products. They should obviously all go in the nonrecyclable domestic waste. The used sensors should go in sharps bin. And the other plastic bits in the recycling bin.