A Cross-Sectional Analysis of Inappropriate Sharps Container Utilization at a Level 1 Trauma Center

BACKGROUND: U.S. hospitals generate ∼6 billion tons of medical waste annually. Disposal costs exceed $4 billion. High-temperature incineration, required for sharp wastes, is the most costly and carbon-intensive disposal. Inappropriate waste contributes significantly to health care's financial and environmental burdens. METHODS: This single-blinded cross-sectional study involved a one-time audit of 176 sharps containers from operating rooms, procedure rooms, and clinics across a Level 1 trauma center, conducted on a single day in 2023. Containers were photographed before disposal. Metadata, such as specialty and room type, were recorded separately. Independent reviewers who analyzed the images were masked to the containers' origins. The proportion of image area occupied by nonsharp items was calculated using ImageJ. Statistical comparisons were performed using independent-samples t-tests and ANOVAs. RESULTS: Overall, 24.74% of sharps container contents were inappropriate. Emergency services had the highest rate (40.22%), followed by surgical (22.37%) and medical services (9.79%) ( p < .001). Specialties differed significantly ( p < .001); orthopedics, otolaryngology, and plastic surgery had lower inappropriate disposal, while emergency medicine and general surgery had higher rates. CONCLUSIONS: Our findings highlight an opportunity for targeted interventions to reduce medical waste misclassification. Standardized protocols and specialty-specific education may reduce costs and support environmental sustainability.