Fifteen Sanitation Workers in My Garage Have Been Stuck With Needles in the Last Fourteen Months

Fifteen sanitation workers in my garage have been stuck with needles in the last fourteen months. I work in that garage. I knew about five.

I missed ten.

I want to tell you who's causing it. It's probably not who you think.

Here's what happens when it happens. You grab a bag off the curb. It's a normal Tuesday morning bag. Plastic, white, knotted at the top. You swing it toward the hopper. Somewhere in the middle of the bag, through the plastic, through your glove, something punches into your fingertip.

You stop. You pull the glove off. You look at the finger. There's a dot of blood. You don't know yet whether it broke the skin enough to matter. You don't know what was in the needle. You don't know who used it last. You start the protocol — wash the wound, report it on the spot, get to a hospital — and the rest of the day stops being about garbage.

Within 72 hours you'll need to start post-exposure prophylaxis if the risk is high enough — ideally within 24, since every hour the drug works less well.¹ That's a 28-day course of antiretroviral medication with real side effects, in case the needle had HIV on it. You'll get tested at three months. Tested again at six. For the next half year your blood is a question mark.

That's if you report it. A lot of guys don't. The treatment is brutal, the testing is invasive, and the time off costs them. So some guys wash the wound, put a new glove on, and finish the route. They take the risk and hope.

Which means the number of needle sticks is always higher than what anyone counts.

Fifteen times in fourteen months. One garage.

My garage services Staten Island 1 — everything on the north shore above the 440. 150+ sanitation workers come out of it.

I worked the night shift last year. When you're working nights, you miss the news. You miss the roll calls. You miss the conversations that happen at the start of the day shift when somebody got stuck the day before and word goes around. I knew it was happening — needles in bags is always part of the job — but I wasn't tracking it. I wasn't paying attention.

This year I went to working days in October. Since then I've been seeing it with my own eyes. Two sticks I witnessed during the back end of last year. Three more since — guys I work with, guys I see at the start of the shift. Five total. That was already a number I'd never seen before in twenty years on the job. When I first started, working out of a Coney Island garage, the rate was about one stick every other year. Sometimes longer.

Five felt like a crisis. After sitting with that number for a few weeks, thinking it was already cause for concern, I found out the real number — twelve from March to March, three more since. Fifteen in fourteen months. Out of one garage. And in the twelve where I was working nights, I had only witnessed two. Ten happened without my knowing.

If five was what I could see now that I was paying attention, what did I miss the year before, when I wasn't? And if one garage is hitting fifteen — what do you think the citywide number looks like?

When most people picture the source of a needle in a garbage bag, they picture a drug user. A syringe from someone shooting heroin in a stairwell. That was the old story. It's still part of the story.

But that's not what's changed.

What's changed is the number of regular New Yorkers — middle-class, employed, insured — who are now injecting medication at home and throwing the needle in the kitchen trash when they're done.

About one in eight American adults is currently taking a GLP-1 weight-loss drug. Ozempic. Wegovy. Mounjaro. Zepbound. Nearly one in five has tried one at some point. Both numbers doubled in eighteen months.² And then there are injectable peptides — used by a growing number of people pursuing fitness, recovery, and longevity goals at home. Sourced through wellness clinics, telehealth, or online suppliers. Hundreds of thousands of Americans are doing this now.⁸ All of them new to needles, most of them with no medical training.

Add testosterone replacement therapy. What used to happen in a clinic now happens at home, prescribed through telehealth, lab work and medication shipped together. TRT use among men under 45 has grown fourfold since 2003, with injection becoming the most common form.⁷

The common thread isn't the medication. The common thread is that millions of people who never handled a needle before in their life are now handling needles every week, and the information about what to do with the used ones isn't reaching them. The packaging does include disposal instructions — but they sit at the back of a dense pamphlet most people never finish reading, after the section on how to inject. Pharmacies don't walk you through it. Telehealth providers don't follow up. And the social stigma around being on a weight-loss drug or a hormone treatment means a lot of people are keeping it quiet — not asking their neighbors, not bringing it up with friends, not telling anyone in the community who might otherwise mention how they handle it themselves.

That's where the needle in the bag is coming from now. Not from who you think.

The job is also structurally different than it used to be.

The bins are bigger. The bags are heavier. The volume per route is higher. Workers are still grabbing, throwing, compressing those bags by hand — and the body is more exposed to whatever's inside than it was a decade ago.

Here is what proper sharps disposal actually looks like. It is not complicated and it is not expensive.

A real sharps container costs $5 to $15 at any pharmacy or on Amazon. If you don't want to buy one, the FDA allows a heavy-duty rigid plastic container — an empty laundry detergent bottle works — with a tight screw-on lid, clearly labeled "HOME SHARPS."³ Don't bend, break, or recap the needle before you throw it in. Just drop it in the container, lid on, set it aside.

When the container is full, you have options. Under New York State law, every hospital and every nursing home in the state is required to accept your sealed sharps container. No identification, no questions, no charge. Just walk it in.⁴ You can also drop it at pharmacies and other sites that have signed up for the city's collection network — DSNY hosts a map at nyc.gov/sanitation showing every drop-off location.⁵ And if you're using a Novo Nordisk product like Wegovy or Ozempic, the manufacturer sends you a free 1.2-gallon sharps container and prepaid return shipping through their NovoCare Drug Disposal Program.⁶ Not every manufacturer offers this — check whether yours does.

What you don't do — ever — is put a loose needle in the regular trash. Or the recycling. Or the compost. Loose needles in any of the three streams can end up in the body of the worker who picks the bag up.

If you use needles at home for any reason — diabetes, fertility treatments, allergy shots, TRT, peptides, weight-loss medication — your sharps disposal is on you. Nobody else is going to do it for you. The pharmacy isn't going to do it. The manufacturer isn't going to do it unless you sign up for the mail-back. The sanitation worker who picks up your bag definitely isn't going to do it.

The sanitation worker is somebody's father. Somebody's husband. Somebody's son. He has a twenty-year career and kids at home and a wife who is going to spend the next six months waiting on test results because of something that took you four seconds to do correctly and you didn't.