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Chemotherapy generates some of the most hazardous medical waste in the medical industry and is a critical aspect of the medical waste management disposal plan for healthcare generators. Trace Chemo removal services requires proper training.
How is chemotherapy waste segregated and disposed properly?
Choosing the right containment, transportation method, and treatment for chemo waste items contaminated with chemotherapy or antineoplastic agents can be confusing.
It is important to understand which pharmaceuticals utilized are considered hazardous as stated in the Resource Conservation and Recovery Act (RCRA). RCRA identifies the pharmaceuticals (and other chemicals) which are considered hazardous waste. Once the category of waste is designated, the next step is to determine if the waste is considered “trace” or “bulk”. The words “trace” and “bulk” are common terms used to describe chemotherapy waste. These terms are widely used in the industry even though they are not official EPA designations.
Transportation of Infectious Substances
An infectious substance, including regulated medical waste, is regulated as a hazardous material under the U.S. Department of Transportation's (DOT's) Hazardous Materials Regulations (HMR; 49 C.F.R., Parts 171-180). PHMSA develops and enforces the HMR to ensure the safe transport of hazmat in interstate, intrastate and foreign commerce by aircraft, railcar, vessel, and motor vehicle.
The HMR applies to any materials determined by DOT to pose an unreasonable risk to health, safety, and property when transported in commerce, including infectious substances. An infectious substance must conform to HMR requirements.
Trace chemotherapy is chemotherapy product residue found on any item. Including empty bags, tubing gloves, pads, and gowns. These items can be transported and disposed of through our Chemo Waste Program at Innovative Medical Waste Solutions.
The proper Disposal Chemotherapy Waste?
Innovative Medical Waste Solutions provides biohazard disposal of Trace Chemo Waste. This type of waste must be treated before disposal. Incineration is the method of disposal. All of our medical waste disposal programs and products are designed to emphasize safety and compliance, minimize infection transfer risk, and provide efficient segregation and disposal practices. If you generate trace chemotherapy waste at your facility, you should consider Affinity MedWaste for your chemo biohazard pickup.
Hazardous Waste Chemotherapy Drugs
Federal Resource Conservation and Recovery Act (RCRA) classifies nine chemotherapy drugs as characteristic or listed hazardous waste pharmaceuticals (HWP), https://www.epa.gov/hw/defining-hazardous-waste-listed-characteristic-and-mixed-radiological-wastes
If chemotherapy includes a P or U listed drug, it will be classified as Hazardous Waste and should be placed in a black bin container for disposal through a hazardous waste company. This includes trace P or U listed products as well as the Personal Protective Equipment (PPE), or any other material contaminated with the hazardous product or used in its administration. Proper knowledge, segregation and packaging is key to compliance when handling chemotherapy waste streams.
If a chemo drug waste is classified as a HWP by RCRA, it must be managed as hazardous waste (not medical waste) unless the container is “RCRA-empty” (only residual remaining) or there are only trace amounts of the HWP on waste items, such as gloves or drapes (“trace chemo waste”). HWP that are in containers not RCRA-empty are typically referred to as “bulk chemo waste.” This waste must be managed by a hazardous waste disposal company. Trace chemo waste or RCRA-empty chemo containers can be managed by a medical waste company as long as they are incinerated.
There are numerous chemotherapy drugs that have not been assessed and therefore, not classified as HWP by RCRA. In addition, numerous states require all chemo be handled as HWP. Best management practices in healthcare include the disposal of ALL chemo as trace or bulk HWP as applicable. Having proper containers for segregation of chemo wastes will help keep those wastes out of sharps containers, red bags, and the trash. Note that the terms “trace/residual” or “bulk” chemotherapy are not regulatory terms but are used to differentiate between items that are RCRA- empty from those that are not.
Trace or RCRA-empty chemotherapy can be disposed of in waste containers labeled as “Chemotherapy Waste” or “Incinerate Only” or other labeling that may be required by an individual state. Items contaminated with trace chemo or those RCRA-empty containers can be managed by a medical waste company as long as they are incinerated. They must be marked for incineration because otherwise, sharps containers and red bags are managed as medical waste and treated by au. RCRA-
Empty – Trace/Residual Chemo
For a chemotherapy waste container to be considered RCRA-empty or contain only residual amounts of the drug, all chemo must have been removed using practices commonly employed industry-wide to remove wastes from containers, such as pouring, aspirating, and draining until no more than 3 percent by weight the container remains. Such containers typically include empty IV bags, syringes, and medication vials. Trace chemotherapy can be found on items used to prepare and administer chemo, including gloves, pads, and gowns.
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