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DAMERON HOSPITAL ASSOCIATI <br />DEPARTMENT: Interdisciplinary <br />Page 1 OF 4 <br />REFERENCE# 5010 <br />SUBJECT: Toxic Waste Management <br />EFFECTIVE DATE: 11/20/97 <br />FILING INSTRUCTIONS: Place in Departmental Policy <br />Binders <br />REVISION DATE(S): 6115/01GA:ra <br />4/2/02GA:ra, 10/17/02, 5/27/03 <br />APPROVED BY: See last page <br />REVIEW DATE: <br />Pharmaceutical toxic waste will be managed by hospital employees as designated in the procedure section of <br />this policy under the direction and review of the Director of Pharmacy and Safety Officer. <br />f111T: elff I <br />To comply with Federal, State and Local regulatory agencies' laws and guidelines in reference to <br />pharmaceutical waste and hazardous waste management. <br />IT:ZeZ•i4•I11:7i <br />A. Pharmaceutical Waste <br />1. Expired or remainder drugs not considered for credit will be considered waste. With the changes to the <br />California Medical Waste Management Act, most of the waste pharmaceuticals now fall into the <br />"Medical Waste" category. This includes those wastes that were previously referred to as "California <br />hazardous wastes" or "Non-RCRA hazardous wastes". Some examples are: antibiotics, antihistamines, <br />pain relievers, narcotics, bronchodilators. Waste pharmaceuticals (Non-RCRA wastes) must be <br />packaged to allow for incineration. It is not appropriate to place pharmaceutical wastes in red <br />biohazardous waste bags or into sharps containers. Incineration is the only method that currently <br />exists for disposal of waste pharmaceuticals other than as hazardous wastes. Waste pharmaceuticals <br />must be placed into disposable containers marked with the words "INCINERATION ONLY" on the lid. <br />2. Once the pharmaceutical waste has been placed in the proper container, Environmental Services will <br />be contacted to remove it from the area and they will be responsible for handling the final disposition of <br />the waste. <br />B. Chemotherapy (cytotoxic) Waste <br />1. The key to defining bulk chemotherapy waste is whether or not the waste is "pourable" from the <br />container. <br />a. Pourable chemotherapy waste is considered HAZARDOUS and must be handled as indicated <br />below. <br />b. Non -pourable or "TRACE" chemotherapy waste contains such items as: syringes, needles, empty <br />vials, tubing, gloves, gowns, empty IV bags and other waste possibly contaminated with cytotoxic <br />material. Pace waste in a ziplock bag or container inside the BSC before transferring to another <br />container outside the hood. This waste is handled the same as medical waste, but must be <br />packaged separately, in containers marked as "Chemotherapy Waste". <br />2. Chemotherapy Wastes Not Considered RCRA Hazardous Wastes (These may be disposed of as <br />Medical Wastes) <br />Amifostine <br />Dexrazoxane <br />Lomustine <br />• Ethyol <br />Zinecard Doxorubicin <br />• CCNU <br />Azacitidine <br />• Adriamycin <br />. CeeNU <br />• 5-azacytidine <br />• Rubex <br />Mechlorethamine <br />• Ladakamycin <br />Doxorubicin liposomal <br />• Nitrogen mustard <br />• Mylosar <br />• Doxil <br />• Mustargen <br />Bleomycin <br />Etoposide <br />Methotrexate <br />0 Blenoxane <br />• VP-16 <br />0 MTX <br />