User:APBio1102

Proper Removal of Medical Waste

The proper removal of medical waste and chemotherapy waste is vital. The improper disposal can lead to numerous ground water supply problems and symptoms that can result in causing cancer. Cancer is caused when certain cells experience uncontrolled growth by the abnormalities in the genetic materials. One of the most common ways to cure any form of complicated cancer is through chemo therapy. Chemo, as most call it, contains cytotoxic drugs known to have carcinogenic, mutagenic or teratogenic in them. These chemicals are used to kill cancerous cells in the body which means when they are mixed with the earth it can be disastrous. Chemotherapy drugs are disposed of by using special instructions. According to the Occupational Health and Safety Division who created a health manual to enforce proper disposal methods among all hospitals. Cytotoxic drugs inhibit and prevent the function of cells. Cytotoxic drugs include drugs used to treat cancer and in some cases, to treat certain skin conditions. It is so important to look for the proper disposal method on the prescription bottle, or ask your health care provider for instructions on how to throw away correctly.

Chemo therapy waste is considered to be a biological medical waste or BMW. There are many cherapy drugs some are considered hazardous waste or BMW's while others are not. Some generics that have been identified as hazardous are: Arsenic Trioxide, Chlorambucil, Cyclophosphamide, Daunomycin, Diethystilbestrol, Melphalan, Mitomycin C, Streptozotocin, Uracil Mustard. These drugs are used in various cancer treatments and are administered in different ways. Antineoplastic drugs (drugs used to treat cancer)are administered through IV's, straight injections, pills, liquids, patches etc. These treatments leave behind empty bottles, bags, and needles. Discarded packaging and materials must be considered as well as the discarded human waste of the patients undergoing treatment. The Center for Disease Control (CDC)and the National Institute for Occupational Safety and Health (NIOSH)and many state health programs have websites detailing the guidelines and procedures that medical personel and patients should use. The universal procedures regard the safe administration and disposal of these hazardous drugs are posted by Occupational Safety and Health Administration (OSHA) and National Institutes of Health (NIH)

'''Managing Biomedical Medical Waste (BMW):' Thick, leak-proof plastic bags, colored differently from other hospital trash bags, should be used for routine accumulation and collection of used containers, discarded gloves, gowns, and any other disposable material. Pharmaceutical waste, such as unused ampules, vials, and IV bags, shouldn't be opened. To properly dispose one should wrap up the container with tape, place the container in a plastic container, wrap the outside of the container with more tape, then dispose of the container.

Identification and Segregation: Waste is supposed to be segrated according to type

Sharps Bodily fluids Bio waste

Packaging Requirements:

BMW's should be placed in containers that are rigid, leak-resistant, impervious to moisture, colored to be easier to identify, and strong enough to be handled without breaking open. Sharps are to be placed in containers that are puncture-resistant. Body fluids in quantities greater than 20 cm3 must be placed in containers that are break-resistant and tightly lidded or stoppered. Employees packaging BMW must wear personal protective equipment. The outside of each container must be marked with a water-resistant label displaying the universal biohazard symbol or the words "medical waste" or "infectious waste."

Disposal of Biomedical Waste (BMW):

The main way of disposing BMW's including chemotherapy waste is through incineration. Even incineration leaves incinerator residue which has to be disposed of following regulations. Regulation of transportation and record keeping of such waste must also be carefully followed.

Exposure: The CDC has issued a warning on workers exposure to hazardous drugs and has concluded that there is evidence that despite the safety protocals being followed workers are experiencing serious health effects. In some case studies workers direct exposure was well documented. A number of studies indicate that antineoplastic drugs may cause increased genotoxic effects in pharmacists and nurses exposed in the workplace. There is evidence to show that developmental and reproductive effects including invertility. One of the more deadlier effects can be cancer. A significantly increased risk of leukemia has been reported among oncology nurses identified in the Danish cancer registry for the period 1943−1987.

Determining whether or not a Drug is Hazardous National Institute for Occupational Safety and Health defines hazardous drugs as follows:

Drugs considered hazardous include those that exhibit one or more of the following six characteristics in humans or animals: 1. Carcinogenicity 2. Teratogenicity or other developmental toxicity†† 3. Reproductive toxicity†† 4. Organ toxicity at low doses††

Regulations: There are many state and federal regulations and guidelines around the managing, disposal, tracking, and education regarding BMW's and chemotherapy antineoplastic drugs. Some of these are:

The OSHA hazard communication standard [29 CFR 1910.1200] Connecticut BMW Definitions (Sec. 22a-209b) Connecticut BMW Disposal Requirements (Sec. 22a-209c) Connecticut BMW Disposal by Generators (Sec. 22a-213a) Connecticut Solid Waste Management Requirements Source performance standards (NSPS) for hospital/medical/infectious waste incinerators (HMIWI) (40 CFR 60.50c - 60.58c) Emission guidelines for existing HMIWIs: 40 CFR 60.30e to 60.39e CT BMW Requirements (22a-209-15) and Common Industry Practices (Power Point presentation) CT Permit Application for the Disposal of Special Wastes CT-DEP Waste Transportation Guidance Document CT-DEP Special Wastes or Asbestos Disposal Authorization