There are many types of hazardous drugs commonly found in healthcare organizations. By providing proper training to healthcare staff, healthcare organizations can ensure safe handling of hazardous drugs to protect employees, patients and the environment.
The Environmental Protection Agency (EPA) regulates hazardous chemicals through the Resource Conservation and Recovery Act (RCRA). When these chemicals become waste, they must be disposed according to EPA “Lists” or “Characteristics” of hazardous substances, including:
- Discarded Commercial Chemical Products (U-Listed)
- Acute Hazardous Waste (P-Listed)
- Characteristic Waste
The P and U lists designate as hazardous waste pure and commercial grade formulations of certain unused chemicals that are being disposed. For a waste to be considered a P- or U-listed waste it must meeting the following three criteria:
- The waste must contain one of the chemicals listed on the P List or U list
- The chemical in the waste must be unused
- The chemical in the waste must be in the form of a commercial chemical product
Common P-Listed Chemicals
- Osmium Tetroxide
- Sodium Azide
- Arsenic Acid
The volume of P-listed drugs is small at most nonhospital facilities. P-listed waste must be disposed of with the correct paperwork, tracking, weighing and documentation of amount of P-listed waste generated every month. Some examples of P-listed drugs include:
- Warfarin (Coumadin, Jantoven)
- Nicotine patches, lozenges or gum
- Physostigmine, physostigmine salicylate
- Arsenic trioxide (Trisenox)
Common U-Listed Chemicals
- Acrylamide (* gels not included)
- Formic Acid
- Hydrofluoric Acid
- Methyl Methacrylate
Common U-Listed Drugs and How to Dispose of Them
U-Listed wastes must be disposed as hazardous waste through EH&S Hazardous Waste Program. Make sure containers are properly labeled as “Hazardous Waste.” Most chemotherapy drugs fall into the U-Listed category. While chemotherapy drugs make up the majority in terms of volume of waste generated at healthcare facilities, other U-listed drugs include:
- Mitomycin C
- Chloral hydrate
- Selenium sulfide
Characteristics of waste are defined by the chemical combinations or ingredients that exhibit hazardous characteristics, including:
Wastes that are hazardous due to the ignitability characteristics include liquids with flash points below 60 degree Celsius, non-liquids that cause fire through specific conditions, ignitable compressed gases and oxidizers. The EPA assigns a different code that begins with the letter D to identify chemicals by their characteristics. EPA assigned D001 as the waste code for ignitable hazardous wastes.
Wastes that are hazardous due to the toxicity characteristic are harmful when ingested or absorbed. Toxic wastes present a concern as they may be able to leach from waste and pollute groundwater. The toxicity of a waste is determined by the Toxicity Characteristic Leaching Procedure (TCLP). EPA assigned D004 through D043 as the waste code for toxic chemicals.
Wastes that are hazardous due to the corrosivity characteristic include aqueous wastes with a pH of less than or equal to 2, a pH greater than or equal to 12.5 or based on the liquids ability to corrode steel. EPA assigned D002 as the waste code for corrostive hazardous wastes.
Wastes that are hazardous due to the reactivity characteristic may be unstable under normal conditions, may react with water, may give off toxic gases and may be capable of detonation or explosion under normal conditions or when heated. EPA assigned D003 as the waste code for reactive hazardous wastes.
Hazardous waste regulations are complicated, but Stericycle can help “uncomplicate” the complicated. Stericycle’s Hazardous Drug Disposal Service (HDDS)
provides the correct paperwork, online training, appropriate disposal containers, and proper hazardous waste disposal.