Reyes, Karren T. BSP3C MODULE 7: CHECK IN ACTIVITY 1. Categories of hospital wastes. State also their characteristics. a. Chemical waste Chemical waste consists of discarded solid, liquid, and gaseous chemicals, for example from diagnostic and experimental work and from cleaning, housekeeping, and disinfecting procedures. Chemical waste from health care may be hazardous or nonhazardous. b. Cytotoxic waste Contaminated materials from drug preparation and administration, such as syringes, needles, gauges, vials, packaging; outdated drugs, excess (leftover) solutions, drugs returned from the wards; urine, feces, and vomit from patients, which may contain potentially hazardous amounts of the administered cytostatic drugs or of their metabolites and which should be considered genotoxic for at least 48 hours and sometimes up to 1 week after drug administration. c. Infectious waste Infectious waste is suspected to contain pathogens (bacteria, viruses, parasites, or fungi) in sufficient concentration or quantity to cause disease in susceptible hosts. d. Pathological waste Pathological waste consists of tissues, organs, body parts, human fetuses and animal carcasses, blood, and body fluids. e. Pharmaceutical waste Pharmaceutical waste includes expired, unused, spilt, and contaminated pharmaceutical products, drugs, vaccines, and sera that are no longer required and need to be disposed of appropriately. The category also includes discarded items used in the handling of pharmaceuticals, such as bottles or boxes with residues, gloves, masks, connecting tubing, and drug vials. f. Radioactive waste Radioactive waste includes solid, liquid, and gaseous materials contaminated with radionuclides. It is produced as a result of procedures such as in-vitro analysis of body tissue and fluid, in-vivo organ imaging and tumor localization, and various investigative and therapeutic practices. g. Sharps waste Sharps are items that could cause cuts or puncture wounds, including needles, hypodermic needles, scalpel and other blades, knives, infusion sets, saws, broken glass, and nails. Whether or not they are infected, such items are usually considered as highly hazardous health-care waste. h. Non-hazardous or general waste Any waste that does not cause harm to people or the environment, and regulations for disposal of non-hazardous waste are less strict. 2. Responsibilities of hospital pharmacists in Health Waste Management in the Hospital pharmacy. • All pharmacists should familiarize themselves with their region’s drug disposal activities and be able to recommend them to their patients. Continuing education and training at every level is desirable to generate awareness of hazards associated with indiscriminate disposal of unused/expired pharmaceutical products – an emerging environmental issue. • Drug disposal programs and pharmaceutical collection events serve not only as resources to the community for safely disposing of unused or unwanted medications, but also as platforms for examining the causes of medication waste. • Pharmacist also ensures patients safety and counsel patients about the adverse reactions and interactions with other medications, food, alcohol etc. This would aware people about the use and misuse of medicines and the way of disposing it and as a result, it would decrease the risk to the environment and well-being. • Pharmacist being the most respected, trusted and most accessible drug information resource, empower learners of all ages with the technical skills about the medication. • • • • • Pharmacist is involved with the entire process of prescribing, advising, dispensing, pharmaceutical care, disposal of expired medicines and ultimately reduction in metabolic waste discharge into the environment. Pharmacist should take the responsibility for changing the entire medication use process, finding the cure and minimizing the toxic effects of pharmaceuticals on environment. Pharmacists are in the forefront of tackling issues of prudent drug disposal methods to end users of drugs. Pharmacists are the medication experts and the most knowledgeable healthcare professionals, which can provide valuable education to people on how to dispose the unwanted waste in an effective manner. Pharmacists provide information regarding proper disposal of medicines, drug abuse and several drug-managing programs and can be the part of several NGOs for environment protection. 3. Ways on disposing pharmaceutical wastes in a hospital setting. • Step 1: Segregate pharmaceutical waste from biohazardous waste. Proper pharmaceutical waste management is crucial. This starts with making sure it’s handled differently than biohazardous waste so it doesn’t end up in a landfill like biohazardous waste does (after it’s sterilized). Separate out all pharmaceutical waste, and ensure it is not placed in a red biohazardous waste container. • Step 2: Pull out all controlled substances. Next is the segregation of pharmaceutical waste. Start by removing all controlled substances, such as opiates and benzodiazepines. These types of substances must be handled in accordance with Drug Enforcement Agency regulations. In most cases, the DEA requires to contract with a licensed reverse distributor to collect any unused controlled substances and transport them to either have them destroyed or returned to the manufacturer. A licensed reverse distributor will handle the stringent paperwork the DEA requires and will give advice on the type of waste collection container to use. • Step 3: Pull out any trace chemotherapy waste. Chemotherapy waste can be harmful to the public, even in trace amounts, and must be disposed of properly to ensure safety. Trace chemotherapy waste includes empty medication vials, IV tubing used to deliver medication and even medical gloves worn by staff when administering chemotherapy. Place all trace chemotherapy waste in an FDA compliant yellow container. Remember, bulk chemotherapy waste, such as unused or expired medications, should be treated as hazardous chemical waste. • Step 4: Pull out any hazardous waste. Some medications are classified as hazardous chemicals. Hazardous pharmaceutical waste must be disposed of appropriately to reduce the risk to the public. Drugs like warfarin, lindane and mitomycin are considered hazardous waste. These should be placed in black containers and require very specific disposal. • Step 5: Package what’s left. Everything that remains after removing the controlled substances, chemotherapy drugs and hazardous waste is categorized as nonhazardous pharmaceutical waste. It should be disposed of in white containers with blue lids. This ensures the waste is treated to meet environmental requirements. • Step 6: Contract with a licensed biomedical waste disposal service. After all the precautions, partner up with a correct and legit waste disposal service. The right licensed and knowledgeable partner can help the hospital to stay in compliance from delivery to disposal.
