[Pharmwaste] Re: Pharmwaste Digest, Vol 44, Issue 12

[Gilliam, Allen]

Thanx Rudy,

I didn't realize this was published or had forgotten I'd seen it.  ~half
a million possible "end users"?  So much for a comprehensive survey to
this number of folks!  Wonder if the American Pharma Assoc. would be
willing to help out with one?

And, I was told by a reputable source, there can possibly be more unused
meds at CAFOs that are discarded than I would have expected.  No telling
how many lbs of antibiotics, steroids, hormones, etc. are being rain
flushed into waters of the U.S.?

Thanx again for the info,

Allen g

-----Original Message-----
From: Rudy Vingris [mailto:rvingris at woh.rr.com] 
Sent: Tuesday, June 23, 2009 7:31 AM
To: Gilliam, Allen; pharmwaste at lists.dep.state.fl.us
Subject: RE: [Pharmwaste] Re: Pharmwaste Digest, Vol 44, Issue 12


The data below is from US EPA, collected for the Universal Waste Rule
amendment as to the number of healthcare institutions: 
 
Type                        # Facilities 
Hospitals                        7,081 
Outpatient Care                 26,901 
Ambulatory Care                  8,730 
Residential Care                72,103 
Physician Offices              213,611 
Dentist Offices                122,918 
Other Practitioners            115,378   
Veterinary Clinics              27,247 
Pharmacies                      40,544
Reverse Distributors                39

-----Original Message-----
From: Gilliam, Allen [mailto:GILLIAM at adeq.state.ar.us] 
Sent: Monday, June 22, 2009 3:07 PM
To: pharmwaste at lists.dep.state.fl.us
Subject: RE: [Pharmwaste] Re: Pharmwaste Digest, Vol 44, Issue 12
 
Given the huge numbers of the end users, Matt, wouldn't it make more
sense to work with the somewhat more limited number of pharma
manufacturers (suppliers?) to "voluntarily" sweep their customers with a
comprehensive questionnaire?  Just thinking of scratching out a P2 plan
here.
 
You've got quite the overall end users list below.  
 
What are we even guessing here including the hospitals?  10,000?
50,000? 
 
Thanks for opening up my eyes to others I haven't given much thought to.
 
It'd be my guess the non-adherence rate (cessation of taking meds) is
close to zero for the animal sector.
 
Allen g
 
-----Original Message-----
From: pharmwaste-bounces at lists.dep.state.fl.us
[mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Matthew
Mccarron
Sent: Monday, June 22, 2009 11:31 AM
To: William More; pharmwaste at lists.dep.state.fl.us
Subject: [Pharmwaste] Re: Pharmwaste Digest, Vol 44, Issue 12
 
 
This would seem to call for a "baseline assessment" of the industry's
handling practices, so that we can look at "take back" efforts with more
informed vision.
 
I would add that we would need the same assessment for:
-long term care facilities
-Skilled nursing/rehabilitation facilities
-mental heath facilities
-Medical Clinics 
-retirement complexes with medial clinics
-veterinary hospital/kennels
-veterinary services for agricultural purposes -livestock/ feed
lot/dairy
 
There may be others.
 
 
 
Matt McCarron
Pollution Prevention/Green Business
CA Dept. of Toxic Substances Control
700 Heinz Ave. Suite 300  MS R2 - 2-3
Berkeley, CA 94710
 
510-540-3828
 
Sustaining our resources sustains our future generations
 
 
>>> "William More" <wamore at gw.dec.state.ny.us> 6/22/2009 7:57 AM >>>
 
So what is the present compliance rate with our Hospitals Pharmacies
with the RCRA - Hazardous waste regulations? 
How are they achieving Hazardous Waste Determinations? How do they
segregate wastes, and when?
How many have a program that know where the stuff that the reverse
distributors don't want to take go?  What happens to the waste -
contaminated packaging - that comes from dispensing drugs that can be a
"P" waste?  Do the reverse distributors(RDs) tell the hospitals about
these materials? Do they, the RDs, take these back?
Does that make them a TSDF?  Are they manifested?  What mechanisms are
the Hospital Pharmacies using to recover these materials from the
patient floors?
What are the RDs doing with those materials that are never credited? The
partials that can't be reused because that are not factory sealed?
Those materials that are so far out of date?  The RDs know what they
are. Do they pick them up anyway. Does that make them a TSDF? Are they
manifested?
 
Have all of the Hospital Pharmacies had their Formulary,(likely stocked
Drugs), reviewed as to which ones can be a Hazardous Waste when unusable
,unreturnable, un credited, when a waste. Have they looked for
characteristic Hazardous Waste? Mercury compounds that may be used as a
preservative? Metals in vitamins or dietary supplements? Alcohol or CFCs
in inhalers?
 
What are we seeing when we look at these questions???????