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<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>One of the concerns with using reverse
distributors involves hospital generated waste, which includes chemotherapy IVs
and other potentially hazardous drugs from an OSHA perspective. Reverse
distributors are required by FDA and State Boards of Pharmacy to inventory all
items received in their warehouse. I am very concerned about worker exposure
not only to hazardous drugs but also to any infectious waste that might
inadvertently be disposed in that waste stream. This should not be an issue on the
consumer side, unless, of course, patients receiving chemotherapy IVs at home
would send partial IVs, etc. to the RDs. I think all scenarios need to be
carefully examined. <o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p>&nbsp;</o:p></span></font></p>

<div>

<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Charlotte A. Smith, R. Ph., M.S., HEM</span></font><font
color=navy><span style='color:navy'><o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>President</span></font><font color=navy><span
style='color:navy'><o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>PharmEcology Associates, LLC</span></font><font
color=navy><span style='color:navy'><o:p></o:p></span></font></p>

<p class=MsoNormal><st1:Street w:st="on"><st1:address w:st="on"><font size=2
  color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
  color:navy'>200 S. Executive Drive, Suite 101</span></font></st1:address></st1:Street><font
color=navy><span style='color:navy'><o:p></o:p></span></font></p>

<p class=MsoNormal><st1:place w:st="on"><st1:City w:st="on"><font size=2
  color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
  color:navy'>Brookfield</span></font></st1:City><font size=2 color=navy
 face=Arial><span style='font-size:10.0pt;font-family:Arial;color:navy'>, <st1:State
 w:st="on">WI</st1:State> <st1:PostalCode w:st="on">53005</st1:PostalCode></span></font></st1:place><font
color=navy><span style='color:navy'><o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>262-814-2635</span></font><font
color=navy><span style='color:navy'><o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Cell 414-915-4026</span></font><font
color=navy><span style='color:navy'><o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Fax 414-479-9941</span></font><font
color=navy><span style='color:navy'><o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><a href="mailto:csmith@pharmecology.com">csmith@pharmecology.com</a></span></font><font
color=navy><span style='color:navy'><o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><a href="http://www.pharmecology.com">www.pharmecology.com</a></span></font><font
color=navy><span style='color:navy'><o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>H2E Champion for Change Award Winner</span></font><o:p></o:p></p>

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face="Times New Roman"><span style='font-size:12.0pt'>

<hr size=2 width="100%" align=center tabindex=-1>

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<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> pharmwaste-bounces@lists.dep.state.fl.us
[mailto:pharmwaste-bounces@lists.dep.state.fl.us] <b><span style='font-weight:
bold'>On Behalf Of </span></b>Latham, Mark<br>
<b><span style='font-weight:bold'>Sent:</span></b> Wednesday, May 02, 2007 7:53
AM<br>
<b><span style='font-weight:bold'>To:</span></b> Lucy Doroshko;
pharmwaste@lists.dep.state.fl.us; gressitt<br>
<b><span style='font-weight:bold'>Cc:</span></b> Bunnell, Ross; Sullivan, Kevin
T<br>
<b><span style='font-weight:bold'>Subject:</span></b> RE: [Pharmwaste] Federal
RegisterApril 30th</span></font><o:p></o:p></p>

</div>

<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p>&nbsp;</o:p></span></font></p>

<p class=MsoNormal><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'>Thanks, Steve, this is an encouraging&nbsp;development on
the federal level! <o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'>&nbsp;<o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'>Although the state of <st1:State w:st="on"><st1:place
 w:st="on">Connecticut</st1:place></st1:State> has not included pharmaceutical
waste to our universal waste rules, we plan to explore this option&nbsp;in the
future. Our universal waste rules currently&nbsp;include used electronics for
example.&nbsp;I can see that this option would&nbsp;promote the proper and safe
management of hazardous consumer products&nbsp;with some streamlined
requirements and possibly promote recycling-it has been&nbsp;our experience
that virtually all returned drugs are&nbsp;disposed not recycled.&nbsp;I'm not
sure if I agree with not considering a waste a waste until the redistribution
center makes&nbsp;the determination. As a universal waste, it seems to me that
the waste would be declared a&nbsp;waste by the generator, rightfully so!<o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'>&nbsp;<o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'>Lucy,&nbsp;I would like to contact you (<st1:State w:st="on"><st1:place
 w:st="on">Fla.</st1:place></st1:State> and any other state)&nbsp;about the
strengths of your program and&nbsp;any challenges&nbsp;you face if any by
implementing&nbsp;this waste stream as a universal waste.&nbsp;<o:p></o:p></span></font></p>

<div>

<p class=MsoNormal><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'>&nbsp;<o:p></o:p></span></font></p>

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<div>

<p style='margin:0in;margin-bottom:.0001pt'><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma'><!-- Converted from text/plain format -->Best
Regards,<br>
Mark<br>
<br>
Mark Latham<br>
Environmental Analyst 2<br>
Waste Engineering &amp; Enforcement Division<o:p></o:p></span></font></p>

<p style='mso-margin-top-alt:0in;margin-right:0in;margin-bottom:12.0pt;
margin-left:0in'><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'>Department of Environmental Protection<br>
<st1:Street w:st="on"><st1:address w:st="on">79 Elm Street</st1:address></st1:Street><br>
<st1:place w:st="on"><st1:City w:st="on">Hartford</st1:City>, <st1:State w:st="on">CT</st1:State>
 <st1:PostalCode w:st="on">06106</st1:PostalCode></st1:place><br>
<br>
tele: (860) 418-5930, x2170<br>
fax: (860) 424-4059<o:p></o:p></span></font></p>

</div>

<div class=MsoNormal align=center style='text-align:center'><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>

<hr size=2 width="100%" align=center tabIndex=-1>

</span></font></div>

<p class=MsoNormal style='margin-bottom:12.0pt'><b><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma;font-weight:bold'>From:</span></font></b><font
size=2 face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>
pharmwaste-bounces@lists.dep.state.fl.us
[mailto:pharmwaste-bounces@lists.dep.state.fl.us] <b><span style='font-weight:
bold'>On Behalf Of </span></b>Lucy Doroshko<br>
<b><span style='font-weight:bold'>Sent:</span></b> Wednesday, May 02, 2007 8:18
AM<br>
<b><span style='font-weight:bold'>To:</span></b>
pharmwaste@lists.dep.state.fl.us; gressitt<br>
<b><span style='font-weight:bold'>Subject:</span></b> Re: [Pharmwaste] Federal
RegisterApril 30th<o:p></o:p></span></font></p>

<div>

<p class=MsoNormal><st1:State w:st="on"><st1:place w:st="on"><font size=2
  face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>Michigan</span></font></st1:place></st1:State><font
size=2 face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> has
already included pharmaceutical waste in their universal waste rules.&nbsp; Any
other state do that?<o:p></o:p></span></font></p>

</div>

<div>

<p class=MsoNormal><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'>&nbsp;<o:p></o:p></span></font></p>

</div>

<div>

<p class=MsoNormal><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'>Lucy Doroshko, Recycling Specialist<br>
Pollution Prevention and Compliance Assistance Section<br>
MDEQ Environmental Science and Services Division<br>
525 W. Allegan, One North<br>
<st1:address w:st="on"><st1:Street w:st="on">PO Box</st1:Street> 30457</st1:address><br>
<st1:place w:st="on"><st1:City w:st="on">Lansing</st1:City>, <st1:State w:st="on">MI</st1:State>&nbsp;
 <st1:PostalCode w:st="on">48909-7957</st1:PostalCode></st1:place><br>
517/373-1322<br>
FAX:&nbsp; 517/241-0858<br>
<a href="mailto:doroshkl@michigan.gov">doroshkl@michigan.gov</a><o:p></o:p></span></font></p>

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<p class=MsoNormal><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'>&nbsp;<o:p></o:p></span></font></p>

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<div>

<p class=MsoNormal><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma'>Check the DEQ Recycling Website at <a
href="http://www.michigan.gov/deqrecycling">www.michigan.gov/deqrecycling</a><br>
<br>
<br>
&gt;&gt;&gt; &quot;gressitt&quot; &lt;gressitt@uninets.net&gt; 5/1/2007 10:22
PM &gt;&gt;&gt;<o:p></o:p></span></font></p>

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<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>See item 2990 Universal waste and
pharmaceutical products<o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'><o:p>&nbsp;</o:p></span></font></p>

<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>Stevan Gressitt, M.D.<o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>207-441-0291</span></font><font
color=black><span style='color:black'><o:p></o:p></span></font></p>

<p class=MsoNormal><font size=2 color=black face=Calibri><span
style='font-size:11.0pt;font-family:Calibri;color:black'><o:p>&nbsp;</o:p></span></font></p>

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