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<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Eve,<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>That is correct. We only have the
data from samples of take-back programs. A sample of unused and expired
medicines (UEM) indicated 40% of prescription meds were never used based on
actual pill (pill, capsule, and tablet) count and expected standard
packsize. A recent sample from CA showed about 52%. Since these are
data from our National Unused and Expired Medicines Registry, we can’t
generalized too much from the info we have—a limitation for any registry.
<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Do you by any chance have an estimate on response
rate for participation at take-back program? We did a quick pilot study
in <st1:City w:st="on"><st1:place w:st="on">Houston</st1:place></st1:City> with
a closed population and determined a participation rate of 17%.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Matthew C. Mireles<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'><o:p> </o:p></span></font></p>
<div>
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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'> Eva Dale
[mailto:eva@wastenotwashington.org] <br>
<b><span style='font-weight:bold'>Sent:</span></b> Thursday, March 20, 2008
7:52 PM<br>
<b><span style='font-weight:bold'>To:</span></b> matthew mireles; 'Richard
Buggeln'; pharmwaste@lists.dep.state.fl.us<br>
<b><span style='font-weight:bold'>Subject:</span></b> RE: [Pharmwaste] Does
your state have a list ofhazardouspharmaceuticals?</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> </o:p></span></font></p>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Matthew,</span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>I just want to clarify the 40% - 50% you refer to. It's my
understanding that this figure is OF PRESCRIPTION DRUGS COLLECTED AT
TAKE-BACK PROGRAMS and not</span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>40% - 50% of prescription drugs. Please, could you clarify
this?</span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Also, I know that there are many different sources for rates
of disposing of drugs down the drain. I would like to add to the
data in use by giving statistics from a survey performed on a sample
of <st1:PlaceName w:st="on">King</st1:PlaceName> <st1:PlaceType w:st="on">County</st1:PlaceType>
residents (<st1:place w:st="on"><st1:City w:st="on">Seattle</st1:City>, <st1:State
w:st="on">WA</st1:State></st1:place> area). When asked "How does your
household typically get rid of unused or expired medicines?"
the responses were: </span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>52% put in household garbage/trash and</span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>20% flush down the toilet or sink</span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>The remainder reported using other
methods or responded with "does not apply".</span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>(The margin of error is +/- 4%.)</span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>For more survey results, check out <a
href="http://wastenotwashington.org/Pharmsurveyhighlights.htm">http://wastenotwashington.org/Pharmsurveyhighlights.htm</a>.</span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Thanks,</span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Eva Dale</span></font><o:p></o:p></p>
</div>
<div>
<p><font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Pharmaceuticals
and the Environment Project <br>
**************************************************** <br>
<st1:place w:st="on"><st1:State w:st="on">Washington</st1:State></st1:place>
Citizens for Resource Conservation <br>
<st1:address w:st="on"><st1:Street w:st="on">2021 Third Avenue</st1:Street> <br>
<st1:City w:st="on">Seattle</st1:City>, <st1:State w:st="on">WA</st1:State> <st1:PostalCode
w:st="on">98121</st1:PostalCode></st1:address> <br>
(206) 441-1790 </span></font><o:p></o:p></p>
<p style='margin:0in;margin-bottom:.0001pt'><font size=2 face=Arial><span
style='font-size:10.0pt;font-family:Arial'>eva@wastenotwashington.org</span></font><o:p></o:p></p>
<p style='margin:0in;margin-bottom:.0001pt'><font size=2 face=Arial><span
style='font-size:10.0pt;font-family:Arial'>www.wastenotwashington.org </span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
</div>
<blockquote style='margin-top:5.0pt;margin-right:0in;margin-bottom:5.0pt'>
<p class=MsoNormal style='margin-bottom:12.0pt'><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma'>-----Original Message-----<br>
<b><span style='font-weight:bold'>From:</span></b>
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>matthew mireles<br>
<b><span style='font-weight:bold'>Sent:</span></b> Thursday, March 20, 2008
7:51 AM<br>
<b><span style='font-weight:bold'>To:</span></b> 'Richard Buggeln';
pharmwaste@lists.dep.state.fl.us<br>
<b><span style='font-weight:bold'>Subject:</span></b> RE: [Pharmwaste] Does
your state have a list ofhazardouspharmaceuticals?</span></font><o:p></o:p></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Richard,<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>We code pharmaceutical products based on
the PBT Index (persistence in the environment, bioaccumulation, and toxicity)
for our National Unused and Expired Medicines Registry. This
classification system, developed by our Swedish counterpart, is used widely in <st1:place
w:st="on">Europe</st1:place> to categorize environmental hazard potential of
common medicines that might get into the water. The testing is based on
standard risk assessment methods. There are only about 300 drugs on this
current list, and we are working to help the Swedish group expand this
list. Are you familiar with this system?<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>I can talk to you more in detail about
our Registry and application of this classification system. Is anyone
else collecting data on returned consumers’ pharmaceutical products?
We would love to compare data. We now have good data from the west and
east coast and discovered that about 40%-50% of prescription drugs are never
used by the consumers and usually would be thrown away by flush down the toilet
and sink. This is a very disturbing finding.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Matthew C. Mireles, PhD, MPH<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>President and CEO<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'>Community Medical Foundation for Patient
Safety<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'><a href="http://www.comofcom.com/">www.comofcom.com</a><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=black face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:black'><o:p> </o:p></span></font></p>
<div>
<div class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>
<hr size=2 width="100%" align=center tabIndex=-1>
</span></font></div>
<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>Richard Buggeln<br>
<b><span style='font-weight:bold'>Sent:</span></b> Friday, March 14, 2008 8:42
AM<br>
<b><span style='font-weight:bold'>To:</span></b>
pharmwaste@lists.dep.state.fl.us<br>
<b><span style='font-weight:bold'>Subject:</span></b> [Pharmwaste] Does your
state have a list of hazardouspharmaceuticals?</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> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><br>
</span></font><font size=2 face=Arial><span style='font-size:10.0pt;font-family:
Arial'>Colleagues...</span></font> <br>
<br>
<st1:place w:st="on"><st1:State w:st="on"><font size=2 face=Arial><span
style='font-size:10.0pt;font-family:Arial'>Florida</span></font></st1:State></st1:place><font
size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'> has a list
of some 200+ hazardous pharmaceuticals...a useful aid for hospitals and
regulators. <st1:State w:st="on">Tennessee</st1:State> regulators have
asked whether other states have similar lists, perhaps even more inclusive than
<st1:place w:st="on"><st1:State w:st="on">Florida</st1:State></st1:place>'s
list. I would appreciate hearing from you, whether or not you have a list
of hazardous pharms---and/or personal care products---so that Tennessee
Department of Environment and Conservation "knows what's out there".
I would happy to provide you with the final compilation of information.</span></font>
<br>
<br>
<font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Thanks
for your help.</span></font> <br>
<br>
<font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Regards,</span></font>
<br>
<br>
<font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Richard
Buggeln, Ph.D.</span></font> <br>
<font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Manager,
Environmental Programs &<br>
<st1:place w:st="on"><st1:State w:st="on">Tennessee</st1:State></st1:place>
Materials Exchange<br>
<st1:place w:st="on"><st1:PlaceType w:st="on">University</st1:PlaceType> of <st1:PlaceName
w:st="on">Tennessee</st1:PlaceName></st1:place><br>
Center for Industrial Services<br>
105 Student Services Bldg.<br>
<st1:place w:st="on"><st1:City w:st="on">Knoxville</st1:City>, <st1:State
w:st="on">TN</st1:State> <st1:PostalCode w:st="on">37996</st1:PostalCode></st1:place><br>
Phone: 865.974.9058<br>
fax: 865.974.1528</span></font><o:p></o:p></p>
</blockquote>
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