I think one of the biggest problems environmentalists face in dealing with issues such as this is language. When Sue asked about hazardous chemotherapeutical drugs, I immediately thought of the warnings I was given by the medical staff when I was getting chemotherapy. I was told that my body fluids were hazardous to others for at least 48 hours after each chem treatment. The advice I was given was that if I needed to leave the house during that time, I should carry a plastic bag and chlorox wipes to ensure the health and safety of others in case of an accident.<br>
<br>But then we get the technical response that 'hazardous' has a legal meaning. That legal meaning means that my response is inaccurate from a technical perspective, but yet has value for non-technical people and when it was used by the medical staff, I took it seriously because the word 'hazardous' has denotative meaning to me.<br>
<br><br><br><br><div class="gmail_quote"><blockquote class="gmail_quote" style="margin: 0pt 0pt 0pt 0.8ex; border-left: 1px solid rgb(204, 204, 204); padding-left: 1ex;">
<br>---------- Forwarded message ----------<br>From: "Suhr, Marcus W." <MSuhr@ChristianaCare.org><br>To: <<a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a>><br>Date: Wed, 17 Feb 2010 10:47:05 -0500<br>
Subject: RE: [Pharmwaste] Question about haz med waste<br>
<div link="blue" vlink="purple" lang="EN-US">
<div>
<p class="MsoNormal"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;">Hopefully this helps answer your questions,</span></font></p>
<p class="MsoNormal"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;"> </span></font></p>
<p class="MsoNormal"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;">When you ask about hazardous drugs, there
are RCRA hazardous, and also NIOSH/OSHA hazardous. Joint Commission also has a
new acute healthcare standard in </span></font><font color="blue"><span style="color: blue;">EOC</span></font><font color="blue"><span style="color: blue;">
(EC.02.02.01.08: The hospital minimizes risks associated with disposing of
hazardous medications. (See also MM.01.01.03, EPs 1, 2, 3)</span> which
mentions hazardous medications but does not define hazardous. In the most
basic definition, hazardous can mean: ‘capable of causing harm to humans
or the environment’. </font></p>
<p class="MsoNormal"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;"> </span></font></p>
<p class="MsoNormal"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;">Please remember medical waste is not
hazardous waste. Medical waste is either infectious waste, or biomedical waste/biohazardous;
all synonymous. Hazardous waste is it’s own category of ‘solid’
waste at the federal level. Many people refer to red-bag waste as hazardous
because they are not aware of the legal difference, in case that is part of
your question. Your state could possibly cover medical waste under their
hazardous waste regulations, but in </span></font><font color="blue"><span style="color: blue;">Delaware</span></font><font color="blue"><span style="color: blue;">, that is not the case.</span></font></p>
<p class="MsoNormal"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;"> </span></font></p>
<p class="MsoNormal"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;">Just to give an example, we have 3000
formulary items and approximately 11% we have deemed as “hazardous”
when disposed of. Guidance used to evaluate ‘hazard’ was taken
from different sources;</span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;">1)<font face="Times New Roman" size="1"><span style="font: 7pt "Times New Roman";">
</span></font></span></font><font color="blue"><span style="color: blue;">RCRA
listed or characteristic waste (complex process to evaluate)</span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;">2)<font face="Times New Roman" size="1"><span style="font: 7pt "Times New Roman";">
</span></font></span></font><font color="blue"><span style="color: blue;">NIOSH
special handling list (i.e. antineoplastic agents) found at <a href="http://www.cdc.gov/niosh/docs/2004-165/2004-165d.html" target="_blank">http://www.cdc.gov/niosh/docs/2004-165/2004-165d.html</a></span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;">3)<font face="Times New Roman" size="1"><span style="font: 7pt "Times New Roman";">
</span></font></span></font><font color="blue"><span style="color: blue;">OSHA technical
manual (</span></font><font color="black" face="Tahoma" size="2"><span style="font-size: 9.5pt; font-family: Tahoma; color: black;"><a href="http://www.osha.gov/dts/osta/otm/otm_vi/otm_vi_2.html" title="CHAPTER 2. CONTROLLING OCCUPATIONAL EXPOSURE TO HAZARDOUS DRUGS" target="_blank">CHAPTER
2. CONTROLLING OCCUPATIONAL EXPOSURE TO HAZARDOUS DRUGS</a>)</span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;">4)<font face="Times New Roman" size="1"><span style="font: 7pt "Times New Roman";">
</span></font></span></font><font color="blue"><span style="color: blue;">PharmEcology
review classified ‘hazardous’ pharmaceuticals, i.e. endocrine
disruptors, anti-virals, hormones, anti-retrovirals etc.</span></font></p>
<p class="MsoNormal"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;"> </span></font></p>
<p class="MsoNormal"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;">There are other solid wastes that can be
considered hazardous by EPA standards; i.e. laboratory solvents etc.</span></font></p>
<p class="MsoNormal"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;"> </span></font></p>
<p class="MsoNormal"><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;">I have profile lists we have developed here
for proper hazardous waste disposal that I can provide as examples upon request
but they will be site specific; we have a rather large formulary so I would
imagine some of the more frequently used pharmaceuticals will be on our lists.
The guide found at this link was paramount to our development of our program
which we are still rolling out; <a href="http://www.hercenter.org/hazmat/tenstepblueprint.pdf" target="_blank">http://www.hercenter.org/hazmat/tenstepblueprint.pdf</a>.
This guide was in-part funded by an EPA grant.</span></font></p>
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<p><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;">Good luck, let me know if there are any other questions;</span></font></p>
<p><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue;">Marcus Suhr, CSP<br>
Occupational Safety Specialist<br>
Christiana Care Health Services<br>
Occupational Safety Department, Office L840J<br>
</span></font><font color="blue"><span style="color: blue;">4755 Ogletown-Stanton
Road</span></font><font color="blue"><span style="color: blue;"><br>
</span></font><font color="blue"><span style="color: blue;">Newark</span></font><font color="blue"><span style="color: blue;">, </span></font><font color="blue"><span style="color: blue;">DE</span></font><font color="blue"><span style="color: blue;">
</span></font><font color="blue"><span style="color: blue;">19718</span></font><font color="blue"><span style="color: blue;"><br>
302-733-3787 (office) <br>
302-573-7662 (pager)<br>
302-733-3771 (fax)<br>
<a href="mailto:MSuhr@christianacare.org" target="_blank">MSuhr@christianacare.org</a> </span></font></p>
<p style="margin-left: 0.5in;"><i><font color="blue" face="Times New Roman" size="3"><span style="font-size: 12pt; color: blue; font-style: italic;" lang="DE">Alle Ding' sind
Gift, und nichts ohn' Gift; allein die Dosis macht, daß ein Ding kein Gift ist.</span></font></i><font color="blue"><span style="color: blue;" lang="DE"> <br>
</span>"All things are poison and nothing is without poison, only the dose
permits something not to be poisonous." - Paracelsus </font></p>
</div>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Tahoma" size="2"><span style="font-size: 10pt; font-family: Tahoma;">-----Original Message-----<br>
<b><span style="font-weight: bold;">From:</span></b> Sue Dayton
[mailto:<a href="mailto:sdayton@swcp.com" target="_blank">sdayton@swcp.com</a>] <br>
<b><span style="font-weight: bold;">Sent:</span></b> </span></font><font face="Tahoma" size="2"><span style="font-size: 10pt; font-family: Tahoma;">Wednesday,
February 17, 2010</span></font><font face="Tahoma" size="2"><span style="font-size: 10pt; font-family: Tahoma;"> </span></font><font face="Tahoma" size="2"><span style="font-size: 10pt; font-family: Tahoma;">7:09 AM</span></font><font face="Tahoma" size="2"><span style="font-size: 10pt; font-family: Tahoma;"><br>
<b><span style="font-weight: bold;">To:</span></b>
<a href="mailto:pharmwaste@lists.dep.state.fl.us" target="_blank">pharmwaste@lists.dep.state.fl.us</a>; 'Tenace, Laurie'<br>
<b><span style="font-weight: bold;">Subject:</span></b> [Pharmwaste] Question
about haz med waste</span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Times New Roman" size="3"><span style="font-size: 12pt;"> </span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">Good morning!</span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;"> </span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">I need help. Can anyone on this list
serve send me information re: the following: </span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;"> </span></font></p>
<p class="MsoNormal" style="margin-left: 1in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">1.<font face="Times New Roman" size="1"><span style="font: 7pt "Times New Roman";">
</span></font></span></font><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">List of pharmaceutical drugs classified as hazardous.</span></font></p>
<p class="MsoNormal" style="margin-left: 1in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">2.<font face="Times New Roman" size="1"><span style="font: 7pt "Times New Roman";">
</span></font></span></font><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">List of chemotherapeutical chemicals classified as
hazardous.</span></font></p>
<p class="MsoNormal" style="margin-left: 1in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">3.<font face="Times New Roman" size="1"><span style="font: 7pt "Times New Roman";">
</span></font></span></font><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">Any other type of medical waste that may be
classified or considered hazardous waste.</span></font></p>
<p class="MsoNormal" style="margin-left: 0.75in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;"> </span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">Thank you in advance! </span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;"> </span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">Best –</span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;"> </span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">Sue Dayton</span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">Blue Ridge Environmental Defense
League</span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">North Carolina</span></font><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;"> Healthy
Communities Program</span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">PO</span></font><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;"> </span></font><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">BOX</span></font><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;"> 44</span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">Saxapahaw</span></font><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">, </span></font><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">NC</span></font><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;"> </span></font><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">27340</span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;">(336) 525-2003</span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Arial" size="2"><span style="font-size: 10pt; font-family: Arial;"><a href="mailto:sdayton@swcp.com" target="_blank">sdayton@swcp.com</a></span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Times New Roman" size="3"><span style="font-size: 12pt;"> </span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Times New Roman" size="3"><span style="font-size: 12pt;"> </span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Times New Roman" size="3"><span style="font-size: 12pt;"> </span></font></p>
<div>
<p class="MsoNormal" style="margin-left: 0.5in;"><i><i><font face="Palatino Linotype" size="3"><span style="font-size: 12pt; font-family: "Palatino Linotype";">Our
lives begin to end the day we become silent about things that
matter. - Martin Luther King Jr.</span></font></i></i></p>
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<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Times New Roman" size="3"><span style="font-size: 12pt;"> </span></font></p>
<p class="MsoNormal" style="margin-left: 0.5in;"><font face="Times New Roman" size="3"><span style="font-size: 12pt;"> </span></font></p>
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</div><br></blockquote></div><br>