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<DIV>So herein lies a challenge because they are not always 2 different
issues...granted we know that the bulk of pharmaceuticals in our environment do
not come from hospitals per se, nevertheless a lot of medications are delivered
via sharps which then get put in sharps containers, whether its trace medication
left in each syringe or a dosage mistake, etc...then there is...</DIV>
<DIV> </DIV>
<DIV>gasp...human error. I can tell you plenty of stories of sharps being
put not in sharps containers, but say trash cans, meals trays returning to the
kitchen....this was common enough to merit its own discussion for months and
yes, more time was devoted to discussing than resolving, much more. Its
safe to assume that despite endless amounts of training and education, clinical
staff make mistakes... its is safe assume that vials of meds end up in
sharps containers or in red bag waste. I've seen trained staff use red bag
containers for chemo waste because "it all goes the same place right?"</DIV>
<DIV> </DIV>
<DIV>So in the big picture, no this is not the iceberg but with the millions of
pounds of medical waste disposed of every year, we should also not discount that
its a source worth paying attention to and its being autoclaved.</DIV>
<DIV> </DIV>
<DIV>Tom Badrick</DIV>
<DIV>Badrick Consulting</DIV>
<DIV> </DIV>
<DIV> </DIV>
<DIV>
<DIV>In a message dated 7/13/2010 11:01:00 A.M. Pacific Daylight Time,
GILLIAM@adeq.state.ar.us writes:</DIV>
<BLOCKQUOTE style="BORDER-LEFT: blue 2px solid; PADDING-LEFT: 5px; MARGIN-LEFT: 5px"><FONT style="BACKGROUND-COLOR: transparent" color=#000000 size=2 face=Arial>
<DIV><FONT color=#0000ff size=2 face=Arial><SPAN class=929514817-13072010>guess we can start searching for another Yucca
Mountain.....</SPAN></FONT></DIV>
<DIV><FONT color=#0000ff size=2 face=Arial><SPAN class=929514817-13072010></SPAN></FONT> </DIV>
<DIV><FONT color=#0000ff size=2 face=Arial><SPAN class=929514817-13072010>and
am not about micro wave. But autoclaving won't
destroy, it simply disinfects doesn't it? disposal of
pharmaceutials and proper disposal of medical waste are two separate
issues.</SPAN></FONT></DIV>
<DIV><FONT color=#0000ff size=2 face=Arial><SPAN class=929514817-13072010></SPAN></FONT> </DIV>
<DIV><FONT color=#0000ff size=2 face=Arial><SPAN class=929514817-13072010>allen g</SPAN></FONT></DIV>
<BLOCKQUOTE style="MARGIN-RIGHT: 0px">
<DIV></DIV>
<DIV dir=ltr lang=en-us class=OutlookMessageHeader align=left><FONT size=2 face=Tahoma>-----Original Message-----<BR><B>From:</B>
pharmwaste-bounces@lists.dep.state.fl.us
[mailto:pharmwaste-bounces@lists.dep.state.fl.us] <B>On Behalf Of </B>Jan
Harris<BR><B>Sent:</B> Tuesday, July 13, 2010 12:12 PM<BR><B>To:</B> Sue
Dayton; 'Al White'; 'gressitt'; 'Holcomb, Sarah, NMENV'<BR><B>Cc:</B>
pharmwaste@lists.dep.state.fl.us<BR><B>Subject:</B> RE: [Pharmwaste] Federal
Incineration Reg - Email found in subject<BR><BR></FONT></DIV>
<DIV class=WordSection1>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #1f497d; FONT-SIZE: 11pt">Sue,
what would be your proposed method of destruction for the pharmaceutical
waste there in NC? <o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #1f497d; FONT-SIZE: 11pt"><o:p> </o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #1f497d; FONT-SIZE: 11pt">Jan
Harris, MPH<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #1f497d; FONT-SIZE: 11pt">Director,
EHS<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #1f497d; FONT-SIZE: 11pt">Sharps
Compliance<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #1f497d; FONT-SIZE: 11pt"><A title=mailto:jharris@sharpsinc.com href="mailto:jharris@sharpsinc.com">jharris@sharpsinc.com</A>
<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #1f497d; FONT-SIZE: 11pt"><o:p> </o:p></SPAN></P>
<DIV>
<DIV style="BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; PADDING-BOTTOM: 0in; PADDING-LEFT: 0in; PADDING-RIGHT: 0in; BORDER-TOP: #b5c4df 1pt solid; BORDER-RIGHT: medium none; PADDING-TOP: 3pt">
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt">From:</SPAN></B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt">
pharmwaste-bounces@lists.dep.state.fl.us
[mailto:pharmwaste-bounces@lists.dep.state.fl.us] <B>On Behalf Of </B>Sue
Dayton<BR><B>Sent:</B> Tuesday, July 13, 2010 5:04 AM<BR><B>To:</B> 'Al
White'; 'gressitt'; 'Holcomb, Sarah, NMENV'<BR><B>Cc:</B>
pharmwaste@lists.dep.state.fl.us<BR><B>Subject:</B> RE: [Pharmwaste] Federal
Incineration Reg - Email found in subject<o:p></o:p></SPAN></P></DIV></DIV>
<P class=MsoNormal><o:p> </o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt">Hello
Al:</SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt"> </SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt">We
are currently “fighting” two medical waste incinerators here in NC:
Stericycle and BMWNC (Healthcare Waste Solutions). Our goal is to convince
them to switch to more environmentally-friendly methods of disposal, (i.e.),
microwaving or autoclaving. Both incinerators are located next to schools
and residential neighborhoods. Both have continued violations. Both are out
of compliance with the new air standards for air pollutants under the new
EPA rules for medical waste incinerators promulgated in 2009. Both burn
paper and plastics as a means to <I>fuel the incinerators</I> – a method to
reduce fuel costs, but a monstrous and absolutely needless disposal method
that results in the formation of dioxins. </SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt"> </SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt">There
is <I>no regulation or testing</I> <I>required</I> for the zillions of
pharmaceuticals being incinerated: we do not know what is going in nor do we
know what is going out. Haz pharms are supposed to be separated from non-haz
pharms in our state (NC does not incinerate haz waste); however, questions
remain if the two are actually being efficiently and effectively segregated.
</SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt"> </SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt">The
new EPA rules include (in addition to better recycling and waste
segregation, increased monitoring/testing and removal of the exemption for
uncontrolled emissions from “by-pass” events) stricter standards for air
pollutants for medical waste incinerators. We are pushing to have our NC
implement the new rules two years earlier than the EPA’s compliance date of
2014. </SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt"> </SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt">Pharms
disposal continues to be a wild card and must somehow be better regulated,
tested and dealt with regarding their potential impacts to public health and
the environment. </SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt"> </SPAN><o:p></o:p></P>
<DIV>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt">Sue
Dayton</SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt">Blue
Ridge Environmental Defense League</SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt">North
Carolina Healthy Communities Program</SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt">PO
BOX 44</SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt">Saxapahaw,
NC 27340</SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt">(336)
525-2003</SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt"><A title=mailto:sdayton@swcp.com href="mailto:sdayton@swcp.com">sdayton@swcp.com</A></SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="COLOR: navy"> </SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="COLOR: navy"> </SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="COLOR: navy"> </SPAN><o:p></o:p></P>
<DIV>
<P style="mso-margin-top-alt: auto; mso-margin-bottom-alt: auto" class=MsoNormal><EM><SPAN style="FONT-FAMILY: 'Palatino Linotype','serif'; COLOR: navy; FONT-SIZE: 10pt">Our
lives begin to end the day we become silent about things that
matter. - Martin Luther King
Jr.</SPAN></EM><o:p></o:p></P>
<P style="mso-margin-top-alt: auto; mso-margin-bottom-alt: auto" class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy"> </SPAN><o:p></o:p></P></DIV>
<P class=MsoNormal><SPAN style="COLOR: navy"> </SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="COLOR: navy"> </SPAN><o:p></o:p></P></DIV>
<DIV>
<DIV style="TEXT-ALIGN: center" class=MsoNormal align=center>
<HR align=center SIZE=2 width="100%">
</DIV>
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt">From:</SPAN></B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt">
pharmwaste-bounces@lists.dep.state.fl.us
[mailto:pharmwaste-bounces@lists.dep.state.fl.us] <B>On Behalf Of </B>Al
White<BR><B>Sent:</B> Tuesday, July 13, 2010 4:26 AM<BR><B>To:</B>
'gressitt'; 'Holcomb, Sarah, NMENV'<BR><B>Cc:</B>
pharmwaste@lists.dep.state.fl.us<BR><B>Subject:</B> RE: [Pharmwaste] Federal
Incineration Reg</SPAN><o:p></o:p></P></DIV>
<P class=MsoNormal> <o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #1f497d; FONT-SIZE: 11pt">Sarah/
Stevan:</SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #1f497d; FONT-SIZE: 11pt"> </SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #1f497d; FONT-SIZE: 11pt">Incineration
is a very cost intensive, non-sustainable practice, Additionally and most
importantly it must be performed properly under strict monitoring
conditions. The un-intended by-product “Dioxin” et.al. will be produced and
released If the pharm compounds are not raised to proper temperatures and
maintained for prescribed time intervals under prescribed containment
conditions. This is not a simple task. I am amazed that this practice is
even permitted.</SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #1f497d; FONT-SIZE: 11pt"> </SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #1f497d; FONT-SIZE: 11pt">Al
White</SPAN><o:p></o:p></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #1f497d; FONT-SIZE: 11pt"> </SPAN><o:p></o:p></P>
<DIV>
<DIV style="BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; PADDING-BOTTOM: 0in; PADDING-LEFT: 0in; PADDING-RIGHT: 0in; BORDER-TOP: #b5c4df 1pt solid; BORDER-RIGHT: medium none; PADDING-TOP: 3pt">
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt">From:</SPAN></B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt">
pharmwaste-bounces@lists.dep.state.fl.us
[mailto:pharmwaste-bounces@lists.dep.state.fl.us] <B>On Behalf Of
</B>gressitt<BR><B>Sent:</B> Monday, July 12, 2010 6:08 PM<BR><B>To:</B>
Holcomb, Sarah, NMENV<BR><B>Cc:</B>
pharmwaste@lists.dep.state.fl.us<BR><B>Subject:</B> Re: [Pharmwaste] Federal
Incineration Reg</SPAN><o:p></o:p></P></DIV></DIV>
<P class=MsoNormal> <o:p></o:p></P>
<P style="MARGIN-BOTTOM: 12pt" class=MsoNormal><SPAN style="FONT-FAMILY: 'Verdana','sans-serif'">I would ask them to
provide the reg. It is not true in Maine.</SPAN><o:p></o:p></P>
<DIV>
<DIV>
<DIV>
<P style="MARGIN-BOTTOM: 10pt" class=MsoNormal>Stevan Gressitt,
M.D.<BR>Faculty Associate, University of Maine Center on Aging<BR>Founding
Director<BR>Maine Institute for Safe Medicine<BR>University of New England,
College of Pharmacy<BR>Department of Pharmaceutical Sciences <BR>Associate
Professor of Clinical Psychiatry<BR>University of New England, College of
Osteopathic Medicine<BR>716 Stevens Avenue <BR>Portland, Maine 04103<BR><A title=mailto:gressitt@gmail.com href="mailto:gressitt@gmail.com">gressitt@gmail.com</A> <BR>Cell:
207-441-0291 <o:p></o:p></P>
<P style="MARGIN-BOTTOM: 10pt" class=MsoNormal> </P></DIV></DIV></DIV></DIV></BLOCKQUOTE><BR><BR>---<BR>Note:
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