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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Cyclophosphamide and Ifosfamide pass through the septic system intact (>98% exits septic system as complete, active drug) so the intact drugs have little direct impact on the bacteria in the activate sludge. However, their breakdown product, acrolein, will damage the activate sludge. After they pass into the leach, cyclophosphamide and ifosfamide will survive in soil for years/>decade thus will pass into surround surface and ground water. These two drugs all pass through drinking water purification (>98%).<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Others such as Actinomycin D, Bleomycin, Doxorubicin, Epirubicin, Idarubicin and Mitomycin are extremely toxic to bacteria and will cause wholesale collapse of the activated sludge/septic system with concurrent negative effects on leach fields and downstream waters. <o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Theresa O’Keefe, Ph.D.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Chief Scientific Officer<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Pharma-Cycle, Inc.</span><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><div><div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in'><p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>From:</span></b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> Jim Mullowney [mailto:jmullowney@pharma-cycle.com] <br><b>Sent:</b> Monday, July 02, 2012 10:01 PM<br><b>To:</b> 'Stevan Gressitt'<br><b>Cc:</b> 'Jeff Hollar'; pharmwaste@lists.dep.state.fl.us; 'Matthew C. Mireles'<br><b>Subject:</b> RE: [Pharmwaste] NIOSH Update<o:p></o:p></span></p></div></div><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Well documented to destroy the septic system, ask your local health inspector. This article from Pumper magazine is from 2008<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><a href="http://www.google.com/url?sa=t&rct=j&q=pumper%20magazine%20say%20no%20to%20drugs&source=web&cd=2&ved=0CFQQFjAB&url=http%3A%2F%2Fwww.pumper.com%2Feditorial%2F2008%2F05&ei=1zryT_qtMcbo2AXZ7-ihAg&usg=AFQjCNE65R8lmeQPmsYo8oEb2DD3I4QKow">http://www.google.com/url?sa=t&rct=j&q=pumper%20magazine%20say%20no%20to%20drugs&source=web&cd=2&ved=0CFQQFjAB&url=http%3A%2F%2Fwww.pumper.com%2Feditorial%2F2008%2F05&ei=1zryT_qtMcbo2AXZ7-ihAg&usg=AFQjCNE65R8lmeQPmsYo8oEb2DD3I4QKow</a><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>From:</span></b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> Stevan Gressitt <a href="mailto:[mailto:gressitt@gmail.com]">[mailto:gressitt@gmail.com]</a> <br><b>Sent:</b> Monday, July 02, 2012 8:14 PM<br><b>To:</b> Jim Mullowney<br><b>Cc:</b> Matthew C. Mireles; Jeff Hollar; <a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a><br><b>Subject:</b> Re: [Pharmwaste] NIOSH Update<o:p></o:p></span></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal style='margin-bottom:12.0pt'>My curiosity is raised. what specifically would the impact of that one dose be on a septic tank/leech field?<o:p></o:p></p><div><p class=MsoNormal>On Mon, Jul 2, 2012 at 7:36 PM, Jim Mullowney <<a href="mailto:jmullowney@pharma-cycle.com" target="_blank">jmullowney@pharma-cycle.com</a>> wrote:<o:p></o:p></p><p class=MsoNormal>There is no established time weighted average exposure allowed for cytotoxins, OSHA is Zero exposure. The bigger problem is for about 25 of the drugs the patient will excrete a large portion of the drug in the active form, so the guy cleaning the toilet or changing the sheets is heavily exposed. How about a patient on Cyclophosphamide who will get 4 grams of the drug injected and 1 gram will be excreted in 24 hours ( estimated one liter of urine in 24 hours that is 1000 ppm). That is a lot of a chemical made by a guy in a spacesuit to send someone home to his family without even telling him. The story gets worse if the guy is on a septic system and a well.<br>Nice work Niosh, OSHA needs to step it up a bit and the EPA should recognize that "drugs are chemicals too". Cyclophosphamide (U058) breaks down into Acrolein (P003).<br>What are we thinking.<br><br>Jim Mullowney<br><br>-----Original Message-----<br>From: <a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us">pharmwaste-bounces@lists.dep.state.fl.us</a> [mailto:<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us">pharmwaste-bounces@lists.dep.state.fl.us</a>] On Behalf Of Matthew C. Mireles<br>Sent: Monday, July 02, 2012 4:40 PM<br>To: Jeff Hollar; <a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a><br>Subject: Re: [Pharmwaste] NIOSH Update<br><br>Jeff, many thanks for this info. Exposure to hazardous materials is measured in time weighted average (TWA), FYI.<br><br>Matthew Mireles<br><br><br>-----Original Message-----<br>>From: Jeff Hollar <<a href="mailto:jhollar@pwaste.com">jhollar@pwaste.com</a>><br>>Sent: Jul 2, 2012 3:22 PM<br>>To: <a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a><br>>Subject: [Pharmwaste] NIOSH Update<br>><br>>We have just updated our database to reflect NIOSH's recent additions<br>>(Table<br>>1) and deletions (Table 2) to the NIOSH hazardous drug list. Waste-ID<br>>subscribers will notice these changes on their next output. A direct<br>>link to the recent changes can be found:<br>><a href="http://www.cdc.gov/niosh/docs/2012-150/pdfs/2012-150.pdf" target="_blank">http://www.cdc.gov/niosh/docs/2012-150/pdfs/2012-150.pdf</a><br>><br>>Jeff Hollar<br>>President<br>>PharmWaste Technologies, Inc.<br>>Urbandale, IA 50322<br>><a href="tel:515-276-5302">515-276-5302</a> (general)<br>><a href="tel:515-331-7310">515-331-7310</a> (direct)<br>><a href="tel:515-360-9785">515-360-9785</a> (cell)<br>><a href="http://www.pwaste.com" target="_blank">www.pwaste.com</a><br>><br>><br>>---<br>>Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients.<br>>---<br>>TO SUBSCRIBE, go to: <a href="http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste" target="_blank">http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste</a><br>>TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to <a href="mailto:pharmwaste-unsubscribe@lists.dep.state.fl.us">pharmwaste-unsubscribe@lists.dep.state.fl.us</a> -- the subject line and body of the e-mail should be blank.<br>>If you believe you may be subscribed with a different email address,<br>>please visit the subscriber listing at<br>><a href="http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste" target="_blank">http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste</a><br>>FOR PROBLEMS: Contact List Administrator <a href="mailto:Laurie.Tenace@dep.state.fl.us">Laurie.Tenace@dep.state.fl.us</a><br>>SEND MAIL to the list server at: <a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a><br><br>---<br>Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients.<br>---<br>TO SUBSCRIBE, go to: <a href="http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste" target="_blank">http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste</a><br>TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to <a href="mailto:pharmwaste-unsubscribe@lists.dep.state.fl.us">pharmwaste-unsubscribe@lists.dep.state.fl.us</a> -- the subject line and body of the e-mail should be blank.<br>If you believe you may be subscribed with a different email address, please visit the subscriber listing at <a href="http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste" target="_blank">http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste</a><br>FOR PROBLEMS: Contact List Administrator <a href="mailto:Laurie.Tenace@dep.state.fl.us">Laurie.Tenace@dep.state.fl.us</a> SEND MAIL to the list server at: <a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a><br><br><br>---<br>Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients.<br>---<br>TO SUBSCRIBE, go to: <a href="http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste" target="_blank">http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste</a><br>TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to <a href="mailto:pharmwaste-unsubscribe@lists.dep.state.fl.us">pharmwaste-unsubscribe@lists.dep.state.fl.us</a> -- the subject line and body of the e-mail should be blank.<br>If you believe you may be subscribed with a different email address, please visit the subscriber listing at <a href="http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste" target="_blank">http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste</a><br>FOR PROBLEMS: Contact List Administrator <a href="mailto:Laurie.Tenace@dep.state.fl.us">Laurie.Tenace@dep.state.fl.us</a><br>SEND MAIL to the list server at: <a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a><o:p></o:p></p></div><p class=MsoNormal><br><br clear=all><br>-- <br>Stevan Gressitt, M.D., D.F.A.P.A.<br>Faculty Associate, University of Maine Center on Aging<br>Academic Member, Athens Institute for Education and Research<br>Athens, Greece<br>Founding Director, International Institute for Pharmaceutical Safety<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>314 Clark Road<br>Unity, Maine, 04988<br><a href="mailto:gressitt@gmail.com" target="_blank">gressitt@gmail.com</a> <br>Cell: 207-441-0291<br><a href="http://www.benzos.une.edu" target="_blank">www.benzos.une.edu</a><br><a href="http://www.safemeddisposal.com" target="_blank">www.safemeddisposal.com</a><o:p></o:p></p></div></body></html>