<html xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:w="urn:schemas-microsoft-com:office:word" xmlns:m="http://schemas.microsoft.com/office/2004/12/omml" xmlns="http://www.w3.org/TR/REC-html40">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=us-ascii">
<meta name="Generator" content="Microsoft Word 14 (filtered medium)">
<style><!--
/* Font Definitions */
@font-face
{font-family:Calibri;
panose-1:2 15 5 2 2 2 4 3 2 4;}
@font-face
{font-family:Tahoma;
panose-1:2 11 6 4 3 5 4 4 2 4;}
/* Style Definitions */
p.MsoNormal, li.MsoNormal, div.MsoNormal
{mso-margin-top-alt:auto;
margin-right:0in;
mso-margin-bottom-alt:auto;
margin-left:0in;
font-size:12.0pt;
font-family:"Times New Roman","serif";
mso-believe-normal-left:yes;}
a:link, span.MsoHyperlink
{mso-style-priority:99;
color:blue;
text-decoration:underline;}
a:visited, span.MsoHyperlinkFollowed
{mso-style-priority:99;
color:purple;
text-decoration:underline;}
p.MsoAcetate, li.MsoAcetate, div.MsoAcetate
{mso-style-priority:99;
mso-style-link:"Balloon Text Char";
mso-margin-top-alt:auto;
margin-right:0in;
mso-margin-bottom-alt:auto;
margin-left:0in;
font-size:8.0pt;
font-family:"Tahoma","sans-serif";}
span.BalloonTextChar
{mso-style-name:"Balloon Text Char";
mso-style-priority:99;
mso-style-link:"Balloon Text";
font-family:"Tahoma","sans-serif";}
span.EmailStyle19
{mso-style-type:personal;
font-family:"Calibri","sans-serif";
color:#1F497D;}
span.EmailStyle20
{mso-style-type:personal;
font-family:"Calibri","sans-serif";
color:#1F497D;}
span.EmailStyle21
{mso-style-type:personal-reply;
font-family:"Calibri","sans-serif";
color:#1F497D;}
.MsoChpDefault
{mso-style-type:export-only;
font-size:10.0pt;}
@page WordSection1
{size:8.5in 11.0in;
margin:1.0in 1.0in 1.0in 1.0in;}
div.WordSection1
{page:WordSection1;}
--></style><![if mso 9]><style>p.MsoNormal
{margin-left:3.0pt;}
</style><![endif]><!--[if gte mso 9]><xml>
<o:shapedefaults v:ext="edit" spidmax="1026" />
</xml><![endif]--><!--[if gte mso 9]><xml>
<o:shapelayout v:ext="edit">
<o:idmap v:ext="edit" data="1" />
</o:shapelayout></xml><![endif]-->
</head>
<body lang="EN-US" link="blue" vlink="purple" style="margin-left:3.0pt;margin-top:3.0pt;margin-right:3.0pt;margin-bottom:.75pt">
<div class="WordSection1">
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Please note this email did not originate with me.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Laurie<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" style="margin:0in;margin-bottom:.0001pt"><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""> Miller, Fred [mailto:millerfl@wsu.edu]
<br>
<b>Sent:</b> Wednesday, November 13, 2013 11:31 AM<br>
<b>To:</b> Jeff Hollar; 'William More'; pharmwaste@lists.dep.state.fl.us<br>
<b>Subject:</b> RE: [Pharmwaste] How is warfarin disposed at your Hospital?<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">Re hazardous waste treatment: RCRA rules allow for generators to treat their own wastes in containers or tanks without a permit. Some states (i.e.
<a href="https://fortress.wa.gov/ecy/publications/publications/96412.pdf">Washington</a>) have gone so far as to publish guidance on how this can be accomplished while other states like California specifically prohibit most treatment by generator activities.<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">That said, unless the generator can demonstrate through testing or generator knowledge that treatment is effective and does result in non-hazardous residuals,
they are still bound to dispose of the resulting materials as regulated waste. A quick review of the literature leaves me unconvinced steam autoclave conditions would result in effective treatment of warfarin. In fact, introducing P001 wastes into the autoclave
would likely result in the entire load and any effluents which contacted the load designating as P001 waste. Unless they have permission from their POTW to discharge such effluent to the sanitary sewer they are violating both RCRA and CWA rules. Similarly,
any resulting solids disposed as MSW would be a violation of RCRA.<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">Note the melting point and solubility data here
<a href="http://www.chemicalbook.com/ChemicalProductProperty_US_CB0413732.aspx">warfarin data</a> Absent addition of a strong mineral acid or base the data lead me to believe no reaction occurs under steam autoclave conditions. If anyone knows of literature
which contradicts my understanding of the chemistry I’d appreciate seeing it.<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">Fred
<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" style="margin:0in;margin-bottom:.0001pt"><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"">
<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us">pharmwaste-bounces@lists.dep.state.fl.us</a> [<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us">mailto:pharmwaste-bounces@lists.dep.state.fl.us</a>]
<b>On Behalf Of </b>Jeff Hollar<br>
<b>Sent:</b> Wednesday, November 13, 2013 6:54 AM<br>
<b>To:</b> 'William More'; <a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a><br>
<b>Subject:</b> RE: [Pharmwaste] How is warfarin disposed at your Hospital?<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">Per EPA, wouldn’t this be considered “treatment” of hazardous waste? I doubt the facility is licensed as a TSDF (Treatment Storage and Disposal Facility).<o:p></o:p></span></p>
<p class="MsoNormal" style="margin:0in;margin-bottom:.0001pt"><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:#1F497D">Jeff Hollar</span><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p></o:p></span></p>
<div>
<p class="MsoNormal" style="margin:0in;margin-bottom:.0001pt"><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:#1F497D">President</span><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal" style="margin:0in;margin-bottom:.0001pt"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:navy">PharmWaste Technologies, Inc.</span></b><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal" style="margin:0in;margin-bottom:.0001pt"><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:#1F497D">4164 NW Urbandale Dr., Ste A</span><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal" style="margin:0in;margin-bottom:.0001pt"><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:#1F497D">Urbandale, IA 50322</span><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal" style="margin:0in;margin-bottom:.0001pt"><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:#1F497D">515-276-5302 (general)</span><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal" style="margin:0in;margin-bottom:.0001pt"><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:#1F497D">515-331-7310 (direct)<o:p></o:p></span></p>
<p class="MsoNormal" style="margin:0in;margin-bottom:.0001pt"><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:#1F497D">515-360-9785 (cell)</span><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p></o:p></span></p>
</div>
<p class="MsoNormal" style="margin:0in;margin-bottom:.0001pt"><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:blue"><a href="http://www.pwaste.com/" title="http://www.pwaste.com/">www.pwaste.com</a></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" style="margin:0in;margin-bottom:.0001pt"><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"">
<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us">pharmwaste-bounces@lists.dep.state.fl.us</a> [<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us">mailto:pharmwaste-bounces@lists.dep.state.fl.us</a>]
<b>On Behalf Of </b>William More<br>
<b>Sent:</b> Wednesday, November 13, 2013 8:12 AM<br>
<b>To:</b> <a href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a><br>
<b>Subject:</b> [Pharmwaste] How is warfarin disposed at your Hospital?<o:p></o:p></span></p>
</div>
</div>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal" style="margin:0in;margin-bottom:.0001pt"><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">I recently came across a Hospital during a Hazardous Waste Inspection that claims steam sterilized Warfarin contaminated containers
are no longer "P Waste." Has anyone seen this? or records of analysis that can back this up? I'm waiting on submission of test results, but thought I would see if anyone else has heard of this.<o:p></o:p></span></p>
</div>
</body>
</html>