<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;}
@font-face
{font-family:Georgia;
panose-1:2 4 5 2 5 4 5 2 3 3;}
@font-face
{font-family:MinionPro-Regular;
panose-1:0 0 0 0 0 0 0 0 0 0;}
@font-face
{font-family:"\@MinionPro-Regular";
panose-1:0 0 0 0 0 0 0 0 0 0;}
/* Style Definitions */
p.MsoNormal, li.MsoNormal, div.MsoNormal
{margin:0in;
margin-bottom:.0001pt;
font-size:11.0pt;
font-family:"Calibri","sans-serif";}
a:link, span.MsoHyperlink
{mso-style-priority:99;
color:#0563C1;
text-decoration:underline;}
a:visited, span.MsoHyperlinkFollowed
{mso-style-priority:99;
color:#954F72;
text-decoration:underline;}
p.byline2, li.byline2, div.byline2
{mso-style-name:byline2;
mso-margin-top-alt:auto;
margin-right:0in;
margin-bottom:0in;
margin-left:0in;
margin-bottom:.0001pt;
line-height:15.0pt;
font-size:10.5pt;
font-family:"Georgia","serif";
color:#777777;
font-weight:bold;}
p.datetime1, li.datetime1, div.datetime1
{mso-style-name:datetime1;
margin:0in;
margin-bottom:.0001pt;
line-height:15.0pt;
font-size:9.0pt;
font-family:"Georgia","serif";
color:#999999;}
p.permalinkable, li.permalinkable, div.permalinkable
{mso-style-name:permalinkable;
mso-margin-top-alt:auto;
margin-right:0in;
margin-bottom:15.0pt;
margin-left:0in;
line-height:15.0pt;
font-size:10.5pt;
font-family:"Georgia","serif";
color:#222222;}
span.EmailStyle20
{mso-style-type:personal;
font-family:"Calibri","sans-serif";
color:windowtext;}
span.changefontlarge1
{mso-style-name:change_font_large1;}
span.changefontsmall1
{mso-style-name:change_font_small1;}
span.EmailStyle23
{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 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="#0563C1" vlink="#954F72"><div class=WordSection1><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-size:12.0pt;font-family:"Times New Roman","serif";color:#1F497D'>Drugs are chemicals too<o:p></o:p></span></b></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:12.0pt;font-family:"Times New Roman","serif";color:#1F497D'>It is irrational to think that the most dangerous category of chemicals invented (Cytotoxins) have no effect on the environment because it is convenient to call them medicines. </span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:12.0pt;font-family:"Times New Roman","serif";color:#1F497D'>It is an act of gross negligence that these “Medicines” always and everywhere are being dumped directly into the environment through human excretion. </span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:12.0pt;font-family:"Times New Roman","serif";color:#1F497D'>Moreover it is insidious for Government and Health Agencies that are aware Cytotoxic Chemotherapy drugs are entering the water system to continue to pretend that this activity does not present major threats to the environment and to the people.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:12.0pt;font-family:"Times New Roman","serif";color:#1F497D'>In August 2013 the WHO defined the problem of Genotoxic Waste as Cytotoxic chemotherapy drug, anything that came into contact with the chemicals and the Patients urine, feces and vomit for 48 hours after treatment. They go to further state: <o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:12.0pt;font-family:"Times New Roman","serif";color:#1F497D'> </span><span style='font-size:16.0pt;font-family:"Times New Roman","serif";background:yellow;mso-highlight:yellow'>Any discharge of genotoxic waste into the environment could have disastrous ecological consequences</span><span style='font-size:16.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:16.0pt'>A review of the requirement that human excrement containing cytotoxic drugs be collected, contained and properly disposed of. This document clearly identifies the Chief Pharmacist as the responsible party for the management of cytotoxic waste and the Hospital and Health Insurance Companies should shoulder the costs associated with its disposal.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span lang=EN> To quote the last article “If we don’t want these things in the wa­ter, we have to remove them at the source, which is us,” Ms. Haack said. <o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span lang=EN>The source of Cytotoxic drugs in the environment is the patient excretions and they can be safely collected and destroyed.</span><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>I am attaching a synoptic review of the “WHO Blue Book” and a full copy can be found at <a href="http://www.cytotoxicsafety.org">www.cytotoxicsafety.org</a> <o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>Thank you for acting.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>Jim Mullowney<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='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"'> pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] <b>On Behalf Of </b>Tenace, Laurie<br><b>Sent:</b> Wednesday, June 25, 2014 3:24 PM<br><b>To:</b> 'pharmwaste@lists.dep.state.fl.us'<br><b>Subject:</b> [Pharmwaste] Medicines, Cosmetics In Water Worry Scientists (MI)<o:p></o:p></span></p></div></div><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><a href="http://www.monroenews.com/news/2014/jun/24/medicines-cosmetics-water-worry-scientists/">http://www.monroenews.com/news/2014/jun/24/medicines-cosmetics-water-worry-scientists/</a><o:p></o:p></p><p class=MsoNormal style='line-height:18.0pt'><span lang=EN style='font-size:16.5pt;font-family:"Georgia","serif";color:black'>Medicines, Cosmetics In Water Worry Scientists<o:p></o:p></span></p><p class=permalinkable><span lang=EN>When people take medicine or apply beauty products, they may think they’re the only ones affected, but as they flush them out of their system or down the drain, wild­life will be getting a dose as well.<o:p></o:p></span></p><p class=permalinkable id=h69732-p2><span lang=EN>Traces of cosmetics and common phar­maceuticals have been detected in the River Raisin spawning from wastewater treatment plant effluents, and while the amounts are not harmful to humans, scientists are con­cerned about the negative impacts they can have on fish and birds.<o:p></o:p></span></p><p class=permalinkable id=h69732-p3><span lang=EN>“This could affect reproduction and sur­vival,” said Sheridan Haack, research hydrol­ogist for the U. S. Geological Survey office in Lansing. “ The concern is we don’t know what compounds do to wildlife once they get in the water at these concentrations.”<o:p></o:p></span></p><p class=permalinkable id=h69732-p4><span lang=EN>A 2010 study by Ms. Haack revealed that the amount of chemicals doubled down­stream from the wastewater treatment plant in Adrian compared to a sample upstream.<o:p></o:p></span></p><p class=permalinkable id=h69732-p5><span lang=EN>Among the higher concentrations were sterols, which are common materials in fe­cal waste, and industrial chemicals while co­tinine, musk fragrances, carbamazepine and pesticides were newly detected, according to the study.<o:p></o:p></span></p><p class=permalinkable id=h69732-p6><span lang=EN>Cotinine is a nicotine metabolite the body processes after smoking and carbamazepine is a drug used to treat epilepsy. Musk fra­grances are beauty products such as lotion and perfume.<o:p></o:p></span></p><p class=permalinkable id=h69732-p7><span lang=EN>While the first two were detected at low levels, musk fragrances were measured at 200 to 500 nanograms a liter, five to 12 times more than carbamazepine, according to the study.<o:p></o:p></span></p><p class=permalinkable id=h69732-p8><span lang=EN>This study is being updated and scientists are measuring the total load of chemicals coming from the River Raisin and other riv­ers as they discharge into the Great Lakes, Ms. Haack said. The new testing site is in Monroe.<o:p></o:p></span></p><p class=permalinkable id=h69732-p9><span lang=EN>The USGS is not alone in its studies as other organizations are testing the effects emerging chemicals of concern have on wildlife.<o:p></o:p></span></p><p class=permalinkable id=h69732-p10><span lang=EN>The U. S. Fish and Wildlife Service will be releasing a study later this summer as well, which analyzes fish and bird eggs along the Detroit River to see if contaminants were present, said Lisa Williams, toxicologist for the service in Lansing.<o:p></o:p></span></p><p class=permalinkable id=h69732-p11><span lang=EN>Research is being done in other parts of the country as well to see how certain chem­icals are affecting fish populations, Ms. Wil­liams said.<o:p></o:p></span></p><p class=permalinkable id=h69732-p12><span lang=EN>For instance, in the Potomac River, scien­tists discovered chemicals in the water were causing some male fish to produce the hor­mone that female fish have to create eggs, she said.<o:p></o:p></span></p><p class=permalinkable><span lang=EN>Estrogen from birth control also has been found in some water sources and can femi­nize male fish, shrinking their gonads and lowering sperm count. Pharmaceuticals like birth control can get into the water from hu­man urine that gets processed in treatment plants.<o:p></o:p></span></p><p class=permalinkable id=h69732-p14><span lang=EN>There are no standards to regulate these chemicals and government agencies won’t be pursuing the possibility in the near fu­ture.<o:p></o:p></span></p><p class=permalinkable id=h69732-p15><span lang=EN>“There’s not enough convincing data to show these quantities pose a threat to aquat­ic life,” said Amy Babcock, toxicologist for the Michigan Department of Environmental Quality, the regulating agency for the state.<o:p></o:p></span></p><p class=permalinkable id=h69732-p16><span lang=EN>Wastewater treatment plants are required to keep certain chemicals at low levels like mercury and PCBs because they have been known to cause harm to both humans and fish, Ms. Babcock said.<o:p></o:p></span></p><p class=permalinkable id=h69732-p17><span lang=EN>However, if eventually regulated to control pharmaceuticals, Ms. Haack isn’t sure plants could treat everything.<o:p></o:p></span></p><p class=permalinkable id=h69732-p18><span lang=EN>“It’s an expensive process,” she said. “One treatment process may treat some chemicals but not others.”<o:p></o:p></span></p><p class=permalinkable id=h69732-p19><span lang=EN>Though most of these chemicals are pres­ent in wastewater effluent, Ms. Haack said the treatment plants are not to blame.<o:p></o:p></span></p><p class=permalinkable id=h69732-p20><span lang=EN>“It’s not their fault; it’s the fault of the con­sumers,” she said, adding that people can limit usage to lessen their impact.<o:p></o:p></span></p><p class=permalinkable id=h69732-p21><span lang=EN>Ways to do this, Ms. Haack said, is to turn in unused medication instead of flushing it and use fewer personal care products.<o:p></o:p></span></p><p class=permalinkable id=h69732-p22><span lang=EN>While people excrete 80 percent of medi­cations naturally, they can use some unnec­essary ones less, she said.<o:p></o:p></span></p><p class=permalinkable id=h69732-p23><span lang=EN>“If we don’t want these things in the wa­ter, we have to remove them at the source, which is us,” Ms. Haack said.<o:p></o:p></span></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>Laurie Tenace<o:p></o:p></p><p class=MsoNormal>Environmental Specialist<o:p></o:p></p><p class=MsoNormal>Waste Reduction Section<o:p></o:p></p><p class=MsoNormal>Florida Department of Environmental Protection<o:p></o:p></p><p class=MsoNormal>2600 Blair Stone Road, MS 4555<o:p></o:p></p><p class=MsoNormal>Tallahassee, FL 32399-2400<o:p></o:p></p><p class=MsoNormal>850.245.8759<o:p></o:p></p><p class=MsoNormal><a href="mailto:Laurie.Tenace@dep.state.fl.us">Laurie.Tenace@dep.state.fl.us</a><o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p></div></body></html>