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<p class="MsoNormal"><span style="color:#1F497D">Hello Jim. I’ve followed your work with great interest for several years. We began managing hazardous waste and chemo drugs in the late 90’s for our healthcare customers and have evolved over the years. I’ve
always considered this an issue to which little or no attention was given and watched from a distance as you’ve struggled to move the issue to the forefront. I admire your perseverance.<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">This issue has been on my mind as of late, not for business, but from a very personal perspective. Within the last two months I’ve had three family members diagnosed with cancer and are in varying stages of
treatment. All of them will undergo outpatient chemo and radiation. They each come from different households (one aunt and two cousins) but the same side of the family. We are a large family and very tightly knit as most Latino families are. We will all
be tending to their needs and I’m concerned for the very reasons you’ve made this your life’s work. We have everyone from infants to elderly and pets. Family members are offering their homes and transportation and some will be tending to the “dirty work”
as it were. Like Jennifer, I too was looking for resources that families can implement to minimize exposure to these dangerous drugs.<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">I haven’t inquired at the hospital (all three family members are at the same hospital) to see if they have a program in place, but I’m not optimistic. I do plan to get the family together and make them aware
of the risks and would like to be able to offer solutions and resources, not just more bad news. There’s lots of material on your website, mostly geared toward regulatory change and I applaud and support that effort. But what specifically can you recommend
to patients and their families? As you know, getting hospitals or governments to implement change is a long-term proposition. Unfortunately time is not on our side when the problem is at your doorstep.<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">Best Regards,<o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D">Barry<o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D"><o:p> </o:p></span></p>
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<p class="MsoNormal" align="center" style="text-align:center"><span style="font-size:12.0pt;font-family:"Times New Roman","serif";color:#1F497D"><img width="168" height="53" id="_x0000_i1027" src="cid:image001.jpg@01CFDE34.573F36E0" alt="Clean Fuels of Florida, Inc. email signature"></span><span style="font-size:12.0pt;font-family:"Times New Roman","serif";color:#1F497D"><br>
<a href="http://www.clean-fuels.net"><span style="font-size:8.0pt;font-family:"Arial","sans-serif";color:#669933">www.clean-fuels.net</span></a><o:p></o:p></span></p>
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<p class="MsoNormal"><b><span style="font-size:10.0pt;font-family:"Arial","sans-serif";color:blue">Barry Fernandez,
</span></b><span style="font-size:8.0pt;font-family:"Arial","sans-serif";color:blue">President</span><span style="font-size:12.0pt;font-family:"Times New Roman","serif";color:#1F497D"><br>
</span><span style="font-size:8.0pt;font-family:"Arial","sans-serif";color:#009900">Mobile (305) 216-4941 barry@clean-fuels.net <br>
Office (954) 791-9588 Fax (954) 791-9366<br>
2635 NE 4th Avenue | Pompano Beach, Florida 33064</span><span style="font-size:12.0pt;font-family:"Times New Roman","serif";color:#1F497D"><o:p></o:p></span></p>
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<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> Thursday, October 02, 2014 10:57 AM<br>
<b>To:</b> 'Volkman, Jennifer (MPCA)'; pharmwaste@lists.dep.state.fl.us<br>
<b>Subject:</b> RE: [Pharmwaste] Cytotoxic drug management<o:p></o:p></span></p>
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<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span style="color:#1F497D">Jennifer, the program must be administered by the hospital and according to the World Health Organization it is the responsibility of the Pharmacist to control the Genotoxic waste including the urine and feces
for 48 hours. 85% of Chemotherapy drugs are given on an outpatient basis so most of the collection is done in the home. The box is 16 inches by 16 inches and is delivered to the patients home the day before the infusion. The box contains enough containers
to collect the patient waste for two days. The waste containers are put back in the box and shipped back to Pharma-Cycle for consolidation and final disposal.<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">Simple solution for a complex problem.<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">Jim M <o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D"><o:p> </o:p></span></p>
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<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"">
<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>Volkman, Jennifer (MPCA)<br>
<b>Sent:</b> Wednesday, October 01, 2014 5:08 PM<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] Cytotoxic drug management<o:p></o:p></span></p>
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<p class="MsoNormal"><o:p> </o:p></p>
<div>
<p class="MsoNormal"><span style="font-size:12.0pt;color:black">I didn't find where to "set up a program" on your link. Your information appears well sourced. I agree that better education and equipment is needed for patients receiving chemo at home and their
families. I hope the proposed legislation is successful. Given the toxicity of chemo related drugs and the random access nature of collection in bins, I don't think any chemo related waste or unused liquids should be put in pharm collection bins.
<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-size:12.0pt;color:black"><o:p> </o:p></span></p>
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<p class="MsoNormal"><span style="font-size:12.0pt;color:black">I was looking for more information on the shipping box-type/size/construction. Without knowing exactly what they are, I can assume they are larger than the "mail slot" size of the collection containers
around the country and that one kit would likely fill a collection bin. I think mail back makes sense and/or a partnership with local clinics and hospitals that prescribe home chemo treatment to take back the packaged materials. Is that what you envision? <o:p></o:p></span></p>
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<p class="MsoNormal" style="margin-bottom:12.0pt"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black">From:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black">
<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us">pharmwaste-bounces@lists.dep.state.fl.us</a> [pharmwaste-bounces@lists.dep.state.fl.us] on behalf of Jim Mullowney [jmullowney@pharma-cycle.com]<br>
<b>Sent:</b> Wednesday, October 01, 2014 2:38 PM<br>
<b>To:</b> 'Seery, Scott, Env. Health'; 'Tenace, Laurie'; <a href="mailto:pharmwaste@lists.dep.state.fl.us">
pharmwaste@lists.dep.state.fl.us</a><br>
<b>Subject:</b> RE: [Pharmwaste] RE: Alameda County ordinance upheld by federal appeal court</span><span style="font-size:12.0pt;font-family:"Times New Roman","serif";color:black"><o:p></o:p></span></p>
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<div>
<p class="MsoNormal"><span style="color:#1F497D">I think it is time to add the collection of human waste containing Cytotoxic Chemotherapy drugs to the program..</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D">Check out <a href="http://www.cytotoxicsafety.org" target="_blank">
www.cytotoxicsafety.org</a> to set up a program.</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D"> </span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D">Jim M.</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D"> </span><span style="color:black"><o:p></o:p></span></p>
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<p class="MsoNormal"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black">From:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black">
<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>Seery, Scott, Env. Health<br>
<b>Sent:</b> Wednesday, October 01, 2014 3:25 PM<br>
<b>To:</b> 'Tenace, Laurie'; 'pharmwaste@lists.dep.state.fl.us'<br>
<b>Subject:</b> [Pharmwaste] RE: Alameda County ordinance upheld by federal appeal court</span><span style="color:black"><o:p></o:p></span></p>
</div>
</div>
<p class="MsoNormal"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D">Yes, we think it’s pretty awesome over here.
</span><span style="font-family:Wingdings;color:#1F497D">J</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D"> </span><span style="color:black"><o:p></o:p></span></p>
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<p class="MsoNormal"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black">From:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black">
<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us" target="_blank">pharmwaste-bounces@lists.dep.state.fl.us</a> [<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us" target="_blank">mailto:pharmwaste-bounces@lists.dep.state.fl.us</a>]
<b>On Behalf Of </b>Tenace, Laurie<br>
<b>Sent:</b> Wednesday, October 01, 2014 12:05 PM<br>
<b>To:</b> 'pharmwaste@lists.dep.state.fl.us'<br>
<b>Subject:</b> [Pharmwaste] Alameda County ordinance upheld by federal appeal court<br>
<b>Importance:</b> High</span><span style="color:black"><o:p></o:p></span></p>
</div>
</div>
<p class="MsoNormal"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D">Please note that this email originated with Catherine Zimmer, not me. I am forwarding it for her. Always let me know if you have problems posting to the list serve.</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D">Laurie</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D"> </span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D"> </span><span style="color:black"><o:p></o:p></span></p>
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<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";color:black">From:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black"> Catherine Zimmer [<a href="mailto:zenllc@usfamily.net" target="_blank">mailto:zenllc@usfamily.net</a>]
<br>
<b>Sent:</b> Wednesday, October 01, 2014 8:53 AM<br>
<b>To:</b> <a href="mailto:pharmwaste@lists.dep.state.fl.us" target="_blank">pharmwaste@lists.dep.state.fl.us</a><br>
<b>Subject:</b> FW: Alameda County Drug ordinance upheld by federal appeal court!!! WooHoo!!!<br>
<b>Importance:</b> High</span><span style="color:black"><o:p></o:p></span></p>
</div>
</div>
<p class="MsoNormal"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D">This opens the door for EPR in all the states. Along with the new rules for CS management not only will the burden be shifted from the public—although management of the waste should have oversight, maybe we
will also see some source reduction. </span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D"> </span><span style="color:black"><o:p></o:p></span></p>
<div>
<p class="MsoNormal"><span style="color:#1F497D">Very truly yours,</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D"> </span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D">Catherine Zimmer, MS, BSMT</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D">Zimmer Environmental Improvement, LLC</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D">St. Paul, MN </span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D">Ph: 651.645.7509</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#1F497D"><a href="mailto:zenllc@usfamily.net" target="_blank"><span style="color:blue">zenllc@usfamily.net</span></a></span><span style="color:black"><o:p></o:p></span></p>
</div>
<p class="MsoNormal"><span style="color:#1F497D"> </span><span style="color:black"><o:p></o:p></span></p>
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<p class="MsoNormal"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black">From:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black">
<a href="mailto:cpsc-pharmaceuticals-listserv@googlegroups.com" target="_blank">cpsc-pharmaceuticals-listserv@googlegroups.com</a> [<a href="mailto:cpsc-pharmaceuticals-listserv@googlegroups.com" target="_blank">mailto:cpsc-pharmaceuticals-listserv@googlegroups.com</a>]
<b>On Behalf Of </b>Heidi Sanborn<br>
<b>Sent:</b> Tuesday, September 30, 2014 4:41 PM<br>
<b>To:</b> CPSC Pharmaceutical Listserv (<a href="mailto:cpsc-pharmaceuticals-listserv@googlegroups.com" target="_blank">cpsc-pharmaceuticals-listserv@googlegroups.com</a>)<br>
<b>Subject:</b> FW: Alameda County Drug ordinance upheld by federal appeal court!!! WooHoo!!!<br>
<b>Importance:</b> High</span><span style="color:black"><o:p></o:p></span></p>
</div>
</div>
<p class="MsoNormal"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black">A federal appeals court rejected a challenge Tuesday by the pharmaceutical industry to an Alameda County ordinance, the first in the nation to require drug manufacturers to pay disposal costs for consumers’
unused medications.<o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black">Drug companies, backed by trade associations and the U.S. Chamber of Commerce, argued that the 2012 ordinance illegally shifts local costs to out-of-state producers and interferes with interstate commerce. But
the Ninth U.S. Circuit Court of Appeals in San Francisco said the county’s measure treats all manufacturers equally and imposes no substantial burden on interstate businesses.<o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black">The ordinance “applies to all manufacturers that make their drugs available in Alameda County — without respect to the geographic location of the manufacturer,” Judge N. Randy Smith said in the 3-0 ruling, which
upheld a federal judge’s decision in the county’s favor. “Given that the ordinance applies across the board, it does not discriminate at all,” nor does it regulate conduct outside the county, he said.<o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black">Smith also noted that pharmaceutical companies collect $950 million a year in sales revenue in Alameda County and could comply with the ordinance at an annual cost of $1.2 million, by the comnpanies’ estimate,
or $330,000 by the county’s estimate. The companies could recoup their costs by raising prices in Alameda County by one cent for each $10 in sales, said Arthur Shartsis, a lawyer for the county.<o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black">The court’s affirmance of local regulation was crucial, Shartsis said, because “the pharmaceutical industry has the lobbying power to stop these kinds of programs at the state level. It does not have the power
to stop them at the county level.”<o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black">Pharmaceutical Research and Manufacturers of America, which sued to overturn the ordinance, was not immediately available for comment. The organization could ask the U.S. Supreme Court to review the ruling.<o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black">The ordinance was approved by county supervisors in July 2012 and is still in the process of being implemented. It requires makers of prescription drugs sold in the county to fund a program that picks up and
disposes of leftover drugs.<o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black">Alameda County now operates and pays for about 30 drop-off sites where consumers can discard their pills. County officials who backed the ordinance said drug companies should bear the cost of cleaning up their
products for the sake of the environment and their customers’ health. The Natural Resources Defense Council, city and county governments and Attorney General Kamala Harris filed arguments asking the court to uphold the ordinance.<o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black">Bob Egelko is a San Francisco Chronicle staff writer. E-mail:
<a href="mailto:begelko@sfchronicle.com" target="_blank">begelko@sfchronicle.com</a>. Twitter: @egelko<o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black">For the ruling: <o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black">UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT - PHARMACEUTICAL RESEARCH & MANU V. COUNTY OF ALAMEDA Opinion
<o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black"><a href="http://cdn.ca9.uscourts.gov/datastore/opinions/2014/09/30/13-16833.pdf" target="_blank">http://cdn.ca9.uscourts.gov/datastore/opinions/2014/09/30/13-16833.pdf</a><o:p></o:p></span></p>
<p class="MsoPlainText"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;color:black">Bill Pollock</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;color:black">Program Manager</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;color:black">Alameda County Household Hazardous Waste program</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;color:black">1131 Harbor Bay Parkway M/S51701 (mailing address only)</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;color:black">Alameda, CA 94502</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;color:black">510-670-6460 Fax 510-293-9374</span><span style="color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:black"> <o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Times New Roman","serif";color:black">--
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