Hazardous pharmaceuticals commingled with medical waste

Under very certain conditions, the EPA will allow the commingling of hazardous pharmaceuticals waste with medical waste, (also known as biohazardous waste or infectious waste). The reason for this is that most small offices have such tiny amounts of hazardous waste that the EPA has made the rules slightly less stringent for these small generators

Rule number 1

No P-listed hazardous waste can ever go in a medical waste stream. The containers themselves can be disposed of in the regular waste stream ONLY if they have been triple rinsed. The rinsing agent has to be treated as hazardous waste, though. To keep things simple, keep P-listed pharma waste OUT of the medical waste stream. Here is a partial list of P-listed compounds:

Example RCRA P-Listed Waste Codes

Note: must contain constituent as sole-active ingredient and be unused or discarded

Waste Code

Constituent of Concern  Product Name Examples:

P001

Warfarin & salts (concentration > 0.3%) Coumadin; Warfarin

P012

Arsenic trioxide Trisenox

P042

Epinephrine Adrenalin; EpiPen; Eppy/N; Epifrin; Epinal; Anaphalaxis kit; Epinephrine (inhalants, injectibles, kits); Racepinephrine; Racord; Primatene aerosol inhaler

P046

Phentermine Phentermine (CIV)

P075

Nicotine & salts Nicotine patches; Habitrol; Nicoderm; Nicorette; Nicotrol; Tetrahydronicotyrine (OK to dispose of used nicotine patches, though)

P188

Physostigmine salicylate aka Eserine salicylate

P204

Physostigmine aka Eserine

 

Rule number 2

If the hazardous material has lost the characteristic that made it dangerous, it can be safely disposed in the medical waste stream. (i.e., its toxicity, flammability, corrosively, or reactivity) under some conditions. For U-listed pharamceuticals, all of the medicine has to be administered so that the amount remaining in the syringe or tubing is as empty as possible (no more than 3%). Any pure  unused pharma must be disposed of as hazardous waste.

 

Example RCRA U-Listed Waste Codes

Note: must contain constituent as sole-active ingredient and be unused or discarded

Waste Code

Constituent of Concern  Product Name Examples:

U010

Mitomycin C Mitomycin; Mitomycin C; Mutamycin; Mutamycin VHA Plus

U015

Azaserine Chemotherapy for leukemia

U034

Chloral / Chloral hydrate Chloral hydrate (CIV)

U035

Chlorambucil Leukeran

U044

Chloroform Not commonly seen

U058

Cyclophosphamide CTX; Cytoxan injection, Lycophilized/VHA Plus; Neosar; Procytox

U059

Daunomycin Daunorubicin, Cerubidin, DaunoXome, Rubidomycin; Liposomal; Idarubicin/Idamycin; Daunomycin

U075

Dichlorodifluoromethane Dichlorodifluoromethane

U089

Diethylstilbesterol Diethylstilbestrol, DES (synthetic estrogen), Stilphostrol

U121

Trichloromonofluromethane Trichlorofluoromethane

U129

Lindane G-Well shampoo; Kwell; shampoo

U132

Hexachlorophene Phisohex disinfectant

U150

Melphalan Alkeran; L-PAM; Melphalan

U151

Mercury Mercurochrome; Mercury iodide; Mercury chloride; Mercury sulfate

U182

Paraldehyde Paral; Paraldehyde (CIV)

U187

Phenacetin Acetophenetidin; typically veterinary

U188

Phenol Phenol; Liquified phenol

U200

Reserpine Resperine

U201

Resorcinol Resorcinol

U205

Selenium sulfide Exsel shampoo; selenium sulfide; Selsun

U206

Streptozotocin Streptozotocin; Streptozocin; Zanosar

U237

Uracil mustard Not commonly seen: Uracil mustard; Uramustine

U248

Warfarin & salts (concentration ≤ 0.3%) Warfarin

 

Rule number 3

If you are not sure, contact Medmentum. We are here to help!

(Tabular data courtesy of State of Washington Department of Ecology)

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