Did you know that an improperly handled container of chemotherapy waste could put an entire healthcare facility at risk? Not only can chemotherapy waste cause immediate harm to healthcare workers, but it can also lead to the development of long-term side effects. For this reason, medical staff need to be trained in the proper handling of chemotherapy waste. In this article, we explain the identification, handling, storage, and disposal of chemotherapy waste to ensure your facility stays safe and compliant.
What Is Chemotherapy Waste?
Chemotherapy waste includes products contaminated with drugs used to destroy cancerous cells. These substances are extremely hazardous, as they can damage healthy cells through skin contact, particle inhalation, or needle stick injuries. Even small amounts of chemotherapy waste can be harmful, which is why chemotherapy waste disposal should be carried out with extreme caution.
There are two types of chemotherapy waste: trace chemotherapy waste and bulk chemotherapy waste. Trace chemotherapy waste is any material that contains a residual amount of chemotherapy compounds (3% or less of the original volume). Bulk chemotherapy waste, on the other hand, contains larger quantities of chemotherapy compounds and must be disposed of following the EPA’s hazardous waste regulations.
The following are common examples of chemotherapy waste:
- Drug Administration Equipment: Tools and devices used during drug preparation and administration to patients, such as needles, syringes, drug vials, and IV tubing.
- Personal Protective Equipment: Protective gear that becomes contaminated while handling these drugs, including gloves, face masks, and protective gowns.
- Patient Care Materials: Items used when treating and caring for patients receiving chemotherapy therapy, such as absorbent pads, cotton balls, bandages, adult diapers, and bed sheets.
- Bodily Substances: Body fluids and waste from patients receiving treatment, including urine, feces, vomit, and blood.
How Is Chemotherapy Waste Disposed of?
Proper handling of chemotherapy waste protects healthcare workers, patients, and the wider community from exposure. Here are the best ways to safely dispose of chemotherapy waste:
Segregation
Healthcare workers usually separate chemotherapy waste from other medical waste using a color-coding system. Chemotherapy items are normally placed in yellow containers—non-sharps in bags and medications and sharps in puncture-proof, leak-proof containers. Clear segregation prevents dangerous mix-ups and enables each type of waste to be treated appropriately, reducing the risk of contamination.
Double Bagging
Chemotherapy waste requires extra protection in double bags or leak-proof containers. Double bagging decreases the likelihood of tears, punctures, and spills during handling and transportation. Chemotherapy waste containers must be properly sealed as well. Even items like contaminated IV tubing and gloves require this added protection.
High Heat
Chemotherapy waste must be incinerated at 1200°C or more. The extreme heat breaks down the toxic substances completely, eliminating their potential to cause harm. Where high-temperature incineration is unavailable, encapsulation may be used, though it is considered less effective.
Tips for Safely Handling Chemotherapy Waste
Chemotherapy waste has to be handled carefully to prevent contamination. Healthcare workers at your facility should follow these strategies to ensure a safe working environment:
Do not throw liquid chemotherapy waste down the drain or toilet.
Pouring chemotherapy liquids down the drain or toilet poses a safety risk. Contaminated liquids should be stored in leak-proof containers until they can be treated.
Do not dispose of solid chemotherapy waste in the regular trash or red biohazard bags.
Solid chemotherapy materials should never go in the regular trash or red biohazard bags. These materials belong in yellow bags or containers that warn waste handlers of their contents.
Wear PPE to avoid skin contact and inhalation.
Wearing gloves and, if necessary, a gown, cap, shoe covers, face protection, and respiratory protection can prevent exposure to chemotherapy chemicals used in medical treatment.
Wash your hands after handling chemotherapy waste.
After handling chemotherapy waste, remove your gloves and wash your hands with soap and water for at least 20 seconds to remove any residue that may have gotten beneath your gloves.
Minimize the risk of contaminating surfaces with absorbent pads.
A disposable, plastic-backed absorbent pad should be used when cleaning chemotherapy vials so that spillage is contained. Once the procedure is finished, the surface beneath the pad should be cleaned as a precaution.
Implement a standard procedure for cleaning up chemotherapy spills.
Healthcare facilities should have a standardized procedure for managing chemotherapy spills of powders and liquids. Healthcare workers wearing protective gowns and double gloves should immediately use absorbent pads for liquid spills and wet absorbent gauze for solid substances. The contaminated area should be cleaned with water and soap. All materials used to clean up the spill should be placed in a chemotherapy waste container or bag.
Get OSHA safety training.
All healthcare workers who may come into contact with chemotherapy waste need to be trained on how to handle it properly. OSHA requires that workers exposed to hazardous drugs be trained in the identification of hazardous drugs, appropriate work practices, safety equipment, proper donning of PPE, and emergency procedures for employee exposure. We also recommend documenting safety training to keep track of which employees have been trained.
Do not handle chemotherapy waste if you are pregnant or breastfeeding.
The Oncology Nursing Society (ONS) suggests exempting employees who are planning to get pregnant from handling chemotherapy drugs and waste. Chemotherapy drugs can cause spontaneous abortions, congenital malformations, low birth weight, and fertility issues in developing fetuses. They can also harm breastfeeding infants, which is why pregnant or lactating employees should not be obligated to handle them.
Risks of Exposure to Chemotherapy Waste
When healthcare workers are exposed to chemotherapy substances, their health is at risk. One-time exposure can cause short-term side effects that resolve over time, while repeated exposure can cause irreparable damage. Some of the health risks associated with chemotherapy materials include:
- Skin irritation
- Vomiting
- Dizziness
- Headaches
- Cell mutation
- Soft tissue damage
- Fertility issues
- Abdominal pain
- Nasal sores
- Hair loss
- Liver damage
- Cancer
Contact SWI for Chemotherapy Waste Disposal
Managing chemotherapy waste properly is essential to maintaining the safety of your workplace and the wider community. By hiring a professional disposal provider to handle your facility’s chemotherapy waste, you can ensure compliance with federal and state regulations while eliminating the hassle of having to dispose of your waste on-site. Specific Waste Industries has provided healthcare facilities with waste management solutions for over 45 years. Our team looks after everything from waste collection and transportation to treatment and final disposal. Contact us today for a free quote!