Composition and quantity of cytotoxic waste from oncology wards: A survey of environmental characterization and source management of medical cytotoxic waste

Abstract

Interest in waste drugs as a part of hospital waste in relation to their negative impact on the environment has increased during the past years. Cytotoxic drugs play an important role in the treatment of various neoplastic conditions and are most often used in specialized departments such as oncology and radiotherapy units. In this study an initial inventory of pharmaceuticals and unused pharmaceuticals including hazardous waste drugs and antineoplastic (cytotoxic) chemotherapeutics was provided. By providing a questionnaire, the rate of cytotoxic consumption, residuals of drugs, vial and syringes, needles, gloves and the other cytotoxic waste was measured during a 30-day period in two oncology wards of Qom hospitals in Iran. The results determined that mean production rate of medical waste in two hospital is 435 kg/d and equal to 1.73kg/bed/d, including: 97% infection waste (1.67 kg/ bed/d), 2.5% sharp and syringe waste (43.25 g/bed/d) and 0.5% pharmaceutical waste (8.65 g/bed/d). The rate of cytotoxic waste in the investigated hospitals was 293.5(gr/d) and equal to 0.07 total medical waste. On the other hand the average rate of cytotoxic waste in the oncology departments was 21.5 gr/bed and 16.5 gr / patient. The results determined that over 66% of residuals cyto-toxic drug compounds can be converted in to nontoxic and no genotoxic by chemical degradation. Lack of awareness of health hazards, insuffi cient fi nancial and human resources and poor control of waste disposal are the most common problems connected with healthcare wastes.