Why Trace Chemotherapy Waste Requires Incineration

Although it’s an extremely critical procedure for treating cancer and other medical conditions, chemotherapy produces one of the most dangerous wastes in the medical world. That’s why, when it comes to the disposal of medical wastes, healthcare professionals need to develop an effective medical waste management strategy. Ensuring your medical facility staff and visitors are safe from such toxic wastes is vital when disposing of trace chemotherapy drugs.

Some of the drugs used in chemotherapy, such as antineoplastics and cytotoxics, are highly toxic agents that can lead to serious health issues for your medical facility staff. This is especially true if proper handling, managing, and disposal of such wastes are not maintained.

To ensure your staff is safe, your healthcare organization needs to develop a clear medical waste management and disposal plan to prevent possible exposure and risks.

Understanding Trace Chemotherapy Waste

Trace chemotherapy waste is made up of materials that are used to prepare and administer chemotherapy drugs and includes all contaminated equipment such as Personal Protective Equipment (PPE) and supplies used in the process.

These are hazardous drug wastes, IV bags, and syringes classified by the Resource Conservation and Recovery Act (RCRA) as empty, meaning they contain no more than 3% of the drugs used. Since only residual amounts of the drugs remain, trace chemo waste is classified as non-hazardous.

Trace chemotherapy waste is pharmaceutical waste and therefore, should not be autoclaved. Incineration is the proper disposal method, because other methods do not destroy the cytotoxic nature of the drug residue. It must legally go through waste incineration, which exposes the waste to extremely high temperatures. The waste is reduced to ash (or nearly ash), rather than going through an autoclaving process.

Understanding Bulk Chemotherapy Waste

Bulk Chemotherapy waste, on the other hand, includes all types of chemotherapy waste that do not qualify as “RCRA empty,” meaning these items and equipment contains more than the 3% trace amount of chemo drugs—and are therefore contaminated with toxic chemotherapy agents. These items may include unused or partially empty IV bags, syringes, or vials and materials used to clean up chemo spills.

Bulk chemo waste is collected in black disposal containers used in hazardous medical waste disposal. These items are then picked up by authorized vehicles and personnel for safe, regulated disposal by incineration in an approved incinerator for hazardous waste.

Types of Trace Chemotherapy Waste

The following are the different types of trace chemotherapy waste:

  • Containers such as empty vials, IV bags, and syringes used to hold antineoplastics. They must be completely empty to be classified as trace chemotherapy waste. Also, to be incinerated, you must place them in yellow waste containers.
  • Soft chemo waste: All PPE, including gowns, goggles, gloves, tubing saturated with chemo drugs, and antineoplastics. They should also be kept in the yellow waste containers for incineration.
  • Sharps Chemo Waste: These include needles saturated with antineoplastics. They have designated sharp waste disposal containers managed and regulated by medical waste disposal authorities. Again, these are yellow containers; otherwise, sharps containers would be managed as medical waste and treated by autoclave, which is not appropriate treatment for any pharmaceutical waste.

Recommended Disposal Options For Trace Chemotherapy Waste

All types of chemotherapy wastes should be reviewed first before ascertaining if they can be classified as expired, discontinued, or unused chemo drugs. From there, some can be donated to cancer facilities for reuse programs. They can also be given to pharmaceutical manufacturing companies that accept unused or unopened chemo drugs for recycling.

Otherwise, they can be donated to reverse distributors. Always consult with your trace chemotherapy waste disposal service provider to determine which options are available in your area. Otherwise, any chemotherapy drugs that cannot be administered, donated, or returned are classified as toxic waste.

Handling Non-Hazardous And Trace Chemotherapy Waste

All contaminated gowns, gloves, and other types of PPE are classified as soft chemo wastes. These should be placed in specialized plastic containers with the label “Trace Chemotherapy Waste.”

According to industry standards, all medical facilities must use yellow containers to keep this type of waste. All sharps chemotherapy waste saturated with chemotherapy drugs should be disposed of in a designated container for sharps waste. These should be handled as biohazardous medical waste. If trace chemotherapy waste is accidentally mixed with other infectious medical waste, all of the waste should be handled as trace chemo and incinerated. Therefore, it’s important to properly segregate your waste streams to avoid increased risk and unnecessary costs.

Once contained within proper guidelines and standards, these chemo wastes should be transferred to a qualified pharmaceutical waste disposal company.

To avoid the danger and liabilities associated with hazardous or infectious agents, this standard procedure should be followed when handling all trace chemotherapy waste.

Final Note

Medical waste carries highly potent and infectious characteristics that can pose significant health risks to your hospital staff, be it healthcare workers or housekeeping employees. Most chemotherapy drugs are highly cytotoxic. This means they can potentially kill living cells in the body. And since such drugs are not typically classified as infectious, they can be corrosive. If not disposed of properly, these toxic wastes can cause considerable harm to human health and natural resources.

We are a highly qualified, full-service medical waste disposal company that helps healthcare organizations like yours conduct safe medical waste management practices. We provide effective and efficient chemotherapy waste disposal services in compliance with state and federal regulations. Contact us today to learn more.


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