Disposal of antineoplastic wastes at the National Institutes of Health

The process of developing disposal guidelines for antineoplastic wastes at the National Institutes of Health (NIH) is described. Because of the large volume of hazardous wastes generated, NIH must comply with Environmental Protection Agency (EPA) guidelines for disposal. Seven antineoplastic agents are defined by EPA as hazardous wastes. Because of the similar toxicities and pharmacologic drugs, NIH officials elected to dispose of all such agents as hazardous wastes. Available options are presented. The NIH procedure divides antineoplastic wastes into trace- and bulk-contaminated categories. Trace-contaminated wastes contain minimal or trace amounts of drugs and are disposed of by one-site incineration. Bulk-contaminated materials (defined as intravenous solutions or containers whose contents weigh more than 3% of the capacity of the container) are disposed of by land internment and incineration at EPA-approved sites. Syringes and i.v. bottles containing antineoplastic drugs are labeled with bright red-orange labels instructing personnel to return the materials to the pharmacy for disposal. General decision-making procedures for other institutions are recommended.