What is Cytotoxic Waste?

Cytotoxic waste must be disposed of to avoid its harmful effects after exposure.

Cytotoxic waste is waste associated with cytotoxic drugs which contain chemicals that are toxic to the cells. This includes materials, equipment, and residue that are contaminated by cytotoxic drugs.

Cytotoxic drugs, which are also called antineoplastics, are usually administered to people with cancer and diseases like multiple sclerosis because they prevent the replication and growth of cells. Since the abnormal cells causing these illnesses grow rapidly and uncontrollably, aggressive medication such as cytotoxic drugs are needed to impair and eradicate them quickly.

Risks involved in being exposed to cytotoxic waste

People who work in healthcare settings are at risk of being exposed to cytotoxic waste. Cytotoxic waste may be inhaled, ingested, absorbed by the skin or through percutaneous injury. Patients who take cytotoxic drugs excrete bodily fluids that are contaminated with cytotoxic waste. They must be considered contaminated for up to seven days, and must take the highest precautions. Relatives, nurses, and caregivers must be properly protected when handling excreta and must dispose of it properly.

Although they have the capacity to cure, cytotoxic drugs affect the body in ways that cannot be controlled. They have as much capacity to destroy healthy cells as the unhealthy ones. Because of their inability to target specific cells, they produce a lot of side effects.

Types of cytotoxic waste

Here are some examples of materials that come into contact with cytotoxic drugs and are considered as cytotoxic waste:

• syringes
• vials
• gloves
• needles
• respirator masks
• personal clothing and equipment
• air filters

The handling of cytotoxic drugs poses a lot of danger – from to preparation of the drug, to the administration to the patient, to its disposal. Because of its toxicity, cytotoxic waste must be segregated and disposed properly.

Mixing cytotoxic waste with other wastes will render them hazardous. As such, they must then be disposed of properly. The most acceptable and safest way to dispose cytotoxic waste is through incineration.

How to handle cytotoxic waste

Here are some guidelines on

 how to handle cytotoxic waste.

1. The preparation of cytotoxic drugs must only be administered by trained personnel.
2. All personnel who work with cytotoxic drugs and waste must use the proper protective clothing and gear. They should wear protective gown, mask, head wear, gloves, shoes, and goggles.
3. Clothing that is contaminated with cytotoxic waste must be placed separately in labelled laundry bags. Those who are tasked to wash contaminated clothing must also wear protective clothing and gear.
4. Solid cytotoxic waste materials must be disposed in a double bag or in an impenetrable container and must be labelled and incinerated.
5. All waste containers must be labelled and properly sealed.
6. Waste containers must be stored in a secure area and must be maintained regularly.
7. Patient waste with low cytotoxic waste content may be disposed of in a sewage system.
8. Drivers who are assigned to transport cytotoxic drugs and waste must be informed that they are transporting dangerous and hazardous substances.
9. Procedures and specifications must be written on wastes on how to handle and dispose of them properly.
10. Cytotoxic drugs that have not been administered must be returned to the pharmacy.

Cytotoxic waste must be handled with care

Cytotoxic waste, because it is highly toxic, must be handled with utmost care, otherwise, it can be dangerous to those who are exposed.

Here are some of the risks if you are exposed to cytotoxic wastes:

• allergic reactions
• risk of mutation and formation of abnormal cells
• severe soft tissue damage
• abdominal pain and liver damage
• hair loss
• possibility of foetal loss in pregnant women
• nausea and vomiting

Protection against cytotoxic waste

According to the Environmental Protection Act 1994, cytotoxic waste must be incinerated under its authority. Workplaces that are at risk of cytotoxic waste must have safe systems of storage, segregation, and disposal. All workers must be properly equipped, dressed, informed, and trained to handle cytotoxic waste and they should be monitored regularly for compliance.