Drugs in the WaterDrugs in the Water

Why Should We Care?Why Should We Care?

Things we thought were Things we thought were right…right…• In 1975 I thought oil In 1975 I thought oil

from my Dad’s from my Dad’s Chevy was supposed Chevy was supposed to be disposed of to be disposed of behind the garage. behind the garage.

• In college chemistry In college chemistry classes, we thought classes, we thought it was O.K. to clean it was O.K. to clean our equipment with our equipment with toxic chemicals. toxic chemicals.

Things we thought were Things we thought were right…right…• 1n 1995 I thought fluorescent light bulbs 1n 1995 I thought fluorescent light bulbs

were O.K. to land-fillwere O.K. to land-fill

• In 2007 I thought drugs were safe to flush In 2007 I thought drugs were safe to flush down the toiletdown the toilet

• Until 2007, I thought your body burned up Until 2007, I thought your body burned up medicine and it was gonemedicine and it was gone

I was wrong.I was wrong.

sorry.sorry.

What we need to What we need to UnderstandUnderstand

• PharmaceuticalsPharmaceuticals• DrugsDrugs• MedicinesMedicines

They are all They are all CHEMICALSCHEMICALS

che·mo· ther·a·pyche·mo· ther·a·py :: the use of chemical agents in the the use of chemical agents in the treatment of a medical condition. treatment of a medical condition.

The Bad Side of Good DrugsThe Bad Side of Good Drugs

• Effective drugs for the treatment of cancer Effective drugs for the treatment of cancer often contain properties of which the side-often contain properties of which the side-effects are extremely dangerous and toxic effects are extremely dangerous and toxic to the environment. to the environment.

• Common drugs are being found in most fish Common drugs are being found in most fish populations and affecting them.populations and affecting them.

• Making their way to our drinking water Making their way to our drinking water supply.supply.

MERCK Safety Data Sheet - MERCK Safety Data Sheet - MustargenMustargen

This Drug May Cause:This Drug May Cause:

• CancerCancer

• Heritable Genetic DamageHeritable Genetic Damage

• Harm to the Unborn ChildHarm to the Unborn Child

• Very toxic by inhalation Very toxic by inhalation and if swallowedand if swallowed

• Cytotoxic agentCytotoxic agent

How Dangerous are Many How Dangerous are Many Hazardous Drugs? Hazardous Drugs?

• So Dangerous that the Drug So Dangerous that the Drug companies are subcontracting their companies are subcontracting their manufacture off-site to limit their manufacture off-site to limit their liability to reduce exposure to their liability to reduce exposure to their own workforce.own workforce.

• Some of the doses of these drugs Some of the doses of these drugs are in the nano-gram per liter some are in the nano-gram per liter some in pico-gram per literin pico-gram per liter

This is where Hazardous Drugs get their Start

This is Where the Most Toxic This is Where the Most Toxic Drugs are PreparedDrugs are Prepared

Fundamental QuestionFundamental Question

• How well do you know how your How well do you know how your disposal methods are impacting our disposal methods are impacting our environment?environment?

Health facilities flush Health facilities flush estimated 250M pounds of estimated 250M pounds of drugs a year.drugs a year.USA Today September 14 2008USA Today September 14 2008 • Treating the toilet as a Treating the toilet as a

trash can isn't a good trash can isn't a good option," says Ben option," says Ben Grumbles the EPA's Grumbles the EPA's top water top water administrator administrator

• Why do we flushWhy do we flush

• DEA, Medicare DEA, Medicare

• Keep away from Keep away from childrenchildren

Once Administered, Where does Once Administered, Where does the Chemical Waste Go in Your the Chemical Waste Go in Your Facility?Facility?

Trash Red Bag

Chemo Flush Returns Patient Home

Hazardous Waste

Know what you don’t Know what you don’t know……know……• Identify all locations for waste Identify all locations for waste

pharmaceuticals within your facility.pharmaceuticals within your facility.

• Identify the chemicals (drugs) in your Identify the chemicals (drugs) in your facility.facility.

What can we doWhat can we do

• Audit your complete disposal options Audit your complete disposal options for unused and used for unused and used pharmaceuticals.pharmaceuticals.

• Review nursing management Review nursing management practices for wasting medicine.practices for wasting medicine.

• Understand how your disposal Understand how your disposal methods are impacting the methods are impacting the environment.environment.

The healthcare industry is not The healthcare industry is not the whole problemthe whole problem

• Disposal of unused drugs is only part Disposal of unused drugs is only part of the problem.of the problem.

Again, why do we care? Again, why do we care?

• WILL it become regulated?WILL it become regulated?

• We will be held responsible?We will be held responsible?

• So be Proactive. So be Proactive.

Thank You!Thank You!

James T.F. MullowneyJames T.F. Mullowney