1. In addition to promoting Environmental Stewardship, there are regulations that apply to the management and disposal of pharmaceutical wastes What are healthcare facilities required to do? –Manage all identified Hazardous Waste generated within the facility (Pharmaceuticals, Lab Wastes, Engineering, Solvents, etc.). This program concentrates on the Pharmaceutical Wastes –Some Pharmaceuticals are considered hazardous to the Environment and therefore IU Health Physicians will manage accordingly –Rules and Regulations (EPA, IDEM, DOT) Federal: US Environmental Protection Agency –Rules developed in 1976, recently began looking at Healthcare State: Indiana Department of Environmental Management (IDEM) Additional Regulations – Department of Transportation (when shipping), Sewered Waste (drain disposal). 1 Pharmaceutical Waste- Why the New Change?

2. What this means to you: New bins will be placed in practice/clinic for the collection of pharmaceutical wastes. Pharmaceutical wastes will need to be segregated in accordance with the color coded poster in each collection area. Several current practices will not be affected by the change. Implementation is planned for the end of December 2015 early January 2016 2

3. 3 Waste Stream Management Items that can be poured down the drain Plain IV Solutions Solutions containing additives, such as:  Potassium chloride  Potassium phosphate  Sodium phosphate  Calcium  Sodium bicarbonate  Magnesium Sulfate Controlled Substances Discharge to Drain Sewer System Rx Waste “Dispose in Black Container” Items identified with a message or sticker Examples  Insulin  Some Multivitamins  Digoxin  Cumadin packaging  Nicotine Packaging  Medication Samples  Heparin  Lidocaine  Botox Miscellaneous  Rx Spill Cleanup Debris  Rx in sharp – Discharge into gauze, gauze in container, sharp item to SHARPS Dispose in Black Container Incompatible Rx Waste Incompatible Rx Wastes Require Segregation to Meet DOT, Safety & Disposal Requirements Place in clear zip lock bag  Aerosols such as: Albuterol, Dermaplast  Unused Silver Nitrate Designated Small Black Container Chemotherapy Rx and containers that are NOT empty  Chemo Agents  IVs with Residual Chemo Agents  Chemo Spill Cleanup Debris  Vials with Residual Chemo Agents  Tablets, caps etc. Dispose in Black Container Chemo Waste SHARPS  Needles  Empty syringes  Empty ampoules SHARPS  Needles  Empty syringes  Empty ampoules REGULAR TRASH  Outside packaging and overwrap that did not contact Rx  Regular Trash  Shipping packaging REGULAR TRASH  Outside packaging and overwrap that did not contact Rx  Regular Trash  Shipping packaging “P” Waste Nicotine Gum Nicotine Patches Nicotine Wrappers Designated Small Black Container