How to Dispose of Chemotherapy Waste

Environment Services

 When it comes to collection, segregation, and disposal, it is not just the pharmaceuticals or medications used in chemotherapy delivery that are a concern. What do you do with the tubing, needles, and packaging that the chemo medications arrived in? Is chemotherapy waste treated as hazardous or medicinal waste? Let's start with industry definitions, and then we'll walk you through how to appropriately segregate chemotherapeutic waste at your facility. When it comes to chemotherapy treatments, chemotherapy or trace chemotherapy waste is generated during the preparation or administration of chemotherapy, but not all of it comes into touch with the chemotherapy agent. So, how are these products sorted?



Trace chemotherapeutic trash can comprise IV tubing, medicine bags, vials, or any other component of the tube and needle system used to deliver chemotherapy drugs to patients. However, personal protective equipment (PPE), towels, wipes, and pads may come into touch with chemotherapy medications, thus safe disposal is required. Chemotherapy waste is classified as hazardous waste by the EPA and is managed as medical waste through incineration.

State Guidelines Are More Strict than Federal Guidelines
Every state has its own set of criteria for disposing of chemo waste, but all federal, state, and municipal regulations must be adhered to. For example, New Hampshire's management and disposal recommendations for U-listed antineoplastic (chemo) wastes provide precise guidance on how chemotherapeutic waste should be handled, in addition to adhering to federal criteria.

Because states around the country have varied criteria for storing and disposing of chemotherapeutic waste, it is necessary to become familiar with local and state regulations, as well as federal recommendations forward and backward. Some states require that all chemotherapy waste be treated as a hazardous waste product and separated from other types of waste. Others vary in phrasing and requirements.

Chemotherapy Waste Segregation
Special containers made for chemotherapy waste can aid in the separating procedure. For example, sharps are used to administer chemotherapy. In such cases, not every sharps container is designed to hold all sharps waste. We make it easy to separate chemo waste from other waste streams by offering single-use or reusable chemotherapy collectors and sharps containers in a variety of sizes. Some are intended for small-scale generators and compact spaces. Some are disposable, while others are reusable. When it comes to distinguishing between waste streams, use various colored containers and caps.

Understanding Trace and Bulk Chemotherapy Waste
If a chemo drug waste is designated as a HWP (Hazardous Waste Permitting) by RCRA and contains more than 3% residual drug, it is referred to as "bulk chemo waste" and must be managed as hazardous waste (not chemotherapy waste) and disposed of in a black RCRA container. However, if the container (or waste item) is judged "RCRA-empty" (only residual remaining) or if only trace levels of the chemotherapy or antineoplastic agent remain on the waste materials, this is classified as "trace chemo waste". Items used to administer chemotherapy and antineoplastic medicines that may be contaminated with trace or bulk levels of chemotherapeutic medications include:
  • Disposable gloves
  • Drapes
  • IV bags, tubing
  • Bandages/dressings
Bulk Chemotherapy Waste/RCRA
A container containing trace amounts of RCRA 'empties' and byproducts must be stored in separate containers with clearly labeled labels for "incineration only" or "chemotherapy waste" according to state regulations. Every state facility must confirm the protocol for removing such containers from their site, including with their medical waste company.

Bulk chemo waste must be stored in an RCRA-rated container; black containers are the industry norm, but color is irrelevant. Bulk chemotherapeutic waste refers to any chemotherapy waste that is not RCRA-empty. This may include but is not limited to, half-empty IV bags, vials, or syringes. Any goods utilized to clean up a chemo leak are classified as bulk chemo waste.
Such garbage must be stored in containers designated by the Department of Transportation (DOT) for hazardous material transportation and accurately labeled as hazardous pharmaceutical waste, per highly precise DOT danger classifications.

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