Composition and production rate of cytostatic pharmaceutical waste from a Greek Cancer Treatment Hospital

The objective of this work was to determine the composition and production rate of cytostatic pharmaceutical waste produced by Theagenion Cancer Treatment Hospital (TCTH) in Thessaloniki, Greece. This information is necessary for the design and costing of management systems for cytostatic pharmaceutical waste, for assessing their environmental impact and for health and safety considerations. A total of 826 kg cytostatic pharmaceutical waste was collected, manually separated and weighed over a period of ten working weeks. Total cytostatic pharmaceutical waste was classified in three categories, vial waste comprising 38.3%, syringe waste with 4.5% and intravenous therapy (IV) waste with 57.2% of the total. Vial waste only was classified according to the active ingredients in alkylating agents, antimetabolites, cytotoxic antibiotics, Vinca alkaloids and “other” antineoplastic drugs. The overall cytostatic waste production by the hospital was 22900(6955) g/d, with numbers in parenthesis representing standard deviations. The average unit production rates of total cytostatic pharmaceutical waste were 140(64) g/patient/d and 201(61) g/bed/d. The respective unit production rates were: (1) for vial waste 41(11) g/patient/d and 77(46) g/bed/d, (2) for syringe waste 5(1.5) g/patient/d and 9(5) g/bed/d and (3) for IV waste 94(63) g/patient/d and 115(43) g/bed/d.