Medical waste haulers and incineration firms that specifically handle chemotherapy waste routinely specify in their waste acceptance protocols that only paraphernalia such as tubing, gloves, gowns, and EMPTY vials, syringes, and IVs can be accepted for disposal. These items are considered trace chemotherapy and should be incinerated at a regulated medical waste incinerator to prevent employee exposure during autoclaving, micorwaving, or other alternative treatment.

Bulk chemotherapy waste should be managed as hazardous chemical waste, even though EPA regulations have not been updated in this area. As a result, the EPA only regulates nine chemotherapy drugs as hazardous chemical waste. These nine drugs, arsenic trioxide, chlorambucil, cyclophosphamide, daunomycin, diethylstilbestrol, melphalan, mitomycin C, streptozotocin, and uracil mustard, must be segregated from yellow or white trace chemotherapy waste containers, red sharps containers, or red bags, and placed into RCRA hazardous waste containers when present in bulk amounts. For more information on these containers, check out our resources under hazardous waste handling information and containers.

Since many of the non-regulated chemotherapeutic agents are at least as hazardous as the nine listed chemotherapy drugs, good risk management should involve treating all bulk chemotherapy agents as hazardous waste when discarded.

In addition, chemotherapy spill clean-up materials have traditionally been placed in yellow or white chemotherapy waste containers. Since these absorb more than trace amounts, they should be placed into hazardous waste containers.