Environment and Pharmaceuticaal Waste
A role of a pharmacist in handling and proper management of pharmaceutical waste.
Oh dear! I just threw an empty strip in a red bin (hazardous waste), will have to transfer it to the green one (non-hazardous). That is what we should be doing, segregating the waste, especially when it comes to pharmaceutical waste. Wait a minute, what about after the metropolitan van collects them? Are they segregated well and dumped safe enough for the environment?
Hi, I am a Pharmacist who works to deliver safe medication to my patients. Moreover, I am also responsible for creating a safe and healthy environment because I consider health care facilities and environment affect each other correlatively. Concerns regarding management of waste generated from pharmaceutical companies that includes waste water, chemicals and solvents from day to day operation and discarded materials from pharmacy stores has always grabbed my attention.
What is a pharmaceutical waste?
Waste materials generated from day to day activities in health care facilities like pharmacy, hospitals and pharmaceutical industries can be classified as pharmaceutical waste. These can be in any form either solids, liquids, sludge or contaminated gases.
Waste generated by hospitals and pharmacy stores: Expired medication, Unused medications by patients, Syringes, IV bags, hazardous waste containing chemotherapy residues, absorbents like gauze and cotton.
Waste generated by pharmaceutical industry: Traces of active chemical ingredients, other chemicals and solvents, expired and analyzed medications, water used for manufacturing and cleaning purposes etc.
Waste generated by household: Unused and expired medications, discontinued medications empty containers and vials.
These pharmaceutical waste are classified further into 3 main categories
Hazardous: These waste can cause potential harm to human health and environment as they are corrosive in nature.
Non- hazardous: These waste materials might not have the tendency to cause potential threat to human and environment but this doesn’t mean that proper management of such waste shouldn’t be done.
How does these waste reach environments?
Global demand of pharmaceutical products has been accelerating as per recent reports. In 2021, Pharma revenues worldwide totalled 1.42 trillion U.S. dollars. As per study done by Department of Industry in Nepal, demand for pharmaceutical products is 53.66 tonnes per year and is expected to grow significantly.
Based on these reports we can determine that the waste produced by such companies might upsurge, especially waste water because water is mostly used in pharma industries for the production of pharmaceutical products, cleaning of equipment, as well as for technical purposes like steam generation and cooling These waste water contains traces of active ingredients and other chemicals. Pharmaceutical compounds may enter environment through different route such as discharge of treated waste water, seepage from land fill, sewer lines and runoff from animals. The effects these residues that leave trace in the environment, plant, soil, water resources, animal and microbial life is largely unknown.
Reports of traces found in research
Studies has reported residues of antibiotics in waste water, for example Ciprofloxacin maybe due to its high water solubility, could be related to antibiotic resistance, threatening the ecosystem. Analgesic, antidepressant, antihypertensive, contraceptive, steroids have been detected in water samples from mg/L to µg/L range. Research paper shows some commonly used medications like acetaminophen (detection frequency 0.32%), codeine (0.16%), sulfamethoxazole (0.41%), caffeine (0.24%), carbamazepine (1.5%) and trimethoprim (0.08%) have been detected in different areas. Reports have confirmed the presence of pharmaceuticals in effluents released from of pharma industries.
What can we do as a pharmacist in their respectives working areas.
a. Knowing nature of waste materials:
Before management of any waste the nature of such should be known, this is especially applicable to chemicals. Chemicals that are used in pharma sector can be highly flammable, corrosive, reactive and toxic, thus choosing an appropriate and safe method to manage these waste is a must. Substances that are ignitable and reactive should be handed and stored carefully even at normal conditions as they can cause explosions or generate toxic fumes when heated or even mixed. Corrosive waste generally has pH less than 2 or higher than 12.5 which can corrode metals and burn skin. Thus, choosing a suitable and safe management techniques based on nature of waste materials is very crucial
b. Deep knowledge about various disposal techniques:
There are various methods to dispose waste but we should be aware about the most suitable method. Incineration is a thermal treatment, mainly applicable for solid materials where substances are subjected to high heat combustion and converting them to residues. Wastes containing pressurized gas containers like aerosols and halogenated chemicals like plastics should never be disposed by this method.
Autoclaving treats substances with saturated steam at a constant pressure for specific time. Microwaving can destroy infectious components and turn it to less hazardous Chemical disinfection is suitable for treating wastes materials like blood and other fluids. Combining disinfectants with chlorine and phenolic compounds can help o achieve destruction of pathogens. Deep burial where half of the pit is covered with biomedical waste then lime is added prior to adding soil can be implied. Secure landfilling is one of the common practice in most of the countries. Both hazardous and non-hazardous waste are disposed of by this method. Landfills are designed in unused lands far from city and residential areas.
Organic waste materials can be broken down anaerobically by this method leading to emission of unwanted gases. But if these gases can be extracted it can further be used to generate electricity. Waste immobilization; encapsulation or intertization is recommended. Syrups and other liquid preparations along with solvents are first diluted then later be discarded in sewage without serious environmental effect.
c. Waste management program:
Pharma industries, regulatory bodies and health care facilities can conduct a waste management program to aware professionals along with other people for safe disposal of medications from particular end. Involvement of all the officials and operators is important in such program so that the need of proper waste management is felt from every level.
Simple yet important messages on segregating a waste can be provided along with the knowledge to identify the type of pharmaceutical waste. Staffs should be aware about either returning the waste to pharmacy store or how to dispose them properly. Posters can be kept in most areas to inform people about correct disposal.
d. Waste segregation:
Segregating the waste at the time of collection is very helpful and saves time for further management of such waste. Appling color-coded stickers on dumping bins like red for hazardous waste and green for reusable waste can be helpful. Supplies sent to emergency department or nursing stores in hospitals can be attached with the same coloured sticker as that of disposal bins. This will help them to dump such waste in respective bins encase the nature of effluent is unknown.
An important approach of waste management is preventing generation of waste itself. Making paper based dispensing packets instead of using plastic bags can be one of them. A pharmacist can plan play a major role in this by encouraging people to reuse second hand products where possible and choosing products that are disposable. First a proper waste management plan should be developed, hazardous and non-hazardous waste should be identified, best disposal techniques should be tested and implemented, this way we can protect our environment and ultimately create a healthy place to live.