Chemotherapy is the use of cytotoxic drugs (anti-cancer drugs) that helps to destroy cancer cells and reduces the chances of it multiplying. Chemotherapy can be given in numerous ways. It can be given orally, as a cream, by introducing drugs directly into the affected area or through a needle that slowly injects the medication through a catheter. If the medication is given via a catheter, it is normally placed in a large vein typically in the neck or chest.
Cytotoxic drugs produce cytotoxic waste that are toxic to cells. It is for this reason that the management of cytotoxic waste should be handled properly.
How one can be exposed to cytotoxic waste
Patients undergoing chemotherapy release bodily fluids that are contaminated with cytotoxic waste. This can pose as a threat to people that are in contact with them such as relatives, nurses, doctors and caregivers.
Cytotoxic waste can be easily inhaled, ingested, absorbed by the skin or transferred through per-cutaneous injuries and it is for this reason that someone that is in contact with patients undergoing chemotherapy should take the highest precautions when being in contact with them. Wearing the proper protective wear is vital and handling cytotoxic waste correctly such as needles and trays shouldn’t be taken lightly.
Cytotoxic drugs are dangerous to a non-cancerous person as it has the capability to harm healthy cells as well as unhealthy ones and because they cannot target specific cells, it may result in the production of many side effects.
Examples of cytotoxic waste
Cytotoxic waste could be any items that has been in contact or contaminated by cytotoxic drugs. These are items such as:
- Syringes and Needles
- Personal clothing and equipment
- Protective clothing (e.g gloves, masks, gowns, etc)
- Air filters
Those in close proximity to cytotoxic drugs from the handling of the drug, the administration process to its disposal should always be on high alert at all times. Due to its level of toxicity, especially towards non-cancer patients, cytotoxic waste must be segregated and disposed properly. Mixing cytotoxic waste with other wastes will consider them hazardous and as such, they must then be disposed properly. The most acceptable and safest way to dispose cytotoxic waste is through thermal treatment such as incineration.
The side effects of being exposed to cytotoxic waste
Due to the high levels of toxicity in cytotoxic substances, those that become exposed to cytotoxic waste and aren’t protected may start to experience similar side effects to patients undergoing chemotherapy.
Side effects such as hair loss, allergic reactions, nausea and vomiting are all mild signs that one may have become exposed to cytotoxic substances. However, in some cases, the side effects may become so severe that it could cause soft tissue damage, abdominal pain and liver damage, possibility of fetal loss in pregnant women and the risk of mutation and formation of abnormal cells.
It is for this reason that there are strict rules when it comes to the management of handling cytotoxic medication and waste.
Handling cytotoxic waste
There are rules and regulations set in place on how cytotoxic medication and waste must be handled to ensure the safety of everyone’s health.
Some basic guidelines on handling cytotoxic waste are as follows:
- The preparation of cytotoxic drugs must only be administered by trained personnel.
- All personnel who work with cytotoxic drugs and waste must use the proper protective clothing and gear. They should wear protective gown, mask, head wear, gloves, shoes, and goggles.
- Clothing that is contaminated with cytotoxic waste must be placed separately in labelled laundry bags. Those who are tasked to wash contaminated clothing must also wear protective clothing and gear.
- Solid cytotoxic waste materials must be disposed in a double bag or in an impenetrable container and must be labelled and incinerated.
- All waste containers must be labelled and properly sealed.
- Waste containers must be stored in a secure area and must be maintained regularly.
- Patient waste with low cytotoxic waste content may be disposed of in a sewage system.
- Drivers who are assigned to transport cytotoxic drugs and waste must be informed that they are transporting dangerous and hazardous substances.
- Procedures and specifications must be written on wastes on how to handle and dispose of them properly.
- Cytotoxic drugs that have not been administered must be returned to the pharmacy.