The first step in disposing of pharmaceutical waste is to separate the hazardous waste from the non-hazardous. At a health care facility, staff has traditionally done that sorting. But Clean Harbors Inc. recently began offering to handle the sorting for health care providers. Will the availability of a service like this change pharmaceutical waste collection?

Clean Harbors calls its new service the One Container Program since it enables medical waste generators to dispose of all waste in one bin. The Norwell, Mass.-based hazardous waste company custom designs the program depending on how much the generator wants it to do.

The sorting of pharmaceutical waste requires extensive staff training and effort, the company says. The biggest danger is a slip-up that will land a health care operation in violation of the U.S. Environmental Protection Agency (EPA) Resource Conservation and Recovery Act (RCRA). Non-compliance with RCRA rules can result in fines of up to $37,500 per day, per incident.

“Our research shows that between five and 40 percent of hazardous pharmaceutical waste is misclassified as non-hazardous,” says John Kelsey, vice president, pharmaceutical, biotech and health care for Clean Harbors. “That means that a state or federal inspection on any given day at virtually any health care facility in the country will reveal misclassified hazardous wastes that could result in regulatory action.”

Kelsey, in an email interview, also points out the challenges of managing compliance with health care staff. There are the issues of training, staff turnover and confusion over what is considered hazardous under RCRA. There also is the issue of items that are not on the RCRA hazardous list but have hazardous characteristics, such as the blood thinner Heparin.

Industry experts, Kelsey says, claim only 15 to 20 percent of hospitals and a much smaller amount of other health care facilities have active pharmaceutical waste disposal programs in place that meet EPA disposal guidelines. There also are growing environmental concerns surrounding unacceptable levels of pharmaceuticals in groundwater.

In addition, health care providers are usually working under time pressure and stress. “Often times the pharmaceutical is going into the closest container, no matter what color code it is,” Kelsey says.