E-DRUG: Guidelines on pharmaceutical waste disposal (2)
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Dear Manusika Rai and others
Please consult the following WHO documents and links (please correct hyperlinks if broken):
Guidelines for Safe Disposal of Unwanted Pharmaceuticals in and after Emergencies. WHO/EDM/PAR/99.2
http://www.who.int/water_sanitation_health/medicalwaste/unwantpharm.pdf
Healthcare waste and its safe management.
http://www.healthcarewaste.org/en/115_overview.html
Management of waste from injection activities at district level: guidelines for district health managers.
http://www.who.int/entity/water_sanitation_health/medicalwaste/mwinjections.pdf
Management of wastes from immunisation campaign activities. Practical guidelines for planners and managers.
http://www.who.int/water_sanitation_health/medicalwaste/phe_wsh_immunizationcampaign.pdf
Safe management of wastes from health-care activities.
www.who.int/entity/injection_safety/toolbox/docs/en/waste_management.pdf
(Also search for it under WHO publications at www.who.int. Individual chapters are available for download as pdf)
Please note that these do not deal with the more tricky question of disposing of unwanted pharmaceuticals from households. A number of developed countries are now introducing/have now introduced guidelines but they are not always consistent or easy to implement and are probably not appropriate in many developing countries. Generally speaking it is recommended to have the waste thrown out in the household garbage destined for solid landfill. Washing down the drain is not recommended due to contamination of underground and surface water (even treated drinking water shows traces of organic pharmaceutical compounds in some areas of some developed countries [limited studies]). Reverse distribution networks (return of unwanted medicines through pharmacies or other health outlets) and DUMP campaigns (Dispose of Unwanted Medicines Properly) can reduce the burden which is otherwise thought to be small compared to that of the unwanted medicines from health facilities and which are excreted into the sanitary system from patients.
Regards
Douglas Ball
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Pharmaceutical consultant
Manila, Philippines
douglasball[AT]yahoo.co.uk