Managing Pharmaceutical Waste: A 10 step Blueprint for Health Care Facilities in the United States

The discovery of a variety of pharmaceuticals in surface, ground, and drinking waters around the country is raising concerns about the potentially adverse environmental consequences of these contaminants.  Minute concentrations of chemicals known as endocrine disruptors, some of which are pharmaceuticals, are having detrimental effects on aquatic species and possibly on human health and development. The consistent increase in the use of potent pharmaceuticals, driven by both drug development and our aging population, is creating a corresponding increase in the amount of pharmaceutical waste generated.


Pharmaceutical waste is not one single waste stream, but many distinct waste streams that reflect the complexity and diversity of the chemicals that comprise pharmaceuticals. Pharmaceutical waste is potentially generated through a wide variety of activities in a health care facility, including but not limited to intravenous (IV) preparation, general compounding, spills/breakage, partially used vials, syringes, and IVs, discontinued, unused preparations, unused unit dose repacks, patients’ personal medications and outdated pharmaceuticals.

In hospitals, pharmaceutical waste is generally discarded down the drain or landfilled, except chemotherapy agents, which are often sent to a regulated medical waste incinerator. These practices were developed at a time when knowledge was not available about the potential adverse effects of introducing waste pharmaceuticals into the environment.

2006 version: https://noharm-global.org/sites/default/files/documents-files/73/Managing_Pharma_Waste_H2E.pdf

2008 revision:  http://www.hercenter.org/hazmat/tenstepblueprint.pdf

Type of Document: 
Hospitals for a Healthy Environment
Published Year: