Cytotoxic waste is a type of hazardous waste in nature that is produced by healthcare facilities. It contains chemicals that are toxic to human cells which easily get absorbed by the skin or can enter the human body through inhalation or ingestion. Healthcare equipment like syringes, vials, gloves, needles, masks, air filters, or even personal clothing that are exposed to cytotoxic waste is considered contaminated.

Waste produced by cytotoxic medicines includes compounds that are hazardous to cells. Cytotoxic medications are typically given to patients with cancer and illnesses like multiple sclerosis to stop cell division and growth. Workers in healthcare facilities are in danger of coming into contact with cytotoxic waste.

Cytotoxic Waste Storage

Anyone handling cytotoxic waste is also better protected if it is packaged, stored, and disposed of correctly. Waste generators are in charge of taking care of the proper disposal of cytotoxic waste, whether they are a hospital, a cancer treatment facility, or a pharmacy that sells such medications.

To ensure the preservation of the environment as well as the general population, specific measures are taken;

1. Proper Training

To lessen the danger of exposure, safe handling practices, education, and training are essential for all personnel and facilities using cytotoxic/antineoplastic medications. This applies to sanitary services and housekeeping personnel who could be contaminated during washing, cleaning, or waste disposal procedures.

To lessen the number of drug residues in the air, all cytotoxic/antineoplastic medications and waste should be kept in a secure, enclosed space with suitable ventilation (preferably with negative air pressure).

2. Protective Clothing

Every institution that uses cytotoxic or antineoplastic medications should make sure that employees are properly trained on the risks associated with cytotoxic medications, as well as on disposal techniques and how to wear personal protective equipment (PPE).

Gloves, shoes, a mask, a protective gown, and goggles are all recommended. Clothing that has been exposed to cytotoxic waste has to be put in labelled washing bags separately. Wearing protective gear and clothes is also required for those who are involved in cleaning contaminated clothes.

3. Segregation of Waste

Yellow and purple waste bags are to be used to package cytotoxic and cytostatic medications, respectively. Err on the side of caution and categorise the waste as cytotoxic and cytostatic if the qualities of any medication are ambiguous or difficult to ascertain.

Dispose of cytotoxic and cytostatic medications in rigid yellow containers with purple lids when still in their original packaging. Usually, one is designated for solids and the other is for liquids. This also holds true for leftover cytostatic and/or cytotoxic medications that are not in their original container.

The correct disposal of sharps waste at an authorised incinerator requires segregating it and placing it in a purple-lidded sharps container that has been medicinally contaminated with cytostatic or cytotoxic medications.

Treatment of Cytotoxic Waste

Contamination levels in packaging can be very high. To reduce exposure concerns it is essential to treat cytotoxic waste properly. The main steps include storage, transportation and handling with proper care.

1. Storage

The unpacking area must be in a discrete space apart from the dining rooms. At each stage of the unpacking procedure, employees should inspect the quality of the packaging. Before being stored, the primary and secondary packing has to be cleaned.

Either at this time or prior to storing the product in the clean room, a regular cleaning process should be in place. Utilising pre-moistened towelettes, all medicine containers should be cleaned to minimise external contamination.

When cleaning vials, precautions should be taken to minimise the danger of surface contamination. After finishing the process, wipe down all surfaces. Create a specialised, low-risk negative pressure storage space just for cytotoxic medications. One set of gloves and a gown should be used when taking medications out of the storage room.

2. Transportation

Every employee needs to be trained in the proper handling of cytotoxic medications. Upon receiving, the staff should inspect the external packaging; if a package is broken and likely to spill, follow the hospital’s spill policy.

The receiving staff should transport delivery containers right away to the pharmaceutical division. The shipping containers shouldn’t be opened by the staff in the reception or storage. Care should be used when handling the delivery containers to prevent the breaking of the cytotoxic medicine containers.

Only skilled personnel should carry out the unpacking and following actions. Damaged containers should be handled as cytotoxic spills, and the pharmacist, manufacturer, or distributor should be contacted.

3. Handling with Proper Care

Utilize handling methods that reduce the possibility of harm or unintentional exposure. Unless the clinical protocol specifies otherwise, the spiking of bags and priming of tubing should take place before the administration of the cytotoxic medication.

Cytotoxic medications should be reconstituted in the pharmacy setting as previously stated, including preparation, priming, and air removal from the tubing. The integrity of the medicine containers shouldn’t be compromised by overfilling them.

Never remove air from intravenous tubing while the tube is filled with a medication solution. The cytotoxic medicine or drugs should be introduced to the infusion solution after the intravenous tubing has been primed and any air has been removed in the pharmacy.

Disposal of Cytotoxic Waste

Every hazardous waste material generated from a medical facility requires extra care and effort for proper disposal. Cytotoxic waste must be handled under strict policies for its proper disposal. In addition to the cytotoxic waste or component itself, it’s critical for staff to be aware that byproducts from a treated patient could also contain “unchanged cytotoxic medications or active metabolites.”

The correct disposal of cytotoxic waste comprises the following actions:

1. Proper Storage

Purple coloured bags are used to store the cytotoxic waste in the healthcare facility. Dedicated room or ground is selected to store together all the cytotoxic waste until it is taken further by the waste pickup truck. Only authorised personnel are allowed to enter the place where cytotoxic waste is stored.

2. Labelling

Cytotoxic medications need to be labelled so that anybody handling them is aware of their nature and any necessary safety measures. Drugs that are cytotoxic should be marked with the word “Cytotoxic” or the “Cytotoxic” danger symbol.

3. Incineration

It takes incineration temperatures of up to 1200 °C and a minimum gas residence duration of 2 s in the pressurized vessel with fuel equipment to completely destroy all cytotoxic compounds. Low-temperature incineration may cause dangerous cytotoxic fumes to be released into the atmosphere. The disposal of cytotoxic waste in the majority of incinerators, single-chamber incinerators, or open-air burning is dangerous.


Cytotoxic waste management systems must be safe for storage, segregation, and disposal in workplaces that are exposed to them. All staff must be equipped, informed, and trained to manage cytotoxic waste, and they must be monitored on a regular basis to assure compliance.

For such cautious management, it is better advised to take help from professionals. We at TCW are a team of experts highly qualified in waste management serving in the UK. Book a free site survey right now.

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