Answer to Question #2495 Submitted to "Ask the Experts"

Q

Do you have any guidelines for disposal of radioactive tissue removed during a surgical procedure? If not, do you have any suggestions of Web sites or organizations that may have this information?

A

There are really two issues that must be addressed. The first is that there are specific regulatory requirements for the disposal of all medical waste and biological samples mandated by the U.S. Environmental Protection Agency and regulated by the individual states and territories. Medical and biological samples that require special handling and disposal are generally termed medical pathological waste (MPW), and medical, veterinary, and biological facilities will have programs for the collection of MPW and its disposal. The second issue is the restrictions on how radioactive waste can be disposed as regulated by the U.S. Nuclear Regulatory Commission in 10 CFR 20.2001, General requirements for waste disposal or by the individual Agreement States. The preferred method for the disposal of radioactively contaminated MPW is decay-in-storage. Fortunately, most radionuclide-labeled compounds used in patient studies are short lived. Generally, a program to manage MPW contaminated with radioactive material could include the following:

 

1. Determine if the patient had a radionuclide study or therapy treatment. This could involve the medical staff interviewing the patient and checking the patient's medical record. This may not be as simple as it sounds as the patient may have had a test or treatment performed at a different facility and may not realize that a radionuclide test was performed.
    
2. Collect all MPW contaminated with a radionuclide separately from the uncontaminated MPW.
    
3. The collected MPW is then monitored for radionuclide contamination. If found uncontaminated, it could be released into the normal MPW waste stream. If found contaminated, the waste should be dated and stored in a secure location, like a lockable refrigeration room.
    
4. Periodically or after 120 days, the contaminated MPW will need to be monitored for radionuclide contamination. Following documentation that there is no longer contamination, the MPW can be then released into the normal MPW waste stream.

It is possible, particularly in research, that the biological sample may contain a long-lived radionuclide. In this case, the MPW would be disposed as a mixed hazardous waste according to state and federal regulations. Of course, there are some issues regarding the storage of mixed wastes. As a side note, many waste disposal facilities are installing radiation detection equipment to monitor for radioactive material. If the source of the radioactive-contaminated waste is identified, the waste generator, i.e., the medical facility, is required to collect the material and return it to its facility. Consequently, many hospitals are installing their own radiation monitoring portal systems to check all MPW and regular trash to avoid problems with state regulators and waste facilities.

John P. Jacobus, MS
Certified Health Physicist