Jim Mullowney had spent much of his professional career, up until 2008 at least, working to protect people from the dangers of industrial chemicals. When his mother was diagnosed with breast cancer, he researched the drugs she was prescribed and looked into other cancer treatments. He found that the cornerstone chemotherapeutic drugs attack DNA and pass through cancer patients as active chemicals.

Currently about 85 percent of chemotherapy patients receive their infusions at a hospital or health-care facility. (Home infusion therapy is on the rise and is expected to grow.) They are then sent home — typically with little warning about the dangers the chemicals that soon will be exiting their bodies can pose to family members and caregivers for the next two to three days.

The World Health Organization (WHO) considers contact with residual amounts of chemotherapy drugs a significant risk requiring collection, containment, and proper disposal to avoid exposure “through contact with body fluids and secretions of patients undergoing chemotherapy.”

According to a 2013 WHO report, any wastes produced by these patients within 48 hours of drug administration, and in some cases for up to a week, should be considered genotoxic.

Anyone who touches these contaminated fluids, say, by cleaning the toilet, helping a patient as she vomits, or with other tasks caregivers and family selflessly perform, could absorb dangerous amounts of an active cytotoxic drug.

Mullowney told ecoRI News back in 2012 that “empty vials, empty IV bags, the gloves nurses wear, everything that comes into contact with these materials, even in trace amounts, is treated like it is a chemical weapon. Yet, we inject it into a patient where it passes through the body in three or four days. There’s no thought to where it ends up or the impact these powerful chemicals have on a household.”

Less than three decades ago people gave little thought about how cigarette smoke could impact non-smokers. Scientific studies eventually discovered the dangers, and the EPA, in 1993, concluded that secondhand smoke was causing some 3,000 lung cancer-related deaths annually. It took another decade before a scientific and legal consensus emerged and laws banning smoking in workplaces, bars, restaurants, and many public places passed.

Mullowney noted that a similar debate is emerging about secondhand chemotherapy. He said concern is growing that chemo drugs may be having an impact on those who manufacture the drugs, the pharmacists who compound them, the nurses who administer them, and family and friends who assist cancer patients.

At the moment, however, little research has been done on the health and environmental impacts of secondhand chemo. Some medical professionals have said Mullowney and others have overstated the public health and environmental threats posed by these drugs through human waste.

While industrial chemicals are highly regulated, pharmaceuticals are not — at least when it comes to disposal. Since the 1970s, it has been illegal, for example, to dump paint thinners and polychlorinated biphenyls (PCBs) down the drain. But the waste of chemo-treated patients is routinely flushed down the toilet.

The American Cancer Society warns that toilets being used by patients undergoing chemotherapy can be a hazard for children and pets, it recommends that chemo patients use a separate bathroom, and that men sit down when urinating.

Cytotoxic chemicals have been identified in waterways and the water supply in the United Kingdom, Brazil, Germany, and Switzerland, according to various studies.


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