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Printed at: 11:01:49 / 24-02-2021

What should I do if I have a chemotherapy spillage at home?

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Introduction
This leaflet contains the answers to some questions patients and their carers may have about the disposal of chemotherapy waste and the management of a chemotherapy spillage in the home. It is not meant to replace the discussion between you and the team looking after you, but helps you to understand more about what is discussed. If you are in any doubt after reading this leaflet, please contact the clinical area where you are receiving treatment.

24 hour contact number 01908 660033 bleep 1090

General Information
Keep all chemotherapy medication in a safe place according to the storage instructions on the product label (for example in the refrigerator or at room temperature). Ensure that all medicines, administration equipment and sharps bins are out of reach of children or pets. If you are a carer and are pregnant, think you may be pregnant or are breast feeding, you should not handle chemotherapy drugs, or waste. Always wash your hands thoroughly after handling chemotherapy drugs or waste.

1. Disposal of chemotherapy waste

How should I dispose of empty medicine containers/bottles?
Empty chemotherapy medicine bottles, cartons, tubes can be thrown in household waste or returned to the Macmillan Unit in the Cancer Centre. Put lids/caps on the containers before discarding or returning them. Use a designated spoon, syringe or cup for the administration of oral chemotherapy. Medicine spoons, syringes and cups used to give oral chemotherapy should be washed after each use in warm soapy water, left to dry and stored separately from other household crockery or cutlery, or you could ask the nurse giving you the medicine to provide you with the disposable cups so that they can be discarded after use. On completion of treatment medicine spoons, syringes and cups used to give oral chemotherapy should be washed, dried and discarded in household
waste.

How should I dispose of intravenous infusion devices and syringes?
Empty infusion devices are normally disconnected in the Macmillan Unit or Ward 25-and the nurses their will manage the waste. However, if you have another form of administration for example injections the nurse in either Macmillan Unit or ward 25 will provide you a chemotherapy sharps bin for you to put your chemotherapy sharps into for disposal. Once the sharps bin is three quarters full, it should be sealed and returned to the hospital to either Macmillan Unit or Ward 25.

What should I do with unused chemotherapy medicines?
All unused chemotherapy medications (tablets, capsules or oral liquids, infusors and syringes) MUST be returned to the Macmillan Unit or Ward 25. They should NEVER be flushed down the toilet or thrown away in household waste. Inform your chemotherapy team if you have unused medication-it is important for them to record why you have medication left over.

How should body fluids be disposed of?
Urine, stools and vomit can contain chemotherapy drugs or their breakdown products for as long as seven days after a patient has received treatment. Therefore, it is important that you wear gloves when handling urine, stools, vomit, contaminated bed linen or incontinence pads for seven days following chemotherapy. You should either use the gloves provided to you by the hospital chemotherapy nurses or a pair of household gloves kept especially for this purpose. Gloves should be changed immediately if torn or soiled. The contents of vomit bowls/bedpans/urinals should be flushed down the toilet. Any disposable containers should then be washed thoroughly in warm soapy water and disposed of in the household waste. Non disposable containers should be washed thoroughly in warm soapy water and left to dry. Incontinence pads and gloves should be placed in a bag prior to disposal. Contaminated linen and clothes should be washed separately to other items on the hottest temperature guidance for the item.

2. Management of liquid spills

General information
Any liquid spillages of chemotherapy drugs on to the floor or on your clothes or skin should be dealt with immediately to minimise potential harm to yourself or other people. You must wear gloves when dealing with a chemotherapy spillage. You should either use the gloves provided by your chemotherapy nurse, or a pair of rubber household gloves kept especially for this purpose. Make sure that they are not damaged or split. If you have been provided with a spillage kit, use the contents of the kit for a large spill spillage greater than 10mls (2 teaspoons). Remember to inform your chemotherapy nurse or bleep 1090 as soon as possible that you have had a spillage so that a replacement medication or equipment can be arranged.

What should I do if there is a chemotherapy spillage on work surfaces, furniture or floors?
When liquid is spilled onto a hard surface its splash can travel some distance from the original spillage area. So check to see if the chemotherapy has landed on other pieces of furniture close by.
Cover the spillage using the incontinent sheets you will find in your spillage kit-given to you by your chemotherapy nurse-If you do not have a spillage kit then use kitchen roll and ensure that all the liquid has been mopped up. The work surface, furniture or floor should then be wiped clean using warm soapy water (i.e. washing up detergent\0 as soon as possible. This should be done at least three times. All used absorbent towels should be disposed of as clinical waste-this means you place them in the bags provided in your spillage kit. This means it cannot be put in normal household waste-If you have been given a home spillage kit, follow the instructions given with this.

How should I deal with a chemotherapy spillage onto the skin?
Wash the area with plenty of tap water for at least 10 minutes. This should then be repeated three times using warm soapy water and the area gently dried. If you have a shower, this is preferable to washing the isolated area. Contact the Macmillan Unit, or if they are closed please bleep 1090 and inform them of what has happened and they will give you further advice. Do not apply any moisturising cream or hand cream on the affected area.

Observe for signs of redness, soreness, blistering and/or irritation which may happen soon after the spillage, contact the 1090 bleep immediately if this happens.

How should I deal with a chemotherapy spillage in the eyes?
Immediately flush the eyes and the surrounding areas either large volumes of cool tap water. This should be done for at least 10 minutes. Please go to the nearest Accident and Emergency department as it is important that you seek medical advice or any spillages into the eye.

How should I deal with a chemotherapy spillage onto clothing/bed linen etc?

If receiving chemotherapy through a pump at home, you may wish to buy a plastic mattress protector to prevent spillage of chemotherapy into the bed if an accident occurs. (double bed protectors can be purchased from some companies for £10-£15.00).  Wearing a pair of gloves, blot dry with kitchen towel and remove the contaminated clothing or linen immediately.

The clothes/linen should be washed separately from other clothing as soon as possible on the highest temperature guidance for them. This should be repeated three times to ensure all drugs are completely removed. If the drug has soaked through the clothes to the skin, this should be dealt with as outlined above.

Mattress or plastic mattress covers should be washed three times with warm soapy water and allowed to dry.

Please make sure before you leave the Macmillan Unit or Ward 25 if you are on a chemotherapy infusor that you have a spillage kit and chemotherapy sharps bin.