Pharmaceutical Waste Disposal Research Articles

Household Pharmaceutical Waste Disposal as a Global Problem-A Review.

The negative effect of the pharmaceuticals presence (persistence?) in various components of the environment is a global problem today. These compounds are released into the environment as a result of, inter alia, their use and improper disposal. Therefore, it is important to reduce excessive drug consumption and to develop a system for the collection of unused/expired pharmaceuticals. The effectiveness of actions in this area is inextricably linked with the need to educate society on how to deal properly with unwanted medications. The aim of the study was to show that the inappropriate handling of unused/expired drugs by society is an important problem in waste management systems, and it impacts the state of the environment. Forty-eight scientific articles published between 2012 and 2021 were taken into account that discussed the systems in various countries for the collection of unused/expired pharmaceuticals. This literature review shows that the main method of disposing of unused/expired medications, according to respondents from different countries, is either by disposing of them in household waste or flushing them into the sewage system. This is also the case in countries with systems or programs for the return of redundant drugs, which indicates that these systems are not sufficiently effective. This may be influenced by many factors, including the lack or ineffective education of the society.

Fabrication of cobalt tungstate/N-rGO nanocomposite: Application towards the detection of antibiotic drug-Furazolidone

Pharmaceutical waste disposal, especially antibiotic drug contaminants, is a current topic to investigate in global concern. However, it is critical to recognize and detect due to its adverse effects on ecosystems and human health caused by excessive usage and poor management. In this work, the Cobalt tungstate/Nitrogen-doped reduced graphene oxide (CoWO4/N-rGO) nanocomposite was synthesized through coprecipitation and ultrasonication method and used for electrochemical detection of Furazolidone (Fz) antibiotic drug. The physicochemical properties of as-prepared CoWO4/N-rGO nanocomposite have been investigated by X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FT-IR), X-ray photoelectron spectroscopy (XPS), Raman spectroscopy, Scanning electron microscopy/Energy-dispersive X-ray spectroscopy (SEM-EDX) and Transmission electron microscopy (TEM). The electrochemical behavior of the CoWO4/N-rGO modified electrode was explored by Cyclic voltammetry (CV) and Differential pulse voltammetry (DPV) analysis. From the electrochemical analysis, the CoWO4/N-rGO modified electrode displayed an excellent electrocatalytic activity towards Fz and resulted in good reproducibility, high selectivity and long-term stability. The detection limit of Fz was found to be 0.022 µM along with a linear dynamic range of 0.09–799 µM. The proposed system is effectively applied for detecting Fz in real samples such as human urine and wastewater.

Methods of pharmaceutical waste management disposal practiced in sanitation value chain by community pharmacies and households in Nkubu Town

Introduction: Pharmaceutical Waste Management (PWM) has emerged as a challenging issue, with both health and environmental negative impacts. The study assessed the common methods of pharmaceutical waste management disposal in Nkubu town among community pharmacies and households in the sanitation service chain. Problem statement: Increasing disease incidence and prevalence necessitate healthcare practitioners to prescribe and dispense different medications. According to World Health Organization (WHO2010), more than half of all medications are inappropriately prescribed and sold, which causes unnecessary storage in community pharmacies (CPs) and households creating environmental threats that jeopardize efficiency of sanitation service chain.
 Methods: The study area was Nkubu town, where data was collected by use of structured questionnaires. size was 19 community pharmacies and 380 households. Descriptive statistics were used for data analysis. Results are presented in tables. Results: The study showed that 23.9% (n=91) of the households use pit latrines while 73.5% (n=14) of the community pharmacies use burning as the common methods of pharmaceutical waste disposal. Conclusion: The common method of pharmaceutical waste disposal being practiced in community pharmacies was burning while for households was emptying in the pit latrine. Disposal of unwanted pharmaceutical products through unsafe methods along the sanitation chain was prevalent among the respondents. Recommendation: There is need to create public awareness and establish educational programs regarding management and handling of unwanted pharmaceutical wastes among community pharmacies and households in Nkubu town.

Drivers and Enabler of Circular Economy in the Indian Pharmaceuticals Industry

India has evolved into a substantive base in the narrative of global pharmaceutical as a provider. Developing countries such as India however have been struggling with proper management and disposal of pharmaceutical waste. This has been causing rampant environmental pollution that was adversely impacting the ecosystem and human health. In this study, the circular economy model was adopted to find the drivers and enablers of the three Rs of waste management - Remanufacture, Reuse, Recycle in the context of Indian Pharmaceutical Supply Chains (PSCs). The study was anchored in the theoretical conversation of Stimulus Organism Response (SOR) theory. Data was collected using the survey method from 166 chief supply chain executives from various pharmaceutical companies based in India. The data was analysed with Smart PLS software. The results revealed that most of the green drivers such as regulatory pressure, customer pressure and public pressure have failed to drive the waste management practices in the PSC. Only, pressure from suppliers was driving energy and material input management in the PSC. Also, the other stakeholders (such as media, investors and NGOs) were the sole drivers for the safe disposal of pharmaceutical waste. Further, pressure from competitors and other stakeholders were driving the control of waste and emission leakages from the PSC. The results stated that Green Information Technology System (GITS) played a critical role in enabling waste management practices in pharmaceutical production. Furthermore, the study revealed that Internal Environment Management (IEM) was not just essential for the safe disposal in the PSC, but it also played a decisive role in controlling the waste and emission leakage. The study provided empirical evidence to support the SOR theory and helped to extend the scope of circular economy research to PSC. Additionally, it would benefit managers by fostering better decision-making to devise effective strategies for waste management.

End-of-life management strategies of pharmaceuticals in Portuguese households.

The end of life of pharmaceutical products through environmentally unsafe routes is a growing concern in our society. However, the studies reported so far, apart from being limited in number, do not reflect the current management practices for the end-of-life management of pharmaceuticals. Published work lacks an in-depth analysis in focusing on the pharmaceutical waste in households. The present work focused on (1) performing a state-of-the art overview to compare worldwide studies and the results and (2) implementing a comprehensive survey in Portugal (n = 454 respondents). The results showed that the delivery to pharmacies was used by the majority of the respondents (72%), indicating a good awareness of pharmaceutical waste management issues, when compared to the reviewed studies. Statistically significant variables for the destination of end-of-use pharmaceuticals include gender, age and distance from the residence to the pharmacy (p < 0.05). Most participants believe that educating the population on existing structures of medication and packaging management is of the utmost importance to improve the national managing system. This is the first study conducted in Portugal; it includes statistical analysis of the data and reflects on the practices that should be adopted to reduce incorrect pharmaceutical waste disposal. These findings call upon the strategies to strengthen the pharmaceutical waste management programme.

Effective Disposal of Biological and Pharmaceutical Waste: A Note to the Health Care Professional

The current appraisal aims to educate and give valuable information about disposal methods adopted in hospitals and health sectors. Many healthcare departments like microbiology labs, pharma industries, medical agencies, healthcare sectors all produce waste which usually contains unsafe materials that should not be exposed untreated to the atmosphere. In these health sectors, many types of wastes are separated as lab debris, chemical, and biological waste. These waste are rich in contaminants and pathogenic microbes which will be more lethal if they are not properly disposed of. The authors describe the various wastes and the definite discarding process to minimize costs and impact on the surroundings. Presently many of these sector professionals have some difficulty in disposal, these issues can be overcome by the systematic and easy plan described by the authors. Specific treatment must be required for this waste before they disposed off. This waste must be washed before introducing them into a particular disposable discard. Medical waste can be disposed of thoroughly as they contain infectious or non-infectious microorganisms. Biological and pharmaceutical waste must be disposed of, to prevent environmental hazards. Among the various approaches adopted for the disposing of these waste includes incineration, autoclaving, chemical disinfection, ignitability, etc. are popularly adopted. Each particular waste can be disposed of in a specific manner. The authors succeed in bringing the systematic approach in the disposal of waste in health care units and concludes that proper disposal is important to reduce the contamination and pollution of the environment and maintain a healthy atmosphere.&#x0D;

Household Pharmaceutical Waste Management Practices in the Johannesburg Area, South Africa.

Pharmaceutical wastes are expected to increase given the increasing population growth rates and rapidly rising economic burden of human diseases. This challenge calls for appropriate measures for the management of such hazardous wastes. The purpose of this survey was to document and investigate existing practices for the handling, storage, and disposal of household pharmaceutical wastes (HPWs) in the Johannesburg area. Primary data were collected via online surveys with self-administered questionnaires completed by respondents. The research found that 77% (n = 286) of respondents claimed some knowledge about HPWs. Types of medicines that contributed to HPWs included painkillers or analgesics (73%, n = 270) and drugs for treating colds and flu-related illnesses (52%; n = 193). Although there were a few exceptions, the respondents generally exhibited strong disagreements with environmentally unfriendly and health-threatening disposal practices. Moreover, most participants were willing to return expired medicines to pharmacies (40.7%, n = 151), whereas only 8.6% (n = 32) opposed this solution. Awareness levels tended to vary with employment status, educational qualifications, and place of residence. However, place of residence and household size did not correlate with types of pharmaceutical waste. Additionally, the study found that education attainments significantly influenced the willingness of respondents to return pharmaceutical wastes. Finally, there were no significant differences amongst respondents in terms of waste disposal practices. Altogether, the findings suggest the need for targeted efforts to bring about sustainable waste management at a household level.

Disposal of leftover and expired medicines by community pharmacies and their clients in Ghana.

Improper and unsafe disposal of expired and unwanted medicines could cause harm to both people and the environment and therefore it is of public health importance. The objective of the study was to determine the methods employed by community pharmacist and their clients in the disposal of unwanted and expired medicines. Furthermore, the role of the pharmacists in the assessment of clients left over medicines was also explored. A cross sectional study design was employed with a sample of 120 pharmacy staff and 200 clients. Semi structured questionnaires were developed and administered to the two groups. Ethical approval was obtained. Data collected were analyzed using the Statistical Package for Social Sciences (SPSS v.24). Two hundred and eighty medicines were assessed from 131 respondents (65.5%) who brought their unused or left-over medicines to the pharmacy. These included analgesics 102(36.4%), antibiotics 50 (17.9%) and antacids 22 (7.9%). Disposal of expired and left-over medicines cited by respondents were the general-purpose bin 58(77.0%) and down the sink 11(14.3%). The majority 99(82.9%) of community pharmacies also disposed of solid dosage forms through the general-purpose bin. In addition, 90(75%) community pharmacies disposed of liquid waste in general purpose bin. Lack of enforcement of legislation was cited by community pharmacy staff as a barrier to the proper disposal of pharmaceutical waste. The predominant method of disposal of expired/unwanted medicines by community pharmacies and their clients was via the general-purpose bin. Implementation of interventions such as take back programmes that will enhance proper disposal of expired and left over medicines should be initiated.

Effectiveness of environmental health and loss framing on household pharmaceutical take-back schemes

Pharmaceutical pollution poses an emerging environmental and public health problem. Together with increasing medicine use and pharmaceutical manufacturing effluents, improper disposal of household pharmaceutical waste significantly adds to this issue, despite pharmaceutical take-back schemes having been established in many countries. Even where take-back schemes are available return rates remain low. Previous studies have used only survey and interview methodologies and therefore merely described the situation. This study goes further, exploring not only the effects of the availability of information on pharmaceutical take-back schemes but also the effects of the framing of information provided to individuals on their intentions and reported behaviours to collect unused and/or expired household pharmaceuticals and return them to a pharmacy. The data were collected throughout three preregistered, randomised experiments with representative samples (N = 3754). The results show that tapping into individuals’ pre-existing conception of the problem and psychological biases through the delivery of environmental health, loss framing information highly increased the odds of returning household pharmaceutical waste. This result is long-lasting (Studies 2 and 3), is found in various European countries (Study 1), and remains robust in all studies. Based on the results, we suggest that, in the context of household pharmaceutical waste management, psychologically informed, proactive approaches combined with targeted local action and services can reduce the psychological and practical barriers to pro-health and pro-environmental behaviour. The findings are used to support a policy recommendation that is cost-efficient, easy to use, and effective.

Knowledge, perception and practice of pharmaceutical waste disposal among the public in Lagos State, Nigeria.

Introductionincreased consumption of pharmaceuticals has been reported to cause a high level of their discharge into the environment, and even small quantities in the environment have the potential to cause harm.Methodsa descriptive cross-sectional questionnaire-based study was conducted between April and May 2021. The questionnaire was made available online through social media platforms.Resultsa total number of 534 respondents were surveyed. Two hundred and fifty respondents (46.8%) were presently on one or more medications. Many participants have not received advice on pharmaceutical waste from health professionals (413, 78.3%). There is fair knowledge about pharmaceutical waste 234 (43.8%). Many of the respondents think there is a lack of adequate information on what to do with them (500, 93.6%) and there should be a program/ strategy to retrieve all unused, leftover, or expired medicines (475, 88.9%). A lot of respondents throw unused medicines away in household garbage (391, 73.2%)Conclusionthere is fair knowledge, positive perception, and poor pharmaceutical waste disposal practice. There is a need for the implementation of a “medication take-back program” for appropriate waste disposal practice.

Household pharmaceutical waste (example from Serbia)

Abstract Background Proper disposal of household pharmaceutical waste can reduce the negative influence of medicines on the environment. Environmental awareness do not necessarily equate with proper behavior, as other issues, such as the availability of an organized disposal system, play an important role. The aim was to examine the current disposal methods of unused medicines from households, and the willingness of Serbian residents to participate and bear the costs of an organized collection program. Also, we wanted to define factors contributing to an individual's willingness to participate and pay for a disposal program. Methods The survey included randomly selected patients older than 18 years visiting private pharmacies in the four largest Serbian cities. The questionnaire included information on the presence of unwanted medicines in the household, general medicine disposal practices, the likelihood to participate in a medicine takeback program, willingness to pay for a disposal program, importance to the environment, and demographic variables. Results The majority of Serbian people dispose unused medicines into household garbage. 80% of respondents are likely to participate, however less than half are willing to pay for the collection of unused medicines. The factors that influenced willingness to participate are environmental awareness and income, while the factors affecting willingness to pay, are previously received advice about proper disposal, education level, number of unwanted medicines in the household and gender. Conclusions Awareness campaigns advising the general public on proper medicine disposal and well-organized and easily accessible collection programs are essential in order to enable the general public to return unused medicines for proper disposal. Key messages Household pharmaceutical waste is a major public health issue in Serbia. Residents in Serbia are willing to participate in collection programs, thus building legislative into practice is urgent.

Multi-antibiotic resistant bacteria in landfill bioaerosols: Environmental conditions and biological risk assessment

Landfills, as well as other waste management facilities are well-known bioaerosols sources. These places may foment antibiotic-resistance in bacterial bioaerosol (A.R.B.) due to inadequate pharmaceutical waste disposal. This issue may foster the necessity of using last-generation antibiotics with extra costs in the health care system, and deaths. The aim of this study was to reveal the multi-antibiotic resistant bacterial bioaerosol emitted by a sanitary landfill and the surrounding area. We evaluated the influence of environmental conditions in the occurrence of A.R.B. and biological risk assessment. Antibiotic resistance found in the bacteria aerosols was compared with the AWaRE consumption classification. We used the BIOGAVAL method to assess the workers' occupational exposure to antibiotic-resistant bacterial bioaerosols in the landfill. This study confirmed the multi-antibiotic resistant in bacterial bioaerosol in a landfill and in the surrounding area. Obtained mean concentrations of bacterial bioaerosols, as well as antibiotic-resistant in bacterial bioaerosol (A.R.B.), were high, especially for fine particles that may be a threat for human health. Results suggest the possible risk of antibiotic-resistance interchange between pathogenic and non-pathogenic species in the landfill facilities, thus promoting antibiotic multi-resistance genes spreading into the environment.

Do legislated carbon reduction targets influence pro-environmental behaviours in public hospital pharmacy departments? Using mixed methods to compare Australia and the UK.

Pharmaceuticals and their packaging have a significant negative impact on the environment providing a very strong argument for action on the part of pharmacists and pharmacy technicians to engage with pro-environmental behaviours (PEBs) in their workplaces. The aims of this research were therefore to investigate in hospital pharmacists and pharmacy technicians, 1) factors affecting engagement with workplace PEBs, and 2) determine if legislated carbon reduction targets in the UK influenced workplace PEBs in the UK compared with Australia which does not have legislated carbon reduction targets. The environmentally responsible disposal of pharmaceutical waste was the PEB of interest in this study. A mixed methods research design was utilised and a conceptual model (key variables: environmental attitude, concern, and knowledge, and organisational factors) was developed to identify factors influencing workplace PEBs. Participants were from five hospitals in Queensland, Australia and five NHS hospitals in England, UK. There was no statistically significant difference in environmental attitude or concern between the two groups—most had a mid-environmental attitude score and low levels of environmental concern. Participants lacked knowledge of the issue and the link between the environment and public health. Both Australian and UK participants reported recycling packaging waste was not a priority in the hospital pharmacy workplace (even in hospitals with recycling capability) as hospitals focused on compliance with clinical (contaminated) and confidential waste streams. Environmental attitude, knowledge, and concern therefore appeared to be weak influences on intention to perform workplace PEBs with workplace social norms (compliance due to audits) appearing to be a significant mediator of action. The key difference between the cohorts was that UK pharmacists felt waste was not in the scope of their role, and therefore not their responsibility. This study identified that legislated carbon reduction targets did not influence hospital pharmacy workplace PEBs–neither cohort reported engaging significantly in workplace PEBs. UK Government and NHS sustainability policy did not appear to have disseminated to pharmacy department level of UK public hospitals to any great extent.

Harmonisation of Pharmaceutical Take-Back Systems in the EU.

When medicines enter the environment, they harm living species and ecosystems. Improper disposal of household pharmaceutical waste increases the concentration of pharmaceuticals in the environment and thus their detrimental impacts. Since 2004, the EU has obliged its Member States to establish 'an appropriate collection system' for unused and/or expired medication. However, as no implementation guidelines exist, large differences in the systems and their use remain. Pressure for adoption of guidelines harmonising the systems across the EU has been increasing. We address the question whether such harmonisation could mitigate pharmaceutical pollution, and which regulatory measures would be appropriate. To answer this, we conduct a comparative investigation of the systems' regulation and an empirical study of citizens' beliefs and behaviour across four European countries. We find a potential for increasing the effectiveness of pharmaceutical take-back systems through their harmonisation and conclude that the EU has the competence and tools to regulate this.

Mineralization of Antibiotics in Wastewater Via Photocatalysis

Antibiotics are among the prominent class of pharmaceuticals considered emerging pollutants. This class of compounds has found its way into diverse arrays of water bodies in the environment due to their incomplete decomposition, and also the indiscriminate disposal of pharmaceutical waste from industries, farms, and medical centers. This is often through soluble reactive effluent, water run-offs due to rainfall on agricultural facilities and untreated sewages. Their concentration in the environment usually exceeds the permitted levels, which in turn leads to the possibilities of bio-magnifications and bioaccumulation in the food chain. Consequently, they constitute safety hazards and it is important to remove this class of compounds. Another concern is the development of resistance by the micro-organisms, which could render these drugs ineffective and useless if serious control is not put in place to regulate their usage and presence in the environment. Although different conventional methods are currently used in water treatment plants, the presence of pharmaceuticals, such as antibiotics, has been confirmed in different recycled water meant for consumption. Recently, advanced oxidation processes (AOPs) have emerged as a useful technique for the mineralization of these antibiotics in water via the use of heterogeneous photocatalysis. In this review, a background study on the origin and fate of pharmaceuticals such as antibiotics, and the usefulness of photocatalysis (a prominent method of advanced oxidation process (AOPs)) in the mineralization of this class of pharmaceuticals into less harmful compounds is assessed. The degradation pathway of different classes of antibiotics is also discussed using specific examples of compounds in each of the classes.

Evaluation of the effect of carbamazepine on the concentration of vitellogenin in Pseudoplatystoma magdaleniatum

Abstract Carbamazepine is a pharmaceutical used in patients with seizures and bipolar disorder, which has been found in wastewater and many water resources. This is due to the inadequate disposal of pharmaceutical waste and the lack of treatment of municipal wastewater, as is the case in Colombia. The two main hydrographic basins of Colombia are the Cauca and Magdalena rivers, which are inhabited by the endemic species Striped Catfish (Pseudoplatystoma magdaleniatum). This has become an endangered species for various reasons, including the high contamination level of these rivers. In 2019, mature adult P. magdaleniatum of both sexes were caught in the Cauca river in Colombia. This was in order to assess the concentration of vitellogenin, as a biomarker of endocrine disruption, resulting from exposure to different levels of concentration of the emerging contaminant carbamazepine for 4 months. These tests were carried out in a fish farm. A significant decrease in the vitellogenin concentration was verified in females at concentrations of 25 µg l-1 and 50 µg l-1, and in males at 50 µg l-1 of carbamazepine, with a significance level of p˂0.05. Carbamazepine could cause a negative feedback in gonadotropin secretion, acting as an estrogen mimicker that causes a decrease in the level of vitellogenin.

Химический способ утилизации фармацевтических отходов группы ингибиторов ангиотензинпревращающего фермента

Цель исследования – разработка способа химического обезвреживания фармацевтических отходов, а также оценка его эффективности и экологической безопасности. Материал и методы. В качестве образцов для апробации предлагаемого способа утилизации были использованы субстанции каптоприла, лизиноприла, эналаприла, периндоприла и рамиприла. Проведена химическая инактивация фармакофоров лекарственных средств. Экспериментально установлена структура полученных в ходе разрушения продуктов, а также доказана эффективность обезвреживания отходов методом спектроскопии гигантского комбинационного рассеяния. Токсичность исходных соединений, а также структур, полученных в ходе разрушения, определялась на основании расчета полулетальной дозы (LD 50 ) для крыс при пероральном применении с использованием пакета программ для компьютерного моделирования GUSAR Rat acute toxity. Расчет коэффициента распределения в системе октанол-вода (logP ow ) для анализируемых веществ был осуществлён с использованием программы Molinspiration. Результаты. После проведения реакций деструкции анализируемых субстанций на спектрах отсутствовали пики на частотах, характерных для функциональных групп, влияющих на фармакологическую активность, что подтверждает эффективность химического способа утилизации лекарственных средств. Экотоксикологические характеристики, такие как значение полулетальной дозы и коэффициент распределения в системе октанол-вода, продуктов деградации также имеют более благоприятные значения в сравнении с исходными веществами. Заключение. Доказана возможность применения химического способа для утилизации фармацевтических отходов группы лекарственных средств, ингибирующих ангиотензинпревращающий фермент.

Phase pure synthesis of lanthanum doped bismuth ferrite nanostructures for the adsorption of doxorubicin

The improper disposal of pharmaceutical effluents, hospital sewage, wastes, and domestic drugs are the typical sources of emerging organic contamination (EOC). The untreated doxorubicin (DOX) effluent being released into the environment has harmful influence on human health. In this study, the lanthanum substituted bismuth ferrite nanoparticles with pure rhombohedral phase were prepared via facile co-precipitation technique, wherein the influence of La3+ ion substitution on structural, optical, and electrical properties of BiFeO3 (BFO) nanoparticles was investigated. Lanthanum content increment did not widely impact the structural properties but a systematic decrease in bandgap with increasing concentration of La3+ ion content was observed. DOX was treated with Bi1−xLaxFeO3 to investigate adsorption activity, where the kinetic modelling of isotherms and intraparticle diffusion showed that the adsorption of DOX followed the multi-layered heterogeneous adsorption mechanism. The BFO nanoparticles exhibited the highest adsorption efficiency of about 93% for DOX in the aqueous solution. The electrostatic interaction between DOX and BFO nanoparticles along with substantial diffusion at porous sites was the probable degradation mechanism of DOX. To assess the reusability merit, BFO were reused up to 4 times as an absorbent for DOX adsorption. Phase pure BFO can efficiently remove the DOX from aqueous medium and provide a cost-effective and eco-friendly solution to deal with EOC of water.

Knowledge, Attitude and Practices of Pharmaceutical Waste Disposal in Community Pharmacies of Karachi

Objectives: The aim of the study was to assess the knowledge of community pharmacies about recommended methods of drug disposal and hazardous effects of improper disposal of pharmaceutical waste and to determine the attitude as well as practice of community pharmacies about the proper disposal of pharmaceutical waste. Methods: A cross-sectional study was performed with 139 community pharmacies in Karachi, Pakistan by using non-probability convenient sampling technique. Predesigned structured questionnaire was distributed to different community pharmacies in Karachi and filled questionnaires were collected after one day. Data was analyzed using SPSS 22.0 Results: About 65 (46.8%) of the participants reported to have a system for regularly removing the expired or unused drugs by returning them to contractors/distributors. More than half 86 (61.9%) of the participants disposed of solid, liquid, semi-solid, controlled, and p-listed drugs in the rubbish bin. Approximately half of the participants believed that standard method for disposal of solid, liquid, semi-solid, controlled, and p-listed drugs is by flushing them down the toilet/sink. Conclusion: Our study showed that knowledge and practices of community pharmacies regarding disposal of unused and expired medicines were not satisfactory. However, most of the participants were well aware of the harmful effects caused by improper disposal of pharmaceutical waste on environment and showed positive attitude towards learning safe methods of management and disposal of unused and expired drugs.

PHARMACEUTICAL REVERSE LOGISTICS IMPLEMENTATION IN NORTHERN MALAYSIA

As in many other developing countries, the generation of pharmaceutical wastes in Malaysia has increased significantly over the last few years. Pharmaceutical wastes are the unwanted materials which can no longer be used in the manufacturing processes that can eventually be harmful to the living beings in the ecosystem. Even though the severe impact of pharmaceutical wastes is significant, however only minor attention is given to the pharmaceutical reverse logistics. Hence, this study seeks to investigate the associated factors which affect the implementation of pharmaceutical reverse logistics in Malaysia. The data are collected using questionnaire that contains both closed- ended and multiple-choice questions. Questionnaires are administered to respondents from medical service centres sampled on a convenience basis. A total of 400 samples were collected, and the data are analysed using the Pearson Correlation Coefficient and Multiple Linear Regression. Overall, the Cronbach’s Alpha score was 0.880 . As a result, the findings indicated that all of the independent variables such as costs, personnel, lack of coordination and government have a significant relationship with the implementation of pharmaceutical reverse logistics. Lastly, the outcomes of this study are expected to help the medical service centre to improve the handling and disposal of pharmaceutical wastes in an effective, efficient and environmental friendly way.