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Thank you all - both who replied to the list and separately to me - for your insight. It is a complex issue that seems to have a variety of recommendations based on location. I will be digging into our local regulations to see if there are any</div>
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Thank you all - both who replied to the list and separately to me - for your insight. It is a complex issue that seems to have a variety of recommendations based on location. I will be digging into our local regulations to see if there are any restrictions
to dispose directly into the waste.</div>
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<span style="color: rgb(0, 156, 242);"><b>Shane McCotter, M.S., DABMP </b></span></p>
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<span style="font-size: 10pt;"><b>Medical Physicist</b></span></p>
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<span style="font-size: 9pt;">(218) 349-3548 </span></p>
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<span style="font-size: 9pt; color: rgb(0, 0, 0);">shane@rpcphysics.com</span></p>
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<span style="font-size: 9pt; color: rgb(5, 99, 193);"><a href="https://urldefense.com/v3/__http://www.rpcphysics.com/__;!!KGKeukY!3YYq9qebpJroxYhS85nIaC1GSipt_UwaJORY4HX5MTYXz2JZQ2XLAs2IcsrDA6s8UzZkR3BN3sgN0Ou6c2tTFFqj9UXONqK0GrN9KIc$" style="color: rgb(5, 99, 193); margin-top: 0px; margin-bottom: 0px;"><u>www.rpcphysics.com</u></a></span></p>
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<div id="divRplyFwdMsg" dir="ltr"><font face="Calibri, sans-serif" style="font-size:11pt" color="#000000"><b>From:</b> Medich, Tara <TMEDICH@mgh.harvard.edu><br>
<b>Sent:</b> Tuesday, September 15, 2026 8:03 AM<br>
<b>To:</b> Lemieux, Bryan P. <bryan.lemieux@uky.edu>; Jeff Moirano <jmoirano@gmail.com>; Shane McCotter <shane@rpcphysics.com><br>
<b>Cc:</b> DxMedPhys List <intl_dxmedphys_wd_osu_list@lists.osu.edu><br>
<b>Subject:</b> RE: [Intl_DxMedPhys] Pluvicto Patient Waste Storage Timeframe</font>
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<p class="x_MsoNormal"><span style="font-size:11.0pt">Bryan hit the nail on the head with the local prohibitions of any radioactive material being introduced into municipal waste. It is expressly prohibited by the Department of Environmental Protection here
and our radiation regulators have been trying get the DEP to compromise on patient waste without success.
</span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt"> </span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt">Any waste facility will have radiation detectors to catch hot loads before entering the yard. This requires the facility contact the radiation regulators to make a report so there is a paper trail. Too
many unnecessary resources go into trying to determine the isotope and origin, but more often than not the isotope and the patient is identified. I have had one trash company threaten to stop collecting from a particular route because a patient was disposing
of Lu-177 contaminated incontinence pads. This was waste generated after the precautions had lifted, so he was still excreting measurable amounts after 7 days.
</span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt"> </span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt">From a dosimetric standpoint it makes sense to dispose of all waste in normal trash but it’s a more complex situation than assessing radiation doses because of other laws that may be in place.
</span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt"> </span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt">-Tara</span></p>
<p class="x_MsoNormal"><b><span style="color:#009CA6">______________________________</span></b><b><span style="font-size:11.0pt; color:#009CA6"></span></b></p>
<p class="x_MsoNormal"><span style="font-size:16.0pt">Tara M. Medich, MS, CHP</span></p>
<p class="x_MsoNormal">Director, Radiation Safety<span style="font-size:11.0pt"></span></p>
<p class="x_MsoNormal">Radiation Safety Officer, MGH | BWH | MEEI | NWH | BWFH</p>
<p class="x_MsoNormal"> </p>
<p class="x_MsoNormal"><b>Massachusetts General Hospital</b></p>
<p class="x_MsoNormal"><b>Brigham and Women’s Hospital</b></p>
<p class="x_MsoNormal">125 Nashua St, Suite 641, Boston MA 02114</p>
<p class="x_MsoNormal">MGH 617 724 4577 | BWH 617 525 6612</p>
<p class="x_MsoNormal"><a href="https://urldefense.com/v3/__http://www.massgeneral.org/__;!!KGKeukY!3YYq9qebpJroxYhS85nIaC1GSipt_UwaJORY4HX5MTYXz2JZQ2XLAs2IcsrDA6s8UzZkR3BN3sgN0Ou6c2tTFFqj9UXONqK0KddZrgY$"><span style="color:#0563C1">massgeneral.org</span></a></p>
<p class="x_MsoNormal"><a href="brighamandwomens.org"><span style="color:#0563C1">brighamandwomens.org</span></a></p>
<p class="x_MsoNormal"> </p>
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<p class="x_MsoNormal"><b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif">From:</span></b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif"> Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces+tmedich=mgh.harvard.edu@lists.osu.edu>
<b>On Behalf Of </b>Lemieux, Bryan P. via Intl_dxmedphys_wd_osu_list<br>
<b>Sent:</b> Monday, September 14, 2026 9:44 PM<br>
<b>To:</b> Jeff Moirano <jmoirano@gmail.com>; Shane McCotter <shane@rpcphysics.com><br>
<b>Cc:</b> DxMedPhys List <intl_dxmedphys_wd_osu_list@lists.osu.edu><br>
<b>Subject:</b> Re: [Intl_DxMedPhys] Pluvicto Patient Waste Storage Timeframe</span></p>
</div>
<p class="x_MsoNormal"> </p>
<p class="x_MsoNormal" style=""><span style="font-size:1.0pt; color:white">I would call out 2 points on this. The latest revisions proposed for 8.</span><span style="font-size:1.0pt; font-family:"Arial",sans-serif; color:white"> </span><span style="font-size:1.0pt; color:white">39
want you to consider the dose to receptors from all sources as I recall, you would need to account for this in addition to the potential dose per course of treatment issues.</span><span style="font-size:1.0pt; font-family:"Arial",sans-serif; color:white"> </span><span style="font-size:1.0pt; color:white"></span></p>
<p><b><span style="color:white; background:red"> External Email - Use Caution </span></b></p>
<p class="x_MsoNormal"><span style="color:#212121">I would call out 2 points on this.</span></p>
<p class="x_MsoNormal"><span style="color:#212121"> </span></p>
<ol start="1" type="1">
<li class="x_MsoNormal" style="color:#212121">The latest revisions proposed for 8.39 want you to consider the dose to receptors from all sources as I recall, you would need to account for this in addition to the potential dose per course of treatment issues.</li></ol>
<p class="x_MsoNormal"><span style="color:#212121"> </span></p>
<ol start="2" type="1">
<li class="x_MsoNormal" style="color:#212121">A lot of the problem is state / local laws and ordinances. Good luck w that. MA for example forbids a single radioactive atom from going to landfill or trash to energy processing. When the landfill alarms went
off they wanted us to localize the source, ID it and find where it came from < usually mail from a patient >.... </li></ol>
<p class="x_MsoNormal" style="margin-left:.5in"><span style="color:#212121"> </span></p>
<p class="x_MsoNormal"><span style="color:#212121">There is absolutely nothing the state Radiation regulator can do about it. Unless you get some sort of national preemptive law/regulation on radioactive waste this will not change.</span></p>
<p class="x_MsoNormal"><span style="color:#212121"> </span></p>
<p class="x_MsoNormal"><span style="color:#212121">Even if the NRC and EPA came to some grand agreement tomorrow with a unified standard and guidance it still would not solve the local issues.</span></p>
<p class="x_MsoNormal"><span style="color:#212121"> </span></p>
<p class="x_MsoNormal"><span style="color:#212121">So...to the original question. </span></p>
<p class="x_MsoNormal"><span style="color:#212121"> </span></p>
<ol start="1" type="1">
<li class="x_MsoNormal" style="color:#212121">What does the law In your area require?</li><li class="x_MsoNormal" style="color:#212121">What is the lowest exposure risk including handling and storage?</li><li class="x_MsoNormal" style="color:#212121">What exactly are they storing and why? Take all steps for waste minimization.</li><li class="x_MsoNormal" style="color:#212121">How long to hold is just a guess on how hot it was and how long til "safe" "background " or "low enough they wont see it at the landfill"</li></ol>
<div id="x_ms-outlook-mobile-body-separator-line">
<p class="x_MsoNormal"> </p>
</div>
<div id="x_ms-outlook-mobile-signature">
<p class="x_MsoNormal"><span style="color:#212121">Bryan Lemieux, MS CHP DABMP</span></p>
<p class="x_MsoNormal"><span style="color:#212121">Associate Chief - Radiation Safety</span></p>
<p class="x_MsoNormal"><span style="color:#212121">Radiation Safety Officer </span></p>
<p class="x_MsoNormal"><span style="color:#212121">UK HealthCare</span></p>
</div>
<div class="x_MsoNormal" align="center" style="text-align:center">
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<div id="x_divRplyFwdMsg">
<p class="x_MsoNormal"><b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:black">From:</span></b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:black"> Intl_dxmedphys_wd_osu_list <</span><a href="mailto:intl_dxmedphys_wd_osu_list-bounces@lists.osu.edu"><span style="font-size:11.0pt; font-family:"Calibri",sans-serif">intl_dxmedphys_wd_osu_list-bounces@lists.osu.edu</span></a><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:black">>
on behalf of Jeff Moirano via Intl_dxmedphys_wd_osu_list <</span><a href="mailto:intl_dxmedphys_wd_osu_list@lists.osu.edu"><span style="font-size:11.0pt; font-family:"Calibri",sans-serif">intl_dxmedphys_wd_osu_list@lists.osu.edu</span></a><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:black">><br>
<b>Sent:</b> Monday, 14 September 2026 21:00:44<br>
<b>To:</b> Shane McCotter <</span><a href="mailto:shane@rpcphysics.com"><span style="font-size:11.0pt; font-family:"Calibri",sans-serif">shane@rpcphysics.com</span></a><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:black">><br>
<b>Cc:</b> DxMedPhys List <</span><a href="mailto:intl_dxmedphys_wd_osu_list@lists.osu.edu"><span style="font-size:11.0pt; font-family:"Calibri",sans-serif">intl_dxmedphys_wd_osu_list@lists.osu.edu</span></a><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:black">><br>
<b>Subject:</b> Re: [Intl_DxMedPhys] Pluvicto Patient Waste Storage Timeframe</span>
</p>
<p class="x_MsoNormal"> </p>
</div>
<p class="x_MsoNormal"><b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:#9C6500; border:solid #9C6500 1.0pt; padding:2.0pt; background:#FFEB9C">CAUTION:</span></b><b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:black; border:solid #9C6500 1.0pt; padding:2.0pt; background:#FFEB9C">
External Sender</span></b></p>
<p class="x_MsoNormal"> </p>
<p class="x_MsoNormal" style=""><span style="font-size:1.0pt; color:white">I do agree that having patients collect and decay waste at home is counterproductive, especially for Lu-177 therapies. We recommend they put it all directly in the normal trash. SNMMI,
ACNM, ACR, and AAPM released a joint position statement</span></p>
<p class="x_MsoNormal">I do agree that having patients collect and decay waste at home is counterproductive, especially for Lu-177 therapies. We recommend they put it all directly in the normal trash.
</p>
<p class="x_MsoNormal"> </p>
<p class="x_MsoNormal">SNMMI, ACNM, ACR, and AAPM released a joint position statement that states the same. </p>
<p class="x_MsoNormal"> </p>
<p class="x_MsoNormal">Jeff</p>
<p class="x_MsoNormal"> </p>
<p class="x_MsoNormal"> </p>
<p class="x_MsoNormal"> </p>
<p class="x_MsoNormal">On Mon, Sep 14, 2026 at 1:20<span style="font-family:"Arial",sans-serif"> </span>PM Shane McCotter via Intl_dxmedphys_wd_osu_list <<a href="mailto:intl_dxmedphys_wd_osu_list@lists.osu.edu">intl_dxmedphys_wd_osu_list@lists.osu.edu</a>>
wrote:</p>
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<p class="x_MsoNormal" style=""><span style="font-size:1.0pt; color:white">All, I am interested in your thoughts regarding patient instructions for at-home waste storage before disposal. I have recommended patients collect items (pads, diapers, etc.</span><span style="font-size:1.0pt; font-family:"Arial",sans-serif; color:white"> </span><span style="font-size:1.0pt; color:white">)
for 5 days and store for 70 days before disposal, however, one of</span></p>
<p class="x_MsoNormal" style="background:white"><span style="font-size:11.0pt; color:black">All,</span></p>
<p class="x_MsoNormal" style="background:white"><span style="font-size:11.0pt; color:black"> </span></p>
<p class="x_MsoNormal" style="background:white"><span style="font-size:11.0pt; color:black">I am interested in your thoughts regarding patient instructions for at-home waste storage before disposal. I have recommended patients collect items (pads, diapers,
etc.) for 5 days and store for 70 days before disposal, however, one of our AU's is requesting we remove the storage requirement allow patients to dispose of all materials without decay based on these studies (</span><span style="color:black"><a href="https://urldefense.com/v3/__https://secure-web.cisco.com/1VkkTxGrVZfuFvplK3RkKyrzaBe2jI4C0KHapqq9x2TKjwjHKKq70T2vOIA_I93cI8htObqRmhSmIVHus6paDtI0AUWbixjDyemvczU6k8mhU8IxLxpiX7dEKo_TPTTUnnr4WqPyBB1QsDwsIhMxYgRHrpFQ6lRfpPhh_1KB5cRcu03dlOmS8tWJ_x_kKeHaOo2N0GHJ-XY1baYiuq4ZNn7IfviB-UI3KG_wqDSK5r82BeFnclXi8ngmMIFOWBQhCrWwHm5ff_dhSiGgjr2J8twcA5mePZzWM13DnL-rX4O3TWNJyZs91_Nfxoav24KrFK5wtTJWPkfW8GXpp56pZNQ/https*3A*2F*2Furldefense.com*2Fv3*2F__https*3A*2F*2Fjnm.snmjournals.org*2Fcontent*2F64*2F10*2F1567__*3B*21*21KGKeukY*211AP1MpV5dSTwsgzAipPNSxW2zEFl5sw_yqZ2skGAqT1NFshsAMKGAjzkj7ufTPmG3lI5wa4IXl-WOO0efXaFYKbF29ysFbouyLBIGTA*24__;JSUlJSUlJSUlJSUlJSUlJSU!!KGKeukY!3YYq9qebpJroxYhS85nIaC1GSipt_UwaJORY4HX5MTYXz2JZQ2XLAs2IcsrDA6s8UzZkR3BN3sgN0Ou6c2tTFFqj9UXONqK0dygbbL0$" target="_blank" title="https://jnm.snmjournals.org/content/64/10/1567"><span style="font-size:11.0pt">Link
1</span></a></span><span style="font-size:11.0pt; color:black"> & </span><span style="color:black"><a href="https://urldefense.com/v3/__https://secure-web.cisco.com/1C9NYgY528Dc-0nXj0p8dOA7NZvYZR8PYwEgvSSYdB4307ExRtEKtWh28f7t2Ec20NbVtonJpuWXo1xLA95QSe_9NVOVbDylkHL6m6HG1fZzDJpvCfp1DTmOSUS4fcv_ROksIyIGAEgKbqRBzfqOcVO8OUxnqc0SjGNXBKpmQBabOVPTIrKRnQGytmPSN8ZBVrhi1YnkoEIAA22pdt5-WKFXe_HkYcCaSOFKoso8KoryXQWDPyNsWMCnAKNIg4qvpX1HIcNJSYfgAjaAkm0b3K63r7GDEgOVl8oNr501lvNgg-TJ2L613VNn2ps8ThlxhnSlA2E7gYPeGONzMZZYPYw/https*3A*2F*2Furldefense.com*2Fv3*2F__https*3A*2F*2Fwww.ovid.com*2Fjnls*2Fhealth-physics*2Ffulltext*2F00004032-200203000-00009*2Aradioactivity-appearing-at-landfills-in-household-trash-of__*3Bfg*21*21KGKeukY*211AP1MpV5dSTwsgzAipPNSxW2zEFl5sw_yqZ2skGAqT1NFshsAMKGAjzkj7ufTPmG3lI5wa4IXl-WOO0efXaFYKbF29ysFbou5xnoIrg*24__;JSUlJSUlJSUlJSUlJSUlJSUl!!KGKeukY!3YYq9qebpJroxYhS85nIaC1GSipt_UwaJORY4HX5MTYXz2JZQ2XLAs2IcsrDA6s8UzZkR3BN3sgN0Ou6c2tTFFqj9UXONqK0011oo50$" target="_blank" title="https://www.ovid.com/jnls/health-physics/fulltext/00004032-200203000-00009~radioactivity-appearing-at-landfills-in-household-trash-of"><span style="font-size:11.0pt">Link
2</span></a></span><span style="font-size:11.0pt; color:black">) and discussions they have had with other AU's in NRC and agreement states.</span></p>
<p class="x_MsoNormal" style="background:white"><span style="font-size:11.0pt; color:black"> </span></p>
<p class="x_MsoNormal" style="background:white"><span style="font-size:11.0pt; color:black">I have reached out to a few other RSO's and institutions, and I have received answers to store items ranging from a few days to 70 days, and I am hoping to get a more
definitive answer from the list.</span></p>
<p class="x_MsoNormal" style="background:white"><span style="font-size:11.0pt; color:black"> </span></p>
<p class="x_MsoNormal" style="background:white"><span style="font-size:11.0pt; color:black">Thank you,</span></p>
<p class="x_MsoNormal"><span style="font-size:11.0pt; color:black"> </span></p>
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<p style="margin-right:0in; margin-bottom:0in; margin-left:.1in"><b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif; color:#009CF2">Shane McCotter, M.S., DABMP </span></b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif"></span></p>
<p style="margin-right:0in; margin-bottom:0in; margin-left:.1in"><b><span style="font-size:10.0pt; font-family:"Calibri",sans-serif">Medical Physicist</span></b><span style="font-size:11.0pt; font-family:"Calibri",sans-serif"></span></p>
<p style="margin-right:0in; margin-bottom:0in; margin-left:.1in"><span style="font-size:10.0pt; font-family:"Times New Roman",serif"><a href="tel:(218)%20349-3548" target="_blank"><span style="font-size:9.0pt; font-family:"Calibri",sans-serif">(218) 349-3548</span></a></span><span style="font-size:9.0pt; font-family:"Calibri",sans-serif"> </span><span style="font-size:11.0pt; font-family:"Calibri",sans-serif"></span></p>
<p style="margin-right:0in; margin-bottom:0in; margin-left:.1in"><span style="font-size:10.0pt; font-family:"Times New Roman",serif"><a href="mailto:shane@rpcphysics.com" target="_blank"><span style="font-size:9.0pt; font-family:"Calibri",sans-serif">shane@rpcphysics.com</span></a></span><span style="font-size:11.0pt; font-family:"Calibri",sans-serif"></span></p>
<p style="margin-right:0in; margin-bottom:0in; margin-left:.1in"><span style="font-size:10.0pt; font-family:"Times New Roman",serif"><a href="https://urldefense.com/v3/__https://secure-web.cisco.com/1TssEKfQtjo98OyRVPezZKASgrlcNHsfOlokQdMSzDotNjvz92W_kAAr2rkDzWAkbpL67gqmTvq_Hltwfb3UC33W9M-FgDsCOSAi1829Atj0ROPAacDKEQ3oXkxbKLk_zGRaEUu0OEZ-AqxzhUUxqhfhuZZ9_RTPy-5HhGthRdHisUrK4lAbHWf5MAaYKWfTSbbXhE5TleefVreXs43klEvQo2hU19G3ZZYYieSPzJxxbWaHkPSo7ERuYSD1ZRW8gXEqq11tVooH4WUyvw4KiQJ5cDqgfhnkfeTS_fSe4IdqxchYNVLL974JF--oFOZSzJmprFNnXeICxdFi_6rcjMA/https*3A*2F*2Furldefense.com*2Fv3*2F__http*3A*2F*2Fwww.rpcphysics.com*2F__*3B*21*21KGKeukY*211AP1MpV5dSTwsgzAipPNSxW2zEFl5sw_yqZ2skGAqT1NFshsAMKGAjzkj7ufTPmG3lI5wa4IXl-WOO0efXaFYKbF29ysFbou71hN5tc*24__;JSUlJSUlJSUlJSUlJSU!!KGKeukY!3YYq9qebpJroxYhS85nIaC1GSipt_UwaJORY4HX5MTYXz2JZQ2XLAs2IcsrDA6s8UzZkR3BN3sgN0Ou6c2tTFFqj9UXONqK0i-9l5gQ$" target="_blank"><span style="font-size:9.0pt; font-family:"Calibri",sans-serif; color:#0563C1">www.rpcphysics.com</span></a></span><span style="font-size:11.0pt; font-family:"Calibri",sans-serif"></span></p>
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