[Intl_DxMedPhys] Pluvicto Patient Waste Storage Timeframe

Tue Sep 15 09:03:10 EDT 2026

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.

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.

>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.

-Tara
______________________________
Tara M. Medich, MS, CHP
Director, Radiation Safety
Radiation Safety Officer, MGH | BWH | MEEI | NWH | BWFH

Massachusetts General Hospital
Brigham and Women’s Hospital
125 Nashua St, Suite 641, Boston MA 02114
MGH 617 724 4577    |    BWH  617 525 6612
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brighamandwomens.org

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From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces+tmedich=mgh.harvard.edu at lists.osu.edu> On Behalf Of Lemieux, Bryan P. via Intl_dxmedphys_wd_osu_list
Sent: Monday, September 14, 2026 9:44 PM
To: Jeff Moirano <jmoirano at gmail.com>; Shane McCotter <shane at rpcphysics.com>
Cc: DxMedPhys List <intl_dxmedphys_wd_osu_list at lists.osu.edu>
Subject: Re: [Intl_DxMedPhys] Pluvicto Patient Waste Storage Timeframe

I would call out 2 points on this. 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. 

        External Email - Use Caution
I would call out 2 points on this.

  1.  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.

  1.  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 >....

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.

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.

So...to the original question.

  1.  What does the law In your area require?
  2.  What is the lowest exposure risk including handling and storage?
  3.  What exactly are they storing and why?  Take all steps  for waste minimization.
  4.  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"

Bryan Lemieux, MS CHP DABMP
Associate Chief - Radiation Safety
Radiation Safety Officer
UK HealthCare
________________________________
From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list-bounces at lists.osu.edu>> on behalf of Jeff Moirano via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>>
Sent: Monday, 14 September 2026 21:00:44
To: Shane McCotter <shane at rpcphysics.com<mailto:shane at rpcphysics.com>>
Cc: DxMedPhys List <intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>>
Subject: Re: [Intl_DxMedPhys] Pluvicto Patient Waste Storage Timeframe

CAUTION: External Sender

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
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 that states the same.

Jeff

On Mon, Sep 14, 2026 at 1:20 PM Shane McCotter via Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>> wrote:
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. ) for 5 days and store for 70 days before disposal, however, one of
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.) 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 (Link 1<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!x6KPQO65MK4RALeQ6Ul8PAv4mauEe-pImKcrmDOszE5IguR7st2Pr3mTUCU2iIlU1tuGfc7773qSw11KpTUD6_xp-HDHfrNTjbYBEGo1_ZaddQ$ > & Link 2<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!x6KPQO65MK4RALeQ6Ul8PAv4mauEe-pImKcrmDOszE5IguR7st2Pr3mTUCU2iIlU1tuGfc7773qSw11KpTUD6_xp-HDHfrNTjbYBEGp9gxB5og$ >) and discussions they have had with other AU's in NRC and agreement states.

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.

Thank you,

[cid:image001.png at 01DD44ED.C9FDBC10]

Shane McCotter, M.S., DABMP

Medical Physicist

(218) 349-3548<tel:(218)%20349-3548>

shane at rpcphysics.com<mailto:shane at rpcphysics.com>

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