[Impact of Closed System Drug Transfer Device Architecture on Medical Waste Reduction - A Comparative Analysis of Filter-versus Barrier-Based Designs].

Abstract

Closed system drug transfer devices (CSTDs) are recommended to minimize occupational exposure to antineoplastic drugs, yet their bulky components may increase medical waste. To compare waste volume/weight, greenhouse-gas (GHG) emissions, and disposal cost between filter-based and barrier-based CSTDs under real-world workload. A simulated preparation of 93 inpatient/outpatient chemotherapy cases (322 vials, 342 syringes) was performed using 2 filter CSTDs (Chemo-SafeLockTM and Chemfort®) and 1 barrier CSTD (PhaSealTM). Used components were shaken vertically in a 40-L container (2.5 Hz, 60 s) to determine packed volume and weight. Daily differences were extrapolated to the annual hospital activity (93 preparations × 246 days). Costs and GHG reductions were calculated with national disposal parameters. Filter CSTDs reduced waste volume by 27.9% (84.0 ± 2.3 L vs 114.4 L, p<0.01) without significant weight change. Full conversion would save 187 pails (7.5 kL), 1.06 million JPY, and 0.60 t-CO2e annually. Filter CSTDs provides equivalent containment while markedly decreasing waste and environmental impact, supporting their preferential adoption in sustainable oncology practice.