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Medical Waste Incineration

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Introduction

A comprehensive strategy to protect consumers and the environment from the detrimental effects of medical waste incineration Dean Myers Management Law BU 511 Dr. William Russell May 3, 2007 Abstract Hospitals in the United States generate approximately 4.5 million tons of medical waste each year. According to industry estimates, incinerators burn 75+% of this waste each year. Despite its effectiveness in reducing this waste stream, incineration releases toxic emissions (e.g. dioxins, PCBs and flurans) and produces toxic ash residue (e.g. hydrochloric acid and toxic metals like mercury and lead) that scientists believe degrades the environment and contaminates our food supply. With this in mind, an urgent need exists for legislative and regulatory action to ensure a complete phase-out of waste incineration by 2020 and the implementation of rigorous waste management principles to reduce the overall regulated medical waste 50% by 2012 through waste prevention, re-use and recycling. Hospitals in the United States generate approximately 4.5 million tons of medical waste each year. The Environmental Protection Agency (EPA) defines medical waste as any waste generated in the diagnosis, treatment, or immunization of human beings or animals or in the production or testing of biologicals, including the following (40 CFR � 60.51c, pg. 257): * Cultures and stocks of infectious agents and associated biologicals * Human pathological waste, including tissues, organs, body parts and body fluids that are removed during surgery, autopsy, or other medical procedures, and specimens of body fluids and their containers * Human blood and blood products, including items saturated or dripping with blood * Sharps that have been used in animal or human patient care or treatment or in medical, research, or industrial laboratories * Animal waste, including contaminated animal carcasses, body parts, and bedding of animals that were known to have been exposed to infectious agents during research, production of biologicals, or testing of pharmaceuticals * Isolation wastes, including biological waste and discarded materials contaminated with blood, excretions, exudates, or secretions from humans who are isolated to protect others from ...read more.

Middle

As of June 2004, the EPA estimates that only 95 incinerators operate in the United States to combust medical and infectious waste annually compared to the estimated 1,600 active during the 1980s and 1990s (EPA, 1997). Detrimental Effects of Incineration Despite its effectiveness in reducing the volume of waste, incineration releases toxic air emissions and produces toxic ash residue (e.g. hydrochloric acid and toxic metals like mercury and lead). Health Care Without Harm describes these effects: "The air emissions affect the local environment and may affect communities hundreds or thousands of miles away. The ash residue is sent to landfills for disposal, where the chemical pollutants have the potential to leach into groundwater." (HCWH, 2002, Alternatives for Incineration �). In addition, the burning of RMW consistently creates new toxic compounds such as dioxins, PCBs and flurans. The World Health Organization (WHO) classifies dioxin as a known human carcinogen. EPA identified HMIWIs as the third largest source of dioxin air emissions and as the contributor of 10% of the mercury emissions into the environment. Id. Although strict causal relationships are difficult to identify for a single individual, current scientific thought associates these compounds with a significant increased risk for adverse health effects such as cancer, birth defects, immunosuppression, respiratory disease, developmental delays, hyperactivity, allergies and endocrine disorders. Dioxin is formed as a by-product when products or wastes containing chlorine are burned, such as PVC (polyvinyl chloride) plastic. PVC is a used extensively in hospitals and other healthcare facilities, for common disposable products such as IV and blood bags, gloves, tubing, ID bracelets and mattress covers. Office supplies like binders and chart holders are also made with PVC and typically disposed of. Id. When hospitals incinerate these waste products containing chlorine or heavy metals (e.g. mercury used in thermometers and blood pressure gauges), particles of dioxin and mercury are emitted into the air and carried by the wind before settling on land/plants or in water. ...read more.

Conclusion

. A substantial reduction in the overall volume of RMW and general waste produced by hospitals will help to mitigate the damaging effects of incineration to the environment and the publics' health. This regulatory mechanism serves two purposes: 1) decreasing the market demand for and reliance on incineration as waste volumes decrease, and 2) creating an economic incentive to pursue 'green' business practices (e.g. purchasing, materials and waste management) as disposal savings are realized. The potential for revocation of a facility's participation in the Medicare program will ensure compliance with these requirements. Some hospitals have taken major steps to reduce their use of potentially toxic materials and to decrease the total volume of incinerator waste. A waste reduction program at the Fletcher -Allen Health Care System in Vermont reduced the volume of regulated medical waste at one campus by 75% in a few months. Beth Israel Medical Center in New York City has a program to rigorously reduce the amount of solid waste going into the "red bags" for biohazardous waste. This effort saves the hospital $900,000/year in disposal costs by reducing the amount of RMW that must be treated. Naples Community Hospital switched from incineration to autoclaving of medical waste, reducing disposal operating costs by up to 80%. Significant potential exists for healthcare facilities to reduce incineration use while saving costs (HCWH, 2001). Conclusion The Pollution Prevention Act (PPA) requires the prevention and/or reduction of pollution at the source, with disposal into the environment utilized only as a last resort in an ecologically safe manner (PPA, 1990). With our knowledge of the detrimental effects of incineration, we realize that immediate action is necessary to not only ensure compliance with the PPA mandates but also to avoid further environmental contamination and public health effects. With this in mind, an urgent need exists for legislative and regulatory action to ensure a complete phase-out of waste incineration by 2020 and the implementation of rigorous waste management principles to reduce the overall RMW 50% by 2012 through waste prevention, re-use and recycling. ...read more.

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