RACHEL’s Hazardous Waste News #228

=======================Electronic Edition========================

RACHEL’S HAZARDOUS WASTE NEWS #228
—April 10, 1991—
News and resources for environmental justice.
——
Environmental Research Foundation
P.O. Box 5036, Annapolis, MD 21403
Fax (410) 263-8944; Internet: erf@igc.apc.org
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MEDICAL WASTES INVADE THE COUNTRYSIDE.

Across the land, rural people are being besieged by waste haulers
hell-bent on opening landfills (dumps) and incinerators for all
kinds of wastes. The southern and midwestern states are
particularly hard-hit; there the dumpers are conducting open
warfare against local people. Ironically, haulers are often using
medical wastes to get a foot in the door. Who could oppose
“responsible, state-of-the-art disposal” of wastes created by
nurses and physicians rendering aid to the ill and infirm? Some
communities have even allowed themselves to be convinced they
have an obligation to take such wastes, almost a patriotic duty.

Unfortunately, the situation is not so simple as it may appear.
The nation’s nurses and doctors are doing good as they produce
their dangerous wastes, but many of these wastes are
unnecessarily dangerous and some of them are just plain
unnecessary; worse, the medical community is handing dangerous
wastes over to fly-by-night haulers who are trucking them into
the countryside where they think they can bamboozle local people,
or prey upon their sense of patriotism, or simply dazzle them
with money.

Unfortunately, there are no federal regulations covering medical
waste incineration. Each state must pass its own regulations and
few have done so; fewer still have developed effective
enforcement. Though proponents of new medical waste disposal
facilities complain that they are confined by a web of strict
regulations, the truth is, medical waste regulation is in
disarray and the rule of the day is generally “anything goes.”

After the summer of ’88, when the Jersey shore found itself awash
in needles and blood bags, doctors and their institutions
(hospitals, labs) were willing to pay very high prices to clean
up their image in the press. To get constituents off its back,
Congress passed a half-hearted statute, the Medical Waste
Tracking Act. (That law merely tries to create a paper trail for
medical wastes in 10 states, as a pilot test of a medical waste
tracking system.) The media furor created a business opportunity
for anyone with a dump truck and the nerve to paint “Hi-Tech
Med-Waste–You Call We Haul” on its door. So the past few years
have witnessed an explosion in “medical waste processing”
companies–many of them brand new to the business. The big
haulers like Waste Management and BFI (Browning-Ferris
Industries) jumped in and created new divisions just to handle
medical wastes–though these new divisions use the same old
polluting technologies their other divisions have used for a
decade–landfills and incinerators.

A recent report from the Citizens Clearinghouse for Hazardous
Waste (CCHW) can help people get these problems into perspective.
Entitled MEDICAL WASTE: PUBLIC HEALTH VS. PRIVATE PROFIT, it
describes the problem in particularly graphic terms, giving
several short case studies showing how unscrupulous haulers buy
local officials (for example, giving the mayor stock in the
company), then bulldoze their way into a community demanding the
“right” to pollute the local environment with body parts, needles
and syringes, clothing and equipment contaminated with deadly
diseases, lead, mercury, cadmium, and even some radioactive
materials. Medical waste is not just Kleenex and Band-aids, and
the people bringing these wastes into rural America are not on an
errand of mercy.

As with all pollution problems, real solutions must begin at the
source. Medical practitioners simply use too many disposable
items. This is a complex problem. If a hospital offers you a
stainless steel bedpan, then pays a staff member to empty it,
sterilize it and put it back in the supply closet, they can’t
easily tally the expense and charge you the way they can when
they sell you a plastic disposable bedpan and throw it out after
one use. The patient buys each throw-away and pays for it,
itemized on the bill. Hospitals can mark up each item and make a
small profit. In this sense, disposables are good business.

Secondly, there’s an army of aggressive sales people urging the
latest “innovation” on every doctor and every hospital
administrator. The plastics people are especially good at pushing
their products and they’ve got the medical world convinced that
plastic throw-aways are modern, steel reusables are not.

Thirdly, fear of aids–and of other infections and
liabilities–induces hospitals to use disposables. (This fear is
not justified; reusable items can be safe, but both doctors and
patients have to be educated to the facts.)

To handle the medical waste problem, the people who create
medical waste need to examine their daily routines, item by item,
procedure by procedure, and ask themselves why they use one
product instead of another.

If they choose to use plastic items, they should require plastics
that contain no cadmium, no lead, and no chlorine. These are
common toxins in plastics and they make waste disposal dangerous.
Doctors and medical administrators could drive bad plastics out
of existence if they wrote careful contracts with their suppliers.

The number of disposable items should be decreased wherever
possible. Reusable items should be sterilized by autoclave
(subjected to high-temperature steam for sufficiently long to
achieve sterilization); modern autoclaves work faster and better
than the old designs. A study by California state government
showed that regional autoclaves are the cheapest way for
hospitals to sterilize equipment–cheaper than each hospital
having its own autoclave, and cheaper than incineration. (See
RHWN #179). An alternative to the autoclave is microwave
technology.

Sharps (needles and scalpels) should be collected separately,
sterilized, packaged securely, and sent to a landfill or
processed by patented proprietary techniques.

Organic materials, including body parts, should be shredded,
sterilized, then landfilled.

As Paul Connett of Work on Waste says, from a scientific
viewpoint, “using an incinerator to disinfect pathogens is like
using a chainsaw to cut butter.”

Get: Brian Lipsett, MEDICAL WASTE: PUBLIC HEALTH VS. PRIVATE
PROFIT (Falls Church, VA: Citizens Clearinghouse for Hazardous
Waste [P.O. Box 6806, Falls Church, VA 22040; phone (703)
237-2249], 1990). $8.50. For an additional $15, CCHW sells an
excellent packet of 42 reprinted articles on medical wastes. For
$1.75 more, you get first-class mail delivery.

And get: Office of Technology Assessment, FINDING THE RX FOR
MANAGING MEDICAL WASTES [OTA-O-459; US GPO Stock No.
052-003-01204-9] (Washington, DC: U.S. Government Printing
Office, 1990). $4.75. 76 pgs. Phone (202) 783-3238.
–Peter Montague, Ph.D.

Descriptor terms: waste disposal industry; landfilling;
incineration; south; midwest; medical communities; regulation;
medical waste; hazardous waste; nj; beaches; clean water; water
pollution; medical waste tracking act; wmi; bfi; cchw; studies;
lead; mercury; cadmium; radioactive waste; heavy metals;
disposables; infectious waste; alternative treatment
technologies; autoclaving; paul connett; ota; brian lipsett;

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