Medical Waste

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The Problem | The Solution | Resources
 

The Problem

American hospitals generate 4 billion pounds of waste each year. For various reasons all this waste, including infectious material, hazardous chemicals, and office paper, often ends up in one waste stream. This situation puts not only healthcare workers but also waste handlers at risk of exposure to this potentially hazardous waste.

Hospital waste has historically often been incinerated. Incineration, however, creates toxic air pollution and toxic ash. The air pollutants can affect both the local and global communities. The ash may be placed in a landfill, creating the potential for the pollutants to leach into our ground water. Some of the pollutants persist and accumulate in the environment, and in our bodies. The incineration of regulated medical and general hospital waste results in air and water emissions of dioxin, mercury, other toxic metals, particulates, and sulfur dioxide. The box below lists other hazardous pollutants that have been identified in the emissions from medical waste incinerators.


Hazardous pollutants identified in medical waste incinerators emissions
(Montague, 1990)

arsenic

chromium

ethyl benzene

ammonia

chlorodibromomethane

lead

benzene

chloroform

mesitylene,

bromodichloromethane

cumene

nickel

cadmium

1,2_dibromoethane

particulate matter

trichloroethane

toluene

tetrachloroethane

Trichloromethane

vinyl chloride

1,1,1_trichloroethane

carbon tetrachloride

dichloromethane

naphthalene

xylenes

 

 

The 1997 ANA House of Delegates (HOD) Report: Reduction of Health Care Production of Toxic Pollution states the following: “The process of providing care produces an enormous amount of waste that needs to be disposed of. In mistaken efforts to protect the public most medical waste, that is, the waste generated in the provision of illness and health care has been incinerated.” The HOD report identifies and defines three categories of waste from healthcare facilities, these include:

(1) solid waste, or regular trash; (2) regulated medical waste (RMW), items such as needles, body parts, cultures and stocks, and blood saturated items; and (3) hazardous waste, items such as chemical waste, and solvents. The ‘must be incinerated’ waste is a mere fraction of the total amount of RMW. Much of the RMW can be disinfected by heat, chemical treatments, or radiation, the document describes the type of waste that actually needs to be incinerated: “Not all potentially infectious waste needs to be incinerated. Hospitals and other health care systems need to segregate their wastes appropriately to reduce the amount of regulated medical waste generated which then requires special treatment. The only segment of regulated medical waste that needs to be treated by incineration is pathologic waste (e.g., human tissues, organs, body parts removed during surgery, autopsy, or other medical procedures) and EPA regulated pharmaceuticals. The remainder of regulated medical waste can be safely treated with alternative technologies.”

The Solution

The good news is that while there were 6,200 medical waste incinerators in use in this country in 1988, as of June 2004, only 110 were left, and only 96 of these were in use in the U.S. Because of this, total mercury emissions from medical waste incinerators have been reduced by 99.6%.

Alternatives to incineration of medical waste, include autoclaving, microwaving, chemical treatment, and others (though these also carry their own advantages and disadvantages, but they generally have fewer environmental impacts than incineration). In addition, reduction of volume and toxicity through; careful waste segregation and minimization, resource recovery and recycling, and environmentally preferable purchasing are part of the solution to the problem of incineration.

Six categories of hospital waste include; infectious waste, hazardous chemical waste including hazardous drugs), recyclable/reusable materials, solid waste radioactive waste and chemotherapy waste. By keeping these waste streams separate, each can be handled in an appropriate, and environmentally responsible manner.

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