Medical waste

by Robin Huiras

Most people do not consider the health care industry to be a cause of pollution, especially toxins which contribute to illness.
However, the Environmental Protection Agency has identified the incineration of medical waste, specifically plastics — including IV bags, mattress covers and surgical gloves containing polyvinyl chloride — as the leading source of dioxins in the environment.
“Our purpose is to prevent health problems,” said Carol Johnson, a Women’s Cancer Resource Center board member. “The Hippocratic oath health care professionals take first states ‘do no harm.'”
Addressing this seemingly contradictory situation, 12 health care and environmental organizations sponsored the conference, “First, Do No Harm: Preventing Pollution in Health Care Facilities,” Wednesday at the Sheraton Midway in St. Paul.
Increasing awareness and discussing alternatives to PVC incineration were among the topics discussed.
Technology creates new problems that need to be dealt with as they emerge, said Ed Ehlinger, director of Boynton Health Service, who spoke at the event. “It is a constant redefinition of the unacceptable.”
Boynton produces and disposes of infectious waste by incineration. However, officials are in the process of looking at Boynton’s waste streams to find better products to purchase, Ehlinger said.
Described and documented about 10 years ago by the EPA as a known carcinogen, health problems caused by dioxins include cancer, immune system failure, developmental defects and hormone disruption. Dioxins mimic hormones found naturally in the body; they disrupt and overload the endocrine system which affects reproduction.
When burned, the noxious dioxins in PVCs are released into the atmosphere. Entering the food chain, they lie in the fatty material in many animals which humans consume. According to the EPA, 90 percent of human exposure to dioxins is through food sources.
The EPA also estimates that humans consume more than 300 times the accepted amount of dioxins on a daily basis.
“The average American has already reached the maximum level of dioxin exposure without experiencing detrimental effects,” Johnson said.
Items containing PVCs abound in the medical industry: blood bags, tubing, oxygen tents, breathing masks and packaging materials all contribute to the problem. Reducing the amount of PVC items hospitals use and incinerate would decrease the amount of dioxins in the air.
“Materials which eventually biodegrade would not pose a problem later on,” said Vincent Garry, professor of laboratory medicine and pathology. Alternative polycarbonate plastics or materials derived from grain may be viable solutions.
Johnson said a commitment on the part of medical facilities to purchase alternative plastics is one goal of the conference. She added that these products often cost less than the PVC products.
Health Care Without Harm, a national coalition of health organizations, will talk to Boynton staff in early November to look at possible alternatives and costs, Ehlinger said. Boynton buys products through regular University purchasing and is not contractually obligated to any vendors, making the purchase of other forms of plastics possible.
Conference officials also noted that medical facilities need to decrease the amount of incinerated waste. The Centers for Disease Control released a report stating hospitals burn roughly 75 percent to 100 percent of their infectious waste. However, a mere 2 percent of this waste needs to be burned to maintain public safety.
“Most PVC disposal has been in the form of incineration because of the risk of infection,” said Ian Greaves, associate dean of the University’s School of Public Health. Distinguishing between infectious and non-infectious waste is key in reducing the amounts of material needing to be burned, he said.
Incinerating infected materials is not necessarily bad technology; it is a reasonable way of disposal and preferable to sending the material to a landfill, Greaves said. However, environmentally friendly materials need to be found.
Sterilizing toxic materials presents another alternative. This process, called autoclaving, requires steaming waste at extremely high temperatures.
The University does not burn the infectious waste produced by Fairview and Boynton on campus. Transported by Facilities Management to a loading dock, a private contractor delivers barrels of waste to a commercial facility to be autoclaved or incinerated, said Fay Thompson, the University’s director of environmental health and safety.