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Incinerator

Hypocritical Smoke: The Scandal of Medical Waste Incineration

The middle-class Foxboro subdivision in North Salt Lake City, Utah, is, in many ways, an idyllic community for young families – fresh, small, similarly sized homes on fairly compact lots, close by neighbors linked by sidewalks and streetlights, tons of playmates for all the kids. And Mormon communities have a great deal of kids, munchkins if you will. ”

But a dark cloud hangs over Foxboro, sometimes literally. On a recent Friday evening in late summer, Foxboro was having a locality 5K run/walk for the countless families that reside in the region. Suddenly, it looked just like the Wicked Witch of the West had arrived: thick black smoke and flames billowed from a well-known industrial neighbor right next to the subdivision. Some of them screamed that they couldn’t breathe and ran into other people’s homes to get away from the smoke. Parents panicked. A local resident took this video near the end of the episode. In about 20 minutes, the smoke was gone, but the chemical odor lingered much longer. The next day, I got more e-mails from those who were experiencing a variety of respiratory ailments and wondered what they had been exposed to.

The “Wicked Witch of the West” occasion was just the latest of several similar episodes involving Foxboro’s nonfictional villain – Stericycle, the medical waste incinerator. Stericycle’s North Salt Lake incinerator, however, is emblematic of a much bigger issue: Via front door, hospitals and clinics are purveyors of recovery, well-being and saving lives. But out the back door, they often spread toxins and disease through a waste stream that’s handily, but dangerously, burned into ashes by incinerators like Stericycle.

The story of North Salt Lake’s Stericycle facility is typical of what has happened in many communities throughout the country. The facility was controversial for at least two decades. Back when it was first permitted, there was concern about the health consequences of its emissions. The license was approved by the Utah Air Quality Board with a one-vote margin. Legislation in the time prohibited such facilities from being within one mile of residences.

About 2003, the county Planning and Zoning Commission received a proposal from the Foxboro developer to subdivide the land north and east of Stericycle to a large residential neighborhood. Part of this commission’s decision to grant Foxboro approval was based on discussions with the Division of Air Quality and the Division of Solid and Hazardous Waste. Both divisions were not forthright with information to the commission. They apparently claimed there were no “upset conditions. ” Foxboro’s proposal was accepted, and homes were built up literally against the wall of the incineration property, leading to families living just feet from the incinerator smokestack, with some households literally sharing a backyard fence with Stericycle. This satellite photograph showing the black soot on Stericycle’s roof and its close proximity to homes provokes the gnawing realization of these families are breathing in 24/7.

Stericycle operates six incinerators in the united states and is the largest medical waste treatment and disposal company in the country. Waste incinerators are serious public health dangers. Large studies have shown higher rates of childhood and adult cancers and birth defects among people who live around incinerators. Those results are consistent with the institutions being causative. For instance, a study of 14 million people followed for 13 years demonstrated an increase in cancer deaths of 11,000 people among those that lived within 7.5 kilometers of an incinerator.1,2 The cancer risk doubled for children living within 5 kilometers of an incinerator.3

This body of medical research is sufficiently robust to have precipitated a nationwide citizen motion to have these facilities closed. In reality, during the past 15 years, 98 percent of the 2,373 medical waste incinerators have closed; only 33 remain in operation. While thousands of communities have become cleaner because of this, in Utah things have gotten worse. Stericycle now accepts waste from eight surrounding states to be incinerated in its North Salt Lake plant. The town is serving as the sacrificial lamb for the majority of the western United States. Besides medical waste, including human fluids and tissue, Stericycle is allowed to incinerate animal carcasses (more about that below).

As with the majority of incinerators, the health consequences aren’t as much the high-volume pollutants, like particulate matter, ozone, NOx or SO2, but the amount of the hazardous air pollutants (HAPs) that are designated as such by the EPA because of their high level of toxicity, even at minute concentrations. HAPs include benzene, dioxins, furans, heavy metals, polycyclic aromatic hydrocarbons and even radioactive components. Stericycle officially emits an identical volume of HAPs as a full size oil refinery or coal-fired power plant. But the emissions are released from a much shorter pile; therefore local deposition is greater. Stericycle’s permit allows it to emit 130 pounds of lead per year, 912 pounds of chlorine, 18 pounds of cadmium and 60 pounds of mercury. The complete amount of HAPs allowed in its license is 9.51 tons per year.

Most poisonous heavy metals aren’t combustible, don’t degrade, cannot be destroyed, accumulate in the local surroundings after leaving Stericycle’s smokestack, and accumulate in the bodies of everyone for miles around. They’ve been implicated in a range of emotional and behavioral problems in children – including autism, dyslexia, ADHD, learning problems and delinquency – and in adults – dementia, depression and Parkinson’s disease. Increased rates of autism and learning disabilities have been found around sites that release mercury to the environment, like coal power plants and incinerators.4 Utah has the highest rates of autism in the nation, double the national average. That fact alone should induce our state leaders to manage every potential contributor to this public health disaster. Sources of heavy metal contamination should be first on this list. It said that, “Persistent air pollutants, like dioxins, furans and mercury can be dispersed over large regions – well beyond local areas and even the states where the sources emanate,”5 meaning that Stericycle is far from an issue affecting its immediate neighbors only.

Incinerators don’t eliminate hazardous substances; they focus them, redistribute them, and even create new ones, like dioxins. In addition to dioxins, they emit chlorine, mercury, arsenic, lead, cadmium, ammonia and benzene – spreading miles from the smokestack, eventually inhaled by local residents or consumed when they eat vegetables from their gardens, or their children play on a garden swing set. Dioxins are likely the most toxic manmade substance known after plutonium. A number of these chemicals are equally poisonous and bio-accumulative, building up over time from the body insidiously with the risk of chronic effects from even very low, continuous exposure.

For multiple physiologic and biologic reasons, children and fetuses are at significantly increased dangers from several of those incinerator emissions. 1 example is illustrative of this point. A number of these HAPs focus in human fetuses or in human breast milk. A nursing infant may have 10 to 50 times as much dioxin as the average adult and is much more vulnerable to its toxicity. Six months of breast feeding will move 20% of a mother’s lifetime accumulation of organochlorines (like dioxins) to her nursing child.6 No risk assessment about Stericycle has paid some attention to whether or not their dioxin emissions are causing human breast milk of Utah’s mothers to be dangerous.

The combined effects of extensive geographic spread of incinerator emissions and bioaccumulation is starkly revealed by what was discovered from the Inuit Native Americans from the polar area of Northern Canada. Inuit mothers here have twice the amount of dioxins in their breast milk as Canadians residing in the South. There’s absolutely no source of dioxin within 300 miles. A study tracking emissions from 44,000 sources of dioxin in North America, combining data on toxic releases and meteorological records demonstrated the top contributors were three municipal incinerators in the USA.7,8

Medical waste incinerators are much more hazardous than other incinerators for 2 reasons. Radioactive elements like potassium-40, uranium, thorium, cesium and strontium are ubiquitous in low concentration in human bodies and animal carcasses, and when heaps of carcasses and body parts are incinerated, those radioactive elements are focused and released up the smokestack.

Just as disturbing is the fact that prions, the highly infective mutated proteins that cause Transmissible Spongiform Encephalopathies (TSEs), i.e. Mad Cow disease in cattle, scrapie in sheep, chronic wasting disease in deer and elk and Creutzfeld-Jacob Disease (CJD) in humans – all uniformly fatal – are almost undoubtedly present in Stericyle’s waste stream. Prions are so infective that pathologists don’t want to touch tissue from a suspected victim, be it animal or human. So the diagnosis is generally never produced. And the majority of the time, there’s absolutely no way that Stericycle would even know whether prions are in the waste stream headed to the smokestack then dispersed throughout North Salt Lake. Prions are frighteningly resistant to destruction, including incineration. I’ll have a more detailed depiction of the issue of prions in another essay. A detailed report on the health consequences of waste incinerators can be obtained online.

Any incinerator would represent a serious threat to public health in our community. As dramatic and intuitively dangerous as the video seems, it better serves a bigger point. Any incinerator has start-ups and shutdowns and other “events” that result from the bypass of pollution-control gear on a regular basis. In fact “contamination events” this severe may not represent a license violation – which shows how out of control this situation has become.

Studies at other incinerators demonstrate that “bypass events” may be happening 10 percent of the time. Dioxins produced during start-ups could be twice the annual dioxin emissions under steady state conditions. Spot monitoring, as is done by the Utah Division of Air Quality (DAQ), has been shown to be grossly inadequate and likely underestimates the actual dioxin and heavy metal emissions by 30-50 times.

This facility is anything but “best managed. ” In layman’s terms, the DAQ has captured Stericycle falsifying its documents, intentionally loading the incinerator with material that does not represent its normal feedstock in order to pass their emissions evaluation – Quite simply cheating. Along with the DAQ has found Stericycle emitting hundreds of times more dioxins and furans than Stericycle’s license allows (public health protection would require that the business not be allowed to emit any). We were advised by the DAQ that this facility is currently under criminal investigation in the state and federal level.

An internal DAQ email quotes a subcontractor for Stericycle stating that the company is pressuring its manager to “push the limits of this plant. ” Further, the comment is made that the manager recently got a huge increase and promotion and “that as a consequence, they are now demanding more and more of him. ” The manager is complaining that “he’s under plenty of pressure from his managers to feed more and more waste through the plant and that the plant can’t handle what they want it to do. ” “Bypass events” like the one recorded on video are all too predictable by a corporation that prioritizes profit over safety.

Hospitals and clinics aren’t innocent bystanders. As health care centres, it’s ironic and indefensible for them to dispose of their waste in a fashion that harms community health. The International Red Cross says, “Hospitals are responsible for the waste they produce. They must ensure that the handling, treatment and disposal of that waste won’t have harmful consequences for public health or the environment. ”

Neither is the EPA an innocent bystander. An appeal of Stericycle’s license has been sitting on its desk since 2009. As a consequence of multiple recent community protests of Stericycle’s operations, the EPA has finally agreed to deal with the appeal by mid-October 2013.

Incineration of medical waste is a business that simply shouldn’t exist. No helpful product is produced; no needed service is done. There are safer technologies, like steam autoclaving and burial. Several countries have committed to removing incineration as a destination for medical waste. The United States is not one of them. In reality the list of “educated ” countries is not what you might expect – Ireland, Slovenia, Portugal and the Philippines.

Although many American communities are breathing cleaner air because of widespread closure of incinerators, North Salt Lake, and Foxboro residents particularly, are “taking a hit” for the team. Normally Mormon suburbs are bastions of political and cultural conservatism, reservoirs of silent capitulation and obedience to authority. They even convinced Erin Brockovich to come to Foxboro and lend her fame and legal muscle to the battle.

Foxboro has heard the wisdom of 19th century abolitionist Frederick Douglass. The residents of Foxboro are no longer quietly submitting to the mistake that’s Stericycle, and they are exposing the nationwide scandal that’s medical waste incineration.

Information from: http://www.truth-out.org/news/item/19069-hypocritical-smoke-the-scandal-of-medical-waste-incineration

Although many American communities are breathing cleaner air because of widespread closure of incinerators, North Salt Lake, and Foxboro residents in particular, are needlessly “taking a hit” for the team. Normally Mormon suburbs are bastions of political and cultural conservatism, reservoirs of quiet capitulation and obedience to authority. But in Foxboro, with town hall meetings, protest marches and rallies in the Capitol in front of the governor’s office, they are mounting an unwillingness to remain victims of Stericycle’s profiteering. They even convinced Erin Brockovich to come to Foxboro and lend her fame and legal muscle to the battle.

Foxboro has learned the wisdom of 19th century abolitionist Frederick Douglass. “Find out just what any people will quietly submit to and you have the exact measure of the injustice and wrong which will be imposed on them.” The residents of Foxboro are no longer quietly submitting to the mistake that is Stericycle, and they are exposing the nationwide scandal that is medical waste incineration.

Information from: http://www.truth-out.org/news/item/19069-hypocritical-smoke-the-scandal-of-medical-waste-incineration

How many infectious medical waste?

Polaris Energy saving News: With the extensive use of the medical care industry and the
development of medical disposable products, medical waste generation is growing quickly.
The most recent statistics show that there were 261, in the city to the community solid waste
pollution prevention information, only those 261 cities this year, medical waste quantity attained 547,500 tons.

Another one figures show that at the end of 2012, the total number of health associations of 950 297 beds 5.7248 million, according to an average of 1 kg per bed
medical waste every day, the whole number of medical waste generated in the country annually to reach 200 million tons.

Faced with such a huge amount of waste created, but many cities are composed of one or a
few waste disposal in a single way of managing medical waste incineration. After a case of waste incineration plants closed down, the authorities and the hospital at the
management of medical waste and daily operations, will face enormous challenges.

In actuality, hospital waste generated a big part of municipal solid waste and similar low-
risk waste, about 75% to 90%, the remaining 10% to 25% are believed to be dangerous, it could pose
a health hazard, hospitals infectious waste is generally not more than 10 percent of the whole garbage. Reduce the amount of waste generated must be effective category management as the
assumption, but now garbage classification level of the hospital, worrying.

Medical waste collection is key to the implementation of environmentally sound management
of medical wastes, but most Chinese physicians don’t pay attention to the sort processing
medical waste, and open area, no obvious signs, classification level is not high.

General hospital with regular household garbage bins and yellowish medical, hospital and clinic
personnel told Post logo, the swab and other body fluids come into contact with the patient
garbage into yellow garbage bag. But the reporter visited some hospitals found that blood
tests and outpatient medical room yellow garbage bags of medical waste both areas, but
also paper, food packaging and other general household waste.

A poll conducted at a hospital in Wuhu, Anhui Province indicates that at some health care personnel classification concept is unclear, non-infectious waste, such as medical equipment packaging, special medical waste combined with yellow bag. Although such an approach did not
cause harm to the spread of disease, but it raises the cost of processing medical waste.

research on the status of management and disposal of medical waste in a primary hospital also
revealed that the passing rate of garbage deposited only 45%. The survey also pointed out
that a whole lot of medical waste in the absence of sterilization, transported to the transfer
station processing, which may cause secondary pollution garbage occur during transport.

Many local medical waste disposal fee is calculated according to bed, the total amount of waste
generated by hospitals not directly related to the processing fee paid. If the hospital
improve the control level, reducing the amount of waste created, and the identical amount of beds, garbage fees won’t be reduced, so that’s not conducive to encouraging
hospitals supply waste separation and reduction.

Medical waste are complicated, such as infectious wastes, pathological wastes, chemical
wastes and damaging waste, etc., about different textile materials, plastics, glass,
metal and human organizations, a single treatment is hard to achieve for many different medical garbage harmless treatment.

For different types of medical waste, we have a different processing method and apparatus
have been developed and utilized around the world. Autoclaving is
most likely the most widely used non-burning disinfection, along with chemical processing
technology, processing technology and microwave plasma processing technology.

China is currently widely used is incineration, this approach will generate large quantities of
harmful gas mixture, such as hydrochloric acid, dioxins and furans, as well as toxic
metals lead, cadmium and mercury. However, research indicates that some old equipment
medical incinerators, waste is a direct smoke exhaust emissions.

South China Institute of Environmental Sciences after a medical waste incineration plant in
Guangdong Province as the research object, through the collection and analysis incineration
plant and the surrounding soil and plant samples, PAHs understand incineration plant (PAHs)
distribution, sources and pollution levels.

South China Institute of Environmental Sciences once a medical waste incineration plant in
Guangdong Province as the research object, through the collection and analysis incineration
plant and the surrounding soil and plant samples, PAHs understand incineration plant (PAHs)
distribution, sources and pollution levels. The results show that medical incinerators soil
surrounding a certain degree of contamination of PAHs detected in the soil 16 polycyclic
aromatic hydrocarbons, PAHs total amount ranging 11.83ng / g ~ 788.24ng / g, mean 236.681ng
/ g; in the study area downwind of the prevailing winds in the soil, total PAHs were
significantly higher than the prevailing winds soil content, and the total concentration of
PAHs in soil increases with distance showed a gradual decrease.

Incinerator Maximizing Combustion Efficiency

More smoke and other pollutants are Discharged into the Atmosphere during the’start-up’ and’cool down’ phases of the burn

than during the’Complete burn phase’ when high temperatures are maintained.    

avoided. Burn only dry feedstock and periodically add extra waste to the fire to be able to maintain high burn

temperatures until all waste has been destroyed. If waste is to be open burned on the ground, the use of heavy or steep-walled

‘pits’ should be avoided as this will avoid the necessary turbulent mixing of oxygen with the burnable gases.

Desired operating temperature should be achieved as rapidly as possible when operating any burning or incineration device.  A

rapid’startup’ can be reached by first loosely loading dry paper, paperboard packaging and untreated wood into the bottom

of the device. Dry, loosely packed material will ignite more quickly and burn more evenly than a wet, tightly packed load.

Wet waste should only be added after  the fire is actively burning.  Overfilling the burn chamber will prevent the turbulent

mixing of burnable gases and oxygen, and should be avoided. Additional waste should just be added to those incinerators once the’cool down’ phase has been

completed and it is safe to do so.

completed and it is safe to do so.

Air Emissions Environmental Standards CA

Air emission standards set limits on the amount of contaminants which can be released to the atmosphere. These standards are expressed as a concentration in the exhaust gases leaving the stack and are capable of being accomplished using generally available incineration technology and waste diversion practices. This emission standards1 apply to existing, new or expanding solid waste incinerators operating in Nunavut and have been adopted by the Canadian Council of Ministers of the Environment (CCME) Canada-Wide Standards for Dioxins and Furans and Mercury Emissions, respectively.   Similar standards for the open burning of solid waste haven’t been established.
Unit of measure is micrograms per Reference cubic metre (the volume of gas adjusted to 25oC and 101.3 kilopascals)

Opacity is the degree to which the exhaust gases decrease the transmission of light and obscure the view of any item in the background. It’s expressed as a percentage representing the extent to which an object seen through the gases is obscured. Though not an emission standard, opacity gives an indication of the overall functioning of the incinerator during ordinary operation2.  Opacity in the incinerator stack shouldn’t exceed 5%. Although it is not expected that opacity levels would exceed 1% to 2% under normal operation, values greater than 5 percent indicate that the incinerator isn’t performing correctly and additional performance evaluation and adjustment is needed.

Figure 6 – Examples of Smoke Opacity Ratings
80 pg I-TEQ/cubic metre
20 µg/Rcubic metre
Equivalents per cubic metre of air

Mercury

Mercury
20 µg/Rcubic metre
Unit of measure is micrograms per Reference cubic metre (the volume of gas adjusted to 25oC and 101.3 kilopascals)

Opacity is the degree to which the exhaust gases reduce the transmission of light and obscure the view of any object in the background. It is expressed as a percentage representing the extent to which an object viewed through the gases is obscured. Although not an emission standard, opacity provides an indication of the general performance of the incinerator during normal operation2.  Opacity in the incinerator stack should not exceed 5%. While it is not anticipated that opacity levels would exceed 1% to 2% under normal operation, values greater than 5% indicate the incinerator is not performing properly and additional performance evaluation and adjustment is required.

Figure 6 – Examples of Smoke Opacity Ratings
The opacity ratings are estimates and are provided for illustrative purposes only
Centre and right photos courtesy of GNWT Department of Environment and Natural Resources

biomedical waste management