Air Date: Week of April 24, 1998

According to the Environmental Protection Agency, hospitals are leading sources of dioxin and mercury contamination. Most hospitals burn anything contaminated with blood or bodily fluids; and this waste often contains large amounts of plastics made with Poly-vinyl-chloride. When those plastics are burned, they release dioxin, a substance known to cause cancer and suspected of damaging reproductive organs. Hospital equipment containing mercury, a neurotoxin, can sometimes end up in the waste stream, too. Now, a coalition of environmental groups is calling on hospitals to phase out the incineration of medical waste. Living On Earth's Liz Lempert reports.

Transcript

CURWOOD: According to the US Environmental Protection Agency, hospitals are leading sources of dioxin and mercury contamination. Most hospitals burn anything contaminated with blood or other bodily fluids, and this waste often contains large amounts of plastics made with polyvinyl chloride. When these plastics are burned, they release dioxin, a substance known to cause cancer and suspected of damaging reproductive organs. Hospital equipment containing mercury, a neurotoxin, can sometimes end up in the waste stream, too. Now, a coalition of environmental groups is calling on hospitals to phase out the incineration of medical waste. Living on Earth's Liz Lempert reports.

(Traffic sounds, ambient conversation)

LEMPERT: A group of local environmental activists gathers outside of the Sacred Heart Church in Lawrence. Once a bustling mill town, nowadays 20% of Lawrence residents live below the poverty line.

MAN: And we have 2 elementary schools that are very closely near by this area. The Sacred Heart Parish School as well as the St. Patrick's Elementary School.

LEMPERT: Across the street from Sacred Heart, BFI, Browning-Ferris Industries, runs a medical waste incinerator. It's one of the largest in the state. Everything from syringes to surgical gowns are trucked here from New England hospitals, then burned. Activist Ed Meagher worries about pollution billowing out of BFI's stack. This is one of four incinerators within a 4-mile radius.

MEAGHER: They're all situated in a river valley. And as a result, we believe that there's temperature inversions that hold the dirty air in here, especially on hot, humid days. And not only that, the air quality is very questionable given the fact that Lawrence residents have one of the highest asthma rates in the eastern part of the country. It's really not appropriate to have this much burning in one small area.

LEMPERT: Hospitals say they are removing mercury-filled items like thermometers, but medical waste incinerators remain a major source of the heavy metal. It attacks the central nervous system and can retard fetal brain development. These incinerators are also the second largest source of dioxin, a carcinogen. But it's hard to make a direct link between incinerators and health problems. We know dioxin and mercury particles can rain down near the smokestack, or get carried by the wind for 1,000 miles and wind up in meat, dairy products, and fish. BFI controls its emissions with high-tech filters, but Lawrence activist Arthur Briaen says hospitals shouldn't be burning PVC plastics and mercury in the first place.

BRIEN: Don't the hospitals really have the obligation to look after our health? They're in the health business, and how can they really contribute in a large way to sending stuff to an incinerator somewhere that's really going to contaminate and really hurt the health of its patients?

LEMPERT: The BFI plant burns less than 1% of the garbage processed by the other incinerators in the area. Still, the Lawrence activists, along with the national coalition Health Care Without Harm, are targeting health professionals, hoping they will be the first to change. And the EPA is pressing the issue, too. Last August, it issued new requirements for medical waste incinerators, including pollution control devices, and stricter limits on dioxin and mercury emissions.

(An ambulance siren)

LEMPERT: Ten miles south of BFI, Saints Memorial Hospital in Lowell burns its waste on site in a 20-year-old contraption.

CLARK: I would suspect when this hospital put an incinerator in, that was the best technology at the time to be able to handle the problem.

LEMPERT: Thom Clark is Saints Memorial's president and CEO. His hospital's incinerator, just a metal drum with a 2-story stack rising out of it, won't pass muster under the new EPA rules. So administrators here are debating whether to spend hundreds of thousands of dollars to install pollution controls -- the burner currently has none -- or they could close it down and ship their waste elsewhere, which would also cost money.

CLARK: I don't think this is going to be an inexpensive project at all. I think it would be a huge item by the time it's over.

LEMPERT: Activists at Health Care Without Harm hope hospitals, when faced with these new costs, will reduce their trash, eliminate mercury thermometers and blood pressure devices, and find replacements for IV bags, packaging, and other items made of PVC plastics.

CLARK: But that comes down to be a business decision, and some people don't like that.

LEMPERT: Mr. Clark says alternatives to these materials either aren't available or aren't as cheap, and it's unfair for environmentalists to single out hospitals.

CLARK: While I agree sometimes with some of their goals, I don't think being a zealot gets you anywhere. And I think they're finger-pointing at a hospital for some reason. I don't know why. No, I don't feel any extra responsibility.

LEMPERT: But other hospitals are putting environmental concerns high on their priorities list. The New England Medical Center in Boston steam pressure-cooks its infectious waste to sterilize it before landfilling. That avoids dioxin emissions.

(Steam)

LEMPERT: In a noisy room technicians sort through bags of medical waste, then load them into the cooker or autoclave, a large green tank that holds up to 400 pounds of waste. Michelle Plant heads the Environmental Health Department. She says the system can be expensive to set up, but over 10 years it saved her hospital money.

PLANT: It cost us probably about $112,000 to run our autoclave process including all supplies, everything, per year, and to send this stuff off-site would be approximately $371,000 a year.

LEMPERT: Ms. Plant says she's helped other hospitals put sterilization systems in place, and she thinks demand for the technology will grow.

PLANT: I think more hospitals nowadays are finding out the realities of the waste that they generate, and I believe they're looking toward alternative technologies. In the past, some institutions have had available to them incinerators and it was a quick fix in the past, but that no longer is the case with our new EPA requirements coming up.

LEMPERT: Over the next few years, more hospitals may choose to close down their incinerators. But investment in autoclaves must compete with other priorities, from magnetic imaging machines to new carpets. Many hospitals will probably end up burning their waste at places like the BFI incinerator in Lawrence. There are advantages to centralization. BFI's facility burns cleaner than the low-tech incinerators at most hospitals, and if paying for trash disposal makes institutions reduce waste and pull out contaminants like mercury and PVC plastic, then everyone benefits. But Lawrence residents worry that poor neighborhoods like theirs may still bear the brunt of the pollution that remains. For Living on Earth, I'm Liz Lempert.