Incinerators specializing in burning medical waste are not as common as they once were. In the past, almost every hospital had an incinerator onsite and disposed of their own waste. Toxic emissions poured out of smokestacks into neighborhoods all the time. Since environmental rules and regulations became stricter, many of these facilities closed down and large companies constructed larger incinerators to handle the flow.
Typically, the medical waste disposed of at the incinerator include a range of bloody bandages, used needles, empty intravenous bags, narcotics, and other pharmaceuticals. Add to this list dead fetuses, removed body organs, biopsy discards, amputated limbs, and cancer treatment byproducts. Many similar items from veterinary offices are sometimes allowed to be accepted and sent for disposal as well.
According to a paper from Columbia University, there were over 2,400 medical waste incinerators operating around the country in 1996. The year 2000 saw new regulations required by the EPA to reduce some of the toxic emissions and odors the incinerators were pumping out of their smokestacks. The cost of the upgrades was more than some of the companies were willing to spend, so they operated up until either their permit ran out or the deadline for the installation of upgrades came. Either way, many of these facilities finally closed their doors.
The ones that stayed and upgraded saw a big increase in business for the most part. Small operations in towns became medium and large ones, filling the gap left by the closed incinerators. On the national level, the volume of waste was increasing. The companies would like to see their investment in new equipment pay dividends as soon as possible. In 2014, there was another change in the regulations that went into effect, again requiring better emission controls to meet the new Clean Air Act standards the government had set.
However, just because the government has standards and says they are stricter than previously required, that does not mean that poisons are still not being emitted into the air. Mercury and other heavy metals, dioxins, and furans are still emitted. “Clean” is a relative term.
For instance, in some cases, the regulations actually allow smaller, rural incinerators to emit up to 15 times the amount of toxic metals and chemicals the larger ones are. Tony and I are unsure what the logic is. All we have are questions. Does the EPA think people in rural areas are worth less and, therefore, have less protections? Does the EPA think smaller incinerators don’t burn as much, so, therefore, they should be allowed to pollute more? Or, is it that the EPA doesn’t want to make the smaller operators have to upgrade their pollution controls because the cost is too high for small operations? It could even be all three. These different levels of compliance based on the size and location of the operations do not seem to be based on scientific reasons but financial ones.
Apparently, because medical waste disposal is worth billions of dollars a year for those who can get a permit to dispose of it, many of the companies operating trash incinerators are moving into the medical waste incineration business too. They’re fighting over the medical waste business because it’s more than just additional revenue; it’s triple the money of burning garbage. The incinerator companies say they only burn certain medical wastes, but the waste that they burn is almost always received in sealed boxes from the hospital and never opened before putting it into the incinerator. As they do not x-ray or examine these packages, it is absurd to believe that they actually know what they are receiving and burning.
Medical waste is a broad category that includes a range of materials: everything from relatively harmless product wrappers to extremely harmful radioactive or pathogenic waste. Disposal of the waste and the separation and handling prior to disposal is important to protect people from being exposed to these pathogens and toxic components. Proper handling of the waste at the source when done correctly separates the waste needing special handling to avoid risks until reaching the final disposal point.
Waste is usually separated into different categories and boxed for storage in the medical facility until picked up by the disposal company. Pathological or infectious waste contains blood, body fluids, and tissue. Many times there are quantities of body parts, such as organs or amputated limbs, as well as bloody bandages, gloves, towels, and other items soiled with blood and body fluids. These wastes are infectious and have the potential to spread diseases or contaminate the areas the waste comes in contact with. Extra special care in handling is needed to ensure the waste stays secure. The receiving facility is supposed to check the type of waste that comes in to ensure they are placed into the incinerator at the proposer temperature and with the correct amount of fuel. Unfortunately, many of the boxes are never checked to see what the contents are and if the labels are correct. The lack of checking may lead to waste that needs higher temperatures in the incinerator or additional levels of fuel based on the contents being wetter not being properly incinerated, leaving much more contaminants and unburnt materials to go out of the smokestack.
The operation of the incinerator poses dangers to the surrounding area in the community from a number of areas.
Many metals are basic elements, and one of the main issues of a medical waste incinerator is that much of these metals put in for destruction are not incinerated. Materials such as lead, mercury, and cadmium simply do not disappear or get destroyed. Quite simply, they take another form after incineration and either become part of the incinerator ash and dumped in a landfill or, in many cases, are emitted from the smokestack to the surrounding areas. This isn’t even secret, hidden information; this information is on the permit application from the incinerator operator to the state environmental agency and the EPA.
Medical waste incinerator operators may make claims such as they reduce emissions of toxic heavy metals by 94% using the latest state of the art technology. We respond by saying that this is only under perfect, ideal operating conditions. On top of that, the 6% that will still be emitted under ideal conditions is still toxic and deadly. Usually, the amount of toxic chemicals being emitted on their permits amounts to quantities quite dangerous to be exposed to. Furthermore, the emissions are ongoing, and the exposure will be cumulative.
Since 1989 North Salt Lake City, Utah, has been plagued with a hospital waste incinerator first run by BFI and then sold to Stericycle in 1999. There was controversy starting when the incinerator first opened in 1989. The clean-running operation the town thought it was approving never materialized. Most people had the impression the medical waste incinerator would only burn wastes from Utah. Instead, it brought in materials from as many as eight other states. Residents in the area noted there were many times thick black smoke coming from the incinerator smokestack. At times, pungent odors drifted through the areas.
For whatever reason that no one to this day understood, the town allowed the rezoning of land up to several hundred yards away from the incinerator to allow building single-family homes. Many of the residents and first-time buyers had no idea they were moving next to a medical waste incinerator that actively burned hazardous materials.
Regulators suspected irregularities in late 2011. Throughout 2012, they conducted a series of three stack tests to determine the level and nature of pollutants released from the plant. These tests are supposed to be conducted at the maximum production or combustion rate and reflect normal, operational variances. The tests showed hazardous pollution beyond the allowed rate, violating their permit.
The company first attempted to blame a flawed laboratory analysis for the test results. After the division obtained additional information, a stack test conducted on December 27 and 28, 2011, found that the incinerator exceeded levels for hazardous pollutants as well as nitrogen oxides, or highly reactive gases. Regulators also said they believed the company’s logs were manipulated to show compliance with operating conditions.
In 2014, the Utah Division of Air Quality fined the company $2.3 million, the largest fine in the history of the division, for misreporting emissions from its North Salt Lake incinerator and violating emissions limits set by the federal Clean Air Act. Finally after 25 years of the community trying to stop the incinerator from poisoning them, the company is closing down the incinerator facility in Utah and moving the disposal facility to North Las Vegas where they will open a larger facility, handling all the medical waste they process in the Western states. The company says they will use the latest technology at this facility. The people in North Las Vegas, however, did not want Stericycle to relocate there and stopped the company from building a new facility. After trying since 2016 Stericycle pulled their permit from consideration in 2019 after receiving opposition not only from the residents but from officials who had reservations about the safety of the incinerator and the pollution it would emit. Experts from North Salt Lake City offered information and stories about their first hand experience with Stericycle in their community and what the incinerator inflicted and subjected people in their community to for years. Stericycle now has its sights set on Reno, Nevada. They have secured basic permits at this point but opposition from nearby businesses and community members is mounting quickly due to the track record of the company.
An upset condition is when the incinerator furnace is not running properly, so steps need to be taken to correct it. A common upset condition is when the furnace has become too hot and needs to be cooled quickly. The operator will bypass certain steps that control the pollutants and vent directly into the atmosphere until the proper temperature has been reached. Clouds of thick smoke, usually black (but other colors too depending on what is in the incinerator), come out of the smokestack. While the operator is required to log and report upset conditions, many times they go unreported due to penalties the operator could be subject to.
Upset conditions are far more frequent than any facility will ever admit. Many incinerators have a documented track record of being cited and fined for them. Based on the way these incinerators operate, it is impossible to eliminate these occurrences. Sometimes they happen because of a human error, such as using the incorrect temperature for what was placed in the incinerator. Sometimes an upset condition happens because the mix of materials was incorrect, so there was an unexpected reaction. Whatever the reason, they can and do occur. At the Stericycle incinerator in North Salt Lake City, neighbors recalled one incident when the power had gone out in their neighborhood and for 20 minutes, thick black smoke billowed out of the incinerator’s smokestack as all the emissions bypassed the pollution control devices and vented into the neighborhood. The state of Utah kept a record of this incinerator: it had 10 instances of these bypass events in the previous 12 month period.
Accidents as well are frequent occurrences, and sometimes entire buildings are destroyed. In Petersburg, Virginia, an explosion destroyed most of the medical waste incinerator operated by Curtis Bay Medical Waste. While employees and the company said no contamination was released, outside emergency personnel noted there were medical waste and contaminated items such as hypodermic needles and blood-soaked bandages strewn around the field of debris. It was determined a boiler in the building had exploded, causing the damage. Environmental crews worked to secure the area by setting up netting and dikes to keep any hazardous substances and materials from being washed off by predicted upcoming rains.
Dioxins are one of the deadliest materials known to mankind besides radioactive isotopes. Dioxins are made from the process of combustion. Nature can also make dioxins when there is a forest fire. That is true; however, the amount of dioxin created from a medical waste incinerator is far greater. The EPA states medical waste incinerators are one of the fourth leading causes of dioxins. Other major industrial sources are cement plants, power generation stations, and metal smelters. Once dioxin enters a person’s system, it never leaves. According to the World Health Organization, dioxin has a half life of 7-11 years, so even though some degrades, there will be dioxin still present. Continued exposure to the source maintains this cycle. This material accumulates in your body and damages cells and organs.
In Brooks, Oregon, the incinerator run by Covanta is importIng medical waste from outside the state to burn at its facility. The incinerator was actually an ordinary trash incinerator whose revenue had dropped, so they convinced the state of Oregon to allow them to burn medical waste at the facility. Up to 15,000 tons of the waste per year are incinerated there. Previously, the incinerator was bringing in medical waste from Canada until people found out the plant was burning human body parts and dead fetuses to generate electricity at the plant. The very idea of this infuriated locals from all across the political spectrum who banded together and stopped the importation of the wastes.
Plastic waste is another issue. Large amounts of plastics are used and disposed of as hospital waste. A trade organization, Plastics Today, estimated that, of the total amount of plastic disposed by hospitals, a third of it is PVC plastic. According to Practice Greenhealth and the Healthcare Plastics Recycling Council, plastics make up between 20 – 25% of medical waste sent out for incineration. Whichever of these two numbers is most accurate, a sizable chunk of medical waste is plastic, especially PVC plastic.
While PVC is great for the incinerator operators because it has a high BTU value and saves money in fuel cost, it is very toxic and releases highly toxic compounds. Cadmium and lead are common elements released by the combustion of PVC, as are dioxins. Rather ironically, the actual medical waste bags used to collect and transport the waste contribute even more to the toxicity and in some cases contain more toxic chemicals than the contents they hold. These bags are mostly made from polyethylene, and burning that compound createsd dioxins. Another item in particular adds to this problem: blue wrap. Blue wrap is used on surgical instruments and accounts for up to 19% of the plastic medical waste at one large California hospital. While recycling programs for blue wrap are available, many hospitals continue to dispose of the polyethylene plastic wrap into medical waste bins, and this too will emit dioxins when it is burned. The smokestack at medical waste incinerators is only capable of filtering some of these dioxins out. The rest get emitted, and more are formed after the smoke has passed the filters because toxic chemicals can bond and create them in the way out too.
Burning human flesh and body parts gives off an unforgettable smell. Along with all the plastics a hospital disposes of, this creates a painfully memorable smell. Of course, the incinerator has air scrubbers and other pollution control devices on the emissions stacks, but only so much odor can be suppressed or masked over.
In Mathews, North Carolina, a medical waste incinerator operated for years. During that time, local residents could tell when human waste was being burned from the smell that permeated their backyards as black smoke came out from the smokestack. Over the years, the residents fought to have the incinerator closed, citing health concerns from mercury and heavy metal emissions, also citing the incinerator’s non-compliance with environmental regulations. Sometimes the area residents could not even hang their clothes out back as black ash and soot would collect on them from incinerator emissions. The town pressured the facility and eventually got the EPA to require the incinerator to add even more pollution control equipment and reduce emissions further. Under all these conditions, which were very costly to the operator, the incinerator finally closed down. The operator denied that was the reason behind the closing.
There are new medical waste incinerators being proposed throughout the country. A great example of one is in West Warwick, Rhode Island, where people wanting to try the industry’s latest experiment are looking to set up a new operation. As always, the industry’s latest experiment has to be tested someplace. This mostly untested method cooks the medical waste and even turns it into electricity. The people looking to operate this waste-cooking business are calling the process “clean and green.” The plans call for processing 70 tons of medical waste from all over New England. They want to operate seven days a week, 24 hours a day. None of the medical waste will be inspected or opened, but they will be checked for radiation. The lack of oversight is self-evidently suspicious and dangerous.
Staying away from a known medical waste incinerator is simply good sense. At the same time, be on the lookout for other places that currently or in the future could burn medical waste as well. Permits need to be issued for facilities to legally accept medical waste. Tracking applications to your state environmental agency gives you a heads up before it becomes too late. Be aware that trash incinerators may also be proposing to burn medical waste because it brings much more revenue to the operators. Places like the Covanta incinerator in Brooks, Oregon, is a perfect example of one which now burns both types of trash.
Tony and I suggest locating a distance of three miles or more away from the area. It should be beyond where many of the heavier particles will be falling. There will still be contaminants in your air; however, they should not be at a level so high as to be an immediate hazard or cause long term health issues.