Improper Medical Waste Treatment Raise Public Concern

The concern for hazardous medical waste started in the 1980s when medical waste was washed up on several east coast beaches (U.S. Environmental Protection Agency, 2016). The improper management of potentially infectious medical waste posed a serious health risk to the public and health care workers. In response this, the Congress drafted the Medical Waste Tracking Act of 1988 (MWTA), which is a United States federal law that imposed heavy penalties for illegal disposal of blood wastes, body tissues, and other contaminated biological materials (Speaker of the House of Representatives, 1988). The law created a two-year program that was enacted in four coastal states (Rhode Island, Connecticut, New York, and New Jersey) and Puerto Rico. After the program expired in 1991, incineration reminded as a popular method for medical waste treatment in the United States.

Before the U.S. Environmental Protection Agency (EPA) passed strict regulations on incinerator ashes emission in August of 1997, over 90% of the potentially infectious medical waste was treated by this method (U.S. Environmental Protection Agency, 2016). In addition to the regulations, EPA’s Risk Reduction Engineering Laboratory also initiated a study to investigate the risk of medical waste treatments and particularly focused on incineration. It was well known that medical waste contains many toxic metals such as lead, cadmium, and mercury (Hickman, 1987). During the incineration process, metals can break down into different phases when they were burned at a high temperature. Toxic metals presented in different physical phases were produced after incinerated, but these substances cannot be destroyed and can leak out of the incinerator by many ways. For example, air pollution may be resulted after incineration if the air pollution control equipment is not working properly or the appropriate control equipment configuration is not even installed. Hence, the control of metal emissions is still a remaining issue for the environment (Lee and Huffman, 1988).

Table 1. EPA’s Risk Reduction Engineering Laboratory found the air concentrations for 6 types of toxic metals after incineration. Table retrieved from Lee and Huffman, 1988.

Incineration may be a decent way to kill off infectious microorganism from medical waste, but its resulting residues can cause unexpected issues.  Incinerator ashes are mutagenic and can lead to respiratory problems, heart diseases, and cancer (Allsopp et al., 2001). For this reason, EPA’s Office of Air Quality Planning and Standards promulgated stricter incineration emission standards. The Council State of Government strongly encouraged public education on medical waste treatments and  set up a guideline on the proper ways of treating medical waste in terms of treatment technologies, disposal, and transportation (The Council of State Governments, 1992). Government and environmental researchers are still working to improve medical waste treatment. As recent as 2013, EPA is still on progress in revising the Hospital Medical Infectious Waste Incinerator to reduce medical waste incinerator ashes and improve the air quality (U.S. Environmental Protection Agency, 2016).

Work Cited

Allsopp, M., Costner, P., and Johnston, P. (2001). Incineration and Human Health. Greenpeace Research Laboratories. University of Exeter, UK.

Hickman, D.C. (1987). Cadmium and Lead in Bio-Medical Waste Incinerators. Master of Science Thesis. University of California, Davis.

Lee, C.C., Huffman, G.L. (1988). Metals Behavior During Medical Waste Incineration. U.S. Environmental Protection Agency Risk Reduction Engineering Laboratory. Cincinnati, Ohio.

Speaker of the House of Representatives, Vice president of the United States, and president of the Senate. (1988). Report for H.R.3515 Medical Waste Tracking Act of 1988. One Hundredth Congress of the United States of America at the Second Session. City of Washington.

The Council of State Government. (1992). Model Guidelines for state Medical Waste Management. Lexington, Kentucky.

U.S. Environmental Protection Agency. (2016). Medical Waste.  Retrieved from https://www.epa.gov/rcra/medical-waste