Subject: Hospital Waste: States Confront Task of Disposal Date: Published: 9/4/85 93 lines Source: Wall Street Journal. Copyright Dow Jones & Co. Inc. Hospital Waste: States Confront Task of Disposal --- By Linda Lehrer Staff Reporter of The Wall Street Journal NEW YORK -- In June, a group of sanitation workers here made a grim discovery. In a public dump on Staten Island, they found bags of hospital wastes, clearly marked as contaminated by acquired immune deficiency syndrome, or AIDS. The illegal dumping -- traced to a major city hospital -- touched off a local furor and has prompted New York to tighten its already strict laws on medical wastes. But the incident also reflects a growing concern in many states about the handling and disposal of medical waste -- particularly materials contaminated by AIDS. In the past year, for example, body parts have reportedly been found in a Pennsylvania landfill. Infectious wastes have been discovered in landfills in Maryland, and cases of improper disposal of AIDS contaminated materials have been reported in Ohio. The new disposal laws in New York, where fear of AIDS is mounting, may prompt other states to set or change their own regulations, health professionals say. Meanwhile, hospitals are starting to look for safer methods of waste disposal -- but are finding the alternatives costly. "The days of being unconcerned about waste management are ended," says T. J. Budacki, a hospital consultant on environmental safety and health for M&M Protection Consultants, a unit of Marsh & McLennan. In trying to establish a system for handling wastes, state officials and hospitals face a major problem: There is no consensus on what constitutes infectious medical waste. In 1982, the Environmental Protection Agency published a draft manual, with guidelines for state regulators, that identified 13 areas of infectious waste, including tissues, organs and other body parts removed in surgery; body wastes from patients in isolation; and contaminated laboratory material. But so far, the EPA hasn't set any regulations, and state and local laws range from the stringent to the nonexistent. Hospitals argue that most medical waste is no more hazardous than household garbage. Indeed, health surveys show that not a single medical professional or hospital worker is known to have contracted AIDS after working with victims of the disease. But others say that hospitals still generate enough infectious waste to make disposal a major problem. The Greater New York Hospital Association, for example, estimates that the city's 80 hospitals produce about 149 million pounds of waste a year, about 10% of which is infectious. That amounts to almost 15 million pounds of material that must either be autoclaved -- sterilized in a high-heat steam process -- and then dumped in a landfill, or specially packaged and carted off to licensed incineration sites. The volume of material makes the potential for mismanagement extremely high, says Mr. Budacki. "Periodic evaluation (of disposal procedures) aren't happening regularly enough," he adds. Eventually, many health officials believe, all American hospitals will be forced to incinerate whatever wastes that they or outside regulators deem dangerous. "The U. S. is now facing the problems that led Europeans to incineration over 20 years ago: lack of landfill space and population density," says John Bleckman, an environmental health consultant for ABAX Inc. in New York. In that period, he says, Europeans developed incinerators to burn waste safely while reclaiming heat that can be used to generate energy. "What will turn us to incineration is that we now know landfills themselves are not benign," Mr. Bleckman says. "There are contaminating things in them that come out of residential garbage" as well as medical waste. A shortage of suitable incinerators, however, means that hospitals must often transport waste great distances at considerable expense -- and with the risk of additional mishandling. Mr. Bleckman says costs can be controlled if hospitals pool their resources, a solution that has worked in Amarillo, Texas, for example. "It's just a matter of time before hospitals will have to turn to incineration," says Mr. Bleckman, who believes that properly built and maintained incinerators create no health hazards. Meanwhile, he warns, the AIDS scare may push states and cities into hasty measures that could complicate the disposal problem rather than solve it. (This article is made available here by Dow Jones Co. for the personal and non-commercial use of callers to this bbs, in the hope that it will be of some help to those who are suffering from the disease and others who are seeking to help them.)