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U Hospital System Facing Tough Decisions on Medical Waste Disposal

Andrea Smardon
Bins of trace chemotherapy waste are picked up once a week at the Hunstman Cancer Hospital on the campus of the University of Utah.

Last year, clean air activists called on Utah’s hospitals and clinics to stop sending their waste to Stericycle’s incinerator in North Salt Lake. One of the state’s largest healthcare providers, The University of Utah, is looking at some significant changes to the way it handles medical waste, but there are some types of waste that university officials say they have no other option at this time but to burn.

Prescription drugs, bloody bandages, body parts, used syringes, medical gowns and gloves…. when these things are burned, the process releases hazardous chemical into the air, including dioxins, mercury, and nitrogen oxide. Stericycle has scrubbers on its stack that limit what is released into the air, but the company is allowed to emit certain amounts of these pollutants, under regulations set by the Environmental Protection Agency. Some people believe those regulations ensure the safety of those living nearby. Others do not.

“Exposure to toxic emissions during a critical window of development for a fetus or a small child can have devastating lifetime disease consequences,” University of Utah physician Alalia Berry read from a letter at a press conference in November last year. Utah Physicians for a Healthy Environment sent the letter to major hospitals in the state asking them boycott Stericycle’s medical waste incinerator.  

“Every day that Stericycle is allowed to continue emitting those toxins into the community is a day where the future health of children in those nearby neighborhoods can be compromised,” Berry read. “Unknowingly perhaps, hospital, clinics and other entities shipping waste to Stericycle are obviously key contributors to this regrettable circumstance. It is long overdue that medical facilities discontinue the practice of having their waste incinerated.”

Alicia Connell is a former resident of the Foxboro neighborhood located near Stericycle’s incinerator. Her plea to the hospitals is a personal one.

"We are not stopping until that incinerator is shut down." -Alicia Connell, former Foxboro resident

“There are other technologies. They need to now look at these alternatives, find the best possible way for their facility, and stop incinerating their medical waste,” Connell says. “All the groups that are following me are moms like me, and we’re protecting our children. We are not stopping until that incinerator is shut down.”

On hand at the press conference were some representatives from companies that offer alternative methods of medical waste disposal, including Sterimed. Sterimed treats waste by shredding and sterilizing it with a chemical disinfectant, producing a substance known as ploof – which the EPA deems safe to go in landfills. Dwight Morgan is the company’s Senior Vice President for Strategic Business Development and Chief Engineer. He says they are already treating waste onsite at Blue Mountain hospital in Blanding, Utah.

“We started with Blanding, and we thought that if we could solve their problem at a small scale, and demonstrate reliability of the company, the process, that the Utah departments that govern this would approve it, then we could prove that if it could be done in the smallest location, it can be done anywhere,” Morgan says.  

And Sterimed isn’t the only alternative. There are companies that use steam heat and others that use ozone to sterilize the waste, which can then be recycled or put in landfills.  So, given the options, could Utah’s hospitals just stop sending their waste to Stericycle’s North Salt Lake incinerator?

Michele Johnson is Director of Environmental Health and Safety at the University of Utah. She says the U is seriously considering alternative methods for treating much of the waste they send to Stericycle – most of the infectious waste from the hospitals as well as lab research. They are currently comparing bids from medical waste companies.

“We’re looking at what our options for actually purchasing equipment where we could treat it here on campus. That would fall in line with our clean air initiatives,” Johnson says. She says about 100,000 pounds of waste per year could be treated onsite. Some of it they would hope to recycle. But Johnson says, it’s a tough decision for the University because it means paying more.

“We know that it will cost more, it’s how much more will it cost us in order to be able to discontinue with incineration,” Johnson says.  The other problem, she says, is that not all waste can be treated with these alternative technologies at this time. Body parts, for instance. The state’s policy on human anatomical remains is that they must be incinerated or interred. State lawmakers could change this policy, but the University of Utah must follow the current law. And then there is the trace-chemotherapy waste.

Every Wednesday morning, a truck pulls up to the Huntsman Cancer Hospital’s loading dock. Bins of empty IV-bags, tubes, gowns and gloves contaminated with chemotherapy waste are weighed and loaded on to the truck. There are a dozen large bins, plus many more small bins headed for Stericycle. 

Johnson says the University produces about 50,000 pounds of chemo-waste per year, and the only way to chemically denature chemo-waste is to burn it. Put it in a landfill, and you could have reactive chemicals leach into the land and water.

"There is no technology that is approved by the regulatory agencies that says that any other method beyond incineration is effective for chemo-waste." - Michele Johnson, University of Utah Environmental Health and Safety

“As far as we know so far, there is no technology that is approved by the regulatory agencies that says that any other method beyond incineration is effective for chemowaste,” Johnson says.

In the meantime, the state legislature may consider a bill this year to ban medical waste incineration in the state. Johnson says it’s not clear what the University would do if Stericycle left Utah.

“We’re not seeing fewer cancers, we’re seeing more cancers, and as baby-boomers age, we’re going to see even more. That won’t go away, and it would be interesting if the state did ban incineration for medical waste,” Johnson says.

Utah has one of the largest cancer centers in the country, and it’s only expected to grow. At the same time, the number of medical waste incinerators in the country has been shrinking; there are less than three dozen now. The University could discontinue incineration for much of its waste, but when it comes to chemo-waste or anatomical remains, what the University can and will do is an open question.

Andrea Smardon is new at KUER, but she has worked in public broadcasting for more than a decade. Most recently, she worked as a reporter and news announcer for WGBH radio. While in Boston, she produced stories for Morning Edition, Marketplace Money, and The World. Her print work was published in The Boston Globe and Prior to that, she worked at Seattleââ
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