Contaminated needles and scalpels, bloodied bandages, unused prescription drugs, soiled hospital garments, radioactive waste and refuse tainted with infectious disease: These are only a few items that may be discarded on a curbside, abandoned in a nearby lake or piled in a dumpster headed for the local landfill.
Some say Americans are simply oblivious to the imminent risk of major hazards and contagions spreading throughout their communities at any given time.
Former Rep. Richard Pombo, R-Calif., grew concerned about medical waste hauling after Sept. 11. He told WND that 15 years ago, the nation’s hospitals incinerated much of the infectious waste on site. However, the Environmental Protection Agency mandated strict guidelines for incinerators after concerns about air pollution, forcing most hospitals to hire outside personnel to haul medical waste away.
“What happened was that most hospitals and most doctors’ offices started going off site because they had no other way of treating it on site,” Pombo said. “So this industry was born that picked up medical waste and took it to a centralized site. Those centralized sites are sometimes several hundred miles away from the doctor’s office or the hospital where they’re picking this stuff up.”
Darrell Henry, executive director of the Healthcare Waste and Emergency Preparedness Coalition, expressed concerns about national safety when contagious medical waste that could be contaminated with hepatitis, tuberculosis, flu or even small pox is trucked across America’s roadways.
“More than 80 percent of the hospitals in the country truck this stuff somewhere,” he told WND. “They throw this stuff on the back dock and let it sit there. A truck comes and picks it up, and now it’s a mobile Petri dish moving across our highways, going to be treated somewhere when you could have treated it on site and been done with it.”
Biohazard bags and sharps piled into bins at medical facility (photo: Healthcare Waste and Emergency Preparedness Coalition)
While they are subject to the same background checks as other truck drivers, workers who haul infectious waste often do not have special training or licensing for dealing with contagious materials. San-I-Pak World Health Systems Vice President Arthur McCoy and Pombo told WND they have seen reports of some people collecting medical scraps and sifting through the piles in search of drugs.
“These guys have been arrested because they want to get into the medical waste and try to recover narcotics or prescription medicines,” McCoy said. “Then, after these guys are contaminated, they go to the same gas stations, grocery stores and restaurants as the rest of us. There’s a lot of cross contamination.”
Each year, there are numerous news reports of medical waste trucks involved in accidents on major U.S. highways. In many cases, hospital refuse and even hazardous radioactive medical waste is strewn across roads, discarded in ditches or illegally dumped on beaches and in America’s communities.
Pombo said some medical facilities are charged up to $20 per pound to haul infectious waste away.
“To save a few hundred dollars, they might throw it on the dumpster the day before trash day, and it will be hauled to the regular trash facility,” he said. “It then goes through the regular transfer station with people separating out recyclables. They don’t know what they’re being exposed to.”
McCoy said he has witnessed small clinics discarding numerous red biohazard bags in trash bins.
“I was just casually driving by a little medical complex and saw medical waste bags piling up out of a dumpster,” he said. “That’s how common this is. It’s pretty scary.”
One such example was documented in the following KVUE News report after police found hundreds of syringes near a busy shopping center in Cedar Park, Texas, in October:
Despite shocking details of the public’s daily exposure to infectious waste, Henry said his major concern is about emergency preparedness. He said medical facilities must be equipped to deal with contagions during pandemics, natural disasters and national emergencies – when infection is rampant and waste haulers cannot meet hospital waste removal demands.
“In New York on Sept. 11, nothing got on or off Manhattan Island for a week,” he said, “yet you had hospitals that needed sustainable operation capability to keep going.”
Pombo added, “After Sept. 11 in New York City, the hospitals that had the capability of treating on site were able to treat their waste. For the ones that didn’t, the stuff stacked up, and it was basically locked down. The trucks couldn’t get in and out. So there were patient rooms in the hospitals that had bags and bags of contagious medical waste because they had no way to treat it.”
Medical waste mixed with regular garbage (photo: HWEPC)
Pombo noted that officials had no way of controlling contagions when people were locked down during Hurricane Katrina in 2005, and hospitals could have been ready with on-site waste treatment equipment.
“Their transportation system was gone,” he said. “They had no way of getting anything in and out once it flooded.”
Likewise, Henry said if there’s an earthquake in a location like San Francisco, hospitals must keep functioning.
“They won’t have to worry and wait for trucks to come pick stuff up and take it over the bridge. Last time when the Oakland Bay Bridge collapsed, they closed all the bridges for days,” he said.
Pombo, Henry and McCoy are each concerned the same issues might arise in cases of bioterrorism. While contagious waste management is a subject often neglected in the news media and by lawmakers, they say the nation could be crippled in the event of such emergencies under the current system.
Following recent swine flu concerns, Henry wrote a letter to Kathleen Sebelius, secretary of Health and Human Services, warning her of the need to control infectious waste during national emergencies.
Most states have their own regulation for medical waste management, but many hospitals are limited to off-site disposal. Rep. Frank Pallone Jr., D-N.J., introduced legislation in May to set a nationwide uniform tracking system for medical waste disposal.
The Medical Waste Management Act of 2009, or HR 2552, has been referred to the House Committee on Energy and Commerce. It mandates the monitoring of waste from the place of origin to disposal facilities and addresses syringe disposal procedures.
However, Henry said the legislation simply creates a paper trail for tracking purposes and doesn’t encourage hospitals to destroy infectious waste on site.
“This legislation basically tells EPA to decide how it’s to be treated. But I look at this and ask, are you going to let EPA decide how to do this?” Henry said. “They could screw this up. We’re looking to ensure that certain on-site capabilities qualify under EPA so that in an emergency the hospitals can do this on site. EPA is just looking at putting a regulatory scheme into place, not considering the best practices for hospitals and medical waste infection control.”
While certain types of pathological and pharmaceutical waste must be incinerated, affordable technologies can cleanly, safely and economically sterilize other infectious waste at each hospital – and experts say doing so would be cleaner, safer and less costly than the current alternative.
Autoclave on hospital grounds can sterilize and compact medical waste (photo: San-I-Pak)
McCoy said San-I-Pak, a company that produces on-site waste treatment systems, provides autoclaves to hospitals to sanitize and compact infectious waste so contagions never leave hospital grounds. The machines allow medical facilities to remain efficient during emergencies so they are not forced to depend on outside companies to haul away contaminated refuse.
“In our system, the waste is automatically loaded into the autoclave from the collection carts. Nobody ever touches the material,” he said. “Once the material goes into the San-I-Pak unit, it’s sterilized. After it’s sterilized, it discharges into a compactor and then it’s comingled with the rest of the waste.”
The autoclaves cost less than off-site disposal and are also capable of sterilizing hospital laundry and even disposable items such as gowns, masks and gloves under extreme circumstances.
After processing, the waste is said to be cleaner than common household garbage.
Henry said the government should focus on enabling hospitals to buy similar equipment that would help them deal with a crisis rather than mandating restrictions and paper trails on off-site disposal of infectious waste.
Pombo said most people aren’t aware that infectious and potentially contagious waste is being trucked through their communities, and the subject isn’t a particularly glamorous issue for lawmakers to address.
“One of the problems is that this is garbage,” Pombo said. “Nobody pays a lot of attention to what comes out of that end of the facility. Until there’s a major outbreak of something that gets a lot of press attention, no one will pay attention.”