http://seas.stanford.edu/medwaste/prop.html
Health Care With Harm?
The Impact of Stanford's Medical Waste
Disposal Practices on Human Health and
Recommendations for Impact Reduction
- Students for Environmental Action at Stanford 562 Salvatierra Walkway
Stanford, California 94305
(650) 725-3302
seas@seas.stanford.edu
February 15, 2000
Table of Contents
Executive Summary
Introduction
Part I
Medical Waste
Integrated Environmental Systems
Environmental Justice
Involved Organizations
Part II
What is Dioxin?
Physical Properties
Dioxin in the Environment
Waste Burning
Health Effects of Dioxin
Part III
Immediate Solutions
Long-Term Considerations
Conclusion
References Cited
Appendix A: Public Comments on Proposed Permit
Appendix B: IES Compliance History
Appendix C: Alternative Disposal Technologies
Appendix D: PVC Alternatives
Executive Summary
Part I
Medical Waste
The incineration of red-bag medical waste containing chlorinated plastics produces
dioxin, a potent toxin; over the last decade, these emissions have led many incinerators to
cease operation. Yet medical waste incineration remains the second largest source
nationwide of airborne dioxin. The medical waste stream could be reduced by as much as
85% simply by careful segregation; hospitals across the country have reduced operating
costs by implementing such programs. Nearly all of the remaining infectious waste can
be treated by methods other than incineration.
Integrated Environmental Systems (IES)
Stanford contracts with IES to dispose of its red-bag waste. IES owns and operates the
only remaining commercial medical waste incinerator in California, located in East
Oakland. The IES plant has never undergone public review nor filed an Environmental
Impact Report (EIR) in accordance with CEQA, and has a history of permit violations,
having been cited for over 250 violations since Sept. 1990. Many community members
oppose IES's practices and feel they have been excluded from the public review process.
Environmental Justice
Fruitvale, the Oakland neighborhood where the incinerator is located, is a low-income
community of color -- like 53 of the state's 54 toxic waste disposal sites, and similar
facilities throughout the country. The principle of environmental justice recognizes that
all people have an equal right to a healthy and safety environment regardless of race or
socioeconomic status; violations of this right, known as environmental racism, are illegal
under Title VI of the 1964 Civil Rights Act. Stanford has an opportunity to highlight its
leadership by renouncing environmental racism and implementing just, cost-effective
solutions to the problem of medical waste disposal.
Involved Organizations
While this document is directed at Stanford Hospital and Medical Center in particular,
other organizations are leading efforts to deal with broader aspects of this issue. These
include: People United for a Better Oakland (PUEBLO), a multi-ethnic, multi-issue
community organization; Greenaction, which works for environmental justice across the
southwestern U.S.; Health Care Without Harm (HCWH), an international coalition of
over 250 organizations; the Center for Environmental Health (CEH), whose goal is to
eliminate sources of toxic exposure; and Commonweal, a health and environmental
research institute and founding member of HCWH.
Part II
What is Dioxin?
The term "dioxins" refers to a family of 75 chemicals. Burning organic matter in the
presence of chlorine is one of two processes by which dioxin forms. The World Health
Organization's International Agency for Research on Cancer has classified dioxin as a
known human carcinogen.
Physical Properties
Dioxins are relatively non-water-soluble and, once introduced into the body, tend to
accumulate in fatty tissues. Ingestion in food is the primary means by which most people
are exposed to dioxin.
Dioxin in the Environment
Once formed, dioxin often binds to organic particles which are carried by the wind and
eventually settle into the soil or water bodies. Dioxin's half-life in soil is estimated at 25
to 100 years.
Waste Burning
In 1994, emissions from medical waste incinerators accounted for 53% of all air
emissions of dioxin nationwide. As many incinerators have ceased or reduced operations,
this number has dropped, but medical waste incineration remains the second largest
source or airborne dioxin.
Health Effects of Dioxin
Dioxin affects human health by binding to nuclear DNA. It behaves as a potent cancer
promoter, decreases immune response, and is associated with multiple developmental and
reproductive effects including endometriosis, birth defects, and lowered testosterone
levels. All of these effects may occur at extremely low exposure levels.