Supervisors Toughen Medical Waste Ordinance

Responding to the recent deluge of used medical products washing onto San Diego County beaches, the County Board of Supervisors on Tuesday toughened an existing ordinance to regulate the disposal of medical waste.

The amendment of the county ordinance closes a loophole that until now provided doctors’ offices and other facilities that produced small quantities of medical waste an exemption from stringent disposal procedures.

Previously, only medical facilities that produce more than 220 pounds (100 kilograms) of waste a month were required to destroy the debris by incineration or exposure to steam. There had been no guidelines regulating smaller facilities that produced less than the specified quota. Now, those facilities must follow the stringent disposal procedures regardless of how much waste they generate.

“It seems that medical waste has been washing up on our shores almost every day now,” said Supervisor Susan Golding, who recommended to the board two weeks ago that the current ordinance be made more stringent.

Concern Over Lax Methods

The disturbing dumping incidents that began in late October--when a vial of blood, a syringe and other medical waste were found on La Jolla beaches--have raised concern about lax disposal methods.

Meanwhile, efforts to find the source of such medical waste have been escalated, as the Hazardous Waste Task Force assigned a full-time investigator Tuesday to the recurring problem. The multi-agency task force is responsible for investigating illegal disposal of hazardous waste in the county, said Linda Miller, a spokeswoman for the district attorney’s office.

“Those facilities that are producing large quantities are required to follow strict guidelines,” Golding said. “But those who produce less than 220 pounds (a month) are basically under no regulation at all.”

Golding said she was concerned that drug addicts, for example, could rummage through improperly disposed medical waste in search of syringes and other drug paraphernalia. She also feared that such medical debris could facilitate the spread of disease.

If found guilty of violating the ordinance, perpetrators could be assessed a maximum penalty of $25,000.

‘Have to Close This Loophole’

“We have to close this loophole,” Golding said. “Especially these days, with the AIDS epidemic, I think we have to be concerned about the spread of disease through contaminated needles and vials. All of these items must be properly disposed.”

The new disposal requirements will be published in local medical journals, and a special bulletin will be sent to every physician in the county informing practitioners of the amended ordinance, said Gary Stephany, deputy director of environmental health services.

To allow the changes to take effect immediately, the board voted unanimously, 5-0, to pass the ordinance amendment on an “urgency” basis. A refined version of the urgency ordinance is scheduled to be drafted and submitted before the board Dec. 6 for permanent adoption. If it passes, it will become effective in 30 days.

There was initial concern whether the county could pass the tougher amendment because state regulations cover the medical waste disposal procedure, Golding said.

“However, it is the opinion of our county counsel that the state Health and Safety Code does not preempt us from passing a regulation that is more restrictive,” she said. “Nowhere does it explicitly state in the code that we cannot pass such an ordinance.”

Revised Ordinance

The revised ordinance passed by the supervisors only has jurisdiction in the county’s unincorporated areas.

“That’s why I directed the board to ask all the other cities in the county to enact the same ordinance on an emergency basis,” Golding said. “Without their help, obviously, this will not be effective.”

Previously, Golding has argued that the term medical waste be redefined to include blood and urine samples. She said such medical byproducts need to be destroyed because they are organic compounds that can become breeding grounds for infectious diseases.

The urgency ordinance defines medical waste in two categories and requires that each be handled in a particular fashion:

- Class I medical waste includes items considered to be innocuous solid waste. It requires storage in secure areas before removal to disposal sites.

- Class II medical waste includes items considered to be potentially dangerous, such as blood and blood products, pathological wastes and hypodermic needles. Such items must be disposed of by approved methods such as incineration and exposure to steam.

Task for Ad Hoc Committee

The task of providing an even more refined definition of medical waste will be one of the responsibilities of the newly created ad hoc Medical Waste Review Committee.

The board also unanimously approved a resolution establishing the committee--including representatives from the Medical Society, the Navy and the county Health Department--which will seek technical and community advice to improve disposal procedures.

On Tuesday, the County Health Department turned over its medical waste dumping investigation to the Hazardous Waste Task Force, said Miller, the district attorney spokeswoman.

The task force, which is composed of 15 federal, state and local agencies, has assigned a full-time investigator to the case, she said.

“The health department has not relinquished its role in the investigation,” Miller said. “They just need someone experienced in handling criminal cases to lead the investigation. The health department is primarily a regulating agency.”

Full-Time Investigator

Miller said assigning a full-time investigator does not mean that criminal prosecution is anticipated. “That’s a possibility, but first of all we’re trying to find out where this medical waste is coming from.”

Since the items washed ashore include Navy medical supplies, the Navy, too, is conducting an internal investigation over suspicions that the Navy has dumped antiseptic vials and other wastes into the ocean.

“We have a couple of Navy representatives on the task force,” said Navy Chief Craig Huebler. “It could place us in an awkward spot, if we are the ones the task force investigates. But it is our goal to take part in the task force and to work with them.”

In addition to the task force’s efforts, Huebler said the special, two-member Navy team formed to conduct an internal investigation will continue its effort to help county officials determine the source of medical wastes that have turned up on beaches from Imperial Beach to Carlsbad during the past three weeks.