Medical Waste: Town Tackles Its Burning Issue : Environment: A Carolina hamlet welcomed an incinerator plant as a friendly beast. Many now call it a menacing dragon.


When Hampton got its incinerator plant in the mid-1980s, residents welcomed the big green facility on the outskirts of town as a friendly beast that would eat up tons of garbage and save space in the local landfill.

Three years ago, the plant operators, citing a need for more revenue, decided to burn medical waste in addition to the municipal refuse.

Many people in Hampton feel that decision transformed the friendly beast into a modern-day Grendel that belches foul smoke and ravages their health. Medical waste from faraway places, like New York and New Jersey, began descending on the little hamlet in southern South Carolina before being reduced to ashes.

"It's terrible," said Sadie Gamble, referring to the plant's residue. "It's going to get into our drinking water and cause cancer."

Officials at Southland Exchange Joint Venture, the plant operator, maintain that the plant's three incinerators are safe.

But Hamptonians, angry and fearful, are not assuaged. In the state Legislature session that just ended, lawmakers, feeling pressure, passed a measure that cut in half the amount of medical waste the plant can burn. The cut was to have taken effect today, but Southland Exchange succeeded in getting a court injunction and continues to burn 100 tons of waste daily.

The developments here come amid continued illegal dumping of medical waste, and a national trend toward building more incinerators to get rid of the increasing needles, syringes, bottles, body parts, and other items generated by hospitals, doctors, dentists, undertakers and others.

According to the Environmental Protection Agency, there are 6,000 existing medical waste incinerators nationwide, and 60 new ones are being built each year. The nation's 7,000 hospitals generate about 10,000 tons of medical waste daily--10% of it infectious--and about 90% incinerate their own. But the EPA is only just beginning to formulate regulations to govern the technology.

Meanwhile, from Savannah, Ga., to Susanville, Calif., supporters and critics of the incinerators do battle over where, and whether, they should operate. The battles, highlighting issues of health, environment, money, regional animosity and aesthetics, are intensifying as regional incinerators replace small hospital facilities. The fights are further fueled as landfills reach their limits in many areas and fears of contracting diseases such as cancer, AIDS and hepatitis rise.

--In Savannah, Chatham County officials passed an ordinance prohibiting transportation of medical waste on county roads or across county lines, effectively killing plans to build an incinerator.

--In Susanville, the permitting process is "60% to 70% there" for an incinerator, said Alan Siemer, project manager for Susanville Resources Inc., affiliated with the same company that runs the plant in Hampton. However, Richard Holmes, a high school principal and member of Citizens Against Toxic Emissions, said his group has collected about 2,000 signatures on a petition against the plant and will continue fighting it. An environmental impact study is expected to be released in August.

--The Hospital Council of the Greater Milwaukee Area, despite heavy opposition from local environmentalists, is forging ahead with plans to develop a facility that would burn used tires and pathological waste to make steam. The project has been thwarted several times when environmentalists cited flaws in the state's permit procedure. "We think it is a good project," said Marvin Neely, council president, "but there are those who disagree with us. The point is perseverance."

--In Baltimore, officials at Medical Waste Associates said they will begin testing in October a plant that will serve 19 area hospitals, despite stringent protests from local residents. "A number of them won't be mollified until they see that we have established a track record after we are up and running," said Mike Murphy, a company official.

"The role of incineration is one of the most contentious issues in (waste) management," declared a 1989 report by the Office of Technology Assessment, an arm of the U.S. Congress. "Public opposition to incineration has grown dramatically in many communities because of concerns about the presence of undesired metals and organic chemicals in emissions and in the ash residues."

The report, "Facing America's Trash," goes on to say: "At the same time, however, incineration is attractive because it . . . destroys pathogens, can be adapted to recover energy and greatly decreases the amount of material that must be land-filled."

Rep. Ron Wyden (D-Ore.), chairman of the Small Business Committee's subcommittee on regulation, business opportunities and energy, charged at a hearing last year that "the regulatory safety net which protects us from environmental and health harm caused by medical wastes has huge holes."

Government studies have examined alternative technologies for disposing of medical waste, such as the steam sterilization process called autoclaving, but incineration remains the disposal method of choice because of effectiveness and cost.

And the bottom line emerging from voluminous materials from the Office of Technology Assessment, the General Accounting Office and the EPA is that more studies need to be done before it is known how risky the incinerators are.

For example, a GAO report in March said: "Although it is generally agreed that some medical waste contains infectious agents, a clear consensus on the amount of threat to the general public and on whether medical waste is any more infectious than ordinary garbage has not been reached."

Jim Crowder, a federal EPA official in Research Triangle Park, N. C., said medical waste incinerators are not regulated under the Clean Air Act, but that the agency is working on air emission standards. However, the federal air standards would not apply to existing incinerators, only to those built after the regulations are proposed in perhaps August, 1992.

As for whether the incinerators are dangerous, Crowder said the EPA is "involved in doing field testing. There are no results back yet."

But others say the hazards are plentiful, and obvious.

For example, hospitals and other health care professionals are increasingly turning to plastic, throwaway materials. "Certainly when you combust plastics, you produce dioxins," said Dr. Samuel Epstein, professor of occupational and environmental medicine at the University of Illinois school of public health in Chicago.

He suggested turning to fewer plastics and more laundering, but health care providers defend plastics as more efficient and sanitary and less expensive.

While many incinerators burn the waste at about 1,500 degrees Fahrenheit, Dr. Epstein called that "on the low side" for destroying harmful bacteria.

Here in Hampton, a town of some 3,300 people, such issues rage.

"If you bring up Southland in a conversation, you will get a reaction," said Laura McKenzie, editor of the Hampton County Guardian. "Just the name. It has caused some splits. Some won't be happy until it closes. Others want to keep their jobs."

The center of controversy, the Southland plant, is a huge green, hangar-like structure, containing municipal garbage heaped on the floor and boxes of medical waste. Three incinerators burn the material at temperatures ranging from 1,400 to 1,800 degrees Fahrenheit, and the ashes are taken to a landfill.

Since 1987, the plant has been authorized to burn 100 tons of medical waste a day, along with an equal amount of municipal garbage. If opponents are ultimately victorious in court, the amount of medical waste will be 50 tons.

Ann Ritter is a lawyer who has represented clients in cases involving toxic chemicals and is a member of the local organization For a Cleaner Environment, which has lobbied heavily against the plant. Fifty tons, she said, "is still too much."

Ritter, who lives within a mile of the plant, complains about the odor and said she and others fear toxic agents from both the smoke and from ashes that are buried in the landfill and can leach into ground water.

Michael Crews, Southland spokesman, showing a visitor around the plant, said that the medical waste is less dangerous than municipal waste. "You don't know what's in kitchen garbage," he said.

"The philosophy we're dealing with is when you're dealing with the environment, you're guilty until proven innocent," Crews declared. Referring to critics of the plant, he said: "Some of these people, if we close down this facility and make it a flower shop, still wouldn't like it."

Some would.

"I wish we could get rid of that thing," said Murphy Barnes, taking a break from inspecting his garden crop of corn, beans and squash the other day. "It just ain't right. It's all right to handle what's in South Carolina, but I think every state ought to take care of its own waste."

But Crews argues that Southland contributes greatly to the area's economy, employing 85 workers, paying almost $765,000 in taxes and user fees last year, spending $2 million a year on goods and services and getting rid of the area's garbage.

Nevertheless, the plant has come in for some hard times. In addition to legislation mandating a 50-ton cutback, it was fined $242,000 in April by the state Department of Health and Environmental Control for allegedly violating rules on air quality and solid waste disposal. Southland is appealing the matter and will pay no fines meanwhile.

Several residents asserted that respiratory illnesses are rising because of the plant's emissions. Dorothy Lightsey, school nurse for 20 years, said there are more colds, sore throats and runny eyes among students but added: "I don't know whether to blame it on Southland."

State Sen. Peden McLeod, who represents this area and is chairman of the Committee on Medical Affairs, summed up the feelings of many around here. With the landfill filling up, he said, Southland's facility seemed "an ideal situation" until it started burning medical waste.

"We have nuclear waste, hazardous waste, medical waste," McLeod said. "People are tired of being the dumping ground for everything around. This is an overall grand mess."

Staff researcher Edith Stanley contributed to this story.

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