Medical-Waste Mess Leads to Fees for Health Professionals

Faced with a sharp increase in medical-waste dumping at local beaches, county health officials will impose a $35 fee on doctors and dentists beginning Jan. 1 and use the proceeds to fund a new pollution enforcement and education program.

More than 300 hypodermic needles, glass vials, earplugs and other debris have washed ashore so far this year. In the most serious incident, in February, about 200 needles were discovered, forcing the closure of Bolsa Chica State Beach and Sunset Beach for several days.

The county’s shoreline recorded no incidents of medical-waste dumping in 1995, and officials said they could recall no major cases in 1994.

“The increase this year concerns us,” said Steven Wong, assistant director of Orange County’s environmental health division. “We think it points up the need for more education and enforcement on how to handle medical waste and comply with the legal requirements.”

The $35 annual fee will be charged to as many as 2,000 independent doctors’ and dentists’ offices. The fee is expected to generate about $55,000 in annual revenue, which will be used to hire a new health worker.

Environmentalists praised the county’s efforts, describing it as a novel way of expanding enforcement activities and perhaps cutting pollution.

“Having medical waste illegally dumped into the ocean is very unsanitary and unsafe,” said Bob Sulnick, executive director of the American Oceans Campaign. “Basically, it means beach-goers are swimming and playing in garbage.”

But many doctors and dentists complain that the new fees unfairly single them out and wrongly imply that they are responsible for the illegal dumping.

“In many ways, it’s a double tax on these doctors because they are already paying private collection firms $30 to $40 a month to collect and properly dispose of the waste,” said Sam Roth, communications director for the Orange County Medical Assn., which opposes the fee.

Some doctors have suggested that the fee be applied instead to the waste collection firms, which could then pass the costs along to physicians “in a market-based competitive way,” Roth said.

“People are upset at the presumption . . . that doctors are offshore on boats dumping waste into the ocean,” he added. “There’s no evidence to back that up.”

County health officials stressed that the new program is not meant to blame anyone for the medical-waste problem.

Investigators have been unable to determine the source of needles and other debris that washed ashore this year because the waste had few discernible identifying marks. If convicted, polluters face fines of up to $25,000 and up to three years in state prison.

Hospitals, medical labs and other “major waste generators” already pay $200 to $1,500 a year to fund a separate pollution prevention program. One health worker is responsible for the program, but the county does not currently assign anyone to monitor doctors’ offices and other “small waste generators.”

A recent state audit of the county’s medical waste enforcement program found that staffing levels are “not adequate to perform the required annual inspections” and urged officials to hire a second worker.

“We feel we are on top of things in terms of educating the hospitals and labs,” Wong said. “The [pollution] is caused by a really small percentage of businesses and maybe a few homeowners. Our feeling is that the vast majority of physicians in the county are very responsible.”

Besides the February dumping, smaller amounts of medical waste also washed ashore at Bolsa Chica State Beach in October and November. No one was reported injured in any of the incidents, but, Wong said, the pollution brings significant safety risks.

Children could prick themselves on needles they discover at the beach. If the needles are contaminated from an infectious disease, Wong said, children could become infected. The dumping of human organs or body secretions can also spread disease.

Beach dumping is only part of the problem. Medical waste is often simply tossed in the trash and sent to landfills, where workers occasionally prick their fingers with needles mixed in with other garbage.

The new health worker will be responsible for producing and distributing educational materials, carry out consultations at doctors’ and dentists’ offices and handle the hundreds of phones calls the county receives from physicians and residents with questions about waste disposal rules.

The Board of Supervisors approved the fee earlier this month on a 4-1 vote. The lone opponent, Supervisor Jim Silva, questioned whether the fee would be a excessive burden on doctors and raised concerns about the size of the charge.

But other supervisors said the fee was needed to ensure that the beaches remain free of medical waste. “It’s a serious public health issue,” said Supervisor William G. Steiner. “There needs to be oversight.”

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How to Treat Needle Waste

Here are some tips on disposing of needles, vials and other forms of medical waste used at home.

* Call the doctor’s office where you received the medical supplies and see whether it will dispose of the used materials for you. Many doctors hire professional collection firms to handle medical waste.

* If you purchased needles and vials from a pharmacy, ask if they will take back used supplies. The county is asking Thrifty, Sav-On and other drugstores to establish needle-return programs.

* If the drugstore will not take used needles, place them in their original packaging and throw them in the trash. Do not place needles in trash without thoroughly wrapping them.

* Do not dump medical waste in storm drains, on the street or in the ocean.

Source: Orange County Health Care Agency