The cost of disposing of medical waste would more than double under newly proposed incinerator regulations, handing the healthcare industry an additional annual expense of $425 million, the Environmental Protection Agency projected.
Hospitals, nursing homes, blood banks, commercial research laboratories and veterinary facilities would have to increase prices by fractions of a percent, the EPA said. But it concluded no healthcare facility would be forced to close or consolidate for the cause of cleaner air.
The proposed rules, required by Congress under the 1990 Clean Air Act amendments and issued earlier this month (Feb. 6, p. 15), aim to reduce medical-waste incinerator emissions 95%. The EPA is required to approve a final version of the rules by April 15, 1996.
The proposed rules are likely to undergo a public thrashing by the American Hospital Association.
The AHA took issue with the proposed emissions limits when they were leaked in draft form last summer (Aug. 29, 1994, p. 14). Now it's assembling a task force of "technical experts" to judge their impact for itself, said Jim McLarney, associate vice president.
And late last month, an AHA environmental consultant issued a paper saying the EPA overestimated dioxin emissions of medical-waste incinerators by a factor of 36.
According to the EPA, hospitals produce more than 70% of medical waste and own more than 60% of the country's 3,700 medical-waste incinerators.
The agency predicts as many as 80% of facilities would find it economical to shut down their on-site incinerators under the proposed regulations, with many switching to commercial incinerators or steam autoclaving. In addition, construction of new burners would decline 80%.
Nationwide, hospitals would have to raise prices 0.13% and nursing homes 0.11% as a result of the new regulations, the EPA said.
The entire healthcare industry now spends $328 million annually on medical-waste disposal.
An EPA draft dioxin study, released in September 1994, said medical-waste incinerators are the largest known source of the suspected carcinogen, accounting for 55% of known releases, although half the sources are unknown.
AHA consultant Lawrence Doucet, of the Peekskill, N.Y., firm of Doucet & Mainka, said the EPA overestimated the number of incinerators and the amounts they burn, downplayed theMedical waste
impact of pollution-control systems, and used assumptions that were "faulty and inconsistent with actual practices and operations."
The EPA's dioxin report is undergoing public review.
The AHA also disputes the EPA's finding that alternative disposal methods are readily available.
The EPA based its projections on the experiences of California, New York and Texas-states that tightened regulations on their own. New York estimated 90% of medical-waste incinerators there ceased operation after the state required add-on air-pollution control systems, similar to those proposed by the EPA.
The EPA said waste producers in those states found satisfactory alternatives and nationally, the commercial waste disposal industry reports sufficient capacity to handle medical waste diverted from on-site incinerators.
However, the EPA is considering looser standards for rural hospitals, which might be burdened by high trucking fees.
The EPA has yet to schedule a public hearing, but its air-quality officials will meet with healthcare industry representatives and other interested parties this week.