After two years of proposals and revisions, the U.S. Environmental Protection Agency has issued final rules on hospital incinerators it says should dramatically reduce air pollution from the burning of healthcare waste.
The EPA expects a majority of existing hospital incinerators to close rather than comply with the new standards.
Under the regulations announced Aug. 15, urban hospitals will have to outfit their incinerators with scrubbers to minimize toxic emissions. Rural hospitals, located more than 50 miles from major urban areas, are subject to less stringent controls that require their incinerators to conform to operational standards known as "good combustion."
According to the EPA, the rules will dramatically reduce toxic air pollution from hospital sources.
Mercury emissions are expected to fall by 94% and dioxin emissions by 95%, the EPA says.
But environmental groups criticized the agency for softening the rules under pressure from hospitals.
"We dislike (the standards) because they're way too weak," says Jim Pew, a lawyer with the National Resources Defense Council, Washington.
Based on data from top-performing hospital incinerators, the NRDC estimates the EPA's standards for dioxin and mercury are hundreds of times weaker than they should be. As a result, the organization is considering a court challenge to compel the EPA to toughen the rules.
Even if the rules stand as written, however, hospitals with incinerators will have to spend money to keep them running.
According to the EPA, complying with the rules will add less than 35 cents a day to the average cost of a hospital stay.
Largely because of increased operating costs, the agency expects 50% to 80% of the 2,400 existing hospital incinerators to close rather than comply.
"Most probably will end up shutting down," concurs Robert Cowan, manager of facilities consulting services for Premier, a San Diego-based hospital alliance.
But because disposal can cost 10 times more than incineration, Cowan expects many hospitals to pay more serious attention to reducing waste.
Hospitals will have to "start squeezing down on medical waste," he says.
Still, critics worry the weakened rule will cause hospitals concerned about tougher standards to relax. "We're afraid one of the biggest incentives for shifting away from incineration is gone," says Jackie Savitz, an analyst with the Environmental Group, Washington.