Health and Ecological Effects of Burning Medical Waste

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“Incineration results in the release of extremely harmful pollutants such as dioxins. If we make a decision today to release dioxins into the environment, they will stay there not only during our lifetime, but also the lifetime of our children and their children, and their children’s children,” warned environmental scientist Dr Jorge Emmanuel during his presentation during a forum on the environmental and health impacts of incineration.

         The noted scientist, who helped draft the World Health Organization’s interim guidelines on the management of Ebola waste, painted a grim picture of the health, environmental and economic dangers of climate change, and expounded on the threats posed by medical waste burning to participants composed of hospital representatives, the media, the academe, non-government organizations, professional associations, private sector groups and government agencies.

        Dr Emmanuel explained that dioxins are a group of chemically related compounds that are persistent organic pollutants (POPs). These pollutants accumulate in the environment and in the food chain, mainly in the fatty tissue of animals. Highly toxic, dioxins can cause reproductive and developmental problems, damage the immune system and interfere with hormones, he said.

 “The effects of dioxins include cancer, birth defects, alterations in the reproductive system, impacts in child development, suppression of the immune system, female reproductive effects, reduced fertility and lower sperm count in males, to name a few,” Dr Emmanuel said.

 Dr Emmanuel said that medical waste incinerators can also release a wide variety of pollutants, depending on the composition of the waste. These pollutants include particulate matter such as fly ash; heavy metals such as arsenic, chromium, copper, mercury and lead; acid gases such as hydrogen chloride, hydrogen fluoride, sulfur dioxides and nitrogen oxides; carbon monoxide; and organic compounds. Pathogens can also be found in the solid residues and in the exhaust of poorly designed and badly operated incinerators.

 Dr Emmanuel, who has served as medical waste consultant for the United Nations Environment Programme, the World Bank, the United States’ National Institutes of Health and other organizations in about 40 countries across the globe, proposed the use of alternative technologies, particularly autoclaving. He said that autoclaving is an environment-friendly high-pressure sterilization method that eliminates bacteria, viruses, fungi, and spores. He also stressed that based on various cost analyses, incinerators incur higher capital costs compared with autoclaves. In fact, standard autoclaving has the lowest capital cost among alternative technologies.

          “If we go back to incineration, more health facilities will move away from segregation and waste minimization. Why? Because once you have an incinerator, it is easy to burn everything. There is not an incentive to try to minimize and segregate,” Dr Emmanuel said. The other danger he noted is that the incinerators will most likely not meet international standards and will require constant monitoring by state agencies.

 “If we ever choose technology, let’s make sure they are ones our future generations will thank us for,” he said.

 HCWH-Asia is part of a global organization that is at the center of transforming the health care sector through anti-incineration advocacy and the promotion of green and healthy hospitals.