The scale of the problem
Waste is unavoidable. We need to provide options on how to manage refuse that inevitably gets produced by hospitals. Incineration used to be the technology of choice, but we've learned that this process produces dioxins. This nasty substance is considered one of the most toxic pollutants known. The ash that incineration produces may also contain toxins. These substances can enter the food chain after livestock are exposed and contaminated.
In the United States, a study by the Environmental Protection Agency found that medical waste incinerators produced 40% of the country's air dioxins.
Part of the problem is that medical waste often contains PVC and the chlorine - vital ingredients in dioxins. The World Health Organization (WHO) points out that PVC should not be burned. The Indian government went as far as to rule out the use of PVC altogether.
The Stockholm Convention, which has been signed by over 150 countries, requires that best environmental practices, and best available technologies, be used to reduce the amount of dioxins from incineration.
There's enough proof that this can be done. In the last 20 years, the US has closed 99% of its medical waste incinerators, down from over 6,000 in 1988 to fewer than 60 at the end of 2008.
The Philippines has proven that it's possible to eliminate incineration altogether. In main cities, infectious waste is dealt with by centralized facilities running autoclaves or microwaves. In 2004, HCWH-AP helped the country's Department of Health (DOH) prove that it was possible to manage the waste from a country-wide vaccination program without resorting to open burning or incineration. Read more about the PMEC.
HCWH first published a guide to non-incineration technologies and how they work in 2001. An updated report (pdf) on the Philippines’ successful PMEC campaign was produced in 2004. The report was followed by an inventory of alternative technology suppliers around the world. We identified 113 companies supplying alternative technologies to sixty countries. This list is continually being updated. Manufacturers who want to have their products included in our list may email info@no-harm.org.
On top of the environmental benefits, alternative technologies are usually more economical than incineration. The World Health Organization has developed a Health Care Waste Management Costing Tool to help decision makers working on local or national levels.