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December 12, 2007 > Earth talk

Earth talk

Where does all the medical waste go?

By From the Editors of E/The Environmental Magazine

Dear EarthTalk: Where does all the medical waste from labs, doctor's offices and hospitals go? Does it just get put in a barrel and buried? Do they dump it in the oceans? With all the waste that is probably generated, it would be interesting to know where all those vials of blood and stuff go.

Lee Senat
Haverford, PA

Medical waste is defined as the "biological byproduct of the diagnosis, treatment or immunization of human or animal patients" and includes so-called "sharps" (needles and scalpels), lab cultures and stocks, blood and blood products and any other wastes generated from sick patients or patients with infectious diseases. Such wastes have traditionally been disposed of by burning, either onsite at large medical or veterinary facilities, or offsite by licensed contractors that specialize in handling infectious materials. In most cases, incineration has been found to be effective in neutralizing potentially infectious agents.

But incineration, whether for medical or other purposes, doesn't come without its health and environmental risks. The process generates some highly noxious pollutants, such as mercury and dioxin. Despite modern pollution control equipment on smokestacks, some of this discharge becomes airborne where it can foul the air and end up in waterways. And the incinerator ash left over after burning is usually sent to local landfills, where the pollutants can seep into soils and groundwater if not properly contained.

Given such problems, many of the nation's largest medical waste incinerators have been shut down in recent years in the face of more stringent regulations promulgated under the U.S. Clean Air Act. In their place a wide assortment of alternative methods, including autoclaving (steam sterilization), chemical disinfection, irradiation and enzymatic (biological) processes have emerged. Today more than 100 different technologies are in use in place of incineration. Once medical waste has been decontaminated by any of these methods, it usually ends up in landfills alongside regular municipal solid waste.

Most of us never even thought about medical waste until it started washing up on beaches in New Jersey in 1987 and 1988 in an event that became known as the "Syringe Tide." The event hit the New Jersey tourism industry hard, costing it almost $1 billion in lost revenues. It also served as the basis for Barbara Ehrenreich's book, "The Great Syringe Tide" and reportedly was the inspiration for the line "hypodermics on the shores" in Billy Joel's 1989 hit, "We Didn't Start the Fire."

While there were few if any cases of people getting sick from exposure to such waste on beaches-medical waste poses a far greater risk to health care workers than to casual beachgoers-the events served as a wake-up call to federal and state governments charged with ensuring public safety. In response, Congress passed the Medical Waste Tracking Act (MWTA) in 1988, which classified different types of medical waste and called for the creation of a "cradle-to-grave" tracking system requiring medical facilities and waste haulers to account for the proper handling and whereabouts of the waste they handled.

Congress only funded MWTA for two years, but various states have since enacted their own laws and protocols based on standards set by the original legislation. Not surprisingly, the toughest laws are in place in New Jersey and other Northeast shoreline states.

CONTACT: Medical Waste Tracking Act of 1988,

GOT AN ENVIRONMENTAL QUESTION? Send it to: EarthTalk, c/o E/The Environmental Magazine, P.O. Box 5098, Westport, CT 06881; submit it at:, or e-mail: Read past columns at:

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