Reference 1
Why Ban Incineration?

Burning was once considered the most effective method for disposing of waste materials. But since industrialisation the nature of waste has changed dramatically. The mass production of chemicals and plastics mean that the burning or incineration of waste today is a complex, costly and highly polluting method of disposal. Based on the myth that burning makes waste disappear, incineration has emerged as a widely used method to dispose of many kinds of waste, including hazardous wastes.
 

However, far from making waste disappear incinerators actually create more toxic waste, and through this pose a significant threat to public health and the environment. For example, incineration is touted as an alternative to land filling. Yet incinerator ashes - contaminated with heavy metals, unburned chemicals and entirely new chemicals formed during the burning process - are buried in landfill or dumped in the environment.

Through incineration, industry has found a way to break down its bulk waste and disperse it into the environment via air, water and ash emissions. Incineration is a convenient way for industry to mask today's waste problems and pass them onto future generations.

IMPACTS OF INCINERATION: EMISSIONS

Existing data shows that burning hazardous waste, even in "state-of-the-art" incinerators, will lead to the release of three types of dangerous pollutants into the environment:

1. Heavy metals
2. Unburned toxic chemicals
3. New pollutants - entirely new chemicals formed during the incineration process.

Metals are not destroyed during incineration and are often released into the environment in even more concentrated and dangerous forms than in the original waste. High-temperature combustion releases toxic metals such as lead, cadmium, arsenic, mercury and chromium from wastes that contain these substances, including batteries, paints and certain plastics. They are released in the form of tiny particles or gases, increasing the risk of inhalation. An average-sized commercial incinerator (32,000 tonnes per year) burning hazardous waste with an average metals content emits these metals into the air at the rate of 92 tonnes a year (total for lead,cadmium, arsenic, mercury and chromium); another 304 tonnes a year will be found in residual ashes and liquids. Pollution control equipment can remove some but not all heavy metals from stack gases. But even then the metals do not disappear; they are merely transferred from the air into the ash, which is then landfilled.

Subsequently, metals in the ash may leach into and contaminate soils and potentially groundwater. Presently, ash from incinerators is sometimes being used for construction purposes such as in asphalt, cement and for making paths. This practice can also have implications for the environment and for human health. For instance, metals can leach out of such construction materials. Ash from a municipal waste incinerator in Newcastle, UK, was used on local allotments and paths between 1994 and 1999. All of it had to be removed recently after it was found to contain unacceptably high levels of some heavy metals and dioxins.

Unburned toxic chemicals

No incinerator process operates at 100 per cent efficiency. Unburned chemicals are emitted in the stack gases of all hazardous waste incinerators. They also escape into the air as fugitive emissions during storage, handling and transport. While incinerators are designed to burn wastes, they also produce them in the form of ash and effluent from wet scrubbers and/or cooling processes. Incinerator ash carries many of the same pollutants that are emitted as stack gases. Studies have identified as many as 43 different semi-volatile organic chemicals in incinerator ash, and at least 16 organic chemicals in scrubber water from hazardous waste incinerators. Ash is commonly buried in landfill, while effluent is often treated before being discharged into rivers or lakes.

New pollutants - dioxins and furans

One of the most insidious aspects of incineration is the entirely new and highly toxic chemicals that can be formed during the combustion process.
 

When fragments of partially burned waste chemicals recombine within incinerator furnaces, smokestacks, and/or pollution control devices, hundreds, even thousands, of new substances are created, many of which are more toxic than the original waste itself.

 

There has been very little research on the identification of the multitude of pollutants emitted from incinerators. One study identified 250 volatile organic compounds, many of which are known to be highly toxic or carcinogenic, but it is likely that many other compounds are emitted which have yet to be identified.

Among these are dioxins and furans (often referred to just as dioxins) a class of chemical compounds widely recognised to contain many highly toxic compounds including TCDD, a chemical which has been described as the most toxic chemical known to man. Dioxins are created when chlorine-containing materials are burned. They have no useful purpose and are associated with a wide range of health impacts including, cancer, altered sexual development, male and female reproductive problems, suppression of the immune system, diabetes, organ toxicity and a wide range of effects on hormones.

DIOXINS - GLOBAL KILLERS
 

Once emitted into the environment dioxins can travel vast distances on air and ocean currents, and because of this globe trotting ability are a global contaminant. In 1997, the International Agency for Research on cancer (IARC) classified TCDD, the most toxic dioxin as a human carcinogen.

Dioxins are distributed into the environment as part of incinerator stack gases, bottom ash, fly ash and in the effluent of pollution control devices. The main route of exposure to dioxins in humans is through food intake. Once in the body they are only excreted very slowly and build up in fatty tissues. Studies suggest that people in the U.S. and some European countries now carry dioxins and furans that are at or near those levels which are suspected to cause health effects in humans.

Dioxin released from an incinerator can be readily taken up by grazing animals and fish.

• In 1989, 16 dairy farmers downwind of a Rotterdam incinerator were banned from selling their milk, because it contained dioxin levels three times higher than anywhere else in the Netherlands.

Fugitive Emissions

Some waste is accidentally released when chemicals are removed from storage containers at the incinerator site, moved to transportation vehicles, or being shipped to and moved about within the incineration facility. An average incinerator burning 32,000 tonnes of waste per year will receive over 1500 tanker-truck shipments of wastes per year, or more than 28 trucks per week. According to the US EPA: "Fugitive emissions and accidental spills may release as much or more toxic material to the environment than direct emissions from incomplete waste incineration ..." There is also the risk of catastrophic waste releases in fires and explosions.

Incinerator Ash is Hazardous Waste

Leftover incinerator ash can be extremely toxic, containing concentrated amounts of lead, cadmium and other heavy metals, as well as dioxins and other toxic chemicals. Disposal of toxic ash in an environmentally sound manner is problematic and expensive. If handled properly, ash makes incineration prohibitively expensive for all but the wealthiest communities. If handled improperly it poses short and long-term health and environmental dangers. The better the pollution-trapping device in an incinerator smokestack, the greater the quantity and toxicity content of the residues will become. A hundred times more dioxin may leave an incineration facility on ash, than in air emissions. The average cost in the Midwest US for disposing a ton of hazardous waste is $210, compared to $23 for ordinary waste. Some experts recommend burying this ash in a landfill equipped with a plastic liner to prevent leaching into groundwater. But all landfill liners eventually leak.

Toxic incinerator ash is now being spread over Britain's streets¹

In the last 18 months, public subsidies have been used to build 4 new ash recycling plants in the UK - at Edmonton, SELCHP, Tyseley and Cleveland. These plants can generate 340,000 of 'recycled' ash per year.

This ash, laden with toxic metals, dioxins and other hazardous substances is being used by Birmingham City Council for road building. It is being spread by the thousands of tonnes. In London, it has already been spread in Greenwich (near Woolwich Road), Enfield, Waltham Forest and out into Essex (on the Leyton Relief Road). It is also being spread in Dudley (Netherend Lane) and Stoke.

This reckless practice has to stop.

³This has recently ben exemplified by in Newcastle, UK where fly ash and bottom ash were used for path making and also spread over allotments as fertiliser between 1994 –1999. Recent analysis of ash from the allotments found that it is contaminted with extremely high levels of heavy metals and dioxins.

INCINERATION IN ASIA

Developing countries in Asia are being swamped with proposals to build waste incinerator plants. Faced with shrinking markets in pollution-conscious Northern countries, incinerator companies are turning to Asia where they see a lucrative market for their outdated and poisonous technology.

Today, incinerators are being sold under a variety of guises – such as fluidised bed incinerators, thermal treatment plants or as waste-to-energy systems. Yet in countries, such as the Netherlands, Germany where pollution regulations are impossibly tight, incinerators still continue to incur monumental costs to clean up the pollution they cause. Many of the industrialised countries cited by incinerator salespersons as proponents of incineration technology, are rapidly shutting down their incinerators. By the end of 1998, more than 2000 industrial waste incinerators nation-wide were closed permanently or temporarily in Japan, as a result of tougher limits placed by the Japanese Government on the emission of cancer causing dioxins.

However, following developments in technology for controlling emissions to air, new incinerators are again being proposed in some European countries. Governments charged with managing industrial waste stand at a critical juncture. They can continue to approve and promote incineration, or they can encourage the development and use of clean production methods that eliminate toxic processes, products and waste.

IMPACTS OF INCINERATION: HEALTH AND ENVIRONMENT

• Increased cancer rates, respiratory ailments, reproductive abnormalities and other health effects have been noted among people living near some waste-burning facilities, according to scientific studies, surveys by community groups and local physicians.
• Cancer, birth defects, reproductive dysfunction, neurological damage and other health effects are also known to occur at very low exposures to many of the metals, organochlorines and other pollutants released by waste-burning facilities.
• Many pollutants released in incinerator air emissions have been shown to accumulate in and on food crops, especially crops where the edible portion is exposed such as leafy vegetables. While thorough washing of produce may remove a portion of pollutants on crop surfaces, a significant amount (typically from 15% to 50%) will remain.

• Incineration relies upon the continued generation of waste to support the high operating costs. Pressure to pay back the high cost of building incinerators has had the effect of encouraging and perpetuating waste generation.
• Continued investment in incineration inhibits the development of more sustainable waste minimisation practices, as well as the exploration and development of products and processes that do not use toxic chemicals in the first place.
• Dispersing persistent, bioaccumulative pollutants into the air from incinerator emissions creates more pollution problems.

In theory, a properly designed incinerator should convert simple hydrocarbons into nothing other than carbon dioxide and water. Practical experience, however, has shown that even the best of combustion systems virtually always produce PICs [products of incomplete combustion], some of which have been found to be highly toxic. Even under the strictest of standards, "state-of-the-art" incinerators emit chemicals that have escaped combustion as well as newly-formed "products of incomplete combustion" - thousands of different chemicals of which only a small fraction have been identified.

The monitoring and measuring of incinerator performance is conducted in various ways and on various levels in different countries. Actual incinerator performance can deviate radically due to "combustion upsets" such as: equipment failure, human error and rapid changes in the waste fed to an incinerator. Only a small fraction of the total volume of waste needs to experience on one these "combustion upsets" for there to be significant deviations from the targeted destruction efficiencies.

Medical Waste - useful waste into hazardous waste.

Only 10 percent or less of a typical hospital's waste stream is potentially infectious, and that can be sterilised with heat, microwaves and other non-burn disinfection technologies. The remaining waste is not infectious. Most paper, plastic food waste and other hospital waste are similar to the same waste coming from hotels, offices or restaurants, since hospitals serve all of these functions. By burning medical waste in an incinerator the basic biological problem of disinfecting infectious material - which can be dealt with by various technologies - becomes a formidable chemical pollution problem that is costly to manage and difficult to contain.

Cement Kilns

Throughout the world some 60 cement kilns have been modified so that various wastes can be burned along with conventional fuels. But cement kilns are designed to make cement and not to dispose of waste. According to a study by the US Center for the Biology of Natural Systems, emissions of dioxins are eight times higher from cement kilns burning hazardous waste, than from those that do not burn it.

Pollution Control Devices

Pollution control technologies for different pollutants are often incompatible. So scrubbers designed to filter out particulate and heavy metals, will cool the exhaust gas to the ideal range for dioxin formation. This means that decreasing the emission of one pollutant often increases the emissions of others. And no pollution control device can eliminate dioxin or heavy metal emissions completely.

INCINERATION REMOVES THE INCENTIVE TO RECYCLE AND REUSE

Incinerators with state-of-the-art pollution control equipment are formidably expensive, but once authorities have invested in incineration they often don't have the money to invest in waste reduction. In this way, incineration directly competes with efforts to reduce and recycle waste.

Incineration actually perpetuates the use of landfills because of the large quantities of leftover ash produced by incinerators. It is estimated that for every three tons of waste that is incinerated, one ton of ash is generated. And this ash is very toxic, containing concentrated amounts of heavy metals and dioxins which, when buried, will eventually leach into the soil, potentially polluting groundwater.

Very few jobs are created in return for the huge economic investment in incineration. Most of the jobs are temporary, created during the building of the plant. A large incinerator may employ about 100 workers. On the other hand, community efforts into waste separation, reuse and repair, recycling and composting, can create more jobs, both in the handling of the waste and in secondary industries using recovered material.

Also, most of the money invested in the incinerator leaves the community. The huge engineering firms that build incinerators are seldom located within a community and so most of the money invested leaves the community. On the other hand, money invested in the low-tech alternatives stays in the community creating local jobs and stimulating other forms of community development.

Recycling saves more energy than incineration yields. For instance, if the United States burned all its municipal waste in incinerators, it would contribute less than 1% of the country’s energy needs. Two studies performed in the US in 1993 and 1994 show that if the currently marketable recyclable material, which is typically burned in a modern trash incinerator, was recycled instead, some 3-5 times as much energy would be saved. The reason: Incineration can only recover some of the calorific value contained in the trash; it cannot recover any of the energy invested in extraction, processing, fabrication and chemical synthesis involved in the manufacture of the objects and materials in the waste stream. Reuse and recycling can. In fact, a wide-ranging cost-benefit study conducted for the European Commission 1997 concluded that even landfilling was better and more energy-efficient than incineration for managing household waste.
 

Reference 2

Types of Incineration

Municipal Incinerators Municipal waste incineration is the still the number one dioxin source, according to a 1999 UNEP study. In many countries over the past few years, older incinerators have been updated and new incinerators have been built using improved technologies for air pollution control. This has led to substantial reduction of emissions of toxic substances to air.

Although this is an improvement, the problem of toxic waste products from incineration has not disappeared. In fact, the problem has shifted so that more dioxins and other toxic substances now appear in the ashes therefore creating new disposal and pollution problems.

Studies in Europe have reported that emission measurements from some European incinerators fall within the new proposed EC limit of 0.1 ng I-TEQ/m3 , but others exceed this limit.
 

Industrial/Hazardous waste incineration Only a few studies have been published in the scientific literature on recent emission testing of industrial incinerators.

In Japan, a study performed point measurements on nine industrial waste incinerators (Yamamura et al. 1999). Dioxin emissions were below 0.1 ng I-TEQ/Nm3 for two of the incinerators and above this level (0.13 to 4.2 ng I-TEQ/Nm3) for the remaining six.

In the US, one study reported on dioxin emissions of mobile soil burning incinerators (Meeter et al. 1997). On-site remediation of contaminated soils at hazardous waste sites by such incinerators is employed where sites contain compounds that are difficult to destroy. Data collected primarily from trial burns of 16 incinerators showed that 10 of the incinerators failed to meet the proposed EPA standard of 0.2 ng TEQ /dscm. The authors commented that a significant fraction of soil burning incinerators could have problems meeting the proposed future EPA limit.
 

Medical Waste - useful waste into hazardous waste.

Only 10 percent or less of a typical hospital's waste stream is potentially infectious, and that can be sterilised with heat, microwaves and other non-burn disinfection technologies. The remaining waste is not infectious. Most paper, plastic food waste and other hospital waste are similar to the same waste coming from hotels, offices or restaurants, since hospitals serve all of these functions. By burning medical waste in an incinerator the basic biological problem of disinfecting infectious material - which can be dealt with by various technologies - becomes a formidable chemical pollution problem that is costly to manage and difficult to contain.
 

Waste to energy schemes

The generation of energy from waste has increased recently and in fact is used extensively by governments and industry to "green" incineration and make it more acceptable to the general public. But all of the negative impacts from incineration do also apply to "waste to energy" facilities. Moreover, the energy used to produce the product will get lost anyway and only a fraction of the intrinsic energy content of the materials will be recovered. Reuse and recycling are also from energy perspective preferred options.

Municipal solid waste can be directly combusted in waste-to-energy incinerators or it can be processed as refuse-derived fuel (RDF) before incineration (or combustion in e.g. powerplants); or it can be gasified using pyrolysis or thermal gasification techniques.

Another MSW-to-electricity technology, landfill gas recovery, permits electricity production from existing landfills via the natural degradation of MSW by anaerobic fermentation (digestion) into landfill gas. Anaerobic digestion can also be used on municipal sewage sludge.

Refuse-derived fuel (RDF)

Refuse-derived fuel (RDF) typically consists of pelletized or fluff MSW that remains after the removal of non-combustible materials such as ferrous materials, glass, grit, and other materials that are not combustible. The remaining material is then sold as RDF and used in dedicated RDF boilers or co-incinerated with coal or oil in a multi-fuel boiler.

The environmental concerns of incineration also apply to RDF combustion facilities.

Pyrolysis/Thermal Gasification

Pyrolysis and thermal gasification are related technologies. Pyrolysis is the thermal decomposition of organic material at elevated temperatures in the absence of gases such as air or oxygen. The process, which requires heat, produces a mixture of combustible gases (primarily methane, complex hydrocarbons, hydrogen and carbon monoxide), liquids and solid residues. Thermal gasification of MSW is different from pyrolysis in that the thermal decomposition takes place in the presence of a limited amount of oxygen or air. The produced gas that is generated can then be used in either boilers or cleaned up and used in combustion turbine/generators. Both of these technologies are in the development stage with a limited number of units in operation. Most of the environmental concerns for incineration also apply to pyrolysis and thermal gasification facilities.

Cement Kilns

Throughout the world some 60 cement kilns have been modified so that various wastes can be burned along with conventional fuels. But cement kilns are designed to make cement and not to dispose of waste. According to a study by the US Center for the Biology of Natural Systems, emissions of dioxins are eight times higher from cement kilns burning hazardous waste, than from those that do not burn it.
 

Reference 1http://www.greenpeace.org/~toxics/html/content/incineration/index.html
Alternatives to Incineration

Municipal and hospital waste incinerators, are considered to be the largest dioxin sources in industrial countries. PVC plastic is probably the single most significant source of chlorine in these incinerators - the element necessary for dioxin generation. Incinerators that burn hazardous waste from industry are also point sources of dioxin.

Strategies to prevent the generation of these incinerable waste streams currently exist: by toxic use reduction planning within industries; by waste reduction and alternative forms of sterilisation in hospitals; and by efficient reduction, recycling and compost actions at community level for household waste.

"State of the Art" incinerators and cement kilns that burn hazardous waste can never solve our toxic waste problems. We need a Clean Production approach that substitutes safe materials and processes to stop the generation of hazardous waste in the first place.

Alternatives to Municipal Waste Incineration

Municipal and biomedical waste incinerators, are considered to be the largest dioxin sources in industrial countries, according to the US Environmental Protection Agency. Although it only accounts for approximately 0.5% of municipal waste by weight PVC provides more than 50% of available chlorine - the element essential to dioxin formation. According to the majority of studies on incineration, when all other factors are held constant, there is a direct correlation between input of PVC and output of PCDD/PCDF [dioxin]. For this reason the Danish government policy is to avoid the presence of PVC in incinerators.

Even if all the PVC and chlorinated wastes were taken out of the waste stream, incineration would still be a poor solution due to high costs, loss of jobs in the recycling industry, lost profits from secondary resale and ongoing contamination from heavy metal, hydrocarbon and other air emissions,

Cost effective and eco-efficient waste management alternatives to incineration exist. Glass, metals and paper can be easily recycled and reused. Organic waste fractions can be composted at household or community level. Some plastics such as polyethylene and polypropylene can be efficiently recycled if collection and recycling systems are based within the region.

Recycling is also profitable. A ban on incinerators, legislated in 1992 in the province of Ontario, Canada, stimulated both job creation and the price of secondary materials. Within two years the recycling industry had benefited from price increases of 163% for aluminium cans, 25% for PET bottles, 350% for cardboard, 210% for fine paper, 500% for HDPE, and 350% for newspapers.

A highly successful recycling programme has been running in Curitibi, Brazil since 1989. Ten thousand families participate in the "Garbage That is Not Garbage" programme receiving two kilos of food for every four kilos of recyclable garbage collected and delivered to the mobile units. The programme was initially implemented to foster the separation of organic from inorganic garbage at source as part of the city's environmental programme. Even the admittance to the municipal open air shows requires bringing in a bag for recycling rubbish. Approximately 60 tonnes of paper are recycled every day equivalent to 1,200 trees. The goals for the future are to transform Curitiba into a centre of excellence in the areas of urban planning and transportation and demonstrate the success of good city planning in developing countries.

A study to show the feasibility of a recycling/composting plan in the island of Mallorca in the Mediterranean was prepared by Greenpeace Spain in 1995. The annual waste production of waste is 329,000 tonnes - the majority of which is:
 

compostable material	37.4%
paper	22.2%
plastics	11.5%
glass	10.6%
textiles	7.2%
metals	5.1%
other	6.1%

An analysis of recycling potential including composting found that 72.8% of waste reclamation was possible. The financial costs of incineration (even with energy recovery) were calculated to be 6,000 pesetas/tonne compared to 2,325 pesetas/tonne if materials were recycled. Implementation could achieve a 60% beneficial use within five years and solve the country's escalating waste problem.

A study was done by the Centre for the Biology of Natural Systems in New York, USA in 1996 to examine the costs and benefits of eliminating dioxin sources from all combustion processes in the Great Lakes region of North America. The study found that replacing all municipal waste incinerators in the region with intensive recycling programmes would result in approximately $530 million annual savings.

The consequences of closing all the 52 Great Lakes garbage incinerators and creating programs of intensive recycling capable of diverting the same tonnage of waste that is currently burned involves an increase in collection costs and an increased education cost to the municipalities. But this is balanced against the net income from processing and marketing collected recyclables, the savings from avoiding disposal costs and paying off the debt for the incinerator.

The study estimated that 6,100 jobs would be created from additional collection and processing jobs after deducting job losses at incineration closures. Further job increases of 21,000 are predicted if the additional recycled materials are used by current and new manufacturing firms within the region.

A previous 1991 study by the Worldwatch Institute calculated the number of jobs per 1 million tonnes of waste processed in New York City.
 

Type of waste disposal	Number of jobs
Landfill	40-60
Incinerators	100-290
Mixed waste composting	200-300
Recycling	400-590

Recycling is not the answer to waste reduction however. We need to reduce our use of packaging and products and advocate reusable, returnable packaging and better product design for durability and
reparability.

Alternatives to Medical Waste Incineration

In medical waste incinerators, the dominant chlorine donor is PVC plastic, which enters these facilities as packaging and in many disposal medical products. An estimated 9.4 percent of all infectious waste is PVC, and virtually all available chlorine fed to medical waste incinerators comes from PVC.

In reality there are dioxin-free means of disposing of 99.7% of the medical waste stream.

Because medical waste incinerators are major point sources of dioxins some countries have brought in more stringent regulations. This has resulted in many hospitals closing their own on-site incinerator and shipping waste to a commercial incinerator with more pollution control devices. However, this is increasingly seen as an inadequate solution. Increasingly hospitals in Austria, Germany and Denmark are reducing the amount and nature of wastes by switching to reusables which can be sterilised. Substitution of PVC products go hand in hand with programmes to prevent waste and separate for recycling.

Reasons for phasing out PVC in these hospitals: municipal incineration plants either did not accept wastes in which the chlorine content exceeded the determined percentage, or would do so only at a considerably increased price; incineration plants had to be closed due to more stringent emission regulations; and repeated complaints from the community.

Other reasons exist to substitute PVC products within hospitals. Medical objections against the use of PVC are mainly based on the migration of the plasticiser DEHP. It is soluble in fat-containing fluids such as blood and may cause diseases of the liver, skin and cardiovascular system. Animal experiments have shown a significant increase in liver tumours, when DEHP is added to the food of mice and rats. For this reason DEHP was classified as "carcinogenic in animal experiments" and for lack of adequate epidemiological studies in human beings as "possible human carcinogen" . Recent evidence points to its hormone disrupting potential.

Currently there are often increased costs for PVC alternatives (often 20-30% more expensive). However these costs must be balanced against the cost of ongoing incineration fees and dioxin emissions.

Non-PVC Hospital Products
 

PVC Use	Alternatives
Examination gloves:	PE and/or PE copolymers are recommended. Latex is of higher quality and proven barrier to viruses.
Overshoes:	clogs with leather tops in operating rooms; multiple-use rubber shoes, shoes made of cloth or overshoes made of PE for single use e.g. visitors in intensive care rooms.
Aprons:	cloth alternatives used in low contamination areas PE coated in operating rooms.
Mattress covers:	alternative plastic and rubber use only where necessary washable microfibre - e.g. "Kortex" or "Geritex" more comfortable to patient.
Wound plasters and dressings:	textile materials recommended.
Bedpans:	Stainless steel
Syringes:	PE and PP, sometimes ABS and natural rubber, Glass syringes for blood extraction
Infusion equipment, bottles, and/or bags with suspension devices, tubings, tubing clamps, stop cocks:	Non-PVC infusion equipment, eg. glass for certain uses, PP, PE, PE/PA, EVA PCCE and PSU as well as multi use suspension devices for all common infusion receptacles.
Tubing:	EVA and EVA copolymers, PCCE or PE, In other fields of application, e.g. for respiration, silicon or rubber tubings
Stop cocks:	PE, PC and PSU, often in combination of several plastics. Silicon adapters with connecting parts of PE and PP
Gastric probes:	Silicon and PP
Catheters silicon and latex drainage bottles, collecting bags:	glass, PE, PE/PP
Scalpels: (disposable with PVC handles)	Metal handles with interchangeable, sharpened blades
Breathing masks	rubber, silicon, latex
Special Case Blood Bags	supplier with prototype in USA
Packaging	Mostly PVC free now. PP Blister packs

In general, eighty five percent of the total medical waste stream in hospitals consists of the same mixture of discarded paper, plastic, glass, metal and food waste that is found in ordinary household waste. The remaining 15% is defined as infectious and these wastes must be sterilised. before disposal. A small percentage of this waste or 0.3% of the total medical waste stream, can only be incinerated, in part for cultural or aesthetic reasons, but also because it is difficult to sterilise in any other way. Thus there are dioxin-free means of disposing of 99.7% of the medical waste stream. Non hazardous waste can be recycled within a household waste recycling plan.

Alternative Disinfection

For disposing of infectious waste there are several alternative dioxin-free methods that are cost comparative

Three of these are:
Autoclaving
Microwave Disinfection
Superheated Steam Sterilisation

Autoclaving

An estimated 45% of infectious medical equipment from Western hospitals is already reused through autoclaving. This is basically steam sterilisation which encourages the reuse or recycling of medical equipment. Autoclavers are commercially available in varying sizes from desktop to industrial units.

The process involves heating bags of medical waste at between 120 and 1650C for 30 to 90 minutes in chambers into which pressurised steam is introduced. The steam penetration ensures destruction of bacteria and pathogenic micro-organisms. Waste is reduced by an estimated 75% of its volume and can either be landfilled directly or compacted further. The autoclaved infectious waste adds to the landfill burden, but the amount is usually less than 0.2% of the municipal solid waste stream. According to a recent survey of hospitals that have installed autoclaves, they are easier to operate than incinerators.

Cost Benefits of Autoclaving

A 1996 study by the Centre for the Biology of Natural Systems in New York examined the annual operating costs of hospital incinerators in the Great Lakes Region of North America and found that autoclaving was more profitable.

Total Estimated Costs of Alternative Infectious and Pathological Medical Waste Disposal Methods, for All (609) Hospitals in the Great Lakes Region
 

DISPOSAL METHOD (Millions of 1994 dollars)	ANNUAL OPERATING COST
Existing incinerators (uncontrolled)	9.8
Existing incinerators with mandatory upgrading	55.5
Autoclaves plus small pathological waste incinerator	23.0
Ship to commercial facility	28.0

Autoclaving is the most profitable investment unless there are no regulations at all on incineration emissions. Further assessment was made of the costs to hospitals of converting to autoclaves including paying off the debt on the original purchase of an incinerator. In this scenario conversion costs (2.9 million dollars) are still cheaper than the annual operating cost of incineration with mandatory emission upgrading (3.4 million dollars per year).

Microwave Disinfection

Microwaving is economically competitive, versatile and studies in Europe have shown virtually no emissions since the internal heating system is closed. Consequently there is no need for pollution control devices. Microwave disinfection relies on treating hospital waste with moist heat and conventional microwaves at temperatures of 940C. The equipment can be installed on or off site in stationary or mobile units. The remaining residues which have been reduced by 80% in volume can be landfilled

Superheated Steam Sterilisation

This technology comprises a heated shredder and sterilisation unit. In the shredder, organic liquids are vaporised and solids reduced to gas by superheated steam at temperatures between 500 and 700C. Medical equipment is melted into a sterile mass in under an hour. Remaining residues are cooled and dropped into a collection bin or ground in a heated shredder. The process has been shown to reduce medical waste by 50 to 80% of its original volume.
 

Alternatives to Hazardous Waste Incineration

It is estimated by European researchers that 70% of all current waste and emissions from industrial processes can be PREVENTED AT SOURCE by the use of technically sound and economically profitable procedures.

No country should contemplate a commercial hazardous waste incinerator without a national programme of cleaner production. Policy measures to achieve this have been well documented by UNEP, USEPA, UNIDO and others and cleaner production initiatives have achieved significant results particularly within small and medium scale industries.

Once an incinerator is built, ongoing toxic waste generation is legitimised and there is little incentive to investigate process changes within industry even if cleaner production methods are more profitable. For this reason, mandatory toxic use reduction plans should be prepared by each facility currently generating toxic waste.

BENEFITS OF TOXIC USE REDUCTION:
Massachusetts, USA

The state of Massachusetts in the United States has achieved significant reduction of hazardous waste through mandatory company planning. This legislation and training programme has become a model for pollution prevention activities around the world.

The Toxic Use Reduction Act (TURA) was passed in 1989. The goal of the legislation is to develop toxics use reduction as its primary tool for industrial pollution control while enhancing the competitive position of Massachusetts enterprises. The first goal is to reduce toxic waste generation by 50% through toxics use reduction over a ten year period (1987-1997).

Under TURA firms that use any of a list of approximately 800 chemicals in quantities that annually cross a minimum threshold must:

annually report publically on the amount of chemical used and released; pay an annual fee prepare a plan (updated every two years) on how to reduce or eliminate the use of those chemicals that is certified by a licensed Toxics Use Reduction Planner.

In 1995, 603 firms participated. Over 87% of the participating firms implemented TUR programs. Twenty of the firms eliminated 1.29 million pounds of by-product (wastes) and on average companies saved $35,000 per year.

Between 1990 and 1993 all firms cut their toxic by-product (waste) by 14.5% and plan to generate 23% less waste in 1998. Total volume of listed toxic chemicals in the state dropped by 6% within these three years. Of the 29 firms applying for awards in toxics use reduction, together they had eliminated the use of 2,870 tons of toxic chemicals, reduced 750 tons of hazardous wastes and saved $44 million per year.

Benefits of Toxic Use Reduction: New Jersey, USA

Similar to Massachusetts, the state of New Jersey in the USA has a toxic use reduction goal of 50% within five years. New Jersey mandates pollution prevention planning based on full materials tracking throughout each industry covered by the state regulation. The total net savings to companies as a result of pollution prevention techniques amounts to $105 million dollars per year.

For every dollar spent on the entire process, including Government costs, company costs for compliance and capital costs, the companies' achieved net savings of $5 to $8.

Although all companies had achieved reductions, one-quarter of those who sent in plan summaries had reduction goals of zero for all chemicals reported. The most common pollution prevention methods determined were

raw material substitution
substituting different coating materials
changing to aqueous cleaners

Chlorinated solvents were among the top three chemicals targeted for toxic use elimination by companies.

Alternatives to Other Combustion Sources of Dioxin

Cement Kilns

Increasingly cement kilns are burning hazardous waste as fuel thereby generating dioxins in air emissions and ash. Cement products are now contaminated with heavy metals and dioxins.

A phase out of incinerable waste streams is possible via toxics use reduction legislation. The economic costs of converting these cement kilns back to fuel has been done by the Centre for the Biology of Natural Systems in 1996. The study found that the added expected income from burning hazardous waste in cement kilns is likely to be less than the model estimates due to a declining market share. This would enable kilns to resume former fuel burning of coal, coke, oil or natural gas, as currently practised by three quarters of the kilns in the region. However instead of receiving a tip fee (which in 1993 amounted to $68 million), the 9 cement kilns in the region would then pay for the normal fuel (about $9 million per year) amounting to an increase of approximately $77 million. At the same time, the transition results in a payroll saving since additional employees that handle the hazardous material are no longer needed. Furthermore the kiln could avoid the operational costs of installing control devices and more importantly would not generate dioxin-contaminated emissions and wastes.

PALS REQUIRE THE UK GOVERNMENT AND MKBC TO:

• Abandon all plans to expand the existing landfill site at Newton Longville and adopt the ‘Precuationary principle’. The precuationary principle requires that the burden of proof should not be laid upon the protectors of the environment to demonstrate conclusive harm, but rather on the prospective polluter to demonstrate no likelyhood of harm.
• Abandon plans to expand incineration in Milton Keynes - shut down all the municipal waste incinerators in UK.
• Exclude incineration from the definition of renewable energy in all UK and EU targets
• Start a waste policy based on reduction, re-use and recycling.

References:

1 - Greenpeace website 2001. For further information at: www.greenpeace.org