Regulation of On-Site Medical Waste Incinerators in the United States and the United Kingdom: Is the Public Interest Being Served?

By Manns, Leslie D. | Journal of Economic Issues, June 1995 | Go to article overview
Save to active project

Regulation of On-Site Medical Waste Incinerators in the United States and the United Kingdom: Is the Public Interest Being Served?

Manns, Leslie D., Journal of Economic Issues

Currently, the "vast majority of medical waste disposed of in the United States, and indeed the world, is done so via high-temperature incineration" [U.S. Congress, OTA 1990a, 3]. On-site hospital incinerators are quite common in both the United States and the United Kingdom. However, such incinerators may soon disappear due to new air pollution legislation enacted in both countries. This paper examines medical waste incineration and these legislative changes to determine if the public interest is being well served by legislative and regulatory processes.

Public concern for the environment appears to be increasing at the same time that explicit environmental regulations are being criticized more often by industries subject to these regulations. As a result, governmental action taken to protect the environment must seek to balance efficiency and equity while maintaining the flexibility to adjust to changing conditions [Reynolds 1981, 646]. According to Reynolds [1981] and Kling [1988], workable explicit regulations must be in harmony with the public interest. Ultimately, attaining an effective, explicit regulatory structure requires that such regulations conform to society's evolving understanding of issues and possibilities. Ongoing changes in the regulation of medical waste disposal shows how difficult this can be.

Both the U.S. Clean Air Act Amendments of 1990 and the United Kingdom's Environmental Protection Act of 1990 require the phasing in of much tougher air quality standards that on-site hospital incinerators will have to meet. In choosing to use explicit, function-specific regulations, both countries apparently are seeking to "improve efficiency" and "adjust the distribution of benefits, costs, or liability in conformity with the views of equity expressed through the political process" [Reynolds 1981, 646]. One major concern in both countries is the cost-augmenting nature of the new air quality standards. The cost to hospitals of upgrading antiquated on-site incinerators is often prohibitive at best and infeasible at worst.

The Role of Incineration in Treating Medical Waste

In both the United States and the United Kingdom, incineration is the most common method for disposing of medical waste. The benefits of incineration include total destruction/sterilization of waste, significant volume/weight reduction of waste, virtual elimination of the need to pre- process waste before treatment, and the ability to dispose of incinerator ash in landfills [U.S. Congress, OTA 1990b, 41]. The costs of using incineration include potential pollution risks associated with both gaseous/particulate emissions and incinerator ash, as well as increased costs related to meeting stricter pollution regulations [U.S. Congress, OTA 1988, 15].

One of the major problems associated with on-site hospital incinerators is the age of the equipment used. Most hospital incinerators in use today were installed in the mid-1970s or earlier. As a result, they "lack pollution control equipment, and [often] have low stack heights," which allows emissions to remain close to the ground in areas surrounding hospital incinerators, usually densely populated, urban areas [U.S. Congress, House 1988, 296]. Furthermore, these incinerators were originally designed to bum only pathological waste including body tissue and fluids. As the composition of the hospital waste stream has changed to include a large amount of disposables, especially plastics and lightweight metals, these incinerators have been used to treat wastes for which they were not designed. This only increases the likelihood that medical waste will be inadequately incinerated, leading to potentially significant environmental and/or public health problems [U.S. Department of HHS, ATSDR 1990, 7.5].

On-site Incineration of Medical Waste in the United States

In the United States, there are approximately 6,000 medical waste incinerators currently operating, about 5,000 of which are on-site hospital incinerators [Hearn 1994, 27].

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Cite this article

Cited article

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Regulation of On-Site Medical Waste Incinerators in the United States and the United Kingdom: Is the Public Interest Being Served?


Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?