Dáil Éireann debate -
Wednesday, 5 May 1993

Vol. 430 No. 3

Adjournment Debate. - Hospital Waste Disposal.

Miss Quill

I thank the Ceann Comhairle for allowing me to raise this matter and the Minister of State for remaining in the House after a long day to deal with this issue.

I am raising the problems arising from the incineration of waste material at the Regional Hospital in Cork. Similar problems surround other Cork hospitals and hospitals throughout the country. I assume that a common solution will have to be found for all. It is specifically the matter as it relates to the Cork Regional Hospital that I am raising this evening.

This hospital burns 400 tons of waste per annum. Specific emission data is lacking and there is no monitoring system in place capable of assessing the extent of hazardous emissions. Arising from persistent complaints from residents in the area and from local politicians, Cork Corporation commissioned Eolas to carry out a study of this matter and report to Cork Corporation. This report is scheduled to be with Cork Corporation by Friday next. When that report is available we will have more precise information. However, the problem remains to be solved.

Traditionally, the hazards of hospital wastes have been viewed in terms of the dangers posed to the staff and patients by their proximity to various drugs, chemicals and infectious waste. These potential hazards remain, but in addition it is now recognised that the gases emitting from hospital incinerators can pose extremely serious hazards to the downwind environment, thereby creating serious problems for residents in adjacent housing estates.

The members of the hospital board have admitted that they have a problem with their incinerator, which they argue was not built to take the volume of waste now being burnt, and they have made numerous applications to the Department of Health for funds to enable them to remedy the matter.

The residents in the adjoining area have been very concerned for a number of years about the black belching dioxins and the noxious smells coming from the chimney stack and about the fine black particles on cars, lawns, furniture and windows. Blackening of newly painted houses and outside walls has roused grave suspicions among the residents as to the nature of the material emitting from the chimney stack. Many people are also concerned that the large number of asthma cases and respiratory problems among adults and children could be related to the incinerator as a source of pollution.

I understand that hospital wastes are highly variable in content and that 85 per cent of the total hospital waste treatment can be categorised as general refuse which is non-hazardous. It is the remainder that gives cause for concern.

The presence of halogenated materials in hospital refuse can generate toxic air contaminants during incomplete combustion. In general terms, hospital wastes usually contain about 20 per cent plastics, with levels as high as 30 per cent being reported in some cases. By comparison municipal solid wastes usually contains between 3 per cent and 7 per cent plastics. Polyvinyl chloride and other halogenated polymers make up a significant fraction of plastics in hospital wastes. These include disposal instruments such as syringes, plasticised paperware, plastic cutlery, plastic containers, packaging, bedpans, urine bags, respiratory devices, dialysis equipment and a range of similar material.

There are also serious problems with the incineration of metals. Incineration cannot fully destroy metals. It can only redistribute them. The same quality of metal fed into the incinerator will be released in emission and on the filter. Many of the heavy metals are known to be detrimental to human health even at extremely low concentrations. Without going into any further technical details it is quite evident that the emissions from the chimney stack are highly toxic.

I am asking the Minister to put in place a double strategy, the first being an interim measure, a campaign to cause hospitals to implement some kind of programme to arrest this problem. They should implement a strategy of waste prevention at source. That ought to be done immediately because hospitals should promote health inside and outside and should not spread ill health. At the end of the day there is a need for a national waste management policy. I want the Minister to work towards that and to take steps that would require new hospitals and new extensions to existing hospitals to put in place systems that would avoid the hazards of the existing incinerators.

Mr. N. Treacy

I am pleased to have an opportunity, on behalf of my Government colleagues, Ministers Howlin and O'Dea, to respond to the question raised by Deputy Quill in relation to the disposal of hospital waste at Cork Regional and other hospitals. We are aware of the problems associated with the incineration of hospital waste at Cork and elsewhere and we fully accept the need for a waste management policy in relation to clinical waste.

Attitudes to the generation and treatment of waste have been changing in recent years. People are now more conscious of waste and its effects on the environment. While the direct detrimental effects of poor waste practices on communities and workers involved in handling waste have long been known, the environmental and indirect health, effects have only been recognised fairly recently. The problem of waste is now seen not just as one of local significance, but as one that impacts on the global environment as well.

While this awakening of consciousness has resulted in improvements in some practices, it is likely that the next decade will see significant changes resulting from demands for a more considered approach to waste generation and its consequences. The changes will impact on all consumers, domestic, institutional and industrial, and will be particularly significant for producers of "difficult" wastes. In the health services field, providers of acute care will be affected by more stringent requirements, for the handling and treatment of clinical or health care waste.

Recent waste legislation, mainly EC led, has been reflecting environmental and health and safety concerns and is forcing producers to review, if not to change, their current practices. As far as the health services are concerned, a number of regulatory changes have been introduced, or are pending, which are already having a significant impact. The two most notable changes to date are the introduction of the Air Pollution Act of 1987 and the pending classification of clinical waste as hazardous under EC Council Directive 91/68. A further significant impact is likely when the EC Directive on the Incineration of Hazardous Waste is introduced.

The technical requirements of the EC Directive on the incineration of hazardous waste, in its present draft form, impose very high standards on the incineration of classified substances.

With the impending classification of clinical waste as hazardous, this means the clinical waste may only be incinerated in the most sophisticated and expensive modern plants. Such incinerators would be viable only as large units and the cost per tonne of waste treated could be as much as 10 times greater than current costs. The classification of clinical waste as hazardous will have a further significant impact in that the waste arising will have to be stored, handled, transported, accounted for and disposed of under permit from the local authorities. Strict requirements are laid down for each of these operations.

The problems imposed on health care authorities in complying with new standards on waste are considerable, with a lot of potential for confusion. Meeting the many demands emanating from environmental and health and safety legislation will involve changes in work practices as well as substantial investment in new or upgraded plant. Working to an agreed policy offers the best chance of an orderly and consistent approach to change, as well as ensuring a high degree of continued compliance with the new standards. The implementation of a health service-wide policy should ensure that the best and most appropriate means practicable for handling and treatment are applied to the waste generated. Accordingly, arrangements have been made in the Department of Health to prepare a health services waste policy. A first draft of this document has been prepared and an internal group has been set up to finalise it.

The twin primary aims of the policy are to minimise the impact of waste on the environment and to bring about better conditions for those handling waste.

The secondary aims of the policy are: to ensure that the most appropriate treatment and disposal methods are applied to all waste operations; to ensure that there is the maximum of co-operation and integration of services between the different health providers, in order to minimise costs and made optimum use of available resources; to ensure that consistent standards are applied across the services; to assist in the smooth implementation of new regulations and EC Directives; to indicate the best strategy for dealing with waste and specifically clinical waste; and to offer guidance for the drawing up of waste management plans. In formulating this policy, account will be taken of the good practice and principles currently being proposed or employed for waste in both Europe and in the United States. As these are very much in a state of flux, the policy must be viewed as subject to future alteration, in the light of experience gained and changing knowledge and attitudes.

On behalf of my colleagues, I thank the Deputy for raising this important question and I can assure the House that every effort is being made by the Department of Health to implement a hospital waste management policy that will overcome the difficulties associated with the current incineration arrangements at Cork Regional and other hospitals and comply fully with the demanding requirements of modern environmental standards.

The Dáil adjourned at 9.14 p.m. until 10.30 a.m. on Thursday, 6 May 1993.