The Medical Waste Tracking Act of 1988: Will it Protect our Beaches?
By Suzan Onel
INTRODUCTION
These and similar incidents were the focus of intense media coverage throughout the summer of 1988 and drew the public's attention to the issue of medical waste management. Until November 1988, however, no comprehensive federal authority regulating the disposal of medical waste existed. Although the Environmental Protection Agency (EPA) officially had statutory authority to regulate waste, it claimed that most of the wastes washing ashore were not generated by medical facilities over which it had jurisdiction. Instead, the EPA attributed the medical waste problem to illegal disposal, combined sewer overflow, stormwater runoff, beach litter, legitimate home use of syringes, illegal drug users, and the generally inadequate handling of solid wastes at landfills and coastal transfer facilities.
In the absence of EPA regulation, the Occupational Safety and Health Administration (OSHA) might have regulated in this area. However, OSHA restricted its own activities to rulemaking on the issue of occupational exposure to two viruses, Hepatitis B and AIDS. The agency limited its role despite its authority to issue binding regulations protecting the health and safety of workers in private facilities, including those who may be exposed to medical waste. OSHA's reluctance to provide further leadership precluded the EPA and OSHA from working well together. The EPA believed the problem was primarily occupational, falling under OSHA's jurisdiction, while OSHA declared it was predominately a solid waste problem that falls under EPA's authority. Without uniform guidance from any agency, it is not surprising that medical waste management was in disarray.
This lack of federal guidance forced some states to promulgate their own regulations managing infectious waste, further exacerbating the uniformity problem, while other states and localities did not regulate infectious or medical waste at all, due to a lack of funding or expertise. Where no state or local regulations existed, hospitals and medical facilities used either the EPA or Center for Disease Control (CDC) guidelines. Most hospitals preferred the CDC guidelines since they were less costly. For example, the EPA guidelines require waste segregation, a process which has escalated the cost of waste incineration for a New England Hospital from two cents to $1.50 per pound. Since the amount of waste generated by many hospitals had increased over 50 percent since 1986, the situation was clearly reaching crisis proportions.
When Congress reconvened in the fall of 1988, more than twenty bills were introduced discussing infectious waste management; however, the hearings and Congressional debates indicated a desire to avoid the more complex problems underlying the issue. The Medical Waste Tracking Act (MWTA) of 1988 was the product of Congress' superficial effort.
These and similar incidents were the focus of intense media coverage throughout the summer of 1988 and drew the public's attention to the issue of medical waste management. Until November 1988, however, no comprehensive federal authority regulating the disposal of medical waste existed. Although the Environmental Protection Agency (EPA) officially had statutory authority to regulate waste, it claimed that most of the wastes washing ashore were not generated by medical facilities over which it had jurisdiction. Instead, the EPA attributed the medical waste problem to illegal disposal, combined sewer overflow, stormwater runoff, beach litter, legitimate home use of syringes, illegal drug users, and the generally inadequate handling of solid wastes at landfills and coastal transfer facilities.
In the absence of EPA regulation, the Occupational Safety and Health Administration (OSHA) might have regulated in this area. However, OSHA restricted its own activities to rulemaking on the issue of occupational exposure to two viruses, Hepatitis B and AIDS. The agency limited its role despite its authority to issue binding regulations protecting the health and safety of workers in private facilities, including those who may be exposed to medical waste. OSHA's reluctance to provide further leadership precluded the EPA and OSHA from working well together. The EPA believed the problem was primarily occupational, falling under OSHA's jurisdiction, while OSHA declared it was predominately a solid waste problem that falls under EPA's authority. Without uniform guidance from any agency, it is not surprising that medical waste management was in disarray.
This lack of federal guidance forced some states to promulgate their own regulations managing infectious waste, further exacerbating the uniformity problem, while other states and localities did not regulate infectious or medical waste at all, due to a lack of funding or expertise. Where no state or local regulations existed, hospitals and medical facilities used either the EPA or Center for Disease Control (CDC) guidelines. Most hospitals preferred the CDC guidelines since they were less costly. For example, the EPA guidelines require waste segregation, a process which has escalated the cost of waste incineration for a New England Hospital from two cents to $1.50 per pound. Since the amount of waste generated by many hospitals had increased over 50 percent since 1986, the situation was clearly reaching crisis proportions.
When Congress reconvened in the fall of 1988, more than twenty bills were introduced discussing infectious waste management; however, the hearings and Congressional debates indicated a desire to avoid the more complex problems underlying the issue. The Medical Waste Tracking Act (MWTA) of 1988 was the product of Congress' superficial effort.
