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Hospitals That Poison

"First do no harm" is a fundamental tenet of the Hippocratic oath. So how do we come to grips with the astonishing revelation that the health care industry itself emits nearly half the known dioxin and dioxin-like compounds, as well as a quarter of the mercury, released into the American environment?

Where does your hospital "waste" wind up? The left-over blood and drained internal fluids, the IV bags and gloves; microbial cultures, body parts, scraped tissues; "sharps" like needles, scalpels and lancets; experimental animal carcasses (some with radio-isotopes); food rejects; hankies and sheets from communicable disease; mercury from thermometers, blood pressure gauges, and batteries; AND all the stuff made from chlorinated plastics.

In hospitals, infectious wastes, pathological wastes and chlorinated plastic wastes are unique and intimately meshed with public health. Most hospital waste requiring aggressive treatment cannot be recovered or recycled. Re-use requires extraordinary care and monitoring. To avoid the vengeance of improperly disposed-of medwaste, hospitals need to adopt and custom-modify a twenty-five-year-old American tradition of household awareness: segregate plastic/paper and organic wastes; use biodegradable waste bags; deconsume.

Ask your hospital's administration if it keeps parts or carcasses with radio-isotopes for eight half-lives before burning. If not, it could be adding radioactive ash to the neighborhood. Or, ask the administration how it bags or wraps the unwanted flesh. If it bags with materials made from chlorinated plastics, the hospital incinerator will emit dioxin and dioxin-like compounds.

Since HIV, hospitals have become super-careful about sharps and contact with bodily fluids. No more syringe needles sticking out through the garbage bag. Ironically, this important prevention project led to an unintentional risk increase. Many of the throwaways (especially flexible plastics like gloves or tubes) have been made from extruded chlorinated plastics. Tossed into an unseparated waste heap, then burned, they release carcinogens and endocrine disruptors. According to the Centers for Disease Control, only about two percent of the total hospital waste stream must be burned. Yet, hospitals continue wholesale incineration of all waste. Recent emissions measurements stimulated health care practitioners to think about in-hospital use. They found that some polyvinyl chloride (PVC) tubing employed in long-term care (e.g., kidney dialysis) actually leach toxic molecules into the tube's liquids, then into the patient. In these cases, both use and disposal cause harm, not health.

Changing from incineration to shredding with disinfection, or to autoclaving or to microwaving has encountered formidable barriers. Resistance is tied to the fixed capital invested in incinerators. Investors hardly want incinerators declared obsolete before they are paid off or turn a profit. The labor cost (time) of sorting out chlorinated plastics in the hospitals riles accountants and confuses normal procedures. Hauling and landfill charges are rising and burial space may be hard to find. In the short term (next five years), the best move is dispensing with PVC products altogether and purchasing non-chlorinated substitutes. Like other shifts in consciousness, health care without harm creates new markets and businesses for the innovative and caring, and leaves behind those who place financial return over the value of injuring our persons.