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Blue Mountain Hospital wasn't looking to reduce its impact on Utah air when it leased new equipment to shred and disinfect the 6 tons of garbage it generates a year. The 11-bed facility in Blanding just wanted to reduce costs associated with trucking dialysis, surgical and other hazardous medical waste several hundred miles to be incinerated or steam-treated.
"Honestly, the No. 1 driver for us was financial," said the hospital's Environment of Care Director Trent Herring. "The environmental benefits we learned about afterward."
Blue Mountain is the first Utah hospital to adopt an on-site waste-management system developed by SteriMed Systems, proving there are alternatives to the controversial practice of burning. Herring figures the hospital in Utah's remote southeast corner lowered its monthly waste costs from $5,000 to $1,000, and it's now helping nearby clinics with their waste.
Medical waste has become an incendiary issue in Utah in recent months in the face of concerns that an incinerator in North Salt Lake, operated by waste giant Stericycle Inc. is endangering the health of those who live nearby. State regulators allege the plant manipulated stack test results and has violated emission limits for dioxins, nitrogen oxides and hydrochloric acid.
Utah Physicians for a Healthy Environment says burning is among the worst ways to dispose of medical waste.
"Incineration does not prevent disease, it actually spreads disease. Incineration not only does not remove toxins, it actually creates new ones and merely concentrates, mobilizes and redistributes existing ones," the group wrote in a letter last week imploring Utah hospitals to not send waste to Stericycle.
Stericycle, which denies allegations from state regulators, is now seeking to renew its state air-quality permit for the North Salt Lake plant. The physicians group said it will try to persuade regulators to reject it.
Stericycle officials did not respond to repeated interview requests left at its corporate office in Illinois.
Abandoning incineration • The world's largest handler of medical waste, Stericyle has long been criticized for its continued reliance on incinerators.
When the group Health Care Without Harm formed in the mid-1990s to fight such burning, the nation had 4,500 incinerators handling medical waste. Today there are 60, six of them operated by Stericycle, according to Gary Cohen, the organization's executive director.
"It's a huge change," Cohen said. "Most of the hospitals realized they can dramatically reduce costs by upstream management [of waste], recycling, segregating out what really needs to be treated from normal waste. They reduced it to less than 5 percent of the whole waste stream."
Last week, public health advocates and community activists invited representatives from new waste-handling companies to a Salt Lake City forum to explain how their alternatives work.
SteriMed sells and leases equipment that uses a chemical disinfectant, technology that has only recently received conditional approval in all 50 states.
Clean Waste Systems uses ozone, the three-atom oxygen molecule that has powerful oxidizing properties.
"There is no heat, steam fumes or fly ash," Clean Waste Systems Vice President Peter Jude said. "The ozone decays into clean oxygen."
Both systems shred waste, reducing volumes by up to 90 percent for safe and easier disposal alongside municipal trash.
Autoclaves, which disinfect trash with steam, are widely used as a more environmentally sound process than incinerating. But the waste must still be shipped to a centralized facility, and steam consumes water and generates odors, said SteriMed CEO Dwight Morgan.
Proposing 'ploof' • Blue Mountain installed its system in the fall of 2012. It was approved for use by the state Department of Environmental Quality in January.
Treating waste on-site required an initial investment of $2,500, Herring said, a cost that will soon be recouped because Blue Mountain accepts waste from neighboring clinics. Comparable in size to a photocopier, the SteriMed machine works like an autoclave, but it's more environmentally friendly, Morgan asserts.
SteriMed treats trash with a biodegradable, microbial disinfectant used in low concentrations, combined with a small amount of room-temperature water, Morgan said.
The machine then chomps the solid waste into a confetti-like substance the company calls "ploof," which goes out with the trash.
"Some of our customers have embarked on a zero solid waste footprint by sending the [ploof] to recyclers that use it to create structural plastics and construction materials," Morgan said.
The equipment can be scaled up for larger hospitals and is safer for workers, he added. "In order for waste to leave a facility you have to double-bag it and multiple people are required to handle it, as opposed to, 'Here's a bag, throw it in the machine and push a button.' "
Trash on the move • Incineration is still a likely destination for a few classes of dangerous waste, such as chemotherapy agents, pharmaceuticals and body parts, due to regulations in numerous states.
However, incinerators for medical waste have shut down in many places. Waste from California and several other Western states is hauled to Utah for burning at North Salt Lake and at an incinerator operated by Clean Harbors near Grantsville.
Stericycle's remaining incinerators are in Florida, North Carolina, Illinois, Ohio and Kansas, in addition to the North Salt Lake plant, with a collective processing capacity of 122 million pounds, according to a report by Health Care Without Harm.
The Utah incinerator can handle nearly 22 million pounds a year, based on the 2,500-pounds-per-hour limit on its permit.
According to its filings with state regulators, however, Stericycle burns an average of about 2,100 pounds per hour. In 2011, the Utah plant burned 7,223 tons, all but 1,130 coming from out of state.
Now state officials say the company is contemplating moving its North Salt Lake operations to a less-populated part of the state, but public health advocates say that is no solution.
"This is a good moment for Salt Lake to explore new technologies that address the needs of hospitals," Cohen said. "Our approach is, rather than move somewhere else, invest in these technologies so they can close these remaining incinerators."