Health Care Without Harm, a group dedicated to environmentally responsible health care, says that Stericycle, the nation''s largest medical waste disposal company, should clean up its policies and practices.
The group issued a report - "Stericycle: Living up to its Mission?" - that evaluates the environmental performance of the largest medical waste disposal company in the United States. Stericycle is the only company providing medical waste disposal services nationally and is the sole provider of health care waste management services in many communities.
"Health care providers want to promote and protect the health of the communities they serve. They don''t want the disposal of their waste to harm public health and the environment," says Charlotte Brody, RN, director of Health Care Without Harm (HCWH), a coalition of public health advocates representing 350 groups in 38 countries. "Stericycle has an obligation to provide environmentally responsible services for their health care customers, but unfortunately, our analysis shows that the company has a long way to go."
The report criticizes Stericycle''s continued use of incineration despite the availability of cleaner, safer waste disposal technologies. The group contends that incineration is a leading source of dioxin, a known human carcinogen. HCWH sent Stericycle a letter along with the report, offering to work with the company in an effort to manage medical waste in a more "environmentally healthy" manner, says Stacy Malkan, communication director for HCWH, but has not heard back from the company.
The report also raises concerns about Stericycle''s worker safety record, its failure to keep toxic mercury and chlorinated plastics out of the waste stream, and the siting of treatment facilities in poor communities of color.
Tony Tomasello, Stericycle''s executive vice president and chief technical officer, says the report from HCWH "blindsided me when it showed up on my desk," adding, "There are substantial technical inaccuracies in the report."
He says that not only were there errors in the information reported by HCWH, but that the group included information in the report that they know is incorrect because Stericycle provided them with the correct information and it was not included. Taking issue with the charges of poor worker safety, Tomasello admits that the company has received some citations from the Occupational Safety and Health Administration, but adds, "None of the violations were willful or negligent, and they weren''t because of a lack of a safety program."
The fines were minimal, he says, citing one for $1,400. "I''m not making light of it, but we have over 2,000 employees and we have a good safety record. Could we do better? Absolutely. But we have an entire department devoted to safety and I''m happy with the progress we''ve made," he says.
The HCWH report profiles communities where concerned citizens are opposing permit applications and are seeking to close problem-plagued Stericycle incinerators. In the last few years, according to HCWH, Stericycle has withdrawn incinerator permit applications at other facilities after similar community opposition. The HCWH report also notes that Stericycle has not yet committed to phasing out incineration, as many health care experts and environmentalists believe is warranted.
Tomasello says that in the past seven years, through the purchase of other companies, Stericycle inherited 19-20 incinerators. The company, he claims, has closed half of those incinerators and that the 10 that remain "are in full compliance with all federal, state and local laws."
He also points out that under state and federal laws, approximately 8 percent to 10 percent of medical waste "legally and ethically" must be incinerated. In 2001, less than 18 percent of the total amount of waste material collected by Stericycle was incinerated. So far in 2002, he adds, less than 15 percent of the waste collected has been incinerated. Back in the late 1980''s and early 1990''s, he says, "90 percent of medical waste was incinerated. We''ve done a pretty good job of cutting back [on incineration]."
Malkan disagrees, saying that while some states require incineration of pathological or chemotherapy waste, it amounts to less than 5 percent and that other states offer a choice of incineration or allow the use of another method of disposal.
Peter Orris, M.D., MPH, medical staff president at Chicago''s Cook County Hospital, called the report "a blueprint for the reduction of medical waste''s impact on the environment," adding, "It will allow health care facilities to become educated consumers of Stericyle''s services and permit the market to demand safe non-incineration technologies for waste disposal."
Malkan admits that part of the problem is with the sources of medical waste: hospitals and medical centers, many of which are HCWH members.
"Certainly one of the reasons for the report was to encourage [hospitals and medical providers] to properly separate and minimize waste whenever possible," said Malkan. She adds the group wants Stericycle, as the industry leader, to offer its clients incentives for producing less waste and to do a better job of monitoring wastes, such as mercury and PVC plastics, that can cause serious environmental impact if incinerated.
Tomasello counters that Stericycle is making every effort to educate the consumers of its services by offering training for its customers ranging from sharps disposal to source segregation of waste. Stericycle is committed to helping clients reduce the amount of waste that must be incinerated, he insists.
He questions the reason for the report, saying HCWH wants Stericycle to "dictate practice to our clients" and even charge its clients when they dispose of waste improperly. "We can''t do that," he says. "That''s not our job."
HCWH''s Brody says the goal of the report "is to engage these constituencies in a common effort to improve the health of our communities and the environment we share."
The report, which is based on public information available as of February 2002 according to HCWH, is available at www.noharm.org.
by Sandy Smith ([email protected])