Fluid Medical Waste Stream Disposal Practices - Behind the Emerging Threat

Fact Sheet No. 3

Current fluid medical waste disposal practices can be broken down into two primary categories: military and civilian.

Common civilian disposal methods include:

  • Direct Discharge
  • Incineration
  • Solidification & Landfill Disposal

Common military disposal methods include:

  • Direct Discharge
  • Bag & Bury
  • Open Pit Burning

Civilian

Direct discharge of fluid medical waste into municipal sewer systems is the most common method of disposal in the United States and worldwide. This disposal practice does not treat the waste streams before they are discharged into municipal sewer systems. Hospitals, surgery centers, veterinary and dental clinics, medical laboratories, mortuaries and other medical treatment facilities rely on direct discharge of their untreated waste streams into municipal sewer systems.

Incineration is a disposal method for fluid medical waste. However, since the mid-1990s there have been significantly more incinerators shut down than built new. This resulted partially from society achieving a better understanding of negative effects caused by incineration, including the creation of persistent organic pollutants (POPs) from incineration that are hazardous to human health and the environment.

In many instances fluid medical waste is solidified, bagged and disposed of in landfills around the world. When landfills receive rainfall, exposures can produce a landfill leachate capable of entering drainage systems, resulting in an uncontrolled release of and toxic drug residuals and biological infectives to waterways and watersheds.

Military

U.S. Army Combat Support Hospitals (CSH), Forward Surgical Teams (FST), and other mobile medical units and treatment facilities operating in primitive, austere environments do not have a field deployable treatment system that will denature and disinfect fluid medical waste streams prior to direct discharge into the environment.

Prevalent military disposal practices in austere environments include “bag and bury” and open pit burning. “Bag and bury” entails bagging the collected medical waste and burying it. This results in an uncontrolled environmental fate of the bagged waste, often releasing toxic drug residuals and biological infectives into the ground and consequently, waterways and watersheds.

Open pit burning using a fuel accelerant source produces both ground and air emission byproducts. These byproducts are hazardous to soldiers, the environment and civilians caught downwind of the burn site.

The Emerging Threat

National reconnaissance studies document detectable concentrations of pharmaceuticals and other organic wastewater chemicals in our watersheds and potable water distribution systems that are causing wildlife mutations among fish and other species.

Additionally, biological infectives, pharmaceutical compounds and other POPs found in fluid medical waste streams discharged into municipal sewer systems are contributing to a class of antibiotic resistant bacteria. These resistant bacteria can be found in sewer systems and wastewater treatment plants, and are capable of widespread contamination throughout the environment.

The disposal of untreated waste streams in the United States and worldwide is becoming a rapidly growing domestic and international public health burden because of the infectious diseases, toxic drugs and other organic compounds present in these streams.