The Medical Waste Incinerator on Beacon Hill
by Kristine Wong, Community Coalition for Environmental Justice
July 1998

Since 1986, the Puget Sound Veterans Administration (VA) Medical Center in Beacon Hill has disposed of its medical waste by burning it in an on-site medical waste incinerator. The facility emits a stream of potentially toxic chemicals into the air over Beacon Hill. Citations issued by the Puget Sound Air Pollution Control Agency to bring the VA into line with a variety of emissions standards has had mixed results. But with the advent of alternative methods of waste disposal already adopted by a vast majority of hospitals, a coalition of local residents and community groups are demanding that the VA shut their incinerator down, as the health effects of these chemicals can cause cancer, birth defects, learning disabilities, and a host of other internal disorders. It's not yet clear, though, that the VA is listening to the group's call for environmental justice.

Juan Miranda and his eight grandchildren live in Beacon Hill. "Knowing that there is an incinerator in my neighborhood doesn't make me feel very good. If this affects my grandchildrens' health, then ultimately it will affect me...this is an issue that the community can really rally around." "Most of my neighbors weren’t aware that the incinerator existed until now," Tay Quach commented, an API resident of Beacon Hill. "Now that the word is getting out, people are becoming concerned for their health…it’s a terrible thing to have in our community."

According to Albert Kaufman, a Beacon Hill resident active in local affairs, 400 community members tallied by the Jefferson Park Planning Committee prioritized the closing of the VA incinerator as one of their highest priorities.

The Danger

The history of medical waste incinerators is one of gradually tightening restrictions and a widening field of research into the health risks of the substances that incinerators release into the air. The United States Environmental Protection Agency (EPA) has ranked these facilities as one of the leading sources of dioxins in the environment. A byproduct of plastic and paper that has been burned, dioxin is more commonly known as the active contaminant that made Agent Orange extremely toxic. According to an array of scientists and the American Public Health Association, exposure to dioxin can cause or aggravate cancer, birth defects, and dysfunction of the immune and reproductive system. In addition, scientists have labeled dioxin the single most carcinogenic chemical known to science. Studies cited by the EPA report show that people living near medical waste incinerators carry elevated levels of dioxins in their bodies.

Incinerators also release mercury, cadmium, arsenic, lead, and toxic ash, each accompanied by its own set of health risks. Mercury, a heavy metal, has been shown to cause nervous system disorders, learning disabilities, memory loss, and kidney damage. Lead has been shown to affect the nervous system in young children, causing behavioral disorders. Arsenic, another common chemical that is emitted from incinerators, is also known to promote cancer. Exposure to these chemicals can occur through breathing polluted air, eating contaminated food, or drinking contaminated water. Both mercury and dioxin accumulate in the body over time, but adverse health effects can occur at extremely low levels. Because there are so many other possible sources of mercury and dioxin, it is difficult to assess the impact of the medical incinerator alone on the Beacon Hill community. However, living near an incinerator that has been giving off chemical emissions for over a decade suggests a prolonged exposure for residents that is both
unadvisable and unnecessary.

An Issue of Environmental Justice

The health of people of color and low-income people around the world has been disproportionately affected by environmental health hazards. Coined as "environmental justice" issues, the consumption of contaminated fish, occupational hazards in the garment and electronics industries, and poor housing conditions are just a few examples of the environmental justice issues affecting the health of Asians and Pacific Islanders in America.

The medical waste incinerator in Beacon Hill, home to Seattle's largest Asian Pacific Islander (API) community, is a prime example of an environmental justice issue. Sixty-eight percent of the residents of Beacon Hill are people of color, and the majority of this group are of Asian or Pacific Islander descent. It is mostly Asian immigrants that grow their own vegetables in Beacon Hill's 'p-patch' community gardens, one of which is located about a mile away from the incinerator.

David Della, Executive Director for the Washington State Commission on Asian Pacific American Affairs, grew up in Beacon Hill, and lived in the area for 27 years. "Environmental issues have always been a grave matter for people in Beacon Hill," he commented. "The current fight on the incinerator is just another extension of other ongoing problems in the area, from living near power lines with electromagnetic fields, and living with airplane noise. To me, this issue brings together both issues of environmental health and social justice concerns."

Other evidence has also shown the potential for disproportionate health impacts in the area. In 1990, the Seattle King-County Department of Public Health found that cancer rates in South Seattle were higher when compared to the rest of the city. In the North Beacon Hill area, where fertility rates are higher, children and youth under age 20 make up a higher than average proportion of the population, when compared to the city of Seattle. Pregnant women and nursing children are most susceptible to the health risks of dioxins, which along with other chemicals, can concentrate in the fat of breast milk. Mercury especially affects young children and infants due to their small size, as well as the fact that their nervous systems are not fully developed. A 1997 Health Profile done by the Department of Public Health shows that hospitalization from respiratory disease in North Beacon Hill is 24% higher than Seattle as a whole. In contrast, the Queen Anne Neighborhood health profile shows fewer respiratory disease in North Beacon Hill is 24% higher than Seattle as a whole. In contrast, the Queen Anne Neighborhood health profile shows fewer children and youth among their residents, and a respiratory disease-related hospitalization rate that is 20% lower than the rest of the city.

The Response from the VA

The incinerator facility at the Veterans Administration is one of the last holdouts of a bygone era. According to the Puget Sound Air Pollution Control Agency (PSAPCA), the incinerator at the VA currently burns 10-15 tons a day of medical waste three days a week. In the past, nearly all the major hospitals operated incinerators; since that time, they have all shut down, except for the incinerators at the VA and Northwest Hospital in the Northgate area.

According to Jim Nolan, Director of Compliance for PSAPCA, the VA installed the incinerator without a permit and with minimal pollution controls. Nolan described PSAPCA's current relationship with the VA as good, but that has not always been the case. "The entire history of PSAPCA with the VA has been a litigious one," he said. "Ever since day one, we've been in court trying to get them to comply with the law." Citing legislation mandating that the best technology must be used at the time of construction, PSAPCA ordered the VA to shut down the incinerator. The decision was appealed, setting into motion a 2-year legal battle between PSAPCA and the VA in order to bring the facility into compliance with equipment regulations. Five years after its installation, in 1991, the facility added pollutant controls, in the form of a scrubber system.

Over the years, the VA incinerator has been fined nearly $50,000 for exceeding regulations on their permit. Nolan describes the VA's attempt to come into compliance with their incinerator as a "dismal failure." Nolan suggested that one of the reasons why he felt the VA was slower to comply was that, as a federal facility it could not act as quickly as a private hospital. Currently, levels of dioxin emissions from the VA are sitting right below limits of what is considered to be safe for human health. Ambient Source Impact Levels (ASIL), set by PSAPCA as a threshold concentration limit beyond which emissions can pose a threat to human health, are set at a level of 3x 10-8 mg/m3 for dioxin. PSAPCA records from November 1997 cite the VA's ASIL levels for dioxin at 2.97x10-8 mg/m3. Straddling the limit of such a potent chemical signifies the need for emissions control and constant on-site monitoring. As there are no continuous dioxin monitors, it is extremely difficult to evaluate daily emission patterns. This discrepancy in technology is especially troubling, as PSAPCA noted that the VA incinerator is capable of exceeding dioxin ASIL levels if employed at its maximum load.

Medical waste incinerators are not legally bound to control dioxin emissions. In 1994, EPA proposed medical waste incinerator emissions standards, the first of its kind that would have been implemented on a national level. After much controversy, EPA eventually failed to pass the standards into law. At the time, however, thinking that the standards might pass, PSAPCA tested the VA and Northwest incinerators to see if they would stand up to the proposed levels. The VA did not pass these standards, but worked with PSAPCA for a few years to reach its current
emissions level.

Regulatory oversight at the federal level has allowed local facilities to operate without dioxin permit limits. However, the Washington State Department of Ecology and PSAPCA have the power to give state and local regulatory orders that can change or set emission limits. Having state or local regulatory standards on dioxins and other chemicals is essential, as this is the only way to make the VA legally accountable towards complying with pollution standards for these chemicals. Another way to change permit limits is through "rulemaking," a process that involves going through government agencies to propose new standards to the public, then making amendments or changes from input received at public workshops and hearings.

Pushing for Alternatives

While greater standards and greater enforcement of those standards can be used to control incinerator emissions, community residents and organizations want to bring all emissions to a halt by shutting down the incinerator and phasing out sources of dioxin. Medical waste incineration is largely unnecessary, according to the Centers for Disease Control (CDC). The majority of hospitals in Seattle and elsewhere have switched to safer, less hazardous methods of disposing of their medical waste. Most of what medical waste incinerators burn is paper and plastic stemming from the disposal of latex gloves, syringes, IV and blood bags, and cafeteria paper products. The CDC has estimated that 98% of what is burned does not have to be incinerated, while the rest can be disposed of in ways that do not produce dioxins. Autoclaving, a steam sterilization method, eliminates virtually all of the dioxin emissions from the disposal process. Swedish Medical Center set the stage for reform by abandoning incineration in favor of using an off-site disposal process in 1994.

Switching methods could save the VA money too. "The cost of maintaining an incinerator is a significant one," Nolan said. "The VA will need to decide for themselves whether they are prepared to assume that financial cost."
Laurie Valeriano from the Washington Toxics Coalition points out the success stories of other hospitals which made the switch. "Other hospitals across the nation using alternative technologies have found that it saves money too," she said. According to the new Health Care Without Harm "Greening Hospitals" report, one hospital in Florida, Naples Community Hospital, shut down their incinerator and switched to autoclaving. As a result, their disposal costs dropped more than 80%, from 24 cents to 4 cents a pound.

On June 8, Community Coalition for Environmental Justice (CCEJ), Seattle Health Care Without Harm, and community residents met with the VA directors for the first time. Hospital management reported they were following a comprehensive waste management plan that included a waste stream audit, waste minimization efforts, recycling, and staff training, as well as a cost-benefit analysis of incineration versus other methods of waste disposal. They also noted the hiring of a full time staff person to focus on waste management issues. Chief Medical Officer
Dr. Charles Smith also projected that by the end of the year, a decision will have been made on the future of the incinerator. Rick Barrett, an activist with Seattle Citizens for Quality Living and Seattle Health Care Without Harm who has been working for many years to close the incinerator at Northwest Hospital noted, "While the VA's attitude seems hopeful, Northwest only seems interested in burning as much as they can, even if it means importing waste from other facilities to make it cost-effective."

But it's not clear whether the community's health and input on this issue are the highest priority for the VA administration. While the VA's June 8th presentation seemed to demonstrate that they are looking at alternatives to medical waste incineration from an economic perspective, this kind of decisionmaking approach will not necessarily protect the community's health. At the hourlong meeting, the VA took almost the entirety of the agenda, while community advocates were allowed little time to present their concerns before the VA ended the meeting. Later in the week, the VA issued a memo recommending a follow up meeting in late September of early October. But this isn't good enough for some community members who experience daily exposure to chemical pollutants. David Della emphasized the importance of community action. "A few years ago, they wanted to open a garbage incinerator in Beacon Hill and we organized to stop it from opening. We cant afford not to do anything about this. If we don’t do anything, there will be grave consequences." Albert Kaufman was angry. "I live here in Beacon Hill and we want the incinerator shut down," he said. "Everyday, we are being exposed to more chemicals. This is not acceptable. If nothing is going to be done about it, there's lots of people in the community here that will take action."

Kristine Wong, Community Organizer
Community Coalition for Environmental Justice
(206) 527-1695, fax (206) 525-1218

Other useful links on this topic:

Action: If, after reading this article, you'd like to write to someone, please visit the address book and write a letter to the VA and feel free to cc the Mayor's Office, the City Council and the local media.

Take me home to Beacon Hill 

Last modified:
October 18, 2001