Hospital red bag waste. An assessment and management recommendations.

Chlorinated plastics (PVC) accounted for 9.4 percent of the weight of red bag, supposedly infectious, waste from two community 150- and 98-bed hospitals. The hydrochloric acid, dioxins and furans generated during the burning of this red bag waste are important air pollutants. In this waste, PVC provides much of the organic chloride for the dioxins and furans generated. Their concentrations are least in flue gases from those plants with BACT design, flue gas clean up and management techniques-the most constrained incinerators. The many manually-fed, small categorical red bag incinerators associated with hospitals have no flue gas clean-up systems and represent minimally constrained incinerators. Their toxic stack emissions are considered a significant community health hazard. The evidence that the contents of red bag waste is infectious to such a degree that it cannot be disposed of as municipal solid waste without endangering the public with infectious diseases is not reflected in the relevant hospital accreditation guidelines, Centers for Disease Control recommendations, or related literature. Public health is compromised by the lack of accountability in the handling of some hospital and veterinary wastes, specifically body fluid contaminated equipment and containers as well as microbiological materials. Recommendations to protect public health are included.