|
Ini satu lagi bukti bahwa incinerator
adalah tidak baik utk kita.................
tolong dibaca dgn
seksama............
kalau tidak mengerti bukalah kamus
bahasa inggris.............heheheh
Subject: Medical waste incineration is poisoning
communities.htm
|
Medical waste incineration is poisoning
communities
By Susan Forsyth, RN |
![Die-Oxin]() Even as registered
nurses work to protect their patients from harm, they often discard wastes
that, when incinerated, release a deadly chemical that causes a myriad of
disorders . . . sicknesses that nurses work so diligently to treat. The
chemical is dioxin.
The hazards of dioxin were exposed in 1994 when
the United States Environmental Protection Agency (EPA) issued a critical
report on the substance. The EPA makes no bones about the chemical's
potency, saying that dioxin, a known carcinogen, is the most deadly
substance known to humankind.
Unfortunately, medical waste
incinerators have been identified as one of the largest sources of dioxin
air pollution.
Nurses may be more familiar with dioxin as the
active ingredient in Agent Orange, the defoliant widely sprayed over
Vietnam during the war. To this day, Vietnam veterans exposed to Agent
Orange face an increased risk of many cancers and other endocrine and
immune disorders.
And in the States, many will remember the 1982
environmental disaster when dioxin-contaminated oil was sprayed on the
streets of Times Beach, Mo., to control dust. The town of 2,000 residents
had to be evacuated and all of the houses and businesses were demolished.
(Read how communities are fighting back against
Incinerators)
Yet this deadly poison continues to
be created through medical waste incineration. Unlike most household
trash, hospital waste contains a large amount of polyvinyl chloride (PVC)
plastic. Commonly used PVC items in hospitals include IV bags, IV tubing,
blood bags, endotracheal tubes, office supplies, mattress covers and
oxygen tents. (Anyone involved in home remodeling or building has come
across PVC plastic, as it is frequently used in houses for water
pipes.)
But when PVC plastic is incinerated as a medical waste
disposal method, dioxin is created as an unintended byproduct. Although
dioxin is also created throughout the life cycle of chlorinated plastic,
the EPA currently cites medical waste incinerators as the third largest
source of dioxin production.
Nurses generate a lot of garbage
during their normal workday. Almost every activity a nurse performs, from
inserting a Foley to starting an IV, creates a substantial amount of
trash. As the job complexity, workload and the use of disposables have
increased, so has the amount of garbage coming from a hospital. Since
1955, the amount of medical waste generated per hospital patient has more
than doubled. Generally, only 10 percent to 15 percent of hospital waste
is classified as "infectious." Infectious waste is "red bagged" and
requires special treatment to protect the health of the community.
Yet, even that waste does not need to be incinerated. According to
the Centers for Disease Control, no more than 2 percent of a typical
hospital's waste stream must be incinerated to protect public safety. That
2 percent is mainly pathological waste, such as body parts. Yet, many
hospitals routinely burn 75 to 100 percent of their waste, which creates
this toxin.
Dioxin belongs to a family of 419 chemicals with
related properties and toxicity, but the term "dioxin" is often used to
refer to the 29 that have similar toxicity. Dioxin is created when
industrial products containing chlorine are manufactured or burned. The
most toxic form of dioxin is 2,3,7,8, tetrachlorodibenzo-p-dioxin or TCDD.
This is the form of dioxin used in Agent Orange and sprayed in Times
Beach. Dioxin is a known human carcinogen, according to the International
Agency for Research on Cancer (IARC) and the EPA.
In addition to
being carcinogenic, dioxin disrupts the way human hormones and chromosomes
work. Because of its endocrine-disrupting qualities, dioxin also causes a
host of other illnesses and problems, including reproductive, neurotoxic,
immune system, other hormonal and developmental effects. (To See list of effects, Click
Here)
Poisoned Food
Chain
This deadly chemical is omni- present in our
environment and reaches to all corners of the globe. Dioxin is transported
by water and atmospherically. Because of its ability to travel, dioxin can
enter the food chain far from its point of origin, although the higher
levels of contamination are usually found closer to the source of
production. When PVC plastic is incinerated, dioxin is emitted from
smokestack and also remains in the ash. Both end up deposited on the
ground.
Dioxin is lipophilic and bioaccumulative. Dioxin is first
absorbed into plants, animals then eat the plants and we eat the animals,
with the dioxin levels becoming ever greater as the poison moves up the
food chain. Common human dietary sources of dioxin, which account for 90
percent of human exposure, include meat, dairy products, eggs and fish.
At the top of food chain is the nursing infant. Because of the
high fat content of breast milk, nursing infants are exposed to about 50
times the average adult dose and may receive more than 10 percent of their
lifetime exposure during the nursing period. Although dioxin is found in
breast milk worldwide, the concentration is highest in women living in
industrialized countries and Vietnam.
Dioxin is toxic in smaller
doses than any other chemical known to science. It is measured in parts
per trillion and smaller. Because of its ability to travel so easily, all
human beings alive today carry a body burden of dioxin.
According
to a recently released report by the EPA, the risk from acquiring a
dioxin-related cancer is greater than previous thought for the general
population, although it is higher for people who practice certain dietary
habits. The EPA drew a glum conclusion: No matter what kind of diet people
adhere to, their risk for developing cancer from dioxin exposure is about
one in 1,000. For people who eat a very high-fat diet, that risk can rise
to as high as 1 in 100.
EPA Director Carol Browner suggested that
the solution to this problem is to advise people eat less meat. Although
this may make good dietary sense, this is not the solution.
Cleaning House
Nurses, as
patient advocates, can play a vital role in removing this toxic and
unnecessary chemical from both food and the environment.
"The
waste we throw away should not end up poisoning our patients," says
Charlotte Brody, RN. Brody is an organizer with the Health Care Without
Harm (HCWH) campaign, an international activist coalition that includes
many nurses and their organizations built through the Virginia-based
Center for Health, Environment and Justice. (
To read more about Charlotte Brody, Click Here)
An
important area is purchasing. If hospitals do not purchase chlorinated
plastic products, they cannot be thrown away. Easily replaced items
include patient identification bracelets and cards, IV bags, compression
stockings and fluid collection devices.
"The hospital industry
does not need to use chlorinated plastic products. Safer alternatives
exist for almost all uses of PVC plastic," states Brody. For example, IV
containers made of non-chlorinated plastics such as polyethylene or other
polyolefins are currently available. According to Brody, these plastics do
not produce dioxin when burned or manufactured. Also, rigid PVC products
often have alternatives made of metal or non-chlorinated plastic such as
polypropylene and polycarbonate.
Brody believes that by virtue of
their work settings, nurses are well positioned to have a major impact on
decreasing the amount of dioxin released into the environment. Nurses use
most of the chlorinated plastic products that hospitals purchase, and
nurses are responsible for making waste disposal choices when throwing the
products away.
Within Health Care Without Harm, nurses have worked
hand-in-hand with other coalition members to encourage and in some cases
force, hospitals to change their procurement and disposal
practices.
According to Ann Melamed, RN, project coordinator for
HCWH at the Center for Environmental Health in Oakland, Calif., nurses can
start educating their co-workers and communities about the environmental
and public health dangers of medical incineration. "Also, nurses should
begin to exert their influence to include environmental issues on the
agenda when making purchasing decisions and doing product
evaluations.
"Dioxin is not a necessary by-product of health care,"
says Brody. "Hospitals can use non-PVC medical products and choose
alternative waste treatment methods to provide quality, cost-effective
care for their patients."
Alternative treatment methods to medical
waste incineration exist. They include autoclaving, microwaving,
electrothermal-deactivation, gasification or thermal treatment. Each
treatment method considered would have to be carefully evaluated to assure
that it was appropriate and meets the health and safety needs of the
workers and the community. Nurses, as patient advocates, have a duty to
alert their communities to the hazards of medical waste incineration.
In addition, Melamed believes nurses are in the position to make
conscious, careful choices about their waste disposal practices. According
to Melamed, nurses need to continue to red bag infectious and pathological
waste, but trash that has a low probability of causing disease should be
clear bagged. Nurses can have an impact on the amount of dioxin released
into the environment simply by insisting that clear bags are easily
accessible to the staff and the staff is educated on proper disposal
techniques.
In a truly "green" move, some hospitals also have
implemented active recycling, reuse and red-bag reduction programs. And
hospitals that have actively implemented these programs have actually
saved money. A case in point: Beth Israel Medical Center in New York City
has found that a combination of employee education, monitoring of the
waste stream and strategic placement of red-bag waste containers has cut
the facility's regulated medical waste disposal costs by 60 percent. Not
only is pollution prevention the right thing to do environmentally, but it
is often the cheaper thing to do.
Right now, more than 200 member
groups in Health Care Without Harm's coalition have endorsed its
principles of working to "transform the health care industry so it is no
longer a source of environmental harm by eliminating pollution in health
care practices without compromising safety or care." The HCWH coalition is
actively assisting nurses and other community groups to work toward this
goal.
For more information on how to advocate for patient safety
in this manner, see HCWH's website:
http://www.noharm.org , or contact Ann
Melamed, RN, at the Center for Environmental Health at 510-594-9864, or
call Susan Forsyth, RN, at the California Nurses Association at
510-273-2258.
|
|
