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					Hospitals--Pollution Prevention—Web Resources

Reducing Mercury Use in Health Care: Promoting a Healthier Environment: A How to
Manual
www.epa.gov/glnpo/bnsdocs/merchealth

The purpose of this manual is to help hospitals start mercury pollution prevention programs or
accelerate programs that have already begun. New federal regulations greatly reduce the amount
of mercury that is allowed to be discharged from a municipal wastewater system or an incinerator.
By implementing the best management practices described in this manual, you can reduce the
level of mercury in the environment and avoid the need for increased regulations in the years to
come.

The manual offers general guidance on how to initiate a program and technical guidance for
implementing the program. The manual includes:

            Information about mercury and its impact on people and the environment
            (Chapter 1)
            Overview of pollution prevention strategies (Chapter 1)
            How to start a mercury pollution prevention program in your hospital
            (Chapter 2)
            How to monitor your program, educate staff and measure success
            (Chapter 2)
            Alternatives for mercury-containing products
            (Chapter 3)
            Best management practices for handling, recycling and disposing of
            mercury-containing products still in use
            (Chapter 3)
            Contacts for further information, case studies and other information
            (Appendices)


Healthcare Waste Minimization and Recycling
http://www.gkchc.org/appndxb.htm


Sustainable Hospitals
http://www.uml.edu/centers/LCSP/hospitals/
The Sustainable Hospitals Project (SHP) provides technical support to the healthcare industry for selecting
products and work practices that eliminate or reduce occupational and environmental hazards, maintain
quality patient care, and contain costs.

SHP is a project of the The Lowell Center for Sustainable Production. The Center draws on the resources
and expertise of the University of Massachusetts Lowell, including the Toxics Use Reduction Institute
(TURI) and the Department of Work Environment.



Environmental Procurement for Healthcare
http://www.healthcare-environet.com/environment/procurement.htm
The Healthcare Enviro-Net is a network of healthcare and environmental organizations committed to the
promotion of sustainable development in healthcare.
Our Goal
Our goal is to provide the healthcare community with access to environmental information, products, and
services that support a commitment to quality healthcare, protection of the environment, and
environmentally sustainable development.
The Healthcare Enviro-Net has been established through funding from Environment Canada and the
Ontario Ministry of Environment and Energy and is developed in consultation and partnership with
healthcare and non-government organizations.


101 Ways to Reduce Hazardous Waste in the Lab
http://www.p2pays.org/ref/01/00257.htm
NEED TO CHECK ON CANNOT LINK TO ADDRESS




P2 for Hospitals and Medical Facilities
http://www.healthcare-environet.com/environment/guides/s169.html




Yahoo search
Hospitals and Pollution Prevention - Information on Hospitals and Pollution Prevention Ohio
EPA Office of Pollution Prevention
http://www.epa.state.oh.us/opp/hospital.html


Hospitals for a Healthy Environment: Voluntary Partnership with the American Hospital
Association to Reduce Hospital Waste EPA/742/F-99/016 * (1pp) * January 1999 * HTML Version
http://www.epa.gov/opptintr/p2home/ahafact.htm


Medical Facility Waste
http://sbeap.niar.twsu.edu/docs/medwaste/main.html
This pamphlet summarizes the new source performance standard (NSPS) for new and
reconstructed Hoptial/Medical/Infectious Waste Incinerators (HMIWI) and the guidelines for
existing HMIWIs, provides an overview of hazardous waste regulations, and discusses pollution
prevention as a way to reduce regulatory burdens and costs.


Greening Hospitals Report
http://www.ewg.org/pub/home/reports/greening/greenpr.html

"Greening" Hospitals: An Analysis of Pollution Prevention in America's Top Hospitals
http://www.ewg.org/pub/home/reports/greening/greening.pdf


"Greening" Hospitals Executive Summary
http://www.ewg.org/pub/home/Reports/Greening/greenexec.html
First Do No Harm: Reducing the Medical Waste Threat to Public Health and the Environment
http://www.ewg.org/pub/home/HCWC/DoNoHarm/FullReport.pdf



Mercury Pollution Prevention in Health Care
http://www.greatlakes.nwf.org/pp/hosprpt.htm
CHECK ON THE SITE SERVER MAY BE DOWN

Mercury Use Reduction & Waste Prevention in Medical Facilities
http://www.epa.gov/grtlakes/seahome/mercury/src/title.htm
This is an interactive environmental education software program developed jointly by Purdue University
and the United States Environmental Protection Agency (EPA) to provide information on the proper
handling and disposal of mercury wastes produced by medical facilities.
Contents:
Introduction
         Mercury in Medical Care Settings--
The Big Picture: Mercury in the Environment
Risks of Exposure for Humans to Mercury
Look in the Mirror: Mercury in Medical Institutions
Prevention Measures of Mercury Pollution
Tracking Progress of Mercury Pollution Prevention
EPA & State Agencies
Glossary
Bibliography


4. Waste Reduction Manual for Hospitals
http://www.gkchc.org/cover.htm
CK ON THE SITE SERVER MAY BE DOWN

5. Waste Reduction Activities for Hospitals
http://www.ciwmb.ca.gov/mrt/wpw/wpbiz/fshosp.htm
CK ON THE SITE SERVER MAY BE DOWN

6. P2 Checklist for Hospitals
http://www.orion.org/~owm/health.htm
CK ON THE SITE SERVER MAY BE DOWN



Northern Light Results
Pollution Prevention for Hospital Sterilization
Source: Colorado Department of Public Health
http://www.cdphe.state.co.us/ap/P2/hosp_steril.htm
.PROCESS:
    Recirculate autoclave cooling water. Capture waste formaldehyde for use in other areas of
the hopsital. Frequently inspect and properly maintain EtO sterilization equipment.

EQUIPMENT:
Replace EtO sterilization chamber with: (1) electron beam; (2) gas plasma; (3) microwave; (4)
steam; or (5) vapor phase hydrogen peroxide.

MATERIAL SUBSTITUTION:
Replace glutaraldehyde with: (1) sonic sterilization; (2) peracetic acid; (3) acetic acid; (4)
hydrogen peroxide; (5) autoclaving; or (6) industrial size dishwasher with caustic cleaners.
Use reverse osmosis water treatment to reduce dialysis sterilization demands.

ENERGY EFFICIENCY:
Install high efficiency lighting with T-8 and electronic ballasts. Install occupancy sensors for
lighting system.Conduct flue gas analysis on the boiler every 2 months to increase boiler
efficiency.Insulate piping from boiler to reduce heat loss.
HVAC system should include variable frequency drives on fan motors, air economizers, and
thermostat set backs. Recover waste heat from autoclave.



Fact Sheet On Ethylene Oxide Sterilant Alternatives
http://es.epa.gov/techinfo/facts/ca-htm/oxide-fs.html
Ethylene oxide (EtO) is widely used by health care institutions as a sterilant because of its
potency in destroying pathogens. A few facilities use pure EtO, but the vast majority employ a "
12/88" mixture of EtO and Chloroflourocarbon (CFC1), primarily to improve safety. Use of EtO
sterilizers is of regulatory concern because:

   EtO is flammable and explosive
   EtO is a probable human carcinogen
   EtO is a toxic air contaminant
   CFC is an ozone depleter.

Possible Contacts

For more information, see the Guides to Pollution Prevention: Selected Hospital Waste Streams
and Best Management Practices for Hospitals and Medical Facilities, Palo Alto Regional Water
Quality Control Plant.

Guides to pollution prevention for selected hospital waste streams
Source: OECA document
http://es.epa.gov/oeca/fedfac/fflexp2/hospital.html
This guide provides an overview of hospital waste generating processes and presents options for
minimizing waste generation through source reduction and recycling. Reducing the generation
of these materials at the source, or recycling the wastes on or off site, will benefit hospitals by
reducing disposal costs and lowering the liabilities associated with hazardous waste disposal.

Guides to pollution prevention selected hospital waste streams
EPA/625/-20/009 June 1990
http://www.cepis.org.pe/eswww/fulltext/repind62/gpp/gpp.html

Source: Risk Reduction Engineering Laboratory Center For Environmental Research Information
Office of Research and Development U.S. Environmental Protection Agency
Cincinnati, Ohio 45268

This guide provides an overview of hospital waste generating processes and presents options for
minimizing waste generation through source reduction and recycling. Reducing the generation of
these materials at the source, or recycling the wastes on or off site, will benefit hospitals by
reducing disposal costs and lowering the liabilities associated with hazardous waste disposal.


Mercury Pollution Prevention in Healthcare A Prescription for Success
http://www.nwf.org/greatlakes/pp/hosprpt.html
Source: National Wildlife Federation

This guide, Mercury Pollution Prevention in Healthcare: A Prescription for Success, is intended to
offer guidance to hospitals that are striving to become mercury-free. It is intended to help
healthcare workers and citizens eliminate mercury from hospitals, doctors’ offices and other
healthcare facilities. It provides information on:

Mercury and its effects on people and the environment;
The importance of source reduction;
The healthcare industry’s role in preventing mercury pollution;
The whys and hows of becoming mercury-free; and,
Success stories.

It also includes a resource list with contacts and materials, which are meant to provide specific
information and assistance to anyone interested in developing or furthering mercury pollution
prevention strategies and goals.

Mercury Pollution Prevention Measures in Michigan Health Care Institutions
http://www.nwf.org/greatlakes/pp/mercury.html
Source: National Wildlife Federation
The research for a report by the Health Care Sector Subgroup of the Michigan Mercury Pollution
Prevention Task Force,included interviews with representatives from several hospitals regarding
the topic of mercury pollution prevention measures currently underway in their institutions. While
certain measures must be adhered to under federal and state laws, for example training on spill
prevention and management, these health care institutions have developed additional measures
not required by law which suggest possible avenues for other interested health care institutions to
duplicate. This is a list of their ongoing activities.

Medical Waste Incineration Survey
http://www.nwf.org/greatlakes/pp/medwast.html
Source: National Wildlife Federation
Medical waste incinerators are the largest source of atmospheric dioxin to the Great Lakes and
contribute significant amounts of other contaminants to the Great Lakes enviroment. Here is the
first study of its type to characterize medical waste in Michigan and the types of pollution
prevention practices that are being used to do something about the problem.

Fact Sheet: Medical Waste Management
http://es.epa.gov/techinfo/facts/ca-htm/htmfact8.html
Source: Envirosense

Reducing Hospital Waste
www.aha.org/annualmeeting/1999advocacyhospitalwaste.html
Source: American Hospital Association
This site discusses the background and the basics of the Memorandum of Understanding (see
the EPA link for the actual document) between the AHA and the EPA. The language is much
simpler than that of the actual agreement, and two examples of waste minimization by hospitals
are provided.

Health Care Without Harm
http://www.noharm.org/
Health Care Without Harm seeks environmentally responsible practices within the
healthcare industry. The site contains information about recent HCWH activities
concerning medical products containing PVC and mercury.
.
This site has a database on it.
Environment Issues in Healthcare
www.healthcare-environet.com/environment/intro.html
A directory of many links related to pollution prevention in the healthcare industry.


Mercury Reduction Project for Hospitals
www.epa.state.il.us/p2/mercury-reduction-for-hospitals.html
Source: Illinois EPA
This site discusses the joint project of the Illinois EPA Office of Pollution Prevention
and the Illinois Waste Management and Research Center to provide Illinois
hospitals with pollution prevention assistance, with emphasis on mercury reduction.

United States Environmental Protection Agency (EPA)
Memorandum of Understanding Between the United States Environmental Protection Agency and
the American Hospital Association
www.epa.gov/glnpo/toxteam/ahamou.htm
This document is an agreement between the EPA and the AHA in which both parties agree to
work toward the minimization of persistent, bioaccumulative, and toxic pollutant production and
the reduction of total waste generation by the healthcare industry.

Reducing Mercury Use in Health Care: Promoting a Healthier Environment
www.epa.gov/glnpo/bnsdocs/merchealth/mercury.pdf
This document is a comprehensive manual developed by the EPA to help hospitals set up
mercury pollution prevention programs. Topics covered include pollution prevention strategies,
the establishment of pollution prevention programs at hospitals, and alternatives to mercury-
containing products.

WRRC Sector Hub on Hospital and Medical Waste
Full Title: An Ounce of Prevention - Waste Reduction Strategies for Health Care Facilities
Call Number: HSES 0074 (Document not yet available on-line)
Length: 225 pages
Date: 1993
Full Work Author: Bisson, Connie Leach; McRae, Glenn; Shaner, Hollie Gusky
Abstract: This manual addresses hospital waste, an estimated 1% of the MSW. This guide
addresses solid waste reduction, recycling, and the management techniques to make it happen.
A step-by-step outline is given on how to start a hospital recycling program, including a case
studies and a detailed guide to performing a waste assessment. Advice for working with recycling
haulers and educational programs to support recycling are given. A full implementation section on
a recyling program is provided, including reduction and buying recycled. Includes on medical
waste issues and an overview on state regulations. This guidebook can be purchased for $75 at
http://ashes.org/mall.
Full Title: Guidebook for Hospital Waste Reduction Planning and Program Implementation
Call Number: P 00340 (Document not yet available on-line)
Length: 109 pages
Date: 1996
Full Work Author: McRae, Glenn; Shaner, Hollie Gusky
Abstract: This guidebook provides tools and information to help establish a waste-management
program for a hospital. This companion guide to "An Ounce of Prevention" builds on the approach
established in that earlier work but is not as detailed on some aspects . The approach here is to
give waste managers the information to jumpstart their learning, not to present a cookie-cutter
plan. This guidebook can be purchased for $75 at http://ashes.org/mall.
Full Title: Guides to Pollution Prevention - Selected Hospital Waste Streams
URL: http://www.p2pays.org/02/01059.pdf
Length: 51 pages
Date: June 1990
Full Work Author: US Environmental Protection Agency, Office of Research and Development
Abstract: Specifically addreses the following hospital wastestreams: solvents, chemotherapy,
photographic, formaldehyde, X-ray, and mercury. The most useful information is on pages 5- 17
on waste profiles and reduction options.
Full Title: Pollution Prevention for Hospitals & Medical Facilities
URL: http://www.p2pays.org/ref/04/03259.pdf
Length: 25 pages
Date: 1994
Full Work Author: Palo Alto Regional Water Quality Control Plant
Abstract: A easy to read yet detailed guide to hospital wastes with separate sections for medical
facilities and
medical laboratories. This document is useful for identifying the area of a hospital that may be the
source of a
particular wastewater contaminant. Also contains useful info on water conservation. Many of the
pollution
prevention tips for selenium are of interest primarily to the western U.S.
Full Title: Pollution Prevention Guide for Hospitals (Excluding Medical Wastes)
URL http://www.p2pays.org/ref/03/02116.pdf
Length: 66 pages
Date: May 1998
Full Work Author: California Environmental Protection Agency
Abstract: This guide was developed by the California Office of Pollution Prevention and
Technology Development to assist general medical and surgical hospitals in evaluating their
operations for waste minimization opportunities.

Section Title: Laundries in State-Operated Hospitals are "Cleaning Up" With Ozone Technology
Full Title: Pollution Prevention Virginia
URL: http://www.p2pays.org/ref /03/02345.pdf
Length: 1 page
Date: Summer 1999
Full Work Author: Pollution Prevention Virginia
Section Author: Sarnecky, Bill
Abstract: This article shows how some hospitals in Virginia are using Ozone Technology in their
laundries to reduce pollution.
Full Title: Pollution Prevention Handbook - Hospital, Clinical, and Veterinary Care
URL: http://www.p2pays.org/ref /04/03242.pdf
Length: 6 pages
Full Work Author: Department of the Interior - Office of Environmental Affairs
Abstract: Although you may not realize it, many of the activities that take place at your facility may
pollute the environment and waste money.
Full Title: Waste Reduction and Disposal Options for Specific Hospital Wastes
URL: http://www.p2pays.org/ref /01/00239.pdf
Length: 10 pages
Date: August 1996
Full Work Author: NC Division of Pollution Prevention and Environmental Assistance and NC
Division of Waste Management
Abstract: This fact sheet addresses the following hospital waste streams: mercury, batterries,
radiology wastes, xylene, unused supplies, cafeteria waste, and construction waste. The
radiology and laboratory xylene waste streams are covered most thoroughly.
Section Title: Source Reduction - A Hospital Case Study - Itasca Medical Center
URL: http://www.p2pays.org/ref /04/03237.pdf
Length: 16 pages
Abstract: The Itasca medical Center is a 108-bed community hospital with an attached 35 bed
convalescent nursing care facility. The hospital staff made a commitment to source-reduce the
hospital's waste as much as possible.
Section Title: Advanced Hospital Recycling
Full Title: BioCycle
URL: http://www.p2pays.org/ref /02/01242.pdf
Length: 4 pages
Date: February 1994
Section Author: Riggle, David
Abstract: This article discusses how a Vermont hospital, with no budget for recycling, set up a
self-sustaining, money-saving system for organics collection and composting. The article includes
the motivating factors and cost savings for various areas of the hospital.
Section Title: North Carolina Baptist Hospitals
Full Title: Case Studies - A compilation of successful waste reduction projects implemented by
NCbusinesses
URL: http://www.p2pays.org/ref /01/0056630.pdf
Length: 2 pages
Date: December 1995
Full Work Author: NC Office of Waste Reduction
Full Title: Case Study - Butterworth Hospital, Grand Rapids, Michigan - Waste Reduction: Rx for
a Healthy Environment
URL: http://www.p2pays.org/ref /01/00800.pdf
Length: 6 pages
Date: May 1992
Full Work Author: MI Office of Waste Reduction Services
Full Title: Case Study - McPherson Hospital: Waste Consciousness Leads to the Return of
Washable Dishes
URL: http://www.p2pays.org/ref /01/00138.pdf
Length: 4 pages
Date: October 1996
Full Work Author: MI Department of Environmental Quality
Abstract: This case study describes how one hospital reduced waste by switching from
disposable to non-disposable dishware. Other examples of source reduction and reuse
implemented by the hospital are also discussed.
Full Title: Fletcher Allen Health Care
URL: http://www.p2pays.org/ref/04/03039.pdf
Length: 2 pages
Date: September 1998
Full Work Author: US EPA
Abstract: This is an effective case study for demonstrating the feasibility of hospital food waste
reduction. This 500-bed hospital delivers 90% of it's food preparation scraps and steam table
leftovers to an off-site composting facility. The hospital also donates produce to a food bank. Its
food discard recovery program saves approximately $1400 per year in landfill fees.

P2RIC databases

Hospitals Prescribe P2 Measures for the Environment
Source: Kansas State University Pollution Prevention Institute
http://www.engg.ksu.edu/enggest/ppi/publications/hospital.pdf
This document gives ideas employed by hospitals on how they can prevent pollution.
Four brief case studies are included. Includes bibliography. Length: 4 pages.
Contacts
http://danpatch.ecn.purdue.edu/~epados/mercury/pano/src/statemap.htm

NEBRASKA

Nebraska Department of Economic Development
Environmental Information Toolkit
Website: http://www.ded.state.ne.us
Major list of state environment, waste and recycling contacts.

Nebraska Department of Environmental Quality
Integrated Waste Management Section
1200 N Street, Suite 400
P.O. Box 98922
Lincoln, NE 68509-8922
(402) 471-4210
FAX: 471-2909
E-mail: deqstaff@doc.state.ne.us
Specify person or unit in body of E-mail
   Medical Waste:
      Attention: David Wisch
   Hazardous Waste (RCRA) Section
      (402) 471-4217
      FAX: 471-2909

Nebraska State Recycling Association
1941 South 42nd Stree, Suite 512
Omaha, NE 68105
  Attention: Kay Stevens
     (402) 444-4188
     FAX: 444-3953
     E-mail: nsra@nfinity.com
     Specify Kay Stevens in body of E-mail.

University of Nebraska Cooperative Extension Service
Extension Publications
IANR Communications & Information Technology
Box 830918
Lincoln, NE 68583-0918
FAX: (402) 472-3093
Website: http://ianrwww.unl.edu/IANR/PUBS/catalog/home.htm
Large catalog of publications, more than half downloadable, with complete waste section.

Nebraska Environmental Recycling Hotline
Website: http://www.1800cleanup.org/state/ne.htm
Searchable database of recycling sites.



IOWA

Recycle Iowa
Iowa Department of Economic Development
200 East Grand Avenue
Des Moines, IA 50309
   Attention: Margo Underwood
       (515) 242-4755
       FAX: (515) 242-4749
       Email: margounderwood@ided.state.ia.us
(Coalition of Iowa's Departments of Natural Resources and Economic Development)
Website: http://www.recycleiowa.org/phone.html
Searchable directory of Iowa recyclers, by region and commodity

Iowa Department of Natural Resources
Website: http://www.state.ia.us/government/dnr/pubs.htm
Large assortment of free waste management assistance publications and video loans (but not
downloadable).
Automated order line:
(515) 281-9361, then 4-5421#

Iowa Department of Natural Resources
Environmental Protection Division
900 East Grand Avenue
Des Moines IA 50319
   Land Quality Bureau
      Attention: Allan Stokes, Administrator
      (515) 281-6284
      FAX 281-8895
      E-mail: astokes@max.state.ia.us
      Recovery, recycling, tires, municipal composting, infectious waste

Iowa State University
Cooperative Extension Service
119 Printing & Publications
Ames, Iowa 50111-3171
(515) 294-5247
FAX: (515) 294-2945
Website: http://www.exnet.iastate.edu/Pages/pubs/
Library of environmental and waste management publications for immediate downloading, others
in printed form available free by
mail.

Bluestem Solid Waste Agency
Website: http://www.bluestem.ia.net/Info.html
Downloadable "Home and Business Recycling Company" directory.

Iowa Environmental/Recycling Hotline
Website: http://www.1800cleanup.org/states/ia.htm
Searchable database for nearest recycling center in Iowa

  Return to State Map


KANSAS

Department of Health & Environment
Division of Environment
Office of Science & Support Building 283, Forbes Field
Topeka, KS 66520-0001
   Pollution Prevention
       Attention: Theresa Hodges
      (913) 296-6603
      FAX: 291-3266
      E-mail: uskang4n@ibmmail.com

Kansas Department of Health & Environment
Division of Environment
Bureau of Waste Management
   Waste Divsion
       Forbes Field, Building 740
       Topeka, KS 66520
   Medical waste and mercury in medical facilities:
       Attention: Joe Cronin
       (913) 296-1667
       FAX: 296-1592
   Hazardous Waste, Recycling:
       Attention: Kent Foerster
       (913) 296-1540
       FAX: 296-8909
       E-mail: uskank96@ibmmail.com

Kansas State University
Division of Cooperative Extension
(913) 532-7272 or 532-7139
Website: http://www.oznet.ksu.edu/____library/library.html
Huge publications catalog and many publications for downloading

Kansas Environmental Recycling Hotline
Website: http://www.1800cleanup.org/states/ka.htm
Searchable directory for recycling locations


MISSOURI

Missouri Department of Natural Resources
Division of Environmental Quality
Solid Waste Management Programs
P.O. Box 176
Jefferson City, MO 65102
   Solid Waste
       Attention: Kathy Weinsaft, Chief, Planning Unit
       (573) 751-5401
       FAX: 526-3902
Website: http://www.state.mo.us/dnr/deq/swmp/publist
Information and publications in downloadable form on recycling, pollution prevention, waste
reduction and other solid waste issues.
Website: http://www.state.mo.us/dnr/deq/swmp/swmdinfor.htm
County-by-county directory of solid waste contacts
   Hazardous Waste Programs:
       Attention: Kathy Flippen, Enforcement Section
       Phone: (573) 751-3176
       FAX: 751-7869
Website: http://www.state.mo.us/dnr/dep/hwp/techbu.htm
Many publications and regulations in downloadable form

University of Missouri Cooperative Extension Service
Household Hazardous Waste Project
1031 East Battlefield, Suite 214
Springfield, MO 65807
  Attention: Marie Steinwachs, Director
      (418) 889-5000
      Fax: 889-5012
      Email: steinwam@ext.missouri.edu
Publication website: http://www.extension.missouri.edu/interlink/index.html
Hundreds of water and waste management publications in downloadable form.

Missouri Environmental Recycling Hotline
Website: http://www.1800cleanup.org/states/mo.htm
Searchable database of recycling sites in Missouri.


Wisconsin Mercury Sourcebook:Mercury Use: Dentists
http://www.epa.gov/glnpo/bnsdocs/hgsbook/dentist.pdf
Source: Wisconsin Department of Natural Resources, Bureau of Watershed Management
This is a 44 page manual, one chapter out of the “Wisconsin Mercury Sourcebook.”
The sourcebook was written as a guide for communities to help identify and reduce the
purposeful use of mercury.


Wisconsin Mercury Sourcebook:Mercury Use: Hospitals and Clinics
http://www.epa.gov/glnpo/bnsdocs/hgsbook/hospital.pdf
Source: Wisconsin Department of Natural Resources, Bureau of Watershed Management
This is a 38 page manual, one chapter out of the “Wisconsin Mercury Sourcebook.”
The sourcebook was written as a guide for communities to help identify and reduce the
purposeful use of mercury.


Wisconsin Mercury Sourcebook: Mercury Use: Veterinary Clinics
http://www.epa.gov/glnpo/bnsdocs/hgsbook/veterinary.PDF
Source: Wisconsin Department of Natural Resources, Bureau of Watershed Management
This is a 20 page manual, one chapter out of the “Wisconsin Mercury Sourcebook.”
The sourcebook was written as a guide for communities to help identify and reduce the
purposeful use of mercury.


Medical Waste Incinerators Regulatory Manual
Source :Kentucky Pollution Prevention Center University of Louisville
Resource type: Manual or handbook
http://www.kppc.org/Publications/manuals/mediwaste.html
This manual will help you understand the regulations being developed by EPA regarding
emissions from medical waste incinerators. It provides an overview of the regulation including its
history and development; as well as presenting EPA's current thinking on how to regulate MWIs,
information on emission limits, and the mandatory components of the regulation.

The regulations discussed in this manual describe the New Source Performance Standards
(NSPS) and the Emission Guidelines (EG) for new and existing medical waste incinerators (MWI)
respectively. Before using this manual understand that these regulations are in draft stage. No
concrete requirements have been promulgated. The information presented here was obtained
through phone interviews with Environmental Protection Agency (EPA) personnel and the June
20, 1996 supplemental notice. The word "inclined" or"inclination" is used repeatedly to emphasize
that the manual only represents EPA's current thinking, not their final decisions.
This manual focuses on the EG for existing sources. However, the NSPS contains the same
basic requirements, except more stringent emission standards. For example, size classifications,
and required components remain the same.The NSPS also includes siting requirements for new
sources, while the EG does not.

Date: not available

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Policy and Guidance Record - Medical Waste Incinerators Final Rule
     OAR Policy and Guidance Metarecord. Document Title/Subject: Medical Waste Incinerators
Final Rule. Related Documents: Background Info.
     Document...
     URL: ftp.epa.gov/ttn/oarpg/t3/meta/m21735.html
     Last modified on: 17-Nov-1998 - 6K bytes - in English



Dioxin Prevention and Medical Waste Incinerators
http://132.198.220.45:443/hlthcare/impact/medlwaste.html
Authors: Joe Thornton, Michael McCally, MD PhD, Peter Orris, MD MPH, Jack Weinberg
Source: Public Health Reports July/August 1996 - Volume III
Resource type: Report
Summery
Medical waste incineration is the largest identified source of dioxins. Polyvinyl chloride (PVC)
plastic, as the dominant source of organically bound chlorine in the medical waste stream, is the
primary cause of "iatrogenic" dioxin produced by the incineration of medical wastes. Health
professionals have a responsibility to work to reduce dioxin exposure from medical sources.
Health care institutions should implement policies to reduce the use of PVC plastics, thus
achieving major reductions in medically related dioxin formation.


Source: WWW.HEALTHTECHNET.COM HEALTHCARE TECHNOLOGY MANAGEMENT
Date: 1997
MEDICAL WASTE
Title:Unregulated medical waste incinerators may be snuffed out by new EPA emission limits.
http://132.198.220.45:443/hlthcare/impact/donoharm.html
Resource type: Report


NIEHS Waste Manual: Health and Safety Waste Manual
http://www.niehs.nih.gov/odhsb/wasteman/
Resource type: Manual
Source: National Institute of Environmental Health Sciences
The Health and Safety Branch of the NIEHS has the responsibility to oversee the
handling and eventual disposal of the biological, chemical, and radiological material
used on site. This manual has been developed so that the disposal of these materials
is done safely, effectively, and within State and Federal regulations. The overall goal in
the planning of this manual was to establish reasonable procedures that would require
the least time and effort while still effectively protecting facility personnel.

To use this booklet, either refer directly to the appropriate section (these are broken
down by contamination type) or go to the index. It is important to remember that
packaging and disposal procedures specifically apply to not only the type of waste but
also the type of contamination. If more than one type of contaminant is involved (ex. -
material has chemicals and radioisotopes), refer to the Multi- Hazard Section.
Remember that your experimental protocols may also include specific waste
management practices.

Along with the production of this manual, there have been a variety of labels, tags,
containers, etc. developed which will help standardize the handling of waste materials
at the NIEHS. These items are listed throughout the manual wherever they are
applicable.


A New Prescription: Pollution Prevention Strategies for the Health Care Industry
Wednesday, October 7, 1998
Boston University Corporate Education Center
Tyngsborough, Massachusetts
http://www.magnet.state.ma.us/ota/pubs\MedP2wrkshp.htm


Dental Recycling Manual: A Guide for Dental Practitioners
http://www.wa.gov/ecology/biblio/97436.html
Resource type: manual
Source: Washington State Department of Ecology
Date: 1998
This booklet provides disposal options for dentists within eastern Washington, for the following
wastes: Amalgam, Lead foil packets, X-ray fixer and developer X-ray film, Elemental Mercury


Dental Programs Environmental Competency
http://www.wa.gov/ecology/biblio/97412.html
This document is for use in schools which have Dental Programs. It outlines the Dangerous
Waste Regulations that pertain to the dental sector, and identifies hazardous wastes that are
generated in the dental sector. These wastes include: x-ray film, wash water containing silver,
and lead foil wrapping.
Resource type: article
Source: Washington State Department of Ecology
Date: 1997


A Guide for Dental Programs: Environmental Management and Pollution Prevention
http://www.wa.gov/ecology/biblio/97413.html
This publication gives guidance on how to handle dental wastes, and provides management
options for select dental wastes.
Resource type: guide
Source: Washington State Department of Ecology
Date: 1997

MWRA/MASCO Mercury Workgroup
http://www.masco.org/mercury/
Massachusetts Water Resources Authority
Medical Academic and Scientific Community Organization
Resource type: web site
Date:
This page will link you to all the documents from the MWRA/MASCO hospital mercury workgroup
is a collaboration between hospitals and the Boston water treatment facility. The work resulted in
an 84% decrease in mercury discharge from hospitals. Documents available include an
infrastructure Maintenance Guidebook, reports on mercury loadings from hospitals and end-of-
pipe treatment technologies.


Dioxin Prevention and Medical Waste Incinerators
Public Health Reports
July/August 1996 - Volume III
Resource type: article
Date: 1996

				
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