Just because AIDS-infected hypodermic needles have not washed up on the south shore of the Great Salt Lake, doesn't mean Utah is free of infectious medical waste.
Actually, Utahns may face more danger than New Jersey or New York residents from hospital debris, because this state has no specific regulations to require safe disposal of infectious waste.The exception is a Salt Lake City-County Health Department catch-all rule against public health threats. When a threat is noticed, the department acts.
"We've taken action in the past and will continue to do so," said department director Harry L. Gibbons.
In the East, contaminated material was dumped illegally into the Atlantic Ocean because of strict requirements for safe disposal.
Potentially disease-causing debris closed ocean beaches from Connecticut to North Carolina, and showed up on the Lake Erie shore. It included syringes, blood vials, colostomy bags, catheters, intravenous tubes and needles contaminated by the AIDS virus.
In response to the emergency, the Senate voted to ban disposal of all medical waste in oceans or streams. A similar bill is awaiting action by the House. Because there are no national regulations concerning infectious waste, this vital area is left entirely up to state and local control.
While Utah has no state or local requirement of special handling for infectious waste as of yet, many hospitals and clinics already either incinerate their own waste, or subscribe to a commercial disposal company.
The City-County Health Department is drafting regulations on infectious waste disposal. Presently, such material can be placed in "a regular Dumpster with regular trash," said Ted Diamant, solid and hazardous waste specialist for Salt Lake County.
"We have a lot of transient people, a lot of drug users who are going into the Dumpsters, pulling the needles out, and using them," he said.
The new rules will not only address the disposal of waste - including body parts - by hospitals, but also by clinics and individuals who dispose of a small amount of such material, including hemophiliacs or diabetcs who must use needles at home.
Under the regulations, "sharps," things like needles and glass that could cut plastic bags, will have to be carried in puncture-proof containers.
Small-quantity waste generators will have to put the material in secured garbage containers, so animals and people can't get to them. It won't have to be labeled. "That's the extent (of regulations) for the small-quantity people," he said.
Any facility that generates more than 220 pounds of infectious waste per month will have to steam-sterilize or incinerate the material if its final destination is a landfill.
"Right now, no, there aren't any regulations that require it to be rendered non-infectious," he said. "It can be transported to the landfill with regular garbage. "Right now, there are no regulations on infectious waste in Utah."
Most or all hospitals in Utah follow guidelines on infectious waste disposal issued by the Environmental Protection Agency about five years ago, although there are no provisions for small quantity generators.
"They do what they want," Diamant said. "We have had calls from landfill workers that they have stepped on a syringe or got them stuck on a tractor tire.
Draft rules have been issued, and the county hopes to issue final regulations within the next six months.
"In fact, there're a lot of entrepreneurs that are trying to get into the (disposal) business. They are pushing us to get the regulations adopted."
Rep. Gene Davis, D-Salt Lake, who has been working to establish state infectious waste regulations, said statewide rules are needed in order to ensure the proper disposal of this material. One way this could be done is by building a regional infectious waste incinerator.
"If we're going to allow just the open dumping in the landfills, I guess the economics are not there (to incinerate waste.) It's cheaper to dump it than to burn it," Davis said.
Representatives of PRS - Preferred Reduction Services - a company based in San Clemente, Calif., have told Davis they are interested in setting up a regional incinerator in Utah. It would burn only infectious waste, and none from out of state.
"As you can imagine, there's real liability associated with the improper disposal of some of this," said Kenneth Alkema, director of the Utah Division of Environmental Health.
Health-care facilities have established their own guidelines for handling this dangerous material. "But there's nobody looking over their shoulder," making certain they follow the guidelines, he said.
Dr. David J. Thurman, coordinator of epidemiological studies, Utah Bureau of Epidemiology, said some hospitals incinerate their infectious junk, but he doesn't believe all do. "And what is not (burned), from what I can ascertain, is taken to sanitary landfills," he said.
"People are being a lot more careful about this stuff now than they were 10 years ago," Thurman said.