1 / 24

Medical waste streams: Legal Requirements

Medical waste streams: Legal Requirements. Enviropharm November 17 2011 Jackie Campbell, B.Sc.(Pharm.), LLB. Outline. Types of waste Why do we care? Regulation of waste Case study: mercury. Types of waste. Specific chemicals/elements Mercury (e.g., amalgam, others)

etenia
Download Presentation

Medical waste streams: Legal Requirements

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Medical waste streams: Legal Requirements Enviropharm November 17 2011 Jackie Campbell, B.Sc.(Pharm.), LLB

  2. Outline • Types of waste • Why do we care? • Regulation of waste • Case study: mercury Jackie Campbell

  3. Types of waste • Specific chemicals/elements • Mercury (e.g., amalgam, others) • Mixtures of chemicals • Pharmacy wastes • Lab chemicals/wastes • Biomedical waste • Sharps Jackie Campbell

  4. Types of waste • Mercury waste - Amalgam • Dense, accumulates in plumbing; may then slowly vapourize or methylate • Accumulates in sewage treatment sludge, which is incinerated or spread on farmland • How much is there? • In 2000, 6% of Canada’s atmospheric mercury emissions came from municipal waste/sewage incineration, and 12% from hazardous/biomedical waste incineration • Dental practices contributed to 8-14% of mercury discharged to sewage systems • How does it get into the environment? • What does it do? Jackie Campbell

  5. Types of waste • Pharmacy waste • How much is there? Nobody knows • Ontario’s MHSW Program Plan said approx 10% of pharmaceuticals not consumed; Estimate 659 tonnes avail for collection • How does it get into the environment? • Through use/excretion • Inappropriate disposal • Appropriate disposal - Incineration • What does it do? Jackie Campbell

  6. Types of waste • Biomedical waste • How much is there? • <10% of waste generated in health care • Must be segregated, managed • How does it get into the environment? • What does it do? Jackie Campbell

  7. Why do we care? • Contaminants reach our water, air, soil • Effects • Human health • Sensitive habitats • Wildlife • Emerging scientific knowledge • Confirms/refutes concerns..or..adds to confusion? • Balance against efficient, cost-effective business operations • Can we reduce emission? By how much? What’s cost? Jackie Campbell

  8. How are wastes regulated? • All levels of government have laws that regulate impact of business activities on the environment • Federal • Canadian Environmental Protection Act, 1999 (CEPA), Fisheries Act, • Provincial (e.g., Ontario) • Environmental Protection Act, Ontario Water Resources Act, Toxics Reduction Act, 2009 • May set discharge limits for various parameters • Some discharge permitted - e.g., under Certificate of Approval • Control collection, handling, transportation, storage of parameter • Again, via CofA - waste management • Reporting requirements • Waste Diversion Act, 2002 • Stewardship recycling programs Jackie Campbell

  9. How are wastes regulated? • Municipalities - by-laws • Control discharges • May have reporting requirements • Say what goes in waste streams - garbage, recycling…collection programs ….On the other hand: • Voluntary initiatives • Dental associations - mercury amalgam • Pharmacist groups - pharma waste Jackie Campbell

  10. What if you don’t comply? • Offences - under laws, regulations, by-laws • Penalties can be substantial • Fines and/or imprisonment • Sometimes mandatory minimum fines • Liability imposed on directors, officers, employees, agents of corporate offender - if they authorized, permitted or acquiesced in commission of an offence - even if company not prosecuted • Adverse publicity Jackie Campbell

  11. Case study - Mercury • In 2001, CCME endorsed Canada-Wide Standard - 95% reduction in releases from amalgam by 2005 (base year - 2000) • Voluntary initiative • through MOU between Environment Canada & Cdn Dental Association • Environment Canada provided info and tech support • Included • improved waste management practices • use of amalgam separators by dentists Jackie Campbell

  12. Case study - Mercury • B.C. worked with GVRD, Capital Regional District to develop source-control by-laws to restrict mercury from amalgams • Alberta Dental Assoc & College developed a BMP guide on how to handle and dispose of amalgam; Alberta Environment met with major municipalities • Manitoba worked with Manitoba Dental Association, which agreed to voluntarily implement CWS • N.B. Dept of the Environment and Local Government and the N.B. Dental Society signed a letter of understanding to promote better management of amalgam waste Jackie Campbell

  13. Case study - Mercury • Ontario added amalgam waste disposal to the General Regulation (O.Reg. 205/94) under the Dentistry Act • Adopted a new standard of practice to reduce the amount of amalgam that directly/indirectly enters the sewage system via wastewater from dentists’ offices • Dentists must adhere to standards of practice, or face sanctions from their regulatory body Jackie Campbell

  14. Case study - Mercury • Some municipalities enacted by-laws to address mercury releases from dental clinics - e.g., North Bay, Ottawa, Toronto • Toronto requires pollution prevention plan (PPP) • Discharge limit of mercury into sewer is 0.01 mg/L, and City also limits concentration of mercury in drains that leave the clinics and enter sewers • The separator required by the Ontario regulation may not be capable of meeting Toronto’s more stringent standard • Compliance audits/enforcement measures taken Jackie Campbell

  15. Case study- Mercury • Report card • 95% reduction in releases from by 2005 not achieved • From 2007 survey of Canadian dentists • 70% use ISO certified amalgam separator (up from 27%) • 71.2% had hired a licensed waste carrier to remove amalgam waste • Gap of 1.2% of dentist who don’t use separator but have waste removed appropriately • CCME recommended further action… Jackie Campbell

  16. Case study - Mercury • May 2010 - Environment Canada published a notice under Part 4 of CEPA • Triggers requirement to prepare & implement a PPP for a substance/group of substances specified on the List of Toxic Substances (Sched 1 CEPA) • Sets out requirements to prepare and implement PPP for mercury releases from dental amalgam waste • Notice applies to dentists and/or owner of building where a dental facility is located and dental amalgams are used • Targets dental facilities that have not implemented BMP under MOU Jackie Campbell

  17. Case study - Mercury • Proposed regulations under Canadian Environmental Protection Act, 1999 - published by Environment Canada - February 2011 • Emissions already reduced by 90% since 1970s - via curbing industrial emissions • 27% of Canada’s atmospheric emissions from use and end-of-life disposal of mercury containing products • Would prohibit manufacture, import and sale of mercury-containing products • Some exemptions - e.g., research applications, dental amalgam • Anticipated decrease of 90,000 kg of mercury emissions by 2032 • Part of a global strategy to reduce damage from methyl mercury Jackie Campbell

  18. Case study - Mercury • Most end-of-life mercury-containing products are considered as hazardous waste - e.g., Ontario Regulation 347 (General - Waste Management) under the EPA, hazardous wastes must be • Segregated • Removed from the general waste stream • Collected in dedicated containers • Collected and transported by approved waste management companies • Under Regulation 347, Ontario required hospital incinerators to close by the end of 2003 -- a few years ago there were over 70 such incinerators, and the hospitals sector was the 4th largest mercury emitter in the province • Lakeview generating station stopped burning coal by April 2005 - reducing annual mercury emissions by 45-75 kg • Falls under the Occupational Health & Safety Act Designated Substances Regulation (does not apply to dental offices) • Reg sets out the amount of mercury workers may be exposed to in a given time period and methods to control/measure workplace mercury • Applies to elemental, inorganic and organic mercury Jackie Campbell

  19. Case study - Mercury • Toronto’s Environmental Reporting & Disclosure By-law requires businesses and facilities to report on 25 substances of priority health concern • That they manufacture, use or release to the environment, if these amounts are at or above reporting limits • Hospitals may use and release other chemicals of concern that are not subject to the by-law • By-law excludes medical, dental offices • Mercury: concentration threshold for reporting - 0% w/w Jackie Campbell

  20. Case study - Mercury From Toronto’s Resource for Greening General Medical and Surgical Hospitals Pollution Prevention Information - Dec 2010 Jackie Campbell

  21. Conclusion • Know your processes • Who uses chemicals, produces waste? • What are the wastes produced? • How much? • Where do they go - air, water, sewer, soil? Jackie Campbell

  22. Conclusion • Green procurement policy • Use less hazardous chemicals • Minimize release of chemicals/by-products • Purchasing products & services • What are handling, storage, disposal costs? • Do products/packaging contain hazardous materials? • Anything facility won’t buy? - “unless required” - anything that contains mercury, asbestos, alkyl phenol ethoxylates, methylene chloride • Give preference to products that don’t contain certain chemicals Jackie Campbell

  23. Conclusion • Know the laws • Federal, provincial, municipal? • Reporting requirements • Usually for emissions of more toxic substances • Toxics laws, by-laws Does anything else apply? • Professional standards of practice? Jackie Campbell

  24. Thanks! SAXE LAW OFFICE email: jackie@envirolaw.com Blog: envirolaw.com Jackie Campbell

More Related