Mad cow concerns aired: Burner incapable of destroying fatal disease agentIJ

 

NORTH SALT LAKE — A North Salt Lake hospital waste incinerator that was cited with violations earlier this year has another issue to explain to the public: mad cow disease.

In a public meeting recently, Stericycle officials admitted they are allowed to accept and burn prions from human and animal tissue. Prions are deforming proteins responsible for causing Creutzfeldt-Jacob disease in humans. The disease, better known as mad cow disease, is a 100 percent fatal brain disease, according to the U.S. Centers for Disease Control.

Attempts to contact Stericycle for comment were unsuccessful. However, in a video on the EnviroNews Utah website, Stericycle Vice President of Legislative and Regulatory Affairs Selin Hoboy said the company does have a permit condition for prions, and if the company were to accept them, it would have to notify state regulators.

“There are studies that show that prions are never really fully destroyed and remain in the environment,” Hoboy said in the video.

Dr. Brian Moench is alarmed. He said Stericycle may be burning prion-containing waste and not even know it.

Moench is president of Utah Physicians for a Healthy Environment and a member of the Union of Concerned Scientists and the national Radiation and Health Committee of the Physicians for Social Responsibility. He defines prions as highly infectious strands of protein that have the unique ability to reproduce on their own. They cause a neurodegenerative disease called spongiform encephalopathy that is uniformly fatal in humans and animals. The human version is called Creutzfeldt-Jakob disease; in animals it has been called scrapie, mad cow disease or chronic wasting disease, depending on what animal has been afflicted.

Scott Anderson, a toxicologist with the Utah Division of Solid and Hazardous Waste, said if Stericycle wants to take any waste containing prions, it must first demonstrate its incinerator can handle them.

“I’m not going to debate anything with a group of physicians. Right now Stericycle can’t take it,” he said. “They have to come to us first and make a demonstration proving that their incinerator can handle it, and then if we allowed it, we would have to modify their permit.”

But Moench said it is possible that Stericycle may be unaware they are dealing with such materials, because they do not routinely open containers with human or animal waste tissue to inspect the contents, they just burn them.

“Human tissue that may be contaminated with prions is oftentimes not confirmed because prions are so highly infectious that pathologists don’t want to process it, so a definitive diagnosis is often never made,” Moench said.

Dr. Tyler Yeates, also a member of Utah Physicians for a Healthy Environment, said prions have been shown to survive temperatures hotter than medical waste incinerators use, and Stericycle’s smokestack emissions may indeed be disseminating active prions into the community.

“Stericycle doesn’t test for prions, so it is unknown whether any tissues they incinerate are infected with prions,” he said. “Because they don’t test for it, if any tissues incinerated … were infected with prions, they could be aerosolized into our community, and we would have no way of knowing.”

Yeates said prions are transmitted by ingestion, and scientific research from 2011 demonstrated that prions can be transmitted by small particles being inhaled.

“Particles from incinerators can be aerosolized miles from the source well outside the boundaries of North Salt Lake City,” he said. “In addition, it can get into the soil and food supply and have effects well beyond our local community.”

Moench said prions are extraordinarily resistant to destruction. Prions cannot be destroyed by boiling, alcohol, acid, standard autoclaving methods or radiation, he said.

“In fact, infected brains that have been sitting in formaldehyde for decades can still transmit the disease, as can the instruments used on infected tissue even after the instruments have been ‘sterilized’ by conventional methods, and years after the fact,” he said.

Right now it is not clear what it takes to destroy prions, Moench said, but tests have shown some types may survive cremation temperatures of 2,000 degrees. Other tests have shown the highest temperature achieved in an incinerator like Stericycle’s is not likely to be uniform throughout. In other words, some parts of the incinerator contents do not achieve the desired temperature, leaving some of the waste inadequately treated.

“Theoretically, the risk of prions being disseminated up the smokestack at Stericycle is a genuine risk, but no government entity is currently attempting to evaluate that risk, and neither is Stericycle,” he said. “To my knowledge, no state agency is attempting to see if Davis or Salt Lake County have an unusually high number of deaths from Creutzfeldt-Jakob.”

According to the Utah Department of Health’s monthly communicable disease report, one case of Creutzfeldt-Jakob disease was reported in June. It does not list the county in which the disease was reported. There were 17 cases reported from 2002 to 2011. The health department also reports 35 probable or confirmed cases in Utah between 1980 and 2002.

“Our goal is to shut down the incinerator,” Moench said. “Fifteen years ago there were about 2,300 hospital waste incinerators scattered throughout the country. Since then, over 98 percent of all medical waste incinerators have closed due to increased understanding of the toxicity of their emissions and the availability of safer ways to dispose of hospital waste.”

But the deadly smoke continues to rise from Stericycle, he said, which is now importing waste from eight surrounding states.

“Defenders of Stericycle claim that because Stericycle was there before the subdivisions eventually moved right up to their fence line, that it is not Stericycle’s fault,” Moench said. “But Stericycle should never have been approved in the first place. Now that there are thousands of residents within a mile, it definitely needs to be shut down. Furthermore, Stericycle’s pollution reaches the entire Wasatch Front, not just the residents of the nearby subdivision, Foxboro.”

Moench said large medical studies have shown people who live near medical incinerators have a higher incidence of virtually every adverse health outcome you can think of — cancer, birth defects, neurologic diseases, and respiratory and autoimmune diseases.

“Utah has the highest rates of autism in the nation. Double the national average. The emissions of Stericycle read like an All-Star line up of some of the deadliest compounds known to man — mercury, lead, arsenic, dioxins, polycyclic aromatic hydrocarbons — many of which are known to be toxic to brain development in fetuses and children,” he said. “With Utah experiencing a tragic epidemic of autism, it should compel us to eliminate as many possible contributors to the epidemic as possible, and Stericycle certainly falls into that category.”

Nowhere near enough is being done to regulate this company, Moench said. Although Stericycle represents only a small volume of the primary components of urban pollution, they put out about as much of the deadly compounds, dioxins, heavy metals and others, as a full-sized oil refinery or coal-fired power plant, Moench said.

“Then add to that the possibility of prions in their emissions,” he said.

On May 28, the Utah Division of Air Quality issued a notice of violation and an order to comply for multiple violations of its Title V air-quality operating permit to the company. Violations included emissions exceeding the permit limits for dioxin, furon and nitrogen oxide, failure to report the emission exceedances, failure to maintain normal operating conditions during a stack test and failure to include test results demonstrating these emission exceedances in its semiannual monitoring reports. These violations took place between Dec. 2001 and April 2013, the division said.

The facility has been granted two extensions to comply. The second extension expires Aug. 30.

A protest against the company is scheduled for 5:30 p.m. Thursday at 90 N. 1100 West in North Salt Lake. The public is invited.

“We want the public to call all their elected officials, especially their state reps and senators and the governor’s office, and demand that Stericycle’s permit be withdrawn,” Moench said.

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