Until recently, incineration was the almost exclusive method of treating hazardous medical waste. In 1994, the U.S. Environmental Protection Agency’s (EPA) Reassessment of 2,3,7,8- Tetrachlorodibenzo-p-Dioxin (TCDD) and Related Compounds identified medical waste incineration as the single largest source of dioxin air pollution in the United States of America.

In 1997, the EPA promulgated regulations for existing and new incinerators, setting new emission limits. Existing incinerators had to be equipped with additional air pollution control devices to comply with the new legislation requirements. For the vast majority of hospitals and other medical waste incinerator operators however, investing in efficient filters was too expensive and resulted in the closure of more than five thousands medical waste incinerators.

In 2000, stricter emission limits for medical waste incinerators were introduced in the European Union. This resulted in the closure of many incinerators and an increase in the number of non-incineration facilities for treating infectious medical waste. However, the speed of the introduction of alternative treatments is much slower than in the USA and incineration remains the prevailing method of treating medical waste in Europe.

Although incineration is still widely used, non-incineration technologies are winning increasing support in Europe. Non-incineration technologies (unlike incinerators) do not produce toxic dioxins and their introduction is therefore in accordance with the Stockholm Convention on POPs (Persistent Organic Pollutants) that entered into force in May 2004.

The problem of pollution caused by the incineration of medical waste has been recognised by the World Health Organisation (WHO). In its policy paper entitled Health-care Waste Management (March 2004) WHO states that a long-term goal shall be: Effective, scaledup promotion of non-incineration technologies for the final disposal of health-care wastes to prevent the disease burden from (a) unsafe health-care waste management and (b) exposure to dioxins and furans.

Facilities have to determine which non-incineration technology best meets their needs while minimising the impact on the environment, enhancing occupational safety and demonstrating a commitment to public health. A resource book entitled Non-Incineration Medical Waste Treatment Technologies in Europe has been produced by Health Care Without Harm and provides general information to assist legislators, hospital administrators, facility managers, health care professionals, environmental advocates and community members towards achieving those goals.

Summary brochures have been published by HCWH and EPHA Environment Network and are available for download in English, French and German.