No Such Place as Away

1
No Such Place as Away
How solid waste management decisions affect
public health.

• Jill E. Stein, M.D.
• John W. Andrews
• Lexington Solid Waste Action Team
• 17 Trotting Horse Road, Lexington, MA 02421
• jstein_at_massmed.org

http//www.lexingtonma.org/swat/HomePage.htm
Revision 1.0
2
Introduction

• It has long been recognized that pollution
  resulting from industrial production needs to be
  controlled to prevent serious contamination of
  the environment. But only recently has it become
  clear that the post-consumer disposal of solid
  waste also has serious implications for public
  health and the environment.
• In the past 50 years, our waste stream has become
  increasingly toxic while per capita disposal
  rates have increased dramatically. Disposal can
  release toxins in the waste into the environment.
  And new toxins, not originally present in the
  waste, are produced de novo by waste
  incineration.
• This presentation discusses the overall issue
  of health and waste management. It defines
  decision-making framework that can be used to
  protect public health.

This presentation is in the form of a set of
slides. Most slides are followed by a page of
explanatory text. .
3
Bioconcentration

• At one point, it was thought that the solution
  to pollution is dilution. The ability of trash
  incinerators with tall smokestacks to disperse
  toxins widely over the landscape was viewed as a
  positive feature.
• But we have found that certain persistent toxins
  do not stay dispersed. Through the process of
  bioconcentration they are reconcentrated in the
  food chain. They are appearing dangerous
  concentrations in food, especially in meat, fish,
  and dairy products.

(SWAT.A.08)
4
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5
Health Impacts of Incineration

• .

(SWAT.A.06)
6
Text Health Impacts
This figure summarizes the health issues
associated with incineration of municipal solid
waste. Incineration produces both air emissions
and ash. When the ash is landfilled, leachate
from the landfill can produce water
contamination. Air emissions contain a number of
toxins that produce airborne exposure and which
also fall to earth as particulate
deposition. Respiratory exposure to
particulates, hydrochloric acid (HCl), and
carbon monoxide can produce health effects in the
vicinity of the incinerator. Exposure to dioxin,
lead, and mercury occurs when these material
enter the food chain. Some of the greatest
concerns are for the infant and the fetus, which
is exposed through the mother.
7
192 Organic Compounds Emitted by a Solid Waste
Incinerator

• pentane
• trichlorofluoromethane
• acetonitrile
• acetone
• iodomethane
• dichloromethane
• 2-methyl-2-propanol
• 2-methylpentane
• chloroform
• ethyl acetate
• 2,2-dimethyl-3-pentanol
• cyclohexane
• benzene
• 2-methylhexane
• 3-methylhexane
• 1,3-dimethylcyclopentane
• 1,2-dimethylcyclopentane
• trichloroethene
• heptane

ethylcyclohexane 2-methyloctane
dimethyldioxane 2-furanecarboxaldehyde
chlorobenzene methyl hexanol trimethylcyclohexan
e ethyl benzene formic acid xylene acetic
acid aliphatic carbonyl ethylmethylcyclohexane
2-heptanone 2-butoxyethanol nonane isopropyl
benzene propylcyclohexane dimethyloctane
pentanecarboxylic acid propyl benzene
benzaldehyde 5-methyl-2-furane carboxaldehyde
1-ethyl-2-methylbenzene 1,3,5-trimethylbenzene
trimethylbenzene benzonitrile
methylpropylcyclohexane 2-chlorophenol
1,2,4-trimethylbenzene octadecanecarboxylic
acid hexadecane amide docosane
phenol 1,3-dichlorobenzene 1,4-dichlorobenzene
decane hexanecarboxylic acid
1-ethyl-4-methylbenzene 2-methylisopropylbenzene
benzyl alcohol trimethylbenzene
1-methyl-3-propylbenzene 2-ethyl-1,4-dimethylbenz
ene 2-methylbenzaldehyde 1-methyl-2-propylbenzen
e methyl decane 4-methylbenzaldehyde
1-ethyl-3,5-dimethylbenzene 1-methyl-(1-pro-penyl
)benzene bromochlorobenzene 4-methylphenol
benzoic acid methyl ester 2-chloro-6-methylphenol
ethyldimethylbenzene undecane
heptanecarboxylic acid 1-(chloromethyl)-4-methylb
enzene 1,3-diethylbenzene 1,2,3-trichlorobenzene
4-methylbenzyl alcohol ethylhex anoic acid
ethyl benzaldehyde aliphatic amide
diisooctylphthalate hexadecanoic acid hexadecyl
ester cholesterol.
2,4-dichlorophenol 1,2,4-trichlorobenzene
naphthalene cyclopentasiloxanedecamethyl methyl
acetophenone ethanol-1-(2-butoxyethoxy)
4-chlorophenol benzothiazole benzoic acid
octanoic acid 2-bromo-4-chlorophenol
1,2,5-trichlorobenzene dodecane
bromochlorophenol 2,4-dichloro-6-methylphenol
dichloromethylphenol hydroxybenzonitrile
tetrachlorobenzene methylbenzoic acid
trichlorophenol 2-(hydroxymethyl) benzoic acid
2-ethylnaphthalene-1,2,3,4- tetrahydro
2,4,6-trichlorophenol 4-ethylacetophenone
2,3,5-trichlorophenol 4-chlorobenzoic acid
2,3,4-trichlorophenol 1,2,3,5-tetrachlorobenzene
1,1'biphenyl (2-ethenyl-naphthalene)
3,4,5-trichlorophenol
Chlorobenzoic acid 2-hydroxy-3,5-dichlorobenzalde
hyde 2-methylbiphenyl 2-nitrostyrene(2-nitroethe
nylbenzene) decanecarboxylic acid
hydroxymethoxybenzaldehyde hydroxychloroacetophen
one ethylbenzoic acid 2,6-dichloro-4-nitrophenol
sulphonic acid 4-bromo-2,5-dichlorophenol
2-ethylbiphenyl bromodichlorophenol
1(3H)-isobenzofuranone-5-methyl
dimethylphthalate 2,6-di-tertiary-butyl-p-benzoqu
inone 3,4,6-trichloro-1-methyl-phenol
2-tertiary-butyl-4-methoxyphenol
2,2'-dimethylbiphenyl 2,3'-dimethylbiphenyl
pentachlorobenzene bibenzyl 2,4'-dimethylbipheny
l 1-methyl-2-phenylmethylbenzene benzoic acid
phenyl ester 2,3,4,6-tetrachlorophenol
tetrachlorobenzofurane fluorene phthalic ester
dodecanecarboxylic acid pentachlorobiphenyl
aliphatic amide
3,3'-dimethylbiphenyl 3,4'-dimethylbiphenyl
hexadecane benzophenone tridecanoic acid
hexachlorobenzene heptadecane fluorenone
dibenzothiophene pentachlorophenol sulphonic
acid m.w. 224 phenanthrene tetradecanecarboxylic
acid octadecane phthelic ester tetradecanoic
acid isopropyl ester caffeine
12-methyltetradecacarboxylic acid
pentadecacarboxylic acid methylphenanthrene
nonedecane 9-hexadecene carboxylic acid
anthraquinone dibutylphthalate hexadecanoic
acid eicosane methylhexadecanoic acid
fluoroanthene pentachlorobiphenyl
heptadecanecarboxylic acid octadecadienal
.
Reference K. Jay and L. Steiglitz,
"Identification and Quantification of Volatile
Organic Components in Emissions of Waste
Incineration Plants," CHEMOSPHERE Vol. 30, No. 7
(1995), pgs. 1249-1260
8
Text 192 Organic Compounds
Almost 200 organic chemicals have been identified
in the emissions of a municipal solid waste
incinerator. Some, such as the dioxins, are
known to be harmful. But the effects of most
have not been investigated. Attempting to
regulate exposures on a chemical-by-chemical
basis has the following results expensive,
time-consuming research impossible to
evaluate all chemicals results obtained too
late to prevent harm expensive pollution
controls (one for each regulated chemical)
failure to discover synergistic damage The
latter bullet refers to the fact that two
chemicals in combination can be much more potent
than either chemical separately.
When an industrial process generates a number of
exposures to chemicals with clear potential for
harm, finding an alternative to that process is
often more effective than attempting to regulate
the process on a chemical-by-chemical basis.
9
Particulate Emissions

• Toxic substances are carried on the surface of
  tiny airborne particles.
• Upon entering the lungs, they are absorbed into
  the body.
• Known immediate effects include respiratory
  distress, asthma attacks, and premature death.

(SWAT.A.06)
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Text Particulate Emissions
HEALTH AND ENVIRONMENTAL EFFECTS OF PARTICULATE
MATTER from EPA Fact Sheet, January 13,
1997 Particulate matter is the term used for a
mixture of solid particles and liquid droplets
found in the air. . . . These fine particles are
so small that several thousand of them could fit
on the period at the end of this sentence.
They are of health concern because they easily
lodge in the deepest recesses of the lungs.
A battery of scientific studies have linked
particulate matter, especially fine particles
(alone or in combination with other air
pollutants), with a series of significant health
problems, including Premature death
Respiratory related hospital admissions and
emergency room visits Aggravated asthma
Acute respiratory symptoms, including severe
chest pain, gasping, and aggravated coughing
chronic bronchitis decreased lung function
which can be experienced as shortness of breath
and work and school absences.
EPA believes that the current standards do not
adequately protect the public from the adverse
health effects of particles and need to be
revised. - US EPA, November 1996
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Net Greenhouse Gas Emissions
Reference Greenhouse Gas Emissions from
Municipal Solid Waste Management, USEPA, March
1997
(SWAT.A.02)
12
Text Net Greenhouse Gas Emissions
An EPA study determined the relative greenhouse
gas contributions of different disposal
techniques. The study considered both the
quantity and chemical mix of gases produced by
the different techniques. Waste prevention and
recycling were the most effective in reducing
greenhouse gas emissions. Landfilling and
incineration were least desirable. Under
proposed greenhouse gas reduction schemes, this
can have an economic consequence. If waste
disposal increases emissions, then more costly
reduction measures may have to be imposed to meet
reduction goals.
13
Health Costs

• Health costs arise due to
• Cost of medical treatment
• Lost time at work
• Lost occupational capability
• Learning disabilities (with associated
  education costs and loss of income)
• Premature death (loss of wage earner in
  family)

THESE COSTS APPEAR IN THE ECONOMY AS Cost of
living increases Increased health insurance
premiums Increased employer costs for health
benefits Increased employer costs for worker
replacement
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15
Margin of Safety

• There is wide variation in toxic sensitivities
  and in levels of exposure. This means that even
  when the dosage is acceptable on average, many
  people in a large population will still be hurt.
  A significant margin of safety is often required
  to prevent such injuries.

(SWAT.A.03)
16
Text Margin of Safety
In any population, some individuals will be much
more sensitive to toxic exposure than others. For
example, greater sensitivity to toxic exposure
has been reported for infants and the fetus
the elderly people with liver problems etc. In
some cases, sensitivity is simply a matter of
genetic factors. Furthermore, in any population
the level of exposure will vary with age, diet,
livelihood, place of residence, etc. As a
result, an environmental exposure can injure many
people even though the exposure of the average
individual is below the expected threshold of
harm. For this reason, a margin of safety is
normally provided between the average exposure
and the presumed threshold of harm.
Two additional comments For some substances,
such as carcinogens, there is no threshold below
which the toxin can be guaranteed harmless. In
such cases, the threshold of tolerance is set to
guarantee that the probability of inducing a
cancer is small compared to the probability
produced by other natural causes. Lack of
complete knowledge of the effects of the toxin
can add uncertainty to the setting of an adequate
margin of safety.
17
Timelines of Proven Harm(examples)
One might think that if people were being
seriously injured by toxic exposures, the harm
would be quickly recognized and protective
measures implemented. But history shows that
recognition can come slowly, scientific proof can
take many years, and protection can come too late.
18
Why Proof Takes Time
Scientific proof provides the most solid basis
for policy decisions. But such proof has glaring
shortcomings when lack of proof is used as an
excuse for inaction. Conditions for scientific
proof are difficult to satisfy. Non-proof does
NOT imply that the tested hypothesis is false.

• Proof requires
• strength of association
• known biological mechanism
• consistency with other investigations
• appropriate time sequence
• dose-response relationship

19
Declining Threshold of Harm for Mercury
(SWAT.B.04)
20
Text Declining Threshold of Harm
Frequently it is asserted that an exposure
slightly below the proven threshold of harm is
safe based on scientific analysis. But those
who make such assertions usually have no
scientific proof that the threshold of harm will
not continue to decline. Without that proof,
they are essentially proposing an experiment in
which the expected result is that health will be
damaged.
The proven threshold of harm tends to decrease as
knowledge is accumulated This figure shows the
trend for one toxin mercury. the policy
implications of this trend can be understood by
the following scenario Suppose that in 1985 a
regulatory authority had been asked to issue a
permit for a facility that would expose all
children to levels of 1 micrograms/kg/day. If
the burden of proof were upon the regulator, and
not the polluter, the authority might have issued
the permit because there would be no proof that
the exposure was harmful. And then, in
subsequent years, the scientific data would have
been obtained, and a major public health
catastrophe would become evident. The most
scientific approach to interpreting trends
would be to assume that the long term trend will
continue for several years more, and that harm
will be found at even lower exposures than
currently proven. This is not absolutely
certain, but it more likely than a sudden
leveling off of the trend.
21
Framing the Question Determines Who Will be
Injured
Gives priority to protection of the polluter.
Tends to result in controls that arrive too late
to prevent harm.
Prove that exposure is harmful.
OR
Prove that exposure provides adequate margin of
safety.
Gives priority to the protection of people.
Controls imposed in time to ensure safety
(relaxed if proof of safety is provided).
22
Text Framing the Question

• Often many years elapse between the first
  indication that an exposure is harmful and the
  point at which the harm is fully proven.
• For some substances, such as dioxin, harm occurs
  at levels that are difficult or expensive to
  measure with existing technology.
• The question of the lowest exposure level at
  which harm occurs is often impossible to
  determine without decades of research.
• Inadequate funding can seriously impede progress
  toward proof.
• Waiting for final proof before acting can lead to
  many years of unsafe exposure.

23

• Which curve do we choose to follow?

If the polluter is relieved of the burden of
proof, then injury to people will occur as
knowledge being gained.
region of constrained industrial techniques
(SWAT.A.02)
24
Text Which curve do we choose?
Consider a substance for which there is some
unknown threshold at which harm occurs. At any
given state of knowledge, there is an exposure
that has been proven to be harmful. This is the
upper curve in the figure. There is also an
exposure that has been proven safe. This is
the lower curve in the figure. If we decide to
allow the regulatory process to follow the upper
curve, we will allow exposure until proof of harm
accumulates. Then the exposure level will be
lowered to reflect the new evidence of harm.
This approach guarantees that health will be
harmed as knowledge is accumulated. It also
encourages corporate powers to impede research
activities (e.g. by using their lobbying power to
attack research programs producing evidence of
harm).
If we decide that the regulatory process should
follow the lower curve, human health will be
protected. As knowledge of toxicity is gained,
it may be found that the standards can be
relaxed. In following the health protective
curve, restrictions may be placed on the type of
techniques that can be used in industrial
activities. This may have economic impact upon
particular industries. But experience has shown
that in general there are alternative,
economically-viable industrial processes that
can be substituted for those that must be banned
for health reasons. In many cases, the
alternatives are actually economically
advantageous since they lead to more efficient
use of raw materials and less expense for waste
disposal. And because they do not impose health
costs and environmental remediation costs upon
the economy, they result in a net gain in the
wealth of society.
25
Sustainability
nutrients
(SWAT.B.03)
26
Text Sustainability
The conventional industrial process turns raw
materials into waste in an open loop flow.
Waste disposal is not a consideration for
corporations involved in production. It is
purely a cost to be borne by the consumer.
However, the costs of waste disposal (in terms of
health and environment damage) can detract
considerably from the value of the products
produced. Furthermore, conventional industrial
processes are not sustainable. They gradually
deplete non-renewable resources, usually failing
economically because of rising resource
extraction costs, but ultimately failing because
of resource exhaustion. In the perfect
sustainable production system shown in the bottom
half of the figure, only renewable resources
would be consumed. The only wastes released back
into the environment would be those that could be
reprocessed by natural processes. Other waste
would be recycled within the industrial system.
The costs of pollution damage are avoided and
full value is received for the products
produced.
If our economy is to continue to function, we
must make a transition to sustainable processes.
Such a transition will require sustained effort
from both public and private entities.
If we understand that design leads to the
manifestation of human intention, and if what we
make with our hands is to be sacred and honor the
earth that gives us life, then the things we make
must not only rise from the ground but return to
it, soil to soil, water to water, so everything
that is received from the earth can be freely
given back without causing harm to any living
system. This is ecology. This is good design.
William McDonough, Dean, School of
Architecture, University of Virginia
27
For Further Information
Internet Resources

• SWAT web page
• http//www.lexingtonma.org/swat/HomePage.htm
• Massachusetts DEP Mercury Home Page
• http//www.state.ma.us/dep/files/mercury.htm
• Characterization of Municipal Solid Waste in the
  United States - 1996 Update, EPA, 1996
• http//www.epa.gov/epaoswer/non-hw/muncpl/msw96.ht
  m
• EPA Emission Factors (AP-42, Fifth Edition)
• http//www.epa.gov/ttnchie1/ap42c2.html
• Massachusetts DEP Solid Waste Publications
• http//www.state.ma.us/dep/bwp/dswm/dswmpubs.htm
• EPA Pay-as-you-throw Web Site
• http//www.epa.gov/epaoswer/non-hw/payt/index.htm
  
• The Dioxin Homepage