The original article can be found in: Virgin Islands Daily News By AMANDA NORRIS
ST. THOMAS – Charley Kubler, a certified hazardous materials manager, who works as a consultant for the medical waste broker Medical Waste Experts, said Schneider Hospital’s waste management fails on several levels to conform to best practices he has learned through 26 years of responding to hazardous waste sites and spills and in advising hospitals and waste producers.
“It’s alarming to me, what’s happening here,” Kubler said. “It’s not a four-alarm fire, but it’s unacceptable behavior.”
In an interview Sept. 27, Schneider Chief Executive Officer Bernard Wheatley, Vice President of Facilities Management Karen Hodge and Director of Engineering Julian Magras told The Daily News that the waste outside was “actually safer” than in its unpackaged form on the hospital’s floors.
It did not pose a public health hazard as it was in “its regulated form” because it was being double bagged before being lowered into lined cardboard boxes, they said.
Kubler said packing medical waste in plastic and cardboard boxes is insufficient to minimize the risk of spills and the spread of infectious diseases, which the outdoor storage may expose the public to by a number of pathways.
Further, he said, exposure to the elements can corrode boxes. Leonard has said that hospital staff told her that some of the boxes found on Sept. 27 had been repacked because rain had fallen on them and destroyed their integrity.
Risk Factors
Kubler identified the following risk factors associated with the outdoor storage of medical waste:
– Chemicals from medicines and metals in the equipment contaminating groundwater.
– Animals attracted to the waste carrying microbial agents out and away from the site.
– Workers’ health potentially being affected by a spill or leak from a cardboard box.
– The proximity of the waste to vulnerable parts of the population, such as the sick, the elderly or children who might be visiting or staying in the hospital or nearby medical offices.
“To put it in a plastic bag, then into a cardboard outer container really calls into question, even if indoors, whether that really is a secured package. The reason is, it’s so easy for accidents to happen,” Kubler said. “Accidents happen all the time. The goal is to minimize the likelihood of an accident and to minimize the amount of infectious material that could become uncontained.”
For those reasons, many hospitals use solid plastic containers to package waste, he said.
Non-working freezer
Particularly troubling, according to Kubler, is DPNR’s reluctance to immediately violate the hospital based on the freezer’s containing loose or dripping water.
“No, I disagree with that, everywhere on the planet – it doesn’t matter where you are standing – if water is in its liquid phase, it’s not 32 degrees Fahrenheit,” Kubler said. “For infectious waste, the temperature is part of the containment of that material. In some cases, if it is frozen long enough, it will succeed in killing the dangerous agents in the material, but in all cases, it will prevent it from multiplying and becoming a higher concentration.
“To me, 95 out of 100 environmental and health professionals would agree that you are not properly containing the waste,” Kubler said about Schneider’s current procedures regarding its medical waste.
Long-term concern
Kubler also said the fact that hospital officials have admitted that they store waste outside whenever the freezer reaches capacity and a shipping container is not readily available and have done so at least since 2002, when the incinerator was closed because of EPA regulations, triggers concern about the potential for long-term and cumulative contamination of the water supply.
“In my professional work experience – I have a lot of experience where I have been called in to help people who have been given a ticket by an agency – I find it highly surprising that the agency has stopped at that position,” Kubler said of DPNR’s notice of non-compliance issued Friday.
In terms of isolating disease vectors, Kubler said, it would be difficult to do without sampling of the outdoor area’s surfaces. The public or workers could be at risk of exposure to any and all diseases presented by patients at the hospital or any of the clinics and doctor’s offices for which the hospital collects waste.
Cosmetic fixes
The hospital has provided a sign that reads “Caution-Hazardous Waste Storage Area,” according to Friday’s notice. Also, staff has put a blue tarp against the interior of the loading dock’s fence.
Wheatley and other hospital executives have not responded to The Daily News for further requests for comment.
Schneider Hospital’s legal counsel, Karl Percell, said little about the situation when contacted Friday. Percell said he had not been made aware of the outcome of Tuesday’s DPNR inspection.
“It’s in DPNR’s hands now,” Percell said. “I believe the hospital is complying with whatever statutes they are required to.”
