ILLINOIS POLLUTION CONTROL BOARD
May 28,
1981
In The Matter Of:
Hazardous Hospital Wastes,
)
R80—19
Sections
3(jj)
and 21(h)
of
)
the Environmental Protection Act
)
ADOPTED RULE.
FINAL ACTION.
FINAL OPINION OF THE BOARD
(by J.
Anderson):
This
final Opinion is written in support of the new Part
9
to Chapter
9:
Special Waste,
adopted May 28,
1981 by the Board
as final rules to become effective May
31,
1981.
By its letter
of May
12, JCAR stated
it had no objection to these
Rules.
The purpose of this rulemaking
is the implementation of
Section 21(h) of the Environmental Protection Act
(Act), which
absolutely prohibits the deposit of “hazardous hospital waste”
in any
landfill, and mandates that it he incinerated,
sterilized
or otherwise properly disposed of pursuant to regulations of the
Board.
Section
3(jj)
defines hazardous hospital waste as:
“wastes generated in connection with patient care that
is contaminated with or may be contaminated with an
infectious agent that has the potential of inducing
an infection and has not been rendered innocuous by
sterilization or incineration.”
Much of the history of this rulemaking was explained in
detail
in the Board’s Opinion of December 24,
1980, written in
explanation of the emergency rules
(Chapter IX,
Part
9)
adopted
December 18,
1980 after two inquiry hearings on November 14 and
17,
1980.
That Opinion is incorporated by reference herein as
if fully
set forth.
Also on December 18,
1980, the Board ordered publication of
the First Notice of proposed rules identical, hut for one provi-
sion, to the emergency rules.
These proposed rules were published
in the Environmental Register
#330,
January
6,
1981 and in the
Illinois Register,
Vol
5,
pp.
14—17, January
2,
1981.
Hearings
were held on January
26,
1981 (Springfield) and January
28,
1981
(Chicago),
at which testimony concerning the language of the
proposed rules was received.
*The Board wishes to express its appreciation for the
assistance of Kathleen
M. Crowley,
Administrative Assistant to
J. Anderson and Hearing Officer herein in the drafting of this
Opinion,
as well as the aid of William Withrow,
Technical
Assistant to the Board.
41—517
2
Having considered the testimony presented at hearing,
as
well as all of the written comments received since publication
of the first notice,* the Board has made some revisions.
Prior
to discussion of the specific language changes,
it is necessary
to present an overview of the regulatory and statutory framework
concerning
infectious wastes
i.n which hospitals currently operate,
as an aid to understanding the slightly different direction the
Board has taken in the drafting of Part IX.
OTHER EXISTING REGULATIONS
AND
LEGISLATION
As a general statement,
the Board believes that these
proposed rules reflect the legislative intent to require hospit-tl.s
to more carefully manage the same infectious waste stream that
hospitals currently are expected
to isolate
in their facilities
under other applicable regulations.
Illinois Department of Public Health
The first set of applicable regulations, which affect every
hospital, are those of the Illinois Department of Public Health
(IDPH),
promulgated
in the exercise of its statutory mandate and
authority under the Hospital Licensing Act Ill. Rev.
Stat.
Ch.
111½,
Sec.
142 et
seq.
IDPH requires that each hospital create
art
Infection Control Committee which must establish,
inter alia,
“policies and procedures
for the handling of infectious cases.~
IDPH further requires that the “handling and disposal of contami-
nated material shall be in
a manner designed to prevent the
transmission of the infectious agents.”
IDPH Hospital Licensin~j
Requirements, Part IX, Section D
“Infection Control,” Illinois
Register, Vol
5.,
pp.
553—554
(January
9,
1981).
Waste is to he
“collected,
stored,
and disposed of in a manner that will not
permit the transmission of
a contagious disease;” “potentially
hazardous waste must be double-bagged and identified.”
Part XIV,
Section
B “Garbage, Refuse and Solid Waste Handling and Disposal”
Illinois Register, Vol.
5,
pp.
571—572.
New hospitals are
required to provide incinerators for
“the complete destruction
of pathological and infectious waste.
Infectious waste shall
include, but shall not be limited to, dressings and material
*In its Opinion of December 24,
1980,
the Board acknowledged
receipt of the first eight public comments which were received
in
1980 prior to the Board’s adoption of specific language.
Since
then,
the Board has received comments from August Lorenz,
Abraham
Lincoln Memorial Hospital
(PC 9); Arthur Lelio,
Suburban Medical
Center
(PC 10); Director William Kempiners,
Illinois Department
of
Public Health
(PC 11); Stephen Sokalski, Christ Hospital
(PC 12);
Donna Koser,
St.
Joseph Hospital
(PC
13); Timothy West, Community
Memorial General Hospital
(PC
14); Eric Gleason,
St. Francis
Hospital
(PC 15); and Maurice Davenport, Olin Chemicals
(PC
16).
41—518
3
from open wounds,
laboratory specimens, and all waste material
from open wounds.”
Part XX, Section D(13)(h)(2)
“Waste Proces-
sing Services,”
IDPH publication, eff.
October
1,
1977.
Although
existing hospitals are not required
to have incinerators, they
must provide “space and facilities for the sanitary storage and
disposal of... infectious or radioactive waste substances” Part
XXI,
Section C(13)(h)(2), IDPH publication, eff.
May
26,
1978.
Medicare—Medicaid Program and Joint Commission on Accreditation
of Hospitals
The second set of regulations are applicable to every
hospital which participates
in the federal Medicare—Medicaid
program.
A condition of hospital participation in this federal
program is that
“proper facilities are maintained and techniques
used for incineration of infectious wastes,
as well
as sanItary
disposal of all other wastes” CFR 405.1022(a)(5).
It should
also be noted that most hospitals belong to a voluntary associ-
ation called the Joint Commission on Accreditation of Hospitals
(JCAH), whose findings during its inspections of hospitals for
accreditation purposes may, under the federal
law,
be used by
federal officials when determining compliance with Medicare par-
ticipation standards.
The JCAH has its own detailed standards
for the storage and disposal of infectious waste.
Federal and Illinois Environmental Protection Agencies
As discussed in the Board’s earlier Opinion, both federal
and state legislation
Section
21(h)
of the Act aside
address
the disposal of hazardous waste.
Although the U.S. Environmental
Protection Agency has not promulgated regulations
for the identi-
fication and disposal
of waste with “infectious characteristics”
to implement the Resource Recovery and Conservation Act of 1976,
42 USC S6901—6987,
the Illinois Environmental Protection Agency
has adopted final
“Criteria for Identification of Hazardous Wastes”
to implement Section 22.2 of the Act
(otherwise known as H.B.
453,
P.A.
81—0856 signed September 21,
1979).
Pursuant to Section 22.2
and the Agency criteria, owners or operators of hazardous waste
disposal sites must pay hazardous waste disposal fees if they
receive “...any pathological specimens and any articles attendant
thereto that may be disposed of from humans and animals known to
be contaminated with organisms that may produce communicable
diseases which must be reported to the Illinois Department of
Public Health.
Pathological specimens shall include all solid
tissue, excreta,
and secretions...” (followed by reportable disease
list.
Illinois Register Vol
4,
pp.
133—134).
Since Hazardous
Hospital
(infectious) Waste must be rendered innocuous by steri-
lization or incineration before going to ~
landfill, the above
criteria for determining
fees would no longer appear to apply
to
hospitals.
41—519
4
CHANGES
IN THE RULES AS PROPOSED
The
IDPII stated its support of the rules as drafted, but
also noted that “while
it may be necessary
to
make
additional
changes and revisions to this rule, the basic content will provide
for the protection of the public’s health”
(PC 11).
The Board has
not changed the basic content of the rule, but has made
rnodif
i-
cations to better fit these rules into the hospitals’ existing
regulatory and statutory framework in order to avoid unnecessary
confusion and duplicative record—keeping.
Changes,
and the reason
for these changes~ in each rule are:
Rule 901
Definitions
Hazardous (infectious) Hospital Waste
Infectious Agent
The Board has deleted entirely the definition of infectious
agent.
The “hazardous (infectious) hospital waste” definition
has been divided into subsections
for greater readability.
The
language of the proposed rule has been retained
(but with some
suggested editorial revisions),
and explicitly references IDPH
isolation requirements.
Lastly, the “includes but is not limited
to” language has been deleted, in light of addition of a new
subsection giving hospitals the responsibility to classify suspect
material as infectious,
as already required by the rules of the
IDPH.
Two minor additions have been made to the general legislative
definition in Section
3(jj)
of the Act of “hazardous hospital
waste,” which was repeated verbatim as the first sentence of the
proposed rule.
The Board has chosen to describe the waste with
which the rules
deal as “hazardous
(infectious) hospital waste,”
to allow for instant recognition of the hazardous component of
this waste.
This further identification will counter what the
Board has observed to be a popular misconception:
that Sections
3(jj)
and 21(h) concern themselves with the chemical or low level
radioactive wastes generated by hospitals,
rather than their infec-
tious waste
(See R.
347—363).
A similar clarification,
as suggested
in PC
16,
is the specification that the waste at issue
is waste
“generated by a hospital in connection with patient care.”
While
the Board’s December 24 Opinion made it clear that the legislative
intent was to exclude non—hospital facilities such as first—aid
clinics,
the additional language may be useful
in dispelling any
lingering confusion.
Much of the testimony at hearing concerned the definition of
these terms as proposed, with five of the comments
(PC
9,
13,
14,
15,
16) specifically questioning the definition of the waste,
and
two
(PC 12,
15) questioning the definition of infectious agent.
As these two definitions are so closely related, they will be
considered together.
41—520
5
A significant change has been made
in the thrust and format
of the second sentence of the waste definition, which was drafted
to provide the more specific guidance needed by the persons who
must actually separate a hospital’s infectious “special disposal
required” waste stream from its normal
“no special handling” waste
stream.
The hearing participants were in general agreement with
the definition as proposed,
and indicated that the definit.ion as
drafted identified a waste stream which they were already giving
special internal handling
(e.g.
R.
429).
However,
concern was
expressed both at hearing and in the public comments about the
proposed rule’s statement that hazardous hospital waste “includes
but is not limited to” the items specified,
the primary concern
being that this phrase could
lead to arbitrary identification of
additional
infectious wastes and resulting arbitrary enforcement
(e.g.
R.
248,
277, 285,
446,
PC
9,
14).
On the other hand, there
was also dissatisfaction with the tie—in of the IDPH reportable
disease list with the definition of infectious agent.
At least
some “reportable” diseases do not transmit infection through
waste products,
and these patients,
therefore, are not isolated
(e.g.
R.
263,
Ex.
lB generally).
In this connection, the Board
was again reminded that IDPH rules require that isolation policies
and procedures be in place,
and accepted the suggestion that
direct reference be made to “Isolation Techniques
for Use in
Hospitals,” a publication of the Center for Disease Control, U.S.
Public Health Services
(Ex.
1B).
Hearing participants confirmed
their own as well as the widespread use of this manual,
as yearly
amended
(e.g.
R.
383,
270,
429),
and one participant commented
that both IDPH and JCAH
“beat hospitals over the head with” the
manual
(R.
288).
Therefore,
the Board did not take the “laundry list” approach
of listing infectious agents by name which was taken by the USEPA
in its original RCRA regulation proposal,
43 Federal Register
58946 et seq.
at 58963—64
(December 18,
1978), and to some extent
by the Agency in its criteria for implementation of Section 22.2
of the Act
(supra p.
3).
The Board chose,
instead,
to rely upon
the medical judgment and expertise of the health care profes-
sionals to flesh out a general definition.
The IDPH new hospital
incinerator rule takes this approach
(supra,
p.
2—3),
as does a
similar regulation of the Minnesota Pollution Control Agency of
which the Board takes official notice.*
*The Minnesota Pollution Control Agency has prohibited the
deposit of “special infectious waste”
in any landfill, pursuant
to its general
legislative authorization to control solid waste
disposal
(Minn.
Stat. Ch.
1046,
Sec.
11607).
Minn. Rule SW6(v)
(iii) states that “...special
infectious waste...”
“shall not be
acceptable for deposit
in sanitary landfills...” Minn.
Rule SW1
(12) defines special infectious waste as originating from diag-
nosis, care or treatment of a person or animal that has or may
have been exposed to a contagious or infectious disease.
It
includes, but
is not limited to:
(footnote continued on p.
6)
41—521
6
On balance, the Board finds that the latter approach is
preferable,
particularly since IDPH rules require the development
of isolation practices and procedures and references guidelines
respected in the health care field,
and IDPH and the JCAH already
monitor hospital waste stream separation for their licensing and
accreditation purposes.
Finally,
the legislative history of
Section 21(h) contains no indication that it was considered that
hospitals’
in—house identification of waste was faulty;
the
dissatisfaction lie solely with the holding, transporting and
ultimate disposal methods.
Hospital
No change.
Incineration
This definition has been added.
Innocuous Hospital Waste
The Board has added that this waste
“is not a special waste.”
This reflects the Board’s original intent as expressed
in its
December 24 Opinion,
and should remove any further doubt.
Normal Hospital Waste
The Board has also added that this “is not a special waste.”
It was suggested that there was an overlap between the definition
of infectious agent, now deleted,
and the first sentence of the
definition of “hazardous
(infectious) hospital waste”
(PC 12).
In light of the redefinition of
“hazardous (infectious) hospital
a.
All wastes originating from persons in isolation for control
and treatment of an infectious disease.
h.
Bandages,
dressings,
casts,
catheters,
tubing and similar
disposal items, which have been in contact with wounds,
burns,
anatomical tracts or surgical incisions,
and which
are suspect or have been medically identified
as infectious
and potentially hazardous.
c.
All anatomical waste,
including human and animal parts or
tissues removed surgically or at autopsy.
d.
Laboratory and pathology waste of an infectious nature which
has not been autoclaved.
e.
Any other waste, as defined by the Minnesota Department
of
Health, which, because of its hazardous infectious nature,
requires special handling and disposal
in the manner pre-
scribed for
(a) through
(d).
4 1—522
7
waste,” the first sentence of this “normal” definition has been
deleted to leave only the illustrative examples.
Sterilization
There were no comments concerning this requirement,
so there
has been no change.
Rule 902
Disposal methods for hospital waste
Rule
902 has been changed only by addition in subsection
(b)
of the requirement that the incinerator used be one
“for which
the Agency has issued a permit.”
This language had been included
in 902(c) and was not included in 902(h)
through oversight.
Rule
903
Rendering hazardous
(infectious) hospital waste
innocuous by sterilization
The Rule has been internally renumbered, due to deletion
of former rule 903(b) which would have required segregation and
identification of sterilized hospital waste.
Deletion of this
segregation requirement was suggested
in PC
9,
10,
13,
14, and
15, and by several hearing participants
(e.g.
R.
251, 404,
446).
The purpose of this requirement,
which had been included to
provide an indication to waste haulers and landfill operators that
such waste could be
lawfully accepted,
has been fulfilled in other
ways. First,
the process of autoclaving material enclosed in a
“biohazardous” bag gives
a visual indication that it has been
rendered innocuous,
as it warps the bag
(R.
391—392).
Secondly,
some landfill operators have required hospitals to sign indem-
nification agreements which warrant that their waste
is all
“non—hazardous”
(R.
398,
421—423).
Rule
904
Incinerator Permit Issuance
Rule 905
Agency Criteria
Both of these rules have been deleted in their entirety.
While the Agency has not commented on these or any of the other
proposed rules,
it did, through attorney Richard Warrington,
present testimony that:
“The Agency permits incinerators based on two
criteria.
One is particulates and the other
is carbon
monoxide. ~
The problem of developing the criteria
to permit or not to permit a particular incinerator
for the infectious nature of
...
air emissions will
be unique in the United States, as far as
I know.
41—523
8
In order to do that,
we would have to develop a test
procedure that would be objective and verifiable.
As
such, we do not have one.
And,
I believe there is a
literature search going on right now”
(R.
319,
321).
The Agency could give no estimate as to when its “objectively
verifiable and scientific” test procedure might be developed.
In reply, James Ahrens of the Illinois Hospital Association
(IRA) pointed out that:
“hospitals are making capital expenditures, some of them
very major, based upon the assumption that the Agency
will permit these incinerators ~
people are out there
buying incinerators and assuming that the current
manufacturing standards
...
will be adequate to meet
the needs of this piece of legislation.
So, delay or
change
in
regulations
later on is just going to add
to the cost of
a
lot of things”
(R. 331—332).
Similar ideas were expressed in written comments
(PC
9,
10).
Rules
904 and 905 were originally drafted
to address the twin
problem of infectious material going up the incinerator stack or
remaining
in the incinerator ash to he transported for disposal
in
a landfill.
The Board is aware that some infectious agents are
very resistant to heat; however,
it would seem that the greatest
potential for problem would stem from improper operation of the
incinerator and resulting lack of combustion sufficient to com-
pletely reduce all the waste to innocuous ash.
Given the apparent
lack of stack or incinerator ash testing procedures
for infectious
material, the Board believes the prudent approach at this time
is
to delete Chapter
9 permitting requirements.
If an incinerator
is improperly charged (loaded),
so that combustion is incomplete,
and material
is forced up the stack, this will result
in a vio-
lation of the Board’s Chapter
2 particulate emission standards,
and will trigger enforcement under those rules.
Also,
the Board
has drafted new Rule 904 to require proper operation,
and has
incorporated a flexible incinerator record keeping requirement
into Rule 905 (which details will be discussed below).
Enforce-
ment can proceed under these two rules
if necessary.
In taking this approach,
the Board believes that it has struck
the proper balance between the need to protect public health and
the need to avoid any unnecessary health care expenditures to com-
ply with Section 21(h) of the Environmental Protection Act.
The
Board also wishes to note its concern that any increase
in volume
of waste which must be incinerated could
lead to improper charging
and overloading of incinerators; the Board assumes that the Agency
will consider this factor in developing Chapter
2 monitoring and
inspection schedules.
4
1—524
9
Rule 904
Rendering hazardous
(infectious) hospital waste
innocuous by incineration
The reasons for this new rule are as discussed above.
Rule 905
Recordkeeping requirements for generators of hazardous
(infectious) hospital waste
The comments of the IRA and others expressed concern that the
originally proposed Rule 905 would require unnecessary and costly
recordkeeping
(R.
252,
PC
9,
10,
13).
The rule has been rephrased to reflect the Board’s intent,
which is as follows:
a.
The records describing approximate amounts of waste are
required primarily to assure that a sufficient amount of isolation
waste, consistent with the type of patient care offered by a par-
ticular hospital,
is actually being incinerated and/or sterilized.
The revised rule calls for an approximation of the amount of
incinerated or sterilized waste.
The purpose of the rule is to
aid in detection of unauthorized deposit of waste in a landfill.
For example,
if no infectious waste is incinerated,
and none
autoclaved, enforcement action would seem to be needed,
since it
is reasonable to expect that every hospital will generate some
infectious waste.
Precise weighing
is therefore not required,
nor is precise calculation of volume; the requirement is of a
good faith estimate.
Obviously,
if all waste generated in a
hospital
is sterilized or incinerated, the records need only
to indicate that fact.
b.
The requirement to show proper equipment operation
reflects the need to provide assurance that the statutory mandate
to render the the waste innocuous is being met.
If records are
already kept to comply with existing air pollution, special waste
regulations, and good hospital practice and these, singly or
combined show proper handling and equipment operation, then these
would suffice.
Sterilizer Operation Records.
The spore assay tests are
similar to procedures already
in use by hospitals
in conjunction
with their processing of products to be used for patient care,
and both the IDPH and the JCAH currently provide close oversight
in this area (see IDPH Hospital Licensing Requirements, Part IX,
Section C “Sterilization and Processing of Supplies,”
Illinois
Register Vol.
5,
pp.
548—49,
R.
302—304,
307,
310).
If a steri-
lizer is operated improperly, waste is not rendered innocuous as
required by Section 21(h).
Biological
spore assay can indicate
only that the sterilizer is functioning on that particular day
(R.
305):
the Board has required only weekly tests for the com-
monly used autoclaves.
To be certain each load was rendered
41—525
10
innocuous,
the Board could require that “sterile tape” be put on
each biohazard bag, but at approximately $.16 per bag this would
not be cost effective
(see R.
391).
Another option would he to
require that a spore assay test be put
in every sterilizer
load
(at $1.00 per load), and then to require that the sterilized waste
be stored for the 24-48 hour period until the spore assay had
incubated and complete sterilization had been confirmed.
Waste
storage and biological monitoring would of course impose additional
costs
(R.
309—311).
The Board does concur that there is no need to duplicate
reporting forms, particularly
as it
is not required that the
records be submitted to the Agency, only that they be available
for Agency inspection at reasonable
times in reasonable manners.
Accordingly new subsection
(b) explicitly provides that records
kept for IDPH or JCAH purposes may be used to satisfy this
requirement.
Incinerator Operation Records.
The Board
is aware that
while hospital sterilization procedures are currently monitored
by IDPH, hospital
incineration procedures are not
(R.
308).
The
Board is also aware that incinerators vary
in type and cost,
and
that the highly automatic “Cadillac” of incinerators may well
have monitoring equipment which is not to be found on the older
incinerators.
It is not the Board’s intent in drafting this rule
to cause a hospital
to needlessly “trade—up”
in incinerator class,
or to retrofit with expensive monitoring equipment.
The Board
does intend that each hospital develop as good a system of
housekeeping practices for incinerator use as for sterilizer use.
Written operating and maintenance instructions shall be maintained
(cf. IDPH Hospital Licensing Requirements, Part XVI,
“Maintenance,”
Illinois Register, Vol.
5,
p.
579), as well as records appropriate
to the type of incinerator of its use.
The Board continues to believe that maintenance of some
records is a necessary enforcement tool, and that
the
records to
be kept under Rule 905 add little,
if any new costs.
(In fact,
hospitals who choose to sterilize their waste before depositing
it
in a landfill will be required to keep less complex records
than would be required under H.B.
453,
as disposal of
a hazardous
waste requires use of the Chapter
9 manifest system.)
Rule 906
Defense to enforcement action
The word “enforcement” has been inserted before the word
“action” in the text of the rule in response to JCAR suggestion.
This was done
to clarify that no civil remedies have been impaired
in violation of Section 45(a)
of the Act.
ECONOMIC IMPACT ISSUES
The Illinois Institute of Natural Resources
(Institute)
is
currently in the process of developing an economic impact
study.
1~1—S7t~S
11
Therefore,
no hearings have been held pursuant
to Section 27(b)
of the Environmental Protection Act to receive comments concerning
this economic impact study.
The Board is promulgating these
regulations
in advance of completion of the study because a)
the
economic impact flows from the statute and not the regulations,
and b) the same public health issue that generated the adoption
of the emergency rules
remains.
Section 27(b)
of the Act charges the Board when adopting
regulations to:
“consider those elements detailed in the Institute’s
study and..,
in
the
Board’s
written opinion, make
a determination, based upon the Institute’s study
and other evidence in the public hearing record,
as
to whether the proposed regulation has any adverse
economic impact on the people of the State of Illinois.”
(emphasis added)
The hearing record clearly shows that requiring disposal of
infectious waste by means other than deposit in sanitary
land:tills
will increase costs to at least some hospitals, at least in the
short run.*
Some hearing participants seriously questioned whether
there were benefits to weigh against the costs
(e.g.
R.
347—389).
While the Institute’s
study could, considering
all relevant factors,
suggest that the net economic effect of the regulations is adverse,
any such finding by the Board would he irrelevant in the unique
circumstances of this rulemaking.
Were this a proceeding before the Board pursuant to Section
22(h)
to determine whether land burial of this waste should be
prohibited,
taking into account the technical feasibility, eco-
nomic reasonableness and environmental soundness of all available
disposal options, the Institute’s study would be of considerable
assistance to the Board
in its deliberations.
However,
in passing
Section 21(h),
the legislature has already determined the economic
reasonableness and environmental soundness of the landfill prohi-
bition.
The primary economic impacts therefore flow from the
legislation, and not from the regulations.
The Board’s regulatory
mandate was to fill in the fine details of the broad legislative
enactment.
To the extent that the Board has had discretionary
choices as to how to implement this legislation,
for instance in
determining whether
to require simple or complex recordkeeping,
the Board has,
as is evident, considered the relative economics
in relation to the relative benefits.
It
is therefore the Board’s
*For example,
one administrator of
a 340 bed hospital
testified that, based on capital investment of $15,000 to $200,000
for an incinerator,
and an annual operating expense in energy and
manhours of $37,000, that compliance would cost his hospital in
excess of $77,000 per year
(H.
441—442).
However, another
hospital, with 318 beds,
is considering purchase of a $14,000
sterilizer
(no operating costs computed)
(H.
431).
4
1—527
12
opinion and finding that it has,
under the unique circumstances
of this rulemaking,
satisfied the requirements of Section 28(b)
of the Act.
Even had the Board not made this finding pursuant to Section
28(b), Section 28(c) would authorize promulgation of these rules
pending completion of the Institute’s
study.
The emergency rules
which these rules replace expire May 31,
1981.
Lack of regulations
to implement Section 21(h) will create the same severe threat to
public health which prompted promulgation of the emergency rules
adopted December
18,
1980.
The variance granted by the Board in
Mercy Hospital Medical Center and Illinois Hospital Association
v.
IEPA, PCB 80—218
(December 18, 1980,
and January
22,
1981) was
from its regulations implementing Section 21(h).
If regulations
are not in place,
the variance
is rendered meaningless.
Landfill
operators will no longer be able
to
accept hazardous
(infectious)
hospital waste lawfully, with the resulting likelihood of improper
storage,
faulty incineration, or surreptitious dumping of hospital
wastes by their generators.
This Opinion constitutes the Board’s findings of fact and
conclusions of
law in this matter.
Mr. Werner concurred.
IT IS SO ORDERED.
I, Christan L. Moffett, Clerk of the Illinois Pollution
Control Board, hereby certify that t~eabove Opinion and Order
were adopted by the Board on the
d~8
day of
_____________
1981 by a vote of
4.~
.
Christan L.
Moff~tt1/j
Clerk
Illinois Pollutio~-’~’ontrolBoard
41—528
