1. NEW YORK STATE APPROVED ALTERNATIVE RMW TREATMENT TECHNOLOGIES Sally M. Patterson Regulated Medical Waste Program Coordinator New York State Department of Health Wadsworth Center Albany, New York (518) 408-1146 (518) 474-7992 (Fax) smp10@health.state.ny.us

2. MEDICAL WASTE TREATMENT TECHNOLOGIES  INCINERATION  AUTOCLAVES  SEWERAGE SYSTEM  ALTERNATIVE TECHNOLOGIES

3. ALTERNATIVES TECHNOLOGIES LOW HEAT TREATMENT SYSTEMS - Steam/Heat - Microwave - Electro Thermal HIGH HEAT TREATMENT SYSTEMS - Plasma Arc - Thermal Depolymerization CHEMICAL TREATMENT SYSTEMS - Sterilants and Solidifiers - Alkaline Hydrolysis

4. ADVANTAGES AND DISADVANTAGES OF INCINERATION Advantages Disadvantages Volume Reduction High Investment Costs Weight Reduction High Operating Costs Waste Unrecognizable Air Pollutant Emissions Suitable for All Waste Types Public Opposition Heat to Energy Recovery Bottom and Fly Ash Residue

5. ADVANTAGES AND DISADVANTAGES OF AUTOCLAVES Advantages Disadvantages Low Investment Cost Waste Appearance Unchanged Low Operating Costs Waste Volume Unchanged Ease of Quality Control Unsuitable All Waste Types Limited Environmental Hazards Potential Air Emissions Widely Accepted Technology Ergonomic Concerns

6. ADVANTAGES AND DISADVANTAGES OF LOW HEAT TREATMENT Advantages Disadvantages Waste Unrecognizable High Investment Costs Volume Reduction Unsuitable for all Waste Types Limited Liquid Discharge Slight odor Minimal Emissions Shredder Interference Possibility Automated/Easy to Use Prolonged Treatment Cycle

7. ADVANTAGES AND DISADVANTAGES OF HIGH HEAT TREATMENT Advantages Disadvantages Volume Reduction High Investment Costs Weight Reduction High Operating Costs Waste Unrecognizable Air Pollutant Emissions Treats All Waste Types Suitable for Only Large Operations Heat to Energy Recovery No Track Record

8. ADVANTAGES AND DISADVANTAGES OF CHEMICAL TREATMENT Advantages Disadvantages Rapid Treatment High Investment Costs Waste Unrecognizable Unsuitable For All Waste Types Volume Reduction Potential Air Emissions Waste Deodorization Ergonomic Concerns Suitable For Small Generators Chemical Storage Required

9. OFF-SITE TREATMENT  Transport, storage, treatment and disposal services provided by waste management firms and haulers  Potential Liability  Occupational Injury  Roadway Accidents – Spills  Transport Regulations

10. ON-SITE TREATMENT  SELECT AGENTS  STATE REQUIREMENTS - SITE NOTIFICATION - OPERATIONAL PLAN - VALIDATION PROTOCOL

11. TRANSPORT COSTS  20 cents/lb. – Untreated medical waste 7-9 cents/lb. – Treated medical waste 4-5 cents/lb. – Solid waste  Hidden Hauling Costs

12. ALTERNATIVE TECHNOLOGY COST COMPARISON PROCESS TECH VENDOR COST LOW HEAT THERMAL Autoclave San-I-Tec 26,000-500,000 Autoclave/Shred Tempico 382,000 Steam/Shred/Chemical Sterile Tech. Industries 367,000-427,000 Steam/Shred WPS Company 200,000 Dry-Heat Univec 4,000 MICROWAVE Microwave Treatment Sanitec 500,000-600,000 Microwave Treatment CMB 45,000 CHEMICAL Sodium Hypochlorite Circle Medical Products 295,000 1N Sodium hydroxide WR2 365-000-420,000 HIGH HEAT THERMAL Plasma Pyrolysis Startech Environ. Tech 600,000 – 1 Million Plasma Pyrolysis Integrated Environ. Tech. Thermal Depolymerization Changing World Tech.