1. Canadian Experience – Medical Waste Combustion Prepared for the CEC North American Strategy for Catalyzing Cooperation on Dioxins, Furans and HCB Source Control Workshop April 17-18, 2008 Leon, Guanajuato, Mexico

2. DRAFT – Page 2 – November 21, 2015 Overview of Medical Waste Incinerators in Canada In 2000 – estimate of 120 hospital incinerators In 2006 – 42 medical waste incinerators were identified –Annual throughput ranges from 1 Mg/yr to 2,000 Mg/yr Few details available on process equipment and air pollution controls for majority of units –Some 2- and 3-stage combustors, multiple chambers –Range of air pollution controls include: ▪None; ▪Scrubbers; ▪Combinations of techniques/controls, including: –evaporative cooling tower or rapid quench, –dry scrubber with powdered activated carbon or packed toward with reagent addition, and –fabric filters or venturi scrubbers –1 commercial facility known to have heat recovery Medical waste: any waste which includes as a component any Biomedical Waste as defined in the February 1992 CCME Guidelines for the Management of Biomedical Waste in Canada, with the exception that animal wastes derived from animal health care or veterinary research and teaching establishments are excluded. In Canada, the responsibility for waste management is shared between the federal government and provincial/ territorial governments. –Jurisdictions often work together through the Canadian Council of Ministers of the Environment (CCME) on waste management issues.

3. DRAFT – Page 3 – November 21, 2015 Emissions Data In 1999, medical waste incinerators estimated to release 25 grams 1 In 2006, the sector was estimated to release approximately 3.1 grams of PCDD/DF 2 Little information available on releases of HCB from this sector. 1 – Environment Canada, Canadian Inventory of Releases of PCDDs/PCDFs, Updated Edition, February 2001 2 – A.J. Chandler and Associates Ltd., Review of Dioxins and Furans from Incineration, prepared for the Canadian Council of Ministers of the Environment, 2007. http://www.ccme.ca/assets/pdf/1395_d_f_review_chandler_e.pdf http://www.ccme.ca/assets/pdf/1395_d_f_review_chandler_e.pdf

4. DRAFT – Page 4 – November 21, 2015 Canadian Approach CCME Canada-wide Standards (CWS) for Dioxins and Furans from Waste Incineration (April 2001) http://www.ccme.ca/assets/pdf/d_and_f_standard_e.pdf http://www.ccme.ca/assets/pdf/d_and_f_standard_e.pdf –For new or expanding facilities of any size, application of best available pollution prevention and control techniques, such as a waste diversion program, to achieve a maximum concentration 1 in the exhaust gases from the facility as follows: ▪Medical Waste Incineration 80 pg ITEQ/m 3 –For existing facilities application of best available pollution prevention and control techniques, to achieve a maximum concentration 1 in the exhaust gases from the facility as follows: ▪Medical waste incineration ▪> 26 Tonnes/year 3 80pg I-TEQ/m 3 ▪< 26 Tonnes/year 4 80pg I-TEQ/m 3 1 Stack concentrations of dioxins and furans will be corrected to 11% oxygen content 3 Larger facilities must achieve this stack concentration as confirmed by annual testing. 4 Smaller facilities must make determined efforts to achieve this stack concentration.

5. DRAFT – Page 5 – November 21, 2015 Canadian Approach (continued) Jurisdictions are using variety of tools to implement the CWS. For example: –British-Columbia banned medical waste incinerators in 1998 –Ontario Regulation 347 – required existing medical waste incinerators to cease operations by Dec. 2003. (Environmental Protection Act) There is a now a large, commercial medical waste incinerator which is required to meet the CWS limits. –Manitoba – developing a strategy to address both the D/F and Mercury CWS limits –Alberta - incorporating limits into facility approvals under the Alberta Environmental Protection and Enhancement Act –New-Brunswick – incorporating limits into conditions of individual facilities’ Approvals to Operate issued under the Air Quality Regulation – Clean Air Act. –Prince-Edward Island – incorporating limits into the terms and conditions of the permit to operate an incinerator pursuant to the Air Quality Regulations of the Environmental Protection Act.

6. DRAFT – Page 6 – November 21, 2015 Effectiveness/ Lessons Learned The PCDD/DF Incineration Canada-wide Standards have been effective at reducing emissions of dioxins and furans from medical waste incinerators : –87 % reduction achieved since 1999, primarily through closure of hospital waste incinerators Lessons learned: –phase out old incinerators and replace with new technology Report on progress in achieving the CWS to be delivered in Spring 2008. The report is to evaluate: –Whether targets have been met –Effectiveness

7. DRAFT – Page 7 – November 21, 2015 Further Information Review of Dioxins and Furans from Incineration In Support of a Canada-wide Standard Review, http://www.ccme.ca/assets/pdf/df_incin_rvw_rpt_e.pdf http://www.ccme.ca/assets/pdf/df_incin_rvw_rpt_e.pdf Bob Larocque, a/Chief Waste Programs Chef intérimaire, Programme des déchets 70 Cremazie, 6th floor Gatineau, Quebec 819-953-2242 Robert.Larocque@ec.gc.ca