Standards of Performance for New Stationary Sources and Emission Guidelines for Existing Sources: Medical Waste Incinerators

Federal RegisterJun 20, 1996

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SUMMARY: On February 27, 1995, EPA proposed new source performance

standards (NSPS or standards) and emission guidelines (EG or

guidelines) for new and existing medical waste incinerator(s) (MWI)

that will reduce air pollution from MWI. Once implemented, these

standards and guidelines will protect public health by reducing

exposure to air pollution. In the proposal preamble, EPA made a

commitment to reconsider the proposed NSPS and EG based on new

information submitted. Today's action presents an assessment of the

supplemental information submitted following the proposal and solicits

public comment on this assessment. Today's action also serves to

address comments received on the proposal and reopens the comment

period for development of the MWI standards and guidelines.

DATES: Public Meeting. A public meeting will be held on July 10, 1996

beginning at 9:00 a.m. At the public meeting, EPA will review the

contents of this notice and answer questions so that commenters can

better prepare their written comments. See ADDRESSES below for the

location of the meeting.

Comments. Comments are requested on all information associated

with the development of MWI standards and guidelines. Written comments

must be received on or before August 8, 1996. See ADDRESSES below.

ADDRESSES: Public Meeting. The public meeting will take place at the

Holiday Inn, Hotel and Suites, 625 First Street, Alexandria, Virginia,

22314, (703) 548-6300. Persons interested in attending the meeting

should notify Ms. Donna Collins, U.S. Environmental Protection Agency,

Research Triangle Park, North Carolina 27711, telephone (919) 541-5578.

Comments. Comments should be submitted (in duplicate, if possible)

to the following: The Air and Radiation Docket and Information Center,

ATTN: Docket No. A-91-61, U.S. Environmental Protection Agency, 401 M

Street, SW, Washington, DC 20460.

Submissions containing proprietary information (Confidential

Business Information) should be sent directly to the following address,

not to the public docket, to ensure that proprietary information is not

inadvertently placed in the docket: Attention: Mr. Rick Copland, c/o

Ms. Melva Toomer, U.S. Environmental Protection Agency Confidential

Business Manager, 411 W. Chapel Hill Street, Room 944, Durham, North

Carolina 27701. See SUPPLEMENTARY INFORMATION for further discussion of

confidential business information.

Docket. Docket No. A-91-61, containing supporting information used

in developing the standards and guidelines, is available for public

inspection and copying between 8:00 a.m. and 4:00 p.m. , Monday through

Friday, at the Air and Radiation Docket and Information Center, U.S.

Environmental Protection Agency, 401 M Street, SW, Washington, DC

20460, telephone (202) 260-7548, fax (202) 260-4000. A reasonable fee

may be charged for copying. See SUPPLEMENTARY INFORMATION for a list of

documents most directly related to today's notice.

FOR FURTHER INFORMATION CONTACT: Mr. Rick Copland at (919) 541-5265 or

Mr. Fred Porter at (919) 541-5251, Emission Standards Division (MD-13),

U.S. Environmental Protection Agency, Research Triangle Park, North

Carolina 27711.

SUPPLEMENTARY INFORMATION: Regulated Entities. Entities potentially

regulated by the standards and guidelines are those which operate

medical waste incinerators. Regulated categories and entities include

those listed in Table 1.

Table 1.--Regulated Entities a

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Category Examples of regulated entities

----------------------------------------------------------------------------------------------------------------

Industry.................................................... Hospitals, nursing homes, research laboratories,

other healthcare facilities, commercial waste

disposal companies.

Federal Government.......................................... Armed services, public health service, Federal

hospitals, other Federal healthcare facilities.

State/local/Tribal Government............................... State/county/city hospitals and other healthcare

facilities.

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a This table is not intended to be exhaustive, but rather provides a guide for readers regarding entities likely

to be regulated by the standards or guidelines for MWI. This table lists the types of entities that EPA is now

aware could potentially be regulated. Other types of entities not listed in the table could also be regulated.

To determine whether your facility is regulated by the standards or guidelines for medical waste incinerators,

you should carefully examine the applicability criteria in sections 60.50(c) and 60.51(c) of the February 1995

proposal and sections II(B), II(H), and II(I) of today's notice. If you have questions regarding the

applicability of the MWI standards and guidelines to a particular entity, consult the person listed in the

preceding FOR FURTHER INFORMATION CONTACT section.

Confidential Business Information. Commenters wishing to submit

proprietary information for consideration should clearly distinguish

such information from other comments and clearly label it

``Confidential Business Information.'' Information covered by such a

claim of confidentiality will be disclosed by the EPA only to the

extent allowed and by the procedures set forth in 40 CFR part 2. If no

claim of confidentiality accompanies a submission when it is received,

the submission may be made available to the public without further

notice to the commenter.

Documents Available Electronically. An electronic version of this

action as well as the February 1995 Federal Register proposal notice

are available for download from EPA's Technology Transfer Network

(TTN), which is a network of electronic bulletin boards developed and

operated by EPA's Office of Air Quality Planning and Standards. The TTN

provides information and technology exchange in various areas of air

pollution control. The service is free, except for the cost of a

telephone call. Dial (919) 541-5742 for data transfer of up to 14,400

bits per second. The TTN is also available on the Internet (access:

TELNET ttnbbs.rtpnc.epa.gov). For more information on the TTN, contact

the systems operator at (919) 541-5384.

Documents in the Docket. The documents listed below are not

available through the TTN, but are available through Air Docket No. A-

91-61 located at the Air and Radiation Docket and Information Center

(see the ADDRESSES section earlier in this

[[Page 31737]]

notice). These documents provide the analyses that are summarized in

this notice.

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Item No. Title

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IV-A-7................... National Dioxin Emission Estimates from

Medical Waste Incinerators.

IV-A-8................... Revised Economic Impacts: Existing Medical

Waste Incinerators.

IV-A-9................... Revised Economic Impacts: New Medical Waste

Incinerators.

IV-B-23.................. PM MACT Floor Emission Levels for Potential

Subcategories of the MWI Source Category.

IV-B-24.................. Determination of the Maximum Achievable

Control Technology (MACT) Floor for Existing

Medical Waste Incinerators that Incinerate

General Medical Waste.

IV-B-25.................. Definition of Medical Waste.

IV-B-26.................. Operator Training and Qualification and

Incinerator Inspection Requirements.

IV-B-30.................. Approach Used to Estimate the Capital and

Annual Costs for MWI Wet Scrubbers.

IV-B-32.................. Revised Costs for Dry Injection/Fabric Filter

Controls for MWI.

IV-B-33.................. Revised Costs for Secondary Chamber Retrofits

for MWI.

IV-B-37.................. Projections for New MWI Population.

IV-B-38.................. Determination of the Maximum Achievable

Control Technology (MACT) Floor for New

Medical Waste Incinerators.

IV-B-39.................. Annual Costs for the Operator Training and

Qualification Requirements for MWI

Operators.

IV-B-43.................. Alternative Methods of Medical Waste

Treatment: Availability, Efficacy, Cost,

State Acceptance, Owner Satisfaction,

Operator Safety, and Environmental Impacts.

IV-B-44.................. Determination of Medical Waste Incinerator

(MWI) Size.

IV-B-45.................. Updated Medical Waste Incinerator Data Base.

IV-B-46.................. PM, CO, and CDD/CDF Average Emission Rates

and Achievable Emission Levels for MWI with

Combustion Controls.

IV-B-47.................. Acid Gases and Metals Typical Performance and

Achievable Emission Levels for Medical Waste

Incinerators with Good Combustion Control.

IV-B-48.................. Wet Scrubber Performance Memorandum.

IV-B-49.................. Dry Scrubber Performance Memorandum.

IV-B-50.................. Cost Impacts of the Regulatory Options for

New and Existing Medical Waste Incinerator

(MWI).

IV-B-51.................. Air Emission Impacts of the Regulatory

Options for New and Existing Medical Waste

Incinerators (MWI).

IV-B-52.................. Potential Solid Waste, Wastewater, and Energy

Impacts of the New Source Performance

Standards and Emission Guidelines for New

and Existing Medical Waste Incinerators.

IV-B-54.................. Testing and Monitoring Options and Costs for

MWI--Methodology and Assumptions.

IV-B-56.................. Standards of Performance for Medical Waste

Pyrolysis Units.

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Acronyms, Abbreviations, and Measurement Units. The following list

of acronyms, abbreviations, and measurement units is provided to aid

the reader.

AHA................................. American Hospital Association

Btu................................. British thermal unit

Cd.................................. cadmium

CEMS................................ continuous emission monitoring

system(s)

CFR................................. Code of Federal Regulations

CO.................................. carbon monoxide

dioxin.............................. dioxins and dibenzofurans

DI/FF............................... dry injection/fabric filter

dscf................................ dry standard cubic foot

dscm................................ dry standard cubic meter

EG.................................. emission guidelines

EPA................................. Environmental Protection Agency

ft3................................. cubic feet

FTE................................. full time equivalent

g................................... grams

gr.................................. grains

HCl................................. hydrogen chloride

Hg.................................. mercury

hr.................................. hour

IV.................................. intravenous

lb.................................. pound

MACT................................ maximum achievable control

technology

m3.................................. cubic meter

MW.................................. megawatt

MSA................................. Metropolitan Statistical Area

Mg.................................. megagram

mg.................................. milligram

MM.................................. million

MWI................................. medical waste incinerator(s)

MWTA................................ Medical Waste Tracking Act

MWC................................. municipal waste combustor

ng.................................. nanogram

NOX................................. Oxides of nitrogen

NRDC Natural Resources Defense Council

NSPS................................ new source performance standards

NYSDOH.............................. New York State Department of

Health

O2.................................. oxygen

Pb.................................. lead

PM.................................. particulate matter

ppmdv............................... parts per million by volume (dry

basis)

SO2................................. sulfur dioxide

STAATT.............................. State and Territorial Association

of Alternate Treatment

Technologies

SWDA................................ Solid Waste Disposal Act

TEQ................................. Toxic Equivalency Quality (dioxin

emissions)

TTN................................. Technology Transfer Network

TCLP................................ Toxicity Characteristics Leachate

Procedure

yr.................................. year

Outline of this Notice. The information in this section is

organized as follows:

I. Introduction

A. The Clean Air Act

B. February 1995 Proposal

C. New Information Since Proposal

D. Purpose of this Supplemental Notice

E. New Timeline for Promulgation

II. Review of New Information

A. MWI Inventory

1. Existing Population

2. Future Installations

B. Subcategorization

C. Performance and Cost of Technology

1. Good combustion

2. Wet scrubbers

3. Dry scrubbers

D. MACT Floor

1. Existing MWI

2. New MWI

E. Baseline Emissions

F. Operator Training and Qualification

G. Testing, Monitoring, and Inspection

H. Definition of Medical Waste

I. Pyrolysis Units

J. Alternative Medical Waste Treatment Technologies

III. Regulatory Options and Impacts for Existing MWI

A. Regulatory Options

B. National Environmental and Cost Impacts

1. Analytical approach

2. Air Impacts

3. Water and solid waste impacts

4. Energy Impacts

5. Cost Impacts

C. Economic Impacts

1. Analytical approach

2. Industry-wide economic impacts

3. Facility-specific economic impacts

IV. Regulatory Options and Impacts for New MWI

A. Regulatory Options

B. National Environmental and Cost Impacts

1. Analytical approach

2. Air impacts

3. Water and solid waste impacts

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4. Energy Impacts

5. Cost Impacts

C. Economic Impacts

1. Analytical approach

2. Industry-wide economic impacts

3. Facility-specific economic impacts

V. Inclinations for Final Rule

I. Introduction

A. The Clean Air Act

The Clean Air Act amendments of 1990 added section 129, which

includes specific requirements for solid waste combustion units.

Section 129 requires the EPA, under section 111(b), to establish NSPS

for new MWI and under section 111(d), to establish EG for existing MWI

based on maximum achievable control technology (MACT). Section 129

establishes specific criteria that must be analyzed in developing these

standards and guidelines. In general, this involves (1) determining

appropriate subcategories within a source category; (2) determining the

``MACT floor'' for each subcategory; (3) assessing available air

pollution control technology with regard to achievable emission

limitations and costs; and (4) examining the cost, nonair-quality

health and environmental impacts, and energy requirements associated

with standards and guidelines more stringent than the MACT floor.

Section 129 also directs EPA to establish operator training

requirements for new and existing MWI as well as siting requirements

for new MWI.

Section 129 requires the EPA to include numerical emission

limitations in the standards and guidelines for the following air

pollutants: particulate matter (PM), opacity, sulfur dioxide

(SO2), hydrogen chloride (HCl), oxides of nitrogen (NOx),

carbon monoxide (CO), lead (Pb), cadmium (Cd), mercury (Hg), and

dioxins and dibenzofurans (referred to in this notice as ``dioxin'').

Section 129 requires that these emission limitations reflect the

maximum degree of reduction in air emissions that the Administrator

determines is achievable, taking into consideration the cost of

achieving such emission reduction and any nonair-quality health and

environmental impacts and energy requirements. This requirement is

referred to as MACT.

The MACT for new MWI may not be less stringent than the emissions

control achieved in practice by the best controlled similar unit. The

guidelines for existing MWI may be less stringent than the standards

for new MWI; however, the guidelines may be no less stringent than the

average emission limitation achieved by the best performing 12 percent

of units in the category. These requirements that the standards and

guidelines must be no less stringent than certain levels are referred

to as the ``MACT floor.''

The Clean Air Act requires EPA to consider standards and guidelines

more stringent than the MACT floor, considering costs and other impacts

described above. If EPA concludes that more stringent standards and/or

guidelines are achievable considering costs and other impacts, then the

standards and/or guidelines would be established at these more

stringent levels (i.e., MACT would be more stringent than the MACT

floor). The EPA may establish NSPS or EG at the MACT floor only if it

concludes that NSPS or EG more stringent than the MACT floor are not

achievable, considering costs and other impacts. In no case may EPA

establish emission limitations less stringent than the MACT floor.

Because standards and guidelines developed under Section 129 are to

reflect the performance capabilities of air pollution control

technology, EPA must assess air pollution control technologies and draw

conclusions regarding their performance. This is often misunderstood

and some assume that the regulations require the use of specific

technology. However, the control technology used to achieve the

standards or guidelines is not specified in the regulations. The

regulations only include specific air pollution emission limits that a

source (i.e., an MWI) must achieve. Any control technology that can

comply with the final emission limits may be used.

B. February 1995 Proposal

On February 27, 1995 (60 FR 10654), EPA published proposed NSPS and

EG for MWI. The proposal was the result of several years of effort

reviewing available information in light of the Clean Air Act

requirements described above.

During the data-gathering phase of the project, it was difficult to

get an accurate count of MWI nationwide. In addition, it was difficult

to find MWI with add-on air pollution control systems in place.

Information from a few State surveys led to an estimated population of

3,700 existing MWI.

Subcategories were determined based on design differences among

different types of incinerators: continuous, intermittent, and batch.

These three design types roughly correlate to MWI size.

A few MWI with various levels of combustion control (no add-on air

pollution control) were tested to determine the performance of

combustion control in reducing MWI emissions. One MWI equipped with a

wet scrubber (add-on control) was tested to determine the performance

capabilities of wet scrubbing systems. A few other MWI equipped with

dry scrubbing systems (add-on control) were tested to determine the

performance capabilities of dry scrubbing systems. These systems were

considered typical of air pollution control systems available at the

time, and the data indicated that dry scrubbing systems could achieve

much lower emissions than wet scrubbing systems.

As mentioned above, the MACT floor for new MWI is to reflect the

emissions control achieved by the best controlled similar unit. Dry

scrubbing systems were identified on at least one MWI in each of the

three subcategories (continuous, intermittent, and batch).

Consequently, the MACT floor emission levels for the proposed NSPS

reflected the performance capabilities of dry scrubbing systems.

For existing MWI under the emission guidelines, State regulations

and permits were used to calculate the average emission limitation

achieved by the best performing 12 percent of units. These results were

then compared with the results of the emission tests on wet and dry

scrubbing systems. This comparison led to the conclusion that the MACT

floor for existing MWI would require the use of a dry scrubbing system,

even for small existing batch MWI.

Following determination of the MWI population, subcategories,

performance of technology, and MACT floors, the Clean Air Act requires

EPA to consider standards and guidelines that are more stringent than

the floors. However, because the MACT floors calculated for the

proposal were so stringent, EPA was left with few options to consider.

Emission limits reflecting the capability of dry scrubbing systems were

proposed for all sizes and types of new and existing MWI.

As mentioned earlier, the proposed standards and guidelines

included numerical emission limits reflecting the performance

capabilities of dry scrubbing systems; however, the proposed

regulations would not require the use of a dry scrubbing system.

Emission limits are included in these regulations rather than control

equipment requirements to encourage competition and further the

development of new technologies. Any technology capable of achieving

the emission limitations in the regulations may be used.

[[Page 31739]]

C. New Information Since Proposal

A proposal is essentially a request for public comment on the

information used, assumptions made, and conclusions drawn from the

evaluation of available information. Following proposal, more than 700

comment letters were received, some including new information and some

indicating that commenters were in the process of gathering information

for EPA to consider. The large amount of new information that was

ultimately submitted addressed every aspect of the proposed standards

and guidelines, including: the existing population of MWI, the

performance capabilities of air pollution control systems, monitoring

and testing, operator training, alternative medical waste treatment

technologies, and the definition of medical waste. In almost every

case, the new information has led to different conclusions, as outlined

below.

D. Purpose of This Supplemental Notice

This notice announces the availability of new information, reviews

EPA's assessment of the new information, provides EPA's inclination as

to how the new information might change the final standards and

guidelines, and solicits comments on EPA's assessments and

inclinations. This new information and these assessments are documented

in more detail in a series of memoranda included in Air Docket No. A-

91-61. A listing of these documents can be found at the beginning of

this notice. This action also reopens the public comment period for the

development of standards and guidelines for MWI. Today's action serves

not only as a review of new information and request for comment, but

also as a response to comments on the proposed rule.

This notice is not a reproposal. The proposal date for the MWI

standards and guidelines remains February 27, 1995. Any MWI that has

commenced construction after February 27, 1995, is considered a new MWI

and will be subject to the NSPS, while any MWI that commenced

construction on or before February 27, 1995, is considered an existing

MWI.

E. New Timeline for Promulgation

In 1993, the EPA, the Sierra Club, and the Natural Resources

Defense Council (NRDC) filed a consent decree with the U.S. District

Court for the Eastern District of New York (Nos. CV-92-2093 and CV-93-

0284) that required the EPA Administrator to sign a notice of proposed

rulemaking no later than February 1, 1995 and a notice of final

rulemaking no later than April 15, 1996.

Because of the large amount of new information and conclusions

drawn from the new information, the EPA deemed it necessary to issue

this supplemental Federal Register notice to provide the public

sufficient opportunity to comment on all information used by the Agency

in developing the NSPS and EG. The Agency requested an extension of the

April 15, 1996 court-ordered deadline, and the court order has been

revised to require the EPA Administrator to sign a notice of final

rulemaking no later than July 25, 1997.

II. Review of New Information

As mentioned earlier, more than 700 comment letters were received

following the February 27, 1995 proposal. An assessment of this

information and some of EPA's inclinations in light of this new

information are presented below.

In general, the following process was used to assess the new

information. The public comment letters were reviewed and categorized

by area of comment. Information related to specific issues (e.g., wet

scrubber performance) was reviewed; meetings were then held to discuss

specific areas of comment with relatively small groups who were

believed to have expertise in specific areas. For example, meetings

with wet scrubber vendors were held to discuss the new information

related to the performance capabilities of wet scrubbers. During the

smaller meetings, additional information was received and comment was

taken. Following the smaller meetings, EPA conducted larger public

meetings on June 15, 1995, September 26, 1995, and February 14, 1996,

to review the assessment of new information and take further public

comment. This Federal Register notice provides EPA's review of all

information received since proposal.

A. MWI Inventory

One of the essential starting points in developing EG and NSPS is

compiling an inventory of existing sources and projecting the number of

new sources expected to be built in the future. The MWI inventory is

the basis for the development of MACT floors, environmental impacts,

cost impacts, and economic impacts. The results of these analyses are

then used to determine MACT.

The inventory of existing sources used in this analysis is a

``snapshot'' of the current population of existing MWI. The inventory

of new MWI potentially subject to the NSPS is a prediction of the

number of MWI that will be built over the next 5 years in the absence

of Federal regulations. The MWI inventories are not exact, but are

representative of current and future MWI populations. Consequently,

they are adequate to allow EPA to make informed decisions in developing

standards and guidelines for new and existing MWI.

1. Existing Population

To estimate the nationwide population of existing MWI at proposal,

available State MWI inventory information was gathered. Where MWI

information was not available for a particular State, the State's human

population was used to estimate the MWI population. Human population

was selected as the basis for extrapolation because it is logical that

the amount of medical waste generated (and, therefore, the MWI

population) would correlate with human population. This extrapolation

was a straightforward computation with readily available data; however,

detailed State inventory data were only available from 11 States. This

method resulted in an estimated 3,700 MWI burning general medical

waste.

Following proposal, a number of comments were received regarding

the inventory of existing MWI. Several commenters suggested that the

population of MWI was overestimated. The American Hospital Association

(AHA) submitted comments that included a compilation of approximately

2,200 existing MWI.

To compile a new EPA inventory, the AHA inventory was used as a

starting point. Other sources of information, including State surveys

and a data base of MWI operating permits, were also used to refine the

inventory. Following this initial compilation, the inventory contained

approximately 2,600 MWI. During the September 26, 1995 public meeting,

several stakeholders voiced concern that many of the incinerators

listed in EPA's MWI inventory had ceased operation. To address this

concern, the Agency requested additional information to update the

inventory. Additional information was received from State agencies,

commercial medical waste disposal companies, and MWI vendors. Medical

waste incinerator units were deleted or added based on the new

information provided. Following these revisions, the final EPA

inventory contains approximately 2,400 MWI; this inventory is located

in the docket as item No. IV-B-45.

The inventory also contains information such as MWI type

(continuous/intermittent or batch fed), capacity, and location, as well

as State

[[Page 31740]]

regulatory or permit emission limits. Every MWI in the inventory is

assigned an MWI capacity in pounds per hour (lb/hr) or pounds per batch

(lb/batch). Location information includes rural or urban designations

based on Metropolitan Statistical Area (MSA) boundaries for the U.S.

Facilities within MSA boundaries were considered urban MWI; facilities

outside MSA boundaries were considered rural MWI. Emission limitations

were determined by examining air quality permits, where available, or

examining the emission limitations included in State regulations.

2. Future Installations

Projections of new MWI were made to estimate the costs and other

impacts associated with NSPS. To estimate the number of new MWI that

would be subject to the NSPS, historical sales data were obtained from

MWI vendors. For the proposal, it was estimated that, in the absence of

Federal regulations, 700 MWI would be installed during the 5 years

following proposal (140 MWI per year). This projection was based on

historical sales data gathered from 1985 through 1989.

To update the projection of new MWI that would be subject to the

NSPS, additional data were gathered from MWI vendors following the

proposal. Historical sales data were gathered covering years 1990 to

1995. Based on this new data, 235 MWI are expected to be installed in

the next 5 years in the absence of the NSPS (47 per year). This

projection covers the years 1996 to 2000. The memorandum documenting

the procedures used to estimate the population of new MWI is located in

the docket as item IV-B-37.

B. Subcategorization

Section 129 of the Clean Air Act states that the Administrator may

distinguish among classes, types, and sizes of units within a category

in establishing the standards and guidelines. At proposal, the Agency

concluded the MWI population should be divided into three

subcategories: (1) Continuous MWI, (2) intermittent MWI, and (3) batch

MWI. While these three subcategories were based on design differences

of the MWI, they also correlate roughly with size or MWI capacity.

During the public comment period, a number of comments were

received regarding subcategorization. Several commenters suggested that

EPA subcategorize directly by MWI size. Others suggested that EPA

subcategorize MWI based on heat input capacity. Other commenters

suggested that the Agency set standards based on the location of MWI;

these commenters expressed concern about the lack of medical waste

disposal options in remote rural locations.

Three criteria were subsequently considered in reexamining

potential subcategories: size (capacity to burn medical waste); type

(continuous/intermittent versus batch); and location (urban versus

rural). The first two are clearly identified in Section 129 and have

been used in other Federal regulations as criteria for

subcategorization. Location, by itself, is not a valid criterion for

subcategorization. However, in this case, it is used as a surrogate

measure of the availability of alternative waste disposal options.

Medical waste incinerators located in remote areas might be considered

as a separate ``class'' of incinerator because of the limited

availability of alternative waste disposal options in rural areas.

As mentioned earlier, the MACT floor is the least stringent

regulatory option allowed under the Clean Air Act. Consequently, the

MACT floors were examined using the EPA MWI inventory for various

potential MWI subcategories. Because PM is, by far, the most common

type of emission limitation in State regulations and permits, the PM

MACT floor was the focus in this analysis. Subcategories were

established when significant differences in PM MACT floors were

identified.

The most common size breaks used by States in regulating MWI occur

at 100, 200, 500, 1,000, and 2,000 lb/hr. The MACT floor emission

levels for these size breaks were evaluated to determine appropriate

size breaks for regulation. Significant differences in MACT floors were

identified at 200 lb/hr and 500 lb/hr. Consequently, the three size

ranges determined to be appropriate for the purpose of regulating MWI

are presented in Table 2.

Table 2.--Number of MWI and Size Ranges for Subcategories

------------------------------------------------------------------------

Number

MWI subcategory Size range, lb/hr of MWI

------------------------------------------------------------------------

Small................................ 200.......... 1,139

Medium............................... >200 and 500. 692

Large................................ >500.................... 542

------------------------------------------------------------------------

The three basic design types of MWI are continuous, intermittent,

and batch. A distinction between continuous and intermittent MWI based

on design type may not be appropriate because these two types of units

are essentially identical with the exception of the ash handling

system. Also, the information used to develop the population of

existing MWI does not distinguish between continuous and intermittent

MWI. Batch MWI, however, are very different from intermittent and

continuous units. As a result, batch MWI were further examined to

determine if the MACT floor emission levels are different than those

for continuous and intermittent MWI within the same size range; no

significant difference in MACT floor emission levels was found.

The final criterion considered was location (urban vs. rural). This

analysis focused on the small MWI because commenters were particularly

concerned about small, rural MWI. The MACT floor emission levels for

small urban MWI and small rural MWI, however, were found to be

essentially the same.

Based on the new information, the Agency is inclined to

subcategorize the existing and new population of MWI into three

subcategories as shown in Table 2: small (200 lb/hr), medium

(>200 and 500), and large (>500). The memorandum that

details the procedures used to assess the subcategories is found in the

docket as item IV-B-23. Further subcategorization may be considered in

examining standards and guidelines more stringent than the MACT floors

(see Sections III and IV).

Directly related to the question of using size or burning capacity

to subcategorize MWI, the proposal requested comment on a ``standard''

method of determining MWI size for the purpose of consistent, uniform,

and equitable application of whatever standards and guidelines are

adopted. Comments responding to this request focused on the design heat

release rate of the MWI expressed in British thermal units per hour per

cubic foot (Btu/hr-ft3) in the primary combustion chamber and the

heat content of medical waste expressed in British thermal units per

pound (Btu/lb). Most MWI manufacturers base their design capacities on

these two factors.

In considering and/or adopting a ``standard'' means of determining

MWI size, EPA is not attempting to establish design requirements for

MWI manufacturers. Instead, the only purpose of adopting a standard

method for determining the size of MWI is to ensure that all MWI of the

same ``size'' are subject to the same requirements.

The design heat release rate used by most vendors of continuous and

intermittent MWI is typically 15,000 Btu/hr-ft3. The heat content

of medical waste can vary substantially from 1,000 Btu/lb for

pathological waste to over 10,000 Btu/lb for waste with a high

[[Page 31741]]

plastics content. The heat content generally associated with medical

waste for the purpose of determining nameplate capacity has been 8,500

Btu/lb. The combination of 15,000 Btu/hr-ft3 and 8,500 Btu/lb

results in a volumetric waste burning capacity of 1.76 lb/hr-ft3.

The volume of the primary chamber is multiplied by 1.76 to determine

the size of the MWI. A continuous or intermittent MWI with a primary

chamber volume of 500 ft3 would be sized at 880 lb/hr for the

purpose of determining regulatory requirements.

For batch MWI, the calculation is slightly different. Batch MWI

charge all waste to be burned when the unit is cold. No additional

waste is added during the combustion cycle. The unit is then allowed to

cool before ash is removed and more waste is charged. These units are

given a designation of pounds per batch (lb/batch) rather than lb/hr

and usually take about 12 hours to completely burn the waste. The

density of medical waste is about 4.5 lb/ft3. Consequently, the

combination of 4.5 lb/ft3 and 12 hours per batch yields a

volumetric waste burning capacity of 0.375 lb/hr-ft3. The volume

of the primary chamber would be multiplied by 0.375 to determine the

size of the MWI. A batch MWI with a primary chamber volume of 500

ft3 would be sized at 188 lb/hr for the purpose of determining

regulatory requirements. A more detailed description of the MWI size

methods described above for continuous, intermittent, and batch MWI can

be found in the docket as item IV-B-44.

During a meeting with MWI vendors, it was suggested that MWI size

should be determined by the unit's operating permit rather than its

design capacity. Many States allow MWI to meet less stringent

requirements associated with smaller MWI as long as the MWI is subject

to a permit condition limiting the amount of waste burned.

Consequently, while EPA is inclined to determine MWI size by the

criteria described above, EPA is also considering inclusion of an

option to allow an MWI to change its size designation by operating

under a Federally enforceable requirement limiting the amount of waste

burned (i.e., waste feed rate--lb/hr). For example, a continuous or

intermittent MWI with a 340 ft3 primary chamber, with a design

capacity of about 600 lb/hr (i.e., ``large''), using the procedure

outlined above, could be considered a ``medium'' MWI by operating under

a Federally enforceable requirement limiting its charge rate to no more

than 500 lb/hr. A batch MWI with a 1,000 ft3 primary chamber, with

a design capacity of about 4,500 lb/batch or 375 lb/hr (i.e.,

``medium''), using the procedure outlined above, could be considered a

``small'' MWI by operating under a Federally enforceable requirement

limiting its charge rate to no more than 2,400 lb/batch (200 lb/hr).

Finally, some commenters expressed concern about facilities

installing multiple small MWI at one location in an effort to be

subject to less stringent requirements. Commenters believed this should

not be allowed. Consequently, EPA is inclined to combine the waste

burning capacity of multiple units at one location to determine size.

As stated above, such facilities could still operate under a Federally

enforceable permit limiting their operating capacity to change their

size designation.

C. Performance and Cost of Technology

Section 129 of the Clean Air Act directs the EPA to develop

regulations for MWI that are based on the use of MACT, which is defined

as the maximum reduction in emissions of air pollution the EPA

considers achievable, considering costs, environmental, and energy

impacts. However, Section 129 also states that, for existing MWI, these

regulations can be no less stringent than the average of the best 12

percent of existing MWI, and for new MWI, they can be no less stringent

than the best similar MWI. These minimum stringency requirements for

the regulations are referred to as the ``MACT floors.'' The emission

limits in the final regulations can be no less stringent than the

``MACT floor'' emission levels.

The ``MACT floors'' for the regulations are discussed in detail in

another section of this notice. However, these ``MACT floors'' are only

the starting point for determining MACT. Since MACT is the maximum

reduction in air pollution emissions that is achievable, considering

costs, environ-mental and energy impacts, if more stringent emission

levels than the MACT floor emission levels are achievable, the EPA must

identify these more stringent emission levels and consider them in

selecting the MACT emission limits for MWI.

The EPA determines whether more stringent emission levels than the

MACT floor emission levels are achievable by identifying various air

pollution control technologies used to reduce emissions from MWI. Next,

the EPA gathers and analyzes data on these technologies and draws

conclusions regarding their performance--in terms of their ability to

reduce air pollution emissions. The EPA then is able to determine MACT

as follows.

After the MACT floors have been determined, the EPA can identify

what air pollution control technologies would need to be used by MWI to

achieve or comply with regulations based on these MACT floors. Then the

EPA can identify those air pollution control technologies that are

capable of achieving more stringent emission levels than the MACT

floors. The EPA is then able to analyze and consider these more

stringent emission levels in terms of the cost, environmental, and

energy impacts associated with their use compared to the use of the air

pollution control technologies that can achieve the MACT floor emission

levels. This analysis and consideration serves as the basis for the EPA

to determine MACT.

All of this analysis, with its focus and discussion of air

pollution control technology, is often misunderstood and leads some to

assume that the regulations require the use of a specific air pollution

control technology, which is not the case. The air pollution control

technology used to achieve or comply with the regulations is not

specified in the regulations. The regulations only include emission

limits (i.e., concentration levels in the gases released to the

atmosphere) for specific air pollutants (e.g., hydrogen chloride, lead,

etc.) that an MWI must achieve. The decision on how to meet these

emission limits is left to the MWI owner or operator; an MWI owner or

operator may select any equipment or any means available to comply with

these emission limits.

At the time of proposal, relatively few emission test reports were

available to the EPA from which to draw conclusions regarding the

performance capabilities of various air pollution control systems. The

data indicated that dry scrubbing systems could achieve much lower

emission levels than wet scrubbing systems and that either type of

scrubbing system could achieve much lower emission levels than

combustion controls (i.e., good combustion) alone.

Following proposal, a number of emission test reports were

submitted to EPA. Many commenters believe that EPA misjudged the

performance capabilities of various air pollution control technologies,

especially the capabilities of wet scrubbing systems. The EPA has

reviewed the data contained in these emission test reports and, as

summarized below, EPA's conclusions regarding the performance

capabilities of various air pollution control technologies have been

revised.

Relatively few comments were received regarding EPA's estimates of

the costs of air pollution control technology. The majority of the

[[Page 31742]]

comments regarding cost pertained to wet scrubbing systems. The

reassessment of costs is discussed briefly below for each control

technology.

1. Good Combustion

Combustion controls (i.e., good combustion) are effective in

reducing emissions of combustion-related pollutants, such as PM, CO,

and dioxin, but are not effective in reducing emissions of waste-

related pollutants, such as acid gases or metals. For the combustion-

related pollutants, combustion controls can be divided into two levels

(i.e., 1-second and 2-second residence time) and the achievable

emission levels associated with the use of each of these levels have

been reassessed. In addition, achievable emission levels for waste-

related pollutants were also reassessed. For waste-related pollutants,

performance between the two levels of combustion control is not

distinguishable. The results of the reassessment of combustion control

are shown in Table 3 and are available as item Nos. IV-B-46 and IV-B-47

in the docket.

Table 3.--Achievable Emission Levels For Combustion Control

------------------------------------------------------------------------

Achievable

Pollutant/combustion level emission

levels

------------------------------------------------------------------------

PM, gr/dscf:

1-sec................................................... 0.35

2-sec................................................... 0.25

Dioxin, ng/dscm:

1-sec................................................... 9,000

2-sec................................................... 800

TEQ dioxin, ng/discm:

1-sec................................................... 275

2-sec................................................... 15

CO, ppmdv:

1-sec................................................... 700

2-sec................................................... 40

HCl, ppmdv................................................ 3,100

SO2, ppmdv................................................ 55

NOx, ppmdv................................................ 250

Pb, mg/dscm............................................... 10

Cd, mg/dscm............................................... 4

Hg, mg/dscm............................................... 7.5

------------------------------------------------------------------------

Most of the achievable emission levels associated with combustion

control have changed little from the proposal; the exceptions are the

achievable emission levels for dioxin and Hg. The conclusion drawn at

proposal regarding the achievable emission level for dioxin was driven

by two relatively high data points from two different MWI. A thorough

review of these two MWI and the tests conducted at these two MWI raise

numerous questions and doubts about whether good combustion was

actually employed at these MWI during the emission tests. Consequently,

EPA no longer considers these emission tests representative of good

combustion.

The situation is similar with regard to achievable Hg emission

levels; at proposal, the conclusion regarding achievable emission level

for Hg was driven by one very high data point. Following proposal, the

hospital operating this MWI instituted several common waste management

practices employed by other hospitals, and the MWI was retested by the

EPA. The new data point is very similar to all the other data points.

Consequently, the earlier data point is no longer considered

representative of achievable Hg emission levels.

While no specific comments were received regarding the cost of good

combustion, the costs were reassessed and updated for consistent

comparison with other costs. This information is described in more

detail in item IV-B-33 in the docket.

2. Wet Scrubbers

Following proposal, a number of comments were submitted to the EPA

concerning the performance capabilities of wet scrubbing systems. Some

commenters claimed that the wet scrubbing system tested by EPA was not

representative of current wet scrubber technology and that the scrubber

was not designed for high efficiency PM removal. The commenters

submitted a number of emission test reports from wet scrubbing systems

and urged EPA to reconsider the performance capabilities of these

systems.

The EPA has reviewed these emission test reports and revised its

previous conclusions on the performance capabilities of wet scrubbing

systems. Wet scrubbing systems are capable of achieving three different

levels of performance, depending on their design and operation. For

convenience, these three levels of performance have been termed low

efficiency, moderate efficiency, and high efficiency. A summary of

EPA's revised conclusions regarding achievable emission levels

associated with the use of wet scrubbing systems is shown in Table 4. A

full discussion of these revised conclusions is available as item No.

IV-B-48 in the docket.

Table 4.--Achievable Emission Levels For Wet Scrubbers

----------------------------------------------------------------------------------------------------------------

Achievable emission levels

Pollutant, units ------------------------------------------------------------------------------

Low Moderate High

----------------------------------------------------------------------------------------------------------------

PM, gr/dscf...................... 0.05..................... 0.03.................... 0.015.

dioxin, ng/dscm.................. 125...................... 125..................... 125.

TEQ dioxin, ng/dscm.............. 2.3...................... 2.3..................... 2.3.

HCl, ppmdv....................... 15 or 99%................ 15 or 99%............... 15 or 99%.

Pb, mg/dscm...................... 1.2 or 70%............... 1.2 or 70%.............. 1.2 or 70%.

Cd, mg/dscm...................... 0.16 or 65%.............. 0.16 or 65%............. 0.16 or 65%.

Hg, mg/dscm...................... 0.55 or 85%.............. 0.55 or 85%............. 0.55 or 85%.

----------------------------------------------------------------------------------------------------------------

Percent reflects achievable percentage reduction in emissions. No levels are shown for CO, SO2, or NOx because

wet scrubbers on MWI achieved no further reductions beyond good combustion for these pollutants.

Note that for the waste-related pollutants, the achievable emission

levels in the table are expressed as a numerical concentration level or

a percent reduction. The composition of the waste burned in an MWI is

not uniform; as a result, the concentration levels of waste-related

pollutants from an MWI varies. On occasion, however, a momentary rise

or ``spike'' in the concentration level of a waste-related pollutant

may occur; while a wet scrubbing or dry scrubbing system can reduce

this concentration level considerably, the system can not necessarily

reduce it to the concentration levels shown in the table. For this

reason, conclusions regarding

[[Page 31743]]

achievable emission levels associated with the use of wet or dry

scrubbing systems for waste-related pollutants must include a percent

reduction component to accurately reflect the performance capabilities

of wet and dry scrubbing systems.

Also note that the EPA has no emission data upon which to assess

the performance capabilities of wet scrubbing systems that might

utilize activated carbon. The EPA knows of no wet scrubbing system

currently operating on an MWI using activated carbon, although vendors

have mentioned this technique could be done. Activated carbon used with

a dry scrubber (discussed below) provides enhanced removal of Hg and

dioxin. Thus, the use of activated carbon with a wet scrubbing system,

in an appropriate manner such as a fixed bed, should achieve the same

enhanced performance levels.

Along with new information regarding the performance of wet

scrubbers, EPA received new information regarding the cost of wet

scrubbing systems. Figure 1 shows the relationship between cost and

size of MWI for each level of wet scrubber performance. These costs are

not substantially different from those used at proposal. The key

difference is the distinction in costs between wet scrubbers of

different efficiency. This information is described in more detail in

item IV-B-30 in the docket.

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3. Dry Scrubbers

Very few comments were submitted to EPA following proposal that

questioned EPA's conclusions on the performance capabilities of dry

scrubbing systems. These capabilities were reassessed, however, to

consider data contained in several emission test reports submitted to

EPA from dry scrubbing systems using activated carbon.

The results of this reassessment of dry scrubbing system

performance is shown in Table 5. The conclusions summarized in this

table are similar to those at proposal. Note, however, that as

discussed above under wet scrubbing systems, the achievable emission

levels associated with the use of dry scrubbing systems for waste-

related pollutants are now expressed as a numerical concentration level

or a percent reduction. A discussion of this reassessment is available

as item No. IV-B-49 in the docket.

Table 5.--Achievable Emission Levels For Dry Scrubbers With Activated

Carbon Injection

------------------------------------------------------------------------

Pollutant, units Achievable emission levels

------------------------------------------------------------------------

PM, gr/dscf............................ 0.015.

dioxin, ng/dscm........................ 25.

TEQ dioxin, ng/dscm.................... 0.6.

HCl, ppmdv............................. 100 or 93%.

Pb, mg/dscm............................ 0.07 or 98%.

Cd, mg/dscm............................ 0.04 or 90%.

Hg, mg/dscm............................ 0.55 or 85%.

------------------------------------------------------------------------

Percent reflects achievable percentage reduction in emissions. No levels

are shown for CO, SO2, or NOx because dry scrubbers on MWI's achieved

no further reductions beyond good combustion for these pollutants.

While no specific comments were received regarding the cost of dry

scrubbers, the costs were reassessed and updated for consistent

comparison with other costs. Figure 2 shows the relationship between

cost and size of MWI for dry scrubbing systems. This information is

described in more detail in item IV-B-32 in the docket.

[[Page 31744]]

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D. MACT Floor

1. Existing MWI

The Clean Air Act specifies in Section 129 that the degree of

reduction in emissions that is deemed achievable for existing MWI shall

not be less stringent than the average emission limitation achieved by

the best performing 12 percent of units in a category; this requirement

is referred to as the ``MACT floor'' for existing MWI. Section 302(k)

of the Clean Air Act defines the term ``emission limitation'' as ``a

requirement established by the State or Administrator which limits the

quantity, rate, or concentration of emissions of air pollutants on a

continuous basis.''

Air quality permits and State regulations were examined to

determine the average emission limitations achieved by the best

performing 12 percent of MWI in each of the three subcategories

considered at proposal (continuous, intermittent, and batch MWI). Table

6 presents the MACT floor emission levels identified at proposal.

Table 6.--Proposed MACT Floor Emission Levels For Existing MWI

[February 1995]

----------------------------------------------------------------------------------------------------------------

MWI subcategory

Pollutant, units -----------------------------------------------

Batch Intermittent Continuous

----------------------------------------------------------------------------------------------------------------

PM, gr/dscf..................................................... 0.03 0.03 0.02

CO, ppmdv....................................................... 91 90 76

Dioxin, ng/dscm................................................. NF NF NF

HCI, ppmdv...................................................... 911 115 43

(35%) (92%) (97%)

SO2, ppmdv...................................................... NF NF NF

NOX, ppmdv...................................................... NF NF NF

Pb, mg/dscm..................................................... NF NF NF

Cd, mg/dscm..................................................... NF NF NF

Hg, mg/dscm..................................................... NF NF NF

----------------------------------------------------------------------------------------------------------------

NF=No Floor--the MACT floor emission levels for these pollutants reflect uncontrolled emissions. Numbers in

parentheses indicate percent reduction.

Note that the table indicates no floor for most pollutants. While a

numerical value was calculated for each pollutant, most pollutant MACT

floors reflected uncontrolled emissions. Nevertheless, based on

conclusions drawn at proposal regarding performance of technology, the

MACT floor values included in Table 6 for CO, PM, and HCl indicated, at

proposal, that all existing MWI would need good combustion and dry

scrubbers to meet the MACT floors for CO, PM, and HCl.

As discussed in earlier sections, the new information submitted

following proposal led to changes to the MWI inventory and

subcategories. Because these factors can influence the MACT floors, a

review of the MACT floors was conducted. Recall that the inventory

includes emission limitations for each pollutant based on State permits

and regulations. For each pollutant, the MWI inventory was sorted by

subcategory

[[Page 31745]]

and then by stringency of emission limit (most stringent to least

stringent) within each subcategory. For each pollutant, the emission

limitations for the top 12 percent of units in each subcategory were

averaged to determine the MACT floor emission levels. The results of

these calculations to determine the MACT floor emission levels for

existing MWI in each subcategory based on the new MWI inventory are

presented in Table 7.

Table 7.--Revised MACT Floor Emission Levels for Existing MWI

----------------------------------------------------------------------------------------------------------------

MWI subcategory

Pollutant, units -----------------------------------------------

Small Medium Large

----------------------------------------------------------------------------------------------------------------

PM, gr/dscf..................................................... 0.086 0.043 0.021

CO, ppmdv....................................................... 156 98 87

Dioxin, ng/dscm................................................. NF NF NF

HCI, ppmdv...................................................... NF 589 101

(57%) (93%)

SO2, ppmdv...................................................... NF NF NF

NOX, ppmdv...................................................... NF NF NF

Pb, mg/dscm..................................................... NF NF NF

Cd, mg/dscm..................................................... NF NF NF

Hg, mg/dscm..................................................... NF NF NF

----------------------------------------------------------------------------------------------------------------

NF=No Floor--the MACT floor emission levels for these pollutants reflect uncontrolled emissions. Numbers in

parentheses indicate percent reduction.

Based on the recalculated MACT floors and the new conclusions drawn

regarding the performance capabilities of air pollution control

technologies (Section II.C.), it appears that large MWI would have to

use good combustion and a high efficiency wet scrubber to achieve the

MACT floor emission levels, while a medium-sized MWI would have to

install at least good combustion and a moderate efficiency wet

scrubber. Dry scrubbers could also be used in conjunction with good

combustion to meet the MACT floor emission levels for medium and large

MWI. Available data showing the performance capabilities of good

combustion appears to indicate that the 0.086 gr/dscf PM MACT floor for

small MWI is not achievable with good combustion alone. However, MWI

manufacturers have indicated they routinely guarantee achieving 0.08

gr/dscf with good combustion. Consequently, the MACT floor for small

MWI would require the use of good combustion practices; based on the

claims of MWI manufacturers, add-on scrubbing systems would not be

needed in all cases to meet the MACT floor. Regulatory options

reflecting more stringent guidelines for existing MWI are examined in

Section III of this notice. A memorandum that documents the procedures

used to determine the MACT floors for existing MWI is located in the

docket as item IV-B-24.

2. New MWI

The Clean Air Act specifies in Section 129 that the degree of

reduction in emissions that is deemed achievable for new MWI shall not

be less stringent that the emissions control achieved by the best-

controlled similar unit; this requirement is referred to as the ``MACT

floor'' for new MWI. The MACT floor emission levels identified at

proposal for new MWI are presented in Table 8. These MACT floor values

reflect conclusions at proposal about the performance capabilities of

dry scrubbing systems because such systems were identified on at least

one MWI in each subcategory and because dry scrubbing systems were

considered capable of achieving lower emissions than wet scrubbing

systems.

Table 8.--Proposed MACT Floor Emission Levels For New MWI

[February 1995]

----------------------------------------------------------------------------------------------------------------

MWI subcategory

Pollutant, units -----------------------------------------------

Batch Intermittent Continuous

----------------------------------------------------------------------------------------------------------------

PM, gr/dscf..................................................... 0.013 0.013 0.013

CO, ppmdv....................................................... 50 50 50

Dioxin, ng/dscm................................................. 1,500 450 80

HCl, ppmdv...................................................... 42 42 42

(97%) (97%) (97%)

SO2, ppmdv...................................................... NF NF NF

NOX, ppmdv...................................................... NF NF NF

Pb, mg/dscm..................................................... 0.1 0.1 0.1

Cd, mg/dscm..................................................... 0.05 0.05 0.05

Hg, mg/dscm..................................................... NF NF 0.47

(85%)

----------------------------------------------------------------------------------------------------------------

NF=No Floor--the MACT floor emission levels for these pollutants reflect uncontrolled emissions. Numbers in

parentheses indicate percent reduction.

Again, the new information submitted following proposal led to

changes to the MWI inventory, subcategories, and conclusions about

performance of technology. Because these factors can influence the MACT

floors, a review of the MACT floors was conducted. The revised

inventory of existing MWI was examined to identify the best-controlled

[[Page 31746]]

MWI in each subcategory. The revised MACT floor emission levels for new

MWI are shown in Table 9.

Table 9.--Revised MACT Floor Emission Levels For New MWI

----------------------------------------------------------------------------------------------------------------

MWI subcategory

Pollutant, units -----------------------------------------------

Small Medium Large

----------------------------------------------------------------------------------------------------------------

PM, gr/dscf..................................................... 0.03 0.015 0.015

CO, ppmdv....................................................... 40 40 40

Dioxin, ng/dscm................................................. 125 125 25

HCl, ppmdv...................................................... 15 15 15

(99%) (99%) (99%)

SO2, ppmdv...................................................... NF NF NF

NOx, ppmdv...................................................... NF NF NF

Pb, mg/dscm..................................................... 1.2 0.07 0.07

(70%) (98%) (98%)

Cd, mg/dscm..................................................... 0.16 0.04 0.04

(65%) (90%) (90%)

Hg, mg/dscm..................................................... 0.55 0.55 0.55

(85%) (85%) (85%)

----------------------------------------------------------------------------------------------------------------

NF=No Floor--the MACT floor emission levels for these pollutants reflect uncontrolled emissions. Numbers in

parentheses indicate percent reduction.

The small MWI subcategory consists of MWI operating at a throughput

of 200 pounds per hour (lb/hr) or less of medical waste. The MACT floor

for new small MWI consists of the emission levels that are achievable

with good combustion and a moderate efficiency wet scrubber. The MACT

floor is based on these emissions levels because small existing MWI

equipped with this air pollution control have been identified. No small

existing MWI have been identified with high-efficiency wet scrubbers or

dry scrubbers.

The medium MWI category consists of MWI operating at a throughput

of greater than 200 lb/hr and less than or equal to 500 lb/hr of

medical waste. The MACT floor for new medium-sized MWI is based on

emission levels that are achievable with good combustion and a

combination of two control technologies, the high efficiency wet

scrubber and the dry injection/fabric filter (DI/FF) dry scrubber

system without carbon. At least one existing MWI in the medium

subcategory is controlled with a high efficiency wet scrubber and

another is equipped with a DI/FF system without carbon. The MACT floor

is based on both of these technologies (i.e., a combined dry/wet

scrubber system) because the wet scrubber achieves the lowest dioxin,

HCl, and Hg emissions, but the DI/FF without carbon injection achieves

the lowest Pb and Cd emissions. While no combined dry/wet scrubber

systems were identified on medium MWI, several such systems are

currently in operation on large MWI, as mentioned below. In addition,

as also mentioned below, spray dryer/fabric filter systems could also

meet the MACT floor emission levels for medium-sized MWI.

The large MWI subcategory consists of all MWI operating at a

throughput of greater than 500 lb/hr of medical waste. As with the MACT

floor for new medium MWI, the MACT floor for new large MWI is based on

the emission levels that are achievable with good combustion and a

combination of two control technologies, the high efficiency wet

scrubber and the DI/FF dry scrubber system with carbon. Several

existing facilities in the large category currently control emissions

with a combined dry/wet system. In addition, one existing MWI equipped

with a spray dryer/fabric filter system with carbon was tested during

the EPA testing program and this test demonstrated that this scrubbing

technology could also meet the MACT floor emission levels presented in

Table 9.

Regulatory options reflecting more stringent standards for new MWI

are examined in Section IV of this notice. A memorandum that documents

the procedures used to determine the MACT floors for new MWI is located

in the docket as item IV-B-38.

E. Baseline Emissions

To estimate the environmental impacts of the standards and

guidelines for MWI, an estimate of baseline emissions must be made

(i.e., emissions in the absence of Federal regulations). In the

February 1995 proposal, baseline emissions were estimated for PM, CO,

dioxin, HCl, SO2, NOx, Pb, Cd, and Hg. When this estimate was

developed, very little information was available regarding the actual

number of MWI and the level of air pollution control associated with

each. The emission estimate was derived from an estimated 3,700 MWI

assumed to be operating with little, if any, air pollution control.

As discussed in previous sections, new information has led to new

conclusions about the MWI inventory, performance of technology, and

control levels associated with each existing MWI. As a result, revised

estimates of baseline emissions from existing MWI have been calculated

and are presented in Table 10.

Table 10.--Annual Baseline Emissions For Existing MWI

------------------------------------------------------------------------

Baseline

Pollutant, units emissions

------------------------------------------------------------------------

PM, Mg/yr................................................. 940

CO, Mg/yr................................................. 460

Dioxin g/yr............................................... 7,200

Dioxin g TEQ/yr........................................... 150

HCl, Mg/yr................................................ 5,700

SO2, Mg/yr................................................ 250

NOx, Mg/yr................................................ 1,200

Pb, Mg/yr................................................. 11

Cd, Mg/yr................................................. 1.2

Hg, Mg/yr................................................. 15

------------------------------------------------------------------------

To convert Mg/yr to ton/yr, multiply by 1.1. To convert g/yr to lb/yr,

divided by 453.6.

The results of these emission estimates are significantly lower

than estimates developed at proposal. For example, the estimate of

baseline emissions of dioxin toxic equivalency (TEQ) was 5,100 grams

per year (g/yr) at proposal; the current estimate is 150 g/yr. At

proposal, the estimate of Hg emissions from existing MWI was 64.6 tons

per year (tons/yr); the current estimate is 16.0 tons/yr.

The primary reason for the lower baseline emission estimate is the

much greater level of emission control found

[[Page 31747]]

at existing MWI than was assumed at proposal. Comment is requested on

the methodology and assumptions used to estimate baseline emissions

from existing MWI. Where information on specific air pollution control

equipment was not available, EPA used State regulatory emission limits

to predict the type of air pollution control equipment installed on

each existing MWI. Information is requested which would more accurately

reflect the actual air pollution control equipment installed on each

existing MWI. In addition, emission factors for each type of air

pollution control equipment were developed based on compliance test

reports. Comment is requested on whether these emission factors reflect

actual air emissions from these control devices over the life of the

equipment.

At proposal, baseline emissions were also estimated for new MWI in

the fifth year after adoption of the NSPS. These estimates were based

on a projected number of new MWI and their associated emission controls

that would be installed in the five years following promulgation of the

standards. As with the estimation of baseline emissions for existing

MWI, the estimate of baseline emissions for new MWI has also changed

significantly. This change is due primarily to the lower projected

number of new MWI and the emission control level associated with each

MWI. The revised baseline emissions estimates for new MWI are presented

in Table 11.

Table 11.--Annual Baseline Emissions For New MWI

------------------------------------------------------------------------

Baseline

Pollutant, units emissions

------------------------------------------------------------------------

PM, Mg/yr................................................. 28

CO, Mg/yr................................................. 14

Dioxin g/yr............................................... 47

Dioxin g TEQ/yr........................................... 1.1

HCl, Mg/yr................................................ 64

SO2, Mg/yr................................................ 28

NOx, Mg/yr................................................ 130

Pb, Mg/yr................................................. 0.39

Cd, Mg/yr................................................. 0.051

Hg, Mg/yr................................................. 0.21

------------------------------------------------------------------------

To convert Mg/yr to ton/yr, multiply by 1.1.

To convert g/y to 1b/yr, divided by 453.6.

The memoranda documenting these revised estimates of baseline

emissions from new and existing MWI can be found in the docket as items

IV-B-51 and IV-A-6.

F. Operator Training and Qualification

The proposed standards and guidelines included operator training

and qualification requirements for each MWI operator. These operator

training and qualification requirements included completion of (1) 24

hours of classroom instruction, (2) 4 hours of hands-on training, (3)

an examination developed and administered by the course instructor, and

(4) a handbook or other documentation covering the subjects presented

during the course. The instructor of the operator training course was

not to be employed by the owner or operator of the facility. To obtain

qualification, an operator was to complete the training course and have

either a minimum level of experience or satisfy comparable or more

stringent criteria established by a national professional organization.

The proposed standards and guidelines also required the owner or

operator of the facility to develop and annually update a site-specific

operating manual. This manual would summarize regulations, operating

procedures, and reporting and recordkeeping requirements in accordance

with the proposed standards and guidelines. The proposal required that

each MWI be operated by a trained and qualified operator or by an

individual under the direct supervision of a trained and qualified

operator. The trained and qualified operator would have to be on duty

and at the facility at all times while the incinerator is in operation.

Many comments were received on the proposed operator training and

qualification requirements. The majority of the public comments on

operator training and qualification were related to the third party

training requirement and to the duration that operators must be present

while the MWI is burning waste. Many commenters stated that the EPA

should allow facilities the option of providing training by in-house

personnel because the facility's own personnel would be most familiar

with the operation and maintenance of the incinerator. The commenters

indicated that smaller facilities that do not have the personnel could

use the services of trainers and inspectors that are not affiliated

with the facility.

Many commenters stated that the amount of time that the operator

was required to be present was excessive. Under the proposal, the

operator would have to be on-duty and at the facility during the time

that the combustion air blowers are operating. Several commenters

suggested that this would require operators to be at the incinerator

even when waste was not being burned. Several commenters also suggested

that the trained and qualified operator should be easily accessible

(either at the facility or on-call) while the incinerator is operating.

The EPA is inclined to adopt the operator training and

qualification requirements briefly summarized below and discussed in

greater length in document number IV-B-26, which is available in the

Docket. Cost estimates for operator training and qualification are

documented in item IV-B-39.

The owner or operator of an MWI would be responsible for ensuring

that one or more operators at the facility are qualified. Operator

training may be obtained through a State-approved program or by

completing a training course with (1) 24 hours of classroom

instruction, (2) an examination designed and administered by the course

instructor, and (3) reference material distributed to the attendees

covering course topics.

Operators may obtain qualification by completing a training course

and having one of the following levels of experience: (1) at least 6-

months' experience as an MWI operator, (2) at least 6-months'

experience as the direct supervisor of a qualified MWI operator, or (3)

completion of at least two burn cycles under the observation of two

qualified operators. To maintain qualification, the operator would be

required to complete and pass an annual review or refresher course of

at least 4 hours.

A fully trained and qualified operator would have to be easily

accessible, either at the facility or on-call at all times while the

incinerator is in operation. The trained and qualified operator may

operate the MWI directly or be the direct supervisor of one or more

individuals that charge waste, remove ash, etc. As proposed, the

emission guidelines for existing MWI would require that, 1 year after

approval of the State plan, MWI must be operated by a trained and

qualified operator.

G. Testing, Monitoring, and Inspection

Section 129(c) of the Clean Air Act requires the EPA to develop

regulations that include monitoring and testing requirements. The

purpose of these requirements is to allow the EPA to determine whether

a source is operating in compliance with the regulations.

As mentioned earlier, at proposal relatively few emission test

reports were available to EPA to judge the performance of air pollution

control technologies. These test reports were the result of EPA

emission testing at several MWI. For a variety of reasons, EPA gathered

data during these emission tests using three, 4-hour test runs. The

results of the three test runs were then averaged at each MWI to

calculate a measured emission level. This calculated emission level

represented an

[[Page 31748]]

average emission value over the 12-hour period (i.e., three, 4-hour

runs).

As a result, EPA's assessments of the performance capabilities of

air pollution control technologies and conclusions regarding the

appropriate emission limits to include in the proposed regulations were

based on the measured performance of technology averaged over a 12-hour

period. Emission levels, however, tend to fluctuate somewhat as part of

normal operation. Consequently, during short periods of time, emission

levels may occasionally be greater or lower than the average emission

level over a 12 hour period.

In developing a regulation based on the performance of a particular

technology, the level of performance demanded by the regulation must be

consistent with the level of performance that technology can achieve.

The period of time over which emissions are measured and then averaged

to determine compliance with the regulation, therefore, must correspond

to the period of time over which emission levels were measured and

averaged in determining the emission limits included in the regulation.

If this is not the case, a regulation could include emission limits

that a technology can achieve if emissions are averaged over a

relatively long period of time, but not if emissions are averaged over

a much shorter period of time. For this reason, the proposed regulation

required emission testing to determine compliance by averaging the

results of three, 4-hour test runs, consistent with the procedures

followed in gathering the emission data used to establish the emission

limits included in the regulation.

Many comments were received regarding this proposed requirement to

determine compliance using three, 4-hour test runs. These commenters

noted that a 4-hour test run was much longer than the more conventional

test run of about 1-hour; additionally, many hospitals and healthcare

facilities would normally not have sufficient waste on hand to

accommodate three, 4-hour test runs. Finally, several commenters stated

that the proposed emission testing requirements would substantially

increase the costs associated with emission testing. Consequently,

these commenters urged EPA to revise the emission testing requirements

and adopt the more conventional approach of relying on test runs of

about an hour in length.

As mentioned earlier, more than two dozen test reports were

submitted to EPA following the proposal, and these test reports now

form the basis for revised conclusions regarding the performance

capabilities of technology and the emission limits these technologies

can achieve. The EPA test methods were used to perform the emission

testing summarized in these reports. These methods include procedures

that require the collection of a sufficient sample to accurately

measure emission levels. For most air pollutants, this sample generally

corresponds to a test run of about an hour. The revised conclusions

discussed earlier, therefore, regarding the performance capabilities of

emission control technologies and the emission limits these

technologies can achieve, are based (for the most part) on emission

test data generated by averaging the results of three test runs of

about an hour each (i.e., a 3-hour test).

For this reason, the EPA is inclined to state in the final

regulations adopted for MWI that EPA test methods be followed when

performing any emission testing required to determine compliance with

the regulations. This requirement will ensure that compliance testing

follows the same procedures used to generate the emission data upon

which the emission limits in the final regulation were based. In most

cases, three test runs of about an hour each would be necessary to

determine compliance with the final regulations.

An exception to this requirement is emission testing to measure

dioxin emissions. The procedures in the EPA test method to ensure

sufficient sample is gathered to accurately measure dioxin emissions

frequently leads to test runs longer than 1 hour. Whatever the length

of the emission test, however, the emission testing procedures included

in the EPA test method for measuring dioxin emissions were followed in

the emission test reports submitted to EPA following proposal. As

discussed earlier, these emission test reports serve as the basis for

the dioxin emission limits included in the final regulations and, as a

result, the length of testing necessary to determine compliance will

automatically be consistent with the length of testing used to

determine the emission limits included in the regulations.

The proposed regulations also would have required annual emission

testing to determine compliance. While some commenters supported

emission testing annually or even more frequently (such as every 6

months), a number of commenters believed that annual testing would be

unnecessary or that testing should be required no more than every 5

years. Commenters felt that the requirements for inspections,

monitoring, and operator training are sufficient and much less

expensive than annual emission testing.

Other commenters suggested that the annual emission testing

requirement be replaced with a requirement for annual equipment

inspection/maintenance to ensure that burner settings, air flow rates,

and other operation parameters are properly adjusted. While the

proposal includes a requirement for annual equipment inspection and

maintenance, this requirement would have applied only to existing MWI

until air pollution control equipment had been installed and the MWI

was in compliance with all the emission limits in the regulations. The

purpose of the proposed annual equipment inspection and maintenance

requirements was to ensure that the MWI was in good working order and

physically capable of operating as well as it could operate until

compliance with the emission limits was demonstrated. A MWI in poor

operating condition will likely have higher emissions than a MWI in

good operating condition.

While some commenters stated inspections are not necessary and

others suggested that EPA should let the States decide whether

inspections are necessary, most commenters were generally supportive of

annual inspection and maintenance requirements. Several commenters also

stated that biannual inspections would not be unreasonable. Many of the

commenters supportive of inspection requirements, however, suggested

that the requirement for a ``third party'' inspection be deleted. These

commenters stated in-house personnel are more familiar with the details

and operating intricacies of the equipment installed at their sites. In

addition, serious liability concerns could arise from injury or damage

caused by ``third party'' inspection or maintenance. At this point, EPA

is inclined to include inspection and maintenance requirements wherever

annual stack testing is not required (see document IV-B-26 in the

docket for a description of injection/maintenance requirements). The

inspection would not have to be conducted by a third party.

The proposal also included various monitoring requirements,

requiring the use of continuous emission monitoring systems (CEMS) for

some pollutants and the monitoring of operating parameters for other

pollutants. Some commenters supported the proposed requirements for CO,

opacity, and oxygen (O2) CEMS. Another commenter suggested that

the requirements should be extended to require CEMS for Hg, HCl, and

PM; the commenter suggested that such instruments are available. On the

other

[[Page 31749]]

hand, several other commenters objected to the CEMS requirements in the

proposed rule. These commenters stated that CEMS are not justified,

especially for small MWI, because they are too expensive. These

commenters believe that monitoring operating parameters is a sufficient

substitute for CEMS once compliance has been demonstrated by an initial

emission test.

The monitoring requirements in the proposal for monitoring

operating parameters were structured around the use of dry scrubber

systems. Those who commented on these specific requirements generally

agreed that monitoring of these operating parameters was appropriate

for dry scrubbing systems.

No monitoring requirements were included for monitoring operating

parameters for wet scrubbing systems. The EPA solicited information

regarding an appropriate set of operating parameters for wet scrubbing

systems. The EPA was inclined and is still inclined to include specific

operating parameter monitoring requirements in the final regulations

for wet scrubbing systems as well as for dry scrubbing systems. To

accommodate MWI using an air pollution control system other than a dry

or wet scrubbing system, EPA is inclined to include provisions in the

final regulations for petitioning the Administrator to monitor specific

operating parameters associated with the other air pollution control

system.

A number of commenters responded to EPA's request for suggestions

of monitoring requirements for operating parameters suitable for wet

scrubbing systems. Suggested parameters included pressure drop across

the system, liquor flow rate, flue gas temperature, liquor pH, and

horsepower or amperage. While EPA is inclined to include the same

requirements in the final regulations for monitoring operating

parameters for dry scrubbing systems as proposed, EPA is inclined to

include requirements in the final regulations for monitoring the

following operating parameters for wet scrubbing systems: scrubber exit

temperature, scrubber liquor pH, scrubber liquor flow rate, and energy

input to the scrubber (e.g., pressure drop or horsepower).

To consider the comments outlined above regarding the frequency of

emission testing and the proposed inspection and monitoring

requirements, a matrix of options was developed. This matrix of options

and their annual costs are summarized in Table 12. Each cell or box in

this table represents a combination of emission testing and monitoring

requirements (some combinations also include inspection requirements).

The range in the costs shown in each cell is a reflection of how the

cost of emission testing and monitoring is likely to vary depending on

the emission limits included in the final regulation (i.e., whether the

emission limits are based on the use of good combustion alone or good

combustion and wet or dry scrubbing). These costs vary somewhat because

the operating parameters monitored in each case would be somewhat

different.

Table 12.--Monitoring/Testing Options and Annual Costs

[Thousand $/yr]

----------------------------------------------------------------------------------------------------------------

Testing options

-----------------------------------------------

Monitoring options A Initial and B Initial C Substitute

repeat stack stack testing; stack testing;

testing inspection inspection

----------------------------------------------------------------------------------------------------------------

1--CO CEMS (App F); Opacity CEM (no App F); Operating Parameters 110-119 100-104 99-102

2--Opacity and CO CEMS (no App F); Operating Parameters......... 96-104 85-89 83-86

3--Opacity CEMS (no App. F); Operating Parameters............... 37-46 27-31 26-29

4--Operating Parameters; Quarterly Method 9..................... 10-15 7.5-11 5.8-8.8

----------------------------------------------------------------------------------------------------------------

Table 12 presents the 12 possible combinations of three emission

testing options and four monitoring options that the EPA is considering

including in the final regulations. A more detailed explanation of

these emission testing and monitoring options, as well as their costs,

is available in the docket as item IV-B-54. The following discussion,

however, briefly outlines the essential requirements of each of the

monitoring and emission testing options.

Monitoring Option 1 requires a CO CEMS with Appendix F requirements

(Appendix F requirements ensure the data generated is reliable), an

opacity CEMS without Appendix F requirements, and operating parameter

monitoring requirements for the MWI and, if applicable, for the air

pollution control device. Because the use of Appendix F is required

under this option, the CO CEMS would be used for direct enforcement of

the CO emission limit. The opacity CEMS without Appendix F requirements

would simply provide an indication of opacity and would not be used for

direct enforcement of the opacity limit. Routine opacity testing with

Reference Method 9 is included in Monitoring Option 1 to compensate for

not including Appendix F requirements on the opacity CEMS.

Monitoring Option 2 is the same as Monitoring Option 1, except that

it would not include Appendix F requirements for the CO CEMS, which

would reduce costs. Without Appendix F requirements, the CO CEMS would

provide an indication of CO emissions and would not be used for direct

enforcement of the CO emission limit. Emission testing for CO is

included in Monitoring Option 2 to compensate for excluding Appendix F

requirements on the CO CEMS. An opacity CEMS and operating parameter

monitoring would be required as in Monitoring Option 1.

Monitoring Option 3 is the same as Monitoring Option 2, except

that, instead of the more expensive CO CEMS, stack emission testing for

CO would be required. An opacity CEMS and operating parameter

monitoring would be required as in Monitoring Options 1 and 2.

Monitoring Option 4 would require no CEMS. Instead, it would rely

on manual emission test methods (including more frequent Method 9

opacity tests) and operating parameter monitoring.

For each of these monitoring options, three emission testing

options have been developed. Emission testing Option A would require

initial and annual/skip tests. With the annual/skip test requirement,

emission tests would be required for the first 3 years. If these tests

show that the facility was in compliance each of these 3 years, then

subsequent testing would be done every third year. Emission testing

Option A,

[[Page 31750]]

under all four monitoring options, would require an initial stack test

for all pollutants. Annual or skip emission testing under Monitoring

Options 1, 2, and 3 would also require emission testing of all

pollutants. However, annual or skip emission testing under Monitoring

Option 4 would only require emission testing of a few key or critical

pollutants (i.e., only those necessary to gain a good indication that

the air pollution control system is operating properly).

Emission testing Option B would require an initial emission test

for all pollutants, but would not require annual emission tests. In

lieu of annual or skip emission testing, MWI inspection/maintenance

would be required. This inspection/maintenance would be required

annually under Monitoring Options 1 and 2; however, it would be

required quarterly under Monitoring Options 3 and 4, where no CO CEMS

is required. The inspection/maintenance could be done by in-house

personnel. With regard to any necessary repairs arising from the

inspection/maintenance, the owner or operator of the MWI would be

required to contact the State (or local, if delegated by the State) air

pollution control agency and negotiate a date, within 10 operating days

following the date of the inspection/maintenance, by which the repairs

must be completed.

Emission testing Option C would permit substitute emission testing.

A substitute emission test is an emission test conducted on another,

but identical MWI. An MWI would be required to petition the State (or

local, if delegated by the State) air pollution control agency for

approval, however, and the ``burden of proof'' would be on the MWI to

demonstrate to the satisfaction of the agency that the substitute

emission test is on an identical MWI. In addition, an initial emission

test for Hg would be required; this test would ensure that appropriate

measures for managing the mercury content of the waste are utilized

(e.g., material separation, material purchasing, etc.). Inspection/

maintenance requirements would be the same as under Emission Testing

Option B.

The most direct means of ensuring compliance with emission limits

included in regulations is the use of CEMS. As a matter of policy, the

first and foremost option considered by EPA is to require the use of

CEMS in regulations to demonstrate and ensure compliance on a

continuous basis with the regulations. Only when the impacts of

including such requirements are considered unreasonable, does the EPA

consider other options.

For MWI, it appears that almost all of the emission testing and

monitoring options under consideration cost more than the emission

control system that would be installed to meet the emission limits in

the regulations; in some cases, the emission testing and monitoring

requirements could cost twice as much as the emission control system.

Consequently, the Agency is inclined to include the emission testing

and monitoring requirements under Monitoring Option 4 in the final

regulations to minimize costs. Where the regulations are based on good

combustion and wet and/or dry scrubbing systems, the EPA is inclined to

require Monitoring Option 4 with Emission Testing Option A; where the

regulations are based, in part, on the use of good combustion alone,

the EPA is inclined to require Monitoring Option 4 with Emission

Testing Option B.

The appropriate choice of emission testing and monitoring

requirements (as well as inspection/maintenance requirements) is an

area in which the EPA specifically solicits comments. Many of the MWI

visited or inspected by the EPA in the course of gathering data and

information often appeared poorly maintained and operated. Inadequate

maintenance and/or operation can cause even the best equipment to

perform poorly and result in excess emissions. The inspection/

maintenance and operator training requirements included in the final

regulations are expected to address this problem in a satisfactory

manner; however, the EPA is interested in whether others feel the

inspection/maintenance requirements and operator training requirements

should be supplemented with more extensive emission testing and/or

monitoring requirements.

In addition, CEMS vendors have expressed concern with the costs

developed by EPA for the various CEMS and operating parameter

monitoring requirements. In particular, they believe the costs of CEMS

are much lower than those estimated by EPA. As mentioned, a detailed

breakdown of the EPA estimates of the costs of these requirements is

available in the docket as item IV-B-54. The EPA solicits comments on

these costs and if costs are indeed much lower than estimated, EPA may

consider more comprehensive monitoring requirements in the final rule.

Finally, even if the costs remain similar to those previously

estimated, the EPA is considering more comprehensive emission testing

and monitoring requirements (including CEMS) for large MWI that burn

medical waste generated offsite (i.e., generated at another location

than that of the MWI).

Definition of Medical Waste

Section 129 of the Clean Air Act directs the EPA to adopt

regulations for solid waste incineration units that combust (1)

municipal waste; (2) hospital, medical, and infectious waste; (3)

commercial or industrial waste; and (4) all other solid waste. The

regulations limiting air emissions from solid waste incineration units

combusting municipal waste (otherwise known as municipal waste

combustor(s) or MWC) were promulgated on December 19, 1995 (60 FR

65387). In developing regulations to limit air emissions from solid

waste incineration units combusting hospital, medical, and infectious

waste (otherwise known as medical waste incinerator(s) or MWI), medical

waste was defined as any solid waste that is generated in the

diagnosis, treatment, or immunization of human beings or animals, in

research pertaining thereto, or in the production or testing of

biologicals.

Section 129(g)(6) states that the term ``medical waste'' shall have

the meaning ``established by the Administrator pursuant to the Solid

Waste Disposal Act'' (SWDA). For the proposed air emission standards

and guidelines for MWI, EPA adopted the definition of ``medical waste''

from solid waste regulations codified in 40 CFR part 259, subpart B

because this definition was ``established by the Administrator pursuant

to the [SWDA],'' as amended by the Medical Waste Tracking Act (MWTA).

However, 40 CFR part 259 has since been withdrawn. Consequently, there

is no definition of medical waste which has been ``established by the

Administrator pursuant to the [SWDA],'' and EPA now has the flexibility

to examine and consider other definitions of medical waste. While EPA

is inclined to adopt a specific definition described below, EPA is

considering all of the definitions discussed in this section as well as

the proposed definition and solicits comment on the merits of each

definition discussed as well as other definitions EPA should consider.

During the public comment period, the majority of the comments on

the definition of medical waste stated that the proposed definition was

too broad and that it should be narrowed. Several commenters stated

that this definition would aggravate an already confusing situation,

where the public distinction between the terms medical waste and

infectious waste has become blurred and in most cases lost; these terms

are often used synonymously in public discourse.

[[Page 31751]]

These commenters believed that a broad definition of medical waste

in the regulations for MWI would have the undesirable impact of

fostering and encouraging the use and adoption of this definition in

other areas and by other regulatory authorities. They suggested that as

this definition becomes more widespread and adopted by others,

healthcare facilities would eventually be forced to handle most, if not

all, medical waste as infectious waste--whether it was burned in an

incinerator or not.

These commenters stated the proposed definition of medical waste,

because of the loss of public distinction between this term and the

term infectious waste, and the resulting impact of eventually forcing

healthcare facilities to treat most waste as infectious waste, would

lead to a massive increase in the volume of infectious waste. This

increase would, in turn, lead to a major increase in the costs of

disposal of waste from hospitals, since most waste would have to be

handled as infectious waste.

These commenters stated that, as in implementing the MWTA,

healthcare facilities should be viewed as generating two waste streams:

a medical waste stream, which is usually defined by the potential for

disease transmission and requires special handling; and a noninfectious

waste or ``healthcare trash'' waste stream, which has no potential for

infection and is treated and handled as municipal waste. These

commenters urged EPA to narrow the definition of medical waste used in

the MWI regulations to one of infectious waste, analogous to the term

``regulated medical waste'' adopted in regulations resulting from the

MWTA.

In most--if not all--cases, these commenters indicated that, where

healthcare facilities operate medical waste incinerators, they burn

infectious medical waste or a mixture of infectious medical waste and

noninfectious waste (i.e., healthcare trash). These commenters stated

that there were very few, if any, medical waste incinerators operated

by healthcare facilities that burned only noninfectious waste or

healthcare trash.

Consequently, by defining medical waste narrowly, in a manner

consistent with infectious or regulated medical waste, and by applying

the regulations to incinerators that burn this waste or any mixture of

this waste and other waste, the EPA could achieve the objective, which

is regulating air pollution from medical waste incinerators at

healthcare facilities; this objective would be achieved without adding

to the confusion or leading to the serious impacts outlined above.

These commenters further stated the proposed definition of medical

waste would subject MWC, which burn general nonregulated and

noninfectious waste from hospitals, to the same requirements as those

proposed for MWI. Consequently, even if healthcare facilities were not

eventually forced to handle most waste as infectious waste (because MWC

that burn general nonregulated and noninfectious waste from hospitals

would be subject to the MWI regulations) this broad definition would

result in higher disposal costs for healthcare facilities which send

their general nonregulated and noninfectious waste to MWC for disposal.

Some commenters, on the other hand, support the proposed broad

definition of medical waste. These commenters pointed out that there is

little difference in the air emissions created by burning infectious

medical waste (e.g., regulated medical waste or ``red bag'' waste) and

by burning noninfectious waste (e.g., nonregulated medical waste or

healthcare trash). As a result, the regulations should apply to the

burning of all medical waste, as EPA proposed. These commenters believe

that EPA's use of the broad definition of medical waste, solely for the

purpose of defining what type of incinerator the regulations apply to,

does not imply that more waste or that all medical waste will be

considered infectious waste. Merely requiring that incinerators that

burn medical waste must limit air pollution will not require all

healthcare facilities to handle all their medical waste as infectious

waste.

In fact, these commenters indicated that many healthcare facilities

today routinely separate their waste into two types: infectious waste

(``red bag'') and noninfectious waste (``black bag''). Numerous items

of waste from healthcare facilities are not, nor need not be considered

infectious waste. On the other hand, many healthcare facilities today

do little to separate their waste streams; most waste is handled and

treated as infectious waste. If waste disposal costs were of paramount

concern to healthcare facilities, those that do little separation today

could reduce their present waste disposal costs by more carefully

segregating their waste into infectious and noninfectious waste streams

and properly disposing of these two waste streams.

Finally, several commenters questioned whether animal carcasses and

pathological waste should be included in the definition of medical

waste. These commenters were uncertain as to whether pathological waste

incinerators were to be regulated as MWI or separately. These

commenters requested clarification of this situation and urged EPA to

regulate pathological wastes separately from medical waste.

Similarly, several commenters questioned whether ``out-of-date'' or

``off-spec'' drugs, or radio-active type medical wastes, should be

included in the definition of medical waste. These commenters requested

special treatment for these types of wastes, similar to that proposed

for pathological wastes.

The EPA did not intend to add or contribute to the confusion that

presently exists in the public discourse regarding the distinction or

lack of distinction between the terms medical waste, regulated medical

waste, and infectious medical waste. In fact, the EPA would like to

state very clearly that numerous items within the medical waste stream

are noninfectious and need not be treated as infectious. In fact, the

majority of items in the medical waste stream are noninfectious, and in

terms of percentages, most authorities conclude that only 10 to 15

percent of the items in the medical waste stream are infectious, or

potentially infectious, and warrant special treatment or handling.

In considering the public comments, an interesting and unanimous

agreement emerges, even if it is not stated as such. All of the

commenters seem to agree that healthcare facilities can be viewed as

generating two waste streams: an infectious medical waste stream and a

noninfectious healthcare trash, or ``municipal waste'' type, waste

stream. The challenge for EPA, therefore, is to reconcile the agreement

in this area with the requirement of the Clean Air Act to develop

regulations for incinerators burning hospital, medical, and infectious

waste.

The Clean Air Act requires EPA to develop regulations for the

burning of medical waste; but it also requires EPA to develop

regulations for the burning of municipal waste. In fact, EPA adopted

regulations limiting air pollution from the burning of municipal waste

on December 19, 1995 (60 FR 65387). As a result, if healthcare

facilities are viewed as generating two types of waste streams, an

infectious waste stream and a municipal waste stream, then the burning

of the municipal waste stream is already covered by regulations.

The definition of municipal waste included in the regulations

covering the burning of municipal waste states:

Municipal solid waste * * * means household, commercial/retail,

and/or institutional waste * * * Commercial/retail waste includes

material discarded by stores,

[[Page 31752]]

offices, restaurants * * * Institutional waste includes materials

discarded by schools, nonmedical waste discarded by hospitals, * * *

and material discarded by other similar establishments or

facilities.

The regulations cover the burning of municipal waste discarded from

offices and institutions. Hospitals are cited as an example of an

institution and clinics and nursing homes are considered ``similar

establishment(s)''. Offices include doctors' offices, dentists'

offices, etc. Consequently, noninfectious, municipal-type waste

discarded from healthcare facilities is considered part of the

municipal waste stream and is covered by the regulations adopted for

the burning of municipal waste.

The remaining need, therefore, is to regulate the burning of the

infectious waste stream discarded from healthcare facilities, which can

be achieved by redefining medical waste in terms of infectious or

potentially infectious materials. Thus, the EPA is inclined to narrow

the applicability of the proposed regulations by adopting a definition

of medical waste that focuses on that portion of the overall medical

waste stream that is generally considered infectious or potentially

infectious.

Given the confusion and number of varying definitions of medical

waste, regulated medical waste, infectious waste, etc., at the Federal

and State level, and within the healthcare community, transportation

sector, etc., EPA does not intend to add to this confusion by creating

another definition. As a result, EPA is inclined to adopt a definition

of medical waste, for the MWI regulations, from among those already in

use.

As mentioned, numerous definitions are currently in use, such as

the definition of infectious waste created by the U.S. Department of

Transportation, the definition of regulated medical waste created by

EPA, as well as other definitions created by other regulatory agencies

and national associations, such as the Occupational Safety and Health

Administration, the New York State Department of Health, the American

Hospital Association, etc. While these are just a few of the agencies

or associations that have developed definitions of medical waste that

are currently in use, they are the ones most often cited or suggested

in the public comments. Each of these definitions are slightly

different, but all focus on infectious or potentially infectious

medical waste. These definitions are discussed in more detail in

document number IV-B-25, available in the Docket.

For the most part, infectious or potentially infectious wastes are

defined through the use of categories or classes of wastes. The classes

of wastes most commonly used include:

1. Cultures and stocks of infectious agents;

2. Human pathological wastes;

3. Human blood and blood products;

4. Used sharps;

5. Animal wastes;

6. Isolation wastes; and

7. Unused sharps.

These seven waste classes are commonly used by various agencies and

associations as the basis for defining medical wastes. However, while

the classes of wastes included in two different definitions may be

identical, the specific items included under each class and the

definitions for these items may be very different. Each agency or

association has developed different language to define each of these

waste classes in a way that best serves their purposes. For example,

some definitions include intravenous (IV) bags under class 3 wastes,

while others do not.

It appears that adoption of any one of these definitions or any

definition at all will be controversial. No uniform or widespread

agreement on a definition exists, and for each commenter who argued

strongly for adoption of one particular definition, another commenter

argued equally strongly for adoption of a different one.

Of all these definitions, EPA is inclined to adopt the New York

State Department of Health (NYSDOH) definition, which is one of the

more recently developed definitions for use in the MWI air pollution

emission regulations. This definition was subjected to intense

discussion, consideration, and review within the medical and healthcare

community. Because it was adopted fairly recently, this definition also

benefits from the various controversies and discussions generated by

adoption of earlier definitions by other agencies and associations.

Further, this definition seems to be among the more comprehensive ones

in terms of identifying and defining the various classes of infectious

or potentially infectious medical waste mentioned above.

The NYSDOH definition includes six of the seven waste classes;

isolation wastes (class 6) are not listed as a separate category. The

definitions used for waste classes 1, 2, 4, and 7 are similar to those

used by the MWTA definition. As with the AHA definition, the NYSDOH

definition differs from the MWTA definition in the specifics of class 3

wastes. Class 3 waste under the NYSDOH definition does not include

items caked with dried blood or IV bags. These wastes are included in

the MWTA definition of class 3 waste. The definitions for class 5 waste

only includes wastes from animals exposed to infectious agents during

research, the production of biologicals, or the testing of

pharmaceuticals. Pathological waste from veterinary facilities is

excluded from the MWTA definition. The NYSDOH defines class 5 wastes as

wastes from animals known to be contaminated with infectious agents or

from animals inoculated during research, the production of biologicals,

or pharmaceutical testing. Unlike the MWTA definition, the NYSDOH

definition seems to include some wastes (from animals contaminated with

infectious agents) generated by general veterinary practices. The

specifics of this definition are included in item IV-J-078 in the

docket).

Also, as stated at proposal, the EPA is inclined to exclude

crematories and incinerators used solely for burning pathological waste

(human or animal remains and tissues) from the medical waste

incinerator regulation. However, MWI that burn animal and pathological

waste co-mingled with other classes of medical waste would be subject

to the regulation. Because MWI that burn mixtures of medical and

pathological (or animal) waste would be covered by the regulation, it

is necessary to include a description of pathological and animal waste

in the definition of medical waste. Human pathological waste and animal

waste are included in the NYSDOH definition of medical waste.

In addition, the EPA is inclined to exclude from the regulation

incinerators used solely for burning ``off-spec'' or ``out of date''

drugs or pharmaceuticals, as well as incinerators used solely for

burning radio-active type medical wastes. In other words, as several

comments suggested, the EPA is inclined to treat these wastes in a

manner similar to pathological waste.

While EPA is inclined to exclude these types of wastes from the

regulation for MWI, this exclusion does not mean that EPA will not

develop regulations which will cover these wastes. The Clean Air Act

clearly directs the EPA to develop regulations to cover burning of

these wastes. Thus, this inclination to exclude them is only to

temporarily defer regulation.

The Clean Air Act directs the EPA to develop regulations for all

solid waste incinerators, and burning these wastes will be covered by

regulations developed within the next few years. The Clean Air Act also

directs the EPA to announce a schedule for development

[[Page 31753]]

of these other regulations, and the EPA has announced these regulations

will be developed by the year 2000.

I. Pyrolysis Units

Incineration is only one of several medical waste treatment

technologies. Other treatment technologies, such as autoclaves,

microwaves, and chemical treatment, where there is clearly no

combustion occurring, are referred to in this notice as ``alternative

technologies'' and are discussed further in Section II.J. These

``alternative technologies'' clearly are not subject to MWI

regulations. On the other hand, some medical waste treatment

technologies employ plasma or gasification processes (i.e., pyrolysis).

Because it appears that at least some combustion is taking place in

these devices, EPA considered these pyrolysis technologies covered by

the proposed MWI regulations.

Comments from the vendors of pyrolysis technologies indicated they

believed they could easily meet the emission limitations included in

the proposed MWI standards and guidelines. However, they believed that

their processes are unique enough to warrant a separate category for

regulation. The vendors were particularly concerned that the proposed

compliance and monitoring requirements for MWI do not apply to

pyrolysis technologies. The proposal, therefore, requested comment on

whether pyrolysis units should be regulated as MWI or as a separate

source category.

Numerous comments and suggestions were received following proposal

from vendors of pyrolysis treatment technologies. Based on these

comments and suggestions, a draft regulation for pyrolysis treatment

technologies has been developed and is available in the docket as item

IV-B-56. This draft regulatory text is incomplete at this time. It

includes placeholders and requests for information where such

information is lacking. Comments are requested to help EPA fill in this

missing information.

A separate regulation for pyrolysis treatment technologies would

look very similar to the MWI regulation in that it would contain

definitions, emissions limitations, monitoring and testing requirements

to demonstrate compliance, and reporting and recordkeeping

requirements. It would differ from the MWI regulations in that some

definitions would be different, the emission limitations would, in many

cases, be more stringent than the MWI regulations, and the monitoring

and testing requirements would reflect the operating parameters that

are unique to pyrolysis systems.

The EPA is inclined to adopt separate regulations for pyrolysis

treatment technologies. The EPA specifically requests comment on the

merits of continued development of separate regulations for pyrolysis

systems. These systems appear to be very different than incinerators.

Because they are emerging technologies, however, the normal process of

determining a MACT floor and MACT for these systems is not possible at

this time. In fact, because they appear to be inherently clean

technologies, regulation of these systems may not be warranted at this

time.

J. Alternative Medical Waste Treatment Technologies

In the proposal, it was estimated that many owners of existing

onsite MWI would discontinue use of their existing MWI in favor of less

expensive medical waste disposal options to avoid the high cost of add-

on air pollution control equipment. In addition, many facilities that

would have chosen to purchase a new onsite MWI were estimated to be

likely to choose some other method of waste disposal. This phenomenon

was labeled as ``switching'' in the proposal, and it has already

occurred in a few States that have adopted stringent MWI regulations in

the past few years.

Next to onsite incineration, the two most common methods of medical

waste disposal are (1) offsite contract disposal, which usually

involves larger, commercial incinerators dedicated to medical waste and

(2) onsite alternative medical waste treatment technologies, which

include steam autoclaving, chemical treatment, and microwave

irradiation. Because the MWI regulation may encourage switching and the

use of onsite alternatives, the possible impacts of other waste

disposal methods were assessed. Although autoclaves, chemical treatment

systems, and microwave systems are not covered by the MWI standards and

guidelines, commercial medical waste incinerators would be subject to

the MWI standards and guidelines.

Following proposal, new data on commercial disposal facilities

throughout the U.S. were obtained. Information on the costs of

commercial disposal for medical waste generators in both urban and

rural locations was obtained. Also, information on the environmental

impacts of increased transportation of medical waste was developed.

This new information pertaining to commercial disposal was factored

into the economic and environmental impacts analyses presented in

Sections III and IV of this notice. The remainder of this section will

focus on information relating to nonincineration alternative

technologies (i.e., autoclaves, chemical treatment, microwave

irradiation, etc.).

During the public comment period following proposal, several

concerns were raised regarding the availability, effectiveness, costs,

and environmental impacts of onsite alternative treatment technologies.

Concerns were also raised regarding alternative technology operator

safety and State acceptance of alternative technologies. Because of the

concerns raised during the public comment period, the Agency has

examined the available information on the effects that switching from

onsite incineration to alternative technologies could have on medical

waste generators and the environment.

Following proposal, a great deal of information on alternative

technologies was received. This information was compiled and is

presented in document No. IV-B-43. The material presented in document

IV-B-43 should not be considered an in-depth study of alternative

technologies. Instead, it is a review of the available information.

Based on this information, there appears to be no significant or

substantial adverse economic, environmental, or health and safety

issues associated with the increased use of these nonincineration

alternative medical waste treatment technologies.

The most widely used nonincineration alternative technologies are

autoclaves, chemical treatment systems, and microwave systems. In

autoclaves, the effects of heat from saturated steam and increased

pressure are used to decontaminate the medical waste. In chemical

treatment systems, an antimicrobial chemical, such as sodium

hypochlorite, chlorine dioxide, or peracetic acid, is used to

decontaminate the waste. In microwave technologies, medical waste is

wetted and heated to decontaminating temperatures with microwave

irradiation.

Most alternative technologies are equipped with a shredder or

grinder that is used to reduce the volume of the waste by up to 80

percent and render the waste unrecognizable. In some alternative

technologies, the waste is compacted, and the waste volume is reduced

by 50 percent. With most alternative technologies, the mass of the

waste is not reduced due to the entrainment of liquids that are added

during treatment.

Because shredding or grinding pathological and animal waste may

present aesthetically unacceptable

[[Page 31754]]

results, most alternative technologies are not suitable treatment

methods for these types of waste. Also, alternative technologies are

usually unable to effectively treat chemotherapy, hazardous, or low-

level radioactive wastes. The total waste stream at a typical hospital

contains less than 3 percent by weight of pathological, animal,

chemotherapy, hazardous, and low level radioactive wastes. Facilities

using alternative technologies usually package this portion of the

waste and send it to a commercial disposal facility.

The efficacy of autoclave, microwave, and other thermal treatment

technologies depends primarily on the treatment time and temperature.

The efficacy of chemical treatment systems depends on the treatment

time and the chemical concentration. The most widely used criteria for

determining the efficacy of an alternative technology in

decontaminating the waste was developed by the State and Territorial

Association of Alternate Treatment Technologies (STAATT). The STAATT

criteria recommends, as a safe and satisfactory level of medical waste

treatment, the inactivation of vegetative bacteria, fungi, lipophilic/

hydrophilic viruses, and mycobacteria at a 6 Log10 reduction or

greater and the inactivation of Bacillus subtilis or Bacillus

stearothermophilus at a 4 Log10 or greater. Efficacy test reports

indicate that autoclave systems, chemical treatment systems, and

microwave systems can meet and exceed the STAATT efficacy criteria.

Therefore, the most widely used alternative treatment technologies seem

to be effective methods of decontaminating medical waste.

In most States, alternative technologies must undergo an approval

or permitting process before they can be installed in the State. As

long as the technology can demonstrate that it meets the State's

efficacy requirements, which are usually similar to, if not the same

as, the STAATT criteria, the technology can be installed, unless the

State determines that the technology is unacceptable for some other

reason. The State approval or permitting process usually takes less

than a year. Many alternative technology vendors have gained approval

of their systems in a number of States so that less time will be

required for review of the technology by State regulatory agencies

before the system is installed.

There are some 20 vendors of alternative technologies (i.e.

autoclaves, chemical treatment systems, and microwave systems) that

have a considerable number of installations. These vendors, when

combined, have about 150 years of experience in the medical waste

business. Some of these vendors have more than 15 years of experience

alone. These vendors are responsible for approximately 975 alternative

technology installations, which range in capacity from 12 to 8,000

pounds of medical waste treated per hour. An additional 17 alternative

technology vendors were identified with systems that are under

development and are expected to appear on the market in the near

future.

Alternative technologies seem to be available, and many vendors

have been in the medical waste business for many years. With the number

of vendors that have alternative technologies under development, the

alternatives industry appears to be growing. Alternative technology

vendors claim they will be able to meet any increased demand for onsite

alternative systems due to switching.

The results from reports on the air emissions from autoclaves show

that there are some emissions of volatile organics from autoclaves.

However, the test reports also show that the emissions of Pb, Cd, Hg,

HCl, and PM from autoclaves are insignificant when compared to

emissions of the same pollutants from MWI. No information on dioxin

emissions from autoclaves was available. The available data on the air

emissions from autoclaves shows that these emissions are more organic

than the acid gas and metal emissions from MWI. Furthermore, it appears

that on a pound of pollutant per pound of waste basis, far less total

emissions are produced from treating medical waste in an autoclave than

from burning waste in an MWI.

No data is available on the air emissions from chemical treatment

systems and microwave systems. However, some States require chemical

treatment systems to obtain air permits. The emissions from microwave

systems are likely to be similar to those from an autoclave since lower

temperatures are used during microwaving and the only component added

is water.

Based on the information received, there does not appear to be any

water pollution from the liquid effluents of autoclaves and chemical

treatment systems and no liquid effluent from microwave treatment

systems. The results of Toxicity Characteristics Leachate Procedure

(TCLP) tests conducted on waste treated in an autoclave and a chemical

treatment system were far below the regulatory threshold for metals and

organics. Since the only component added to waste that is treated in a

microwave system is water, the TCLP tests conducted on microwaved waste

should produce similar results to those of autoclaved waste.

The annualized price per pound of medical waste treatment with an

alternative technology is comparable to the price per pound associated

with other methods of medical waste treatment and disposal. For

facilities that wish to treat their medical waste onsite with an

alternative technology, but do not have the capital to purchase an

alternative system, options for leasing or renting an alternative

technology are available. According to alternative technology vendors,

leasing onsite medical waste treatment technologies is a common

practice. Most lease agreements are available either through the

alternative vendor directly or through a third party leasing company.

The results from a survey of hospitals that are currently using

autoclaves, chemical treatment systems, and microwave systems indicate

that these hospitals are pleased with the operation of their

alternative medical waste treatment systems. The hospitals indicated

that problems with shredder jams are rare and that odors are minimal

with the alternative systems. The surveyed hospitals reported that the

alternative technologies are cost effective and easy to operate. The

hospitals also indicated that the waste treated in their alternative

systems is readily accepted at local landfills. Further, the hospitals

indicated that they would recommend their alternative technology as a

method of medical waste treatment.

The potential hazards associated with medical waste treatment arise

primarily from the presence and handling of infectious waste.

Therefore, the potential hazards of medical waste treatment are similar

for operators of all medical waste treatment technologies, including

MWI. Few, if any, additional hazards are associated with alternative

technologies that have not already been associated with medical waste

incineration.

III. Regulatory Options and Impacts for Existing MWI

As discussed earlier, the MACT ``floor'' defines the least

stringent emission guidelines the EPA may adopt for existing MWI.

However, as also discussed earlier, the Clean Air Act requires the EPA

to examine alternative emission guidelines (i.e., regulatory options)

more stringent than the MACT floor. The EPA must consider the cost,

environmental, and energy impacts of these regulatory options and

select one that reflects the maximum reduction in

[[Page 31755]]

emissions that EPA determines is achievable (i.e., MACT).

At proposal, the EPA concluded all existing MWI would need good

combustion and dry scrubbers to meet the MACT floors for CO, PM, and

HCl. Consequently, EPA was left to consider only two regulatory options

for MACT. The first regulatory option reflected the floor (i.e.,

emission limitations achievable with good combustion and dry

scrubbers). The second reflected emission limitations achievable with

good combustion and dry scrubbers with activated carbon injection.

Based on the cost, environmental, and energy impacts of the second

regulatory option relative to the first option, EPA selected the second

option as MACT. Consequently, EPA proposed emission guidelines for

existing MWI based on the use of good combustion and dry scrubbers with

activated carbon injection.

As discussed earlier in this notice, EPA received numerous comments

containing substantial new information following proposal. Based on

this information, new conclusions concerning the MWI inventory, MWI

subcategories, performance of emission control technologies, MACT

floors, and monitoring and testing options have been reached. As a

result, EPA now believes there are several new regulatory options that

merit consideration in selecting MACT for existing MWI. The following

sections summarize these new regulatory options and the EPA's initial

assessment of their merits.

A. Regulatory Options

As discussed earlier, new MACT floor emission levels were developed

for small, medium, and large MWI. To assess the impacts of regulatory

options, EPA must first consider what emission control technology(s)

existing MWI may need to meet regulations based on these floor emission

limits. The floor for small existing MWI appears to require good

combustion; add-on wet scrubbing systems would not be necessary to meet

the MACT floor. For medium existing MWI, the MACT floor appears to

require good combustion and a moderate efficiency wet scrubber. The

MACT floor for large existing MWI appears to require good combustion

and a high efficiency wet scrubber.

Having identified these control technologies, the EPA is now able

to review the performance capabilities of other emission control

technologies and identify those that are capable of achieving even

greater emission reductions. This review enables EPA to identify

regulatory options more stringent than the floor that could be selected

as MACT.

For small existing MWI, as mentioned above, good combustion is the

emission control technology most MWI would probably need to meet the

MACT floor emission levels. Therefore, this technology serves as the

basis for the first regulatory option for the MACT emission guidelines

for small existing MWI. Based on the performance capabilities of

various emission control technologies, however, using low efficiency

wet scrubbing systems in addition to good combustion could achieve

greater emission reductions. This combination would achieve further

emission reductions in PM and dioxins, as well as HCl, Pb, Hg, and Cd.

Therefore, these controls used together are a possible option beyond

the MACT floor emission levels for small existing MWI.

As discussed earlier in Section II.B., the availability of

alternatives for the treatment and disposal of medical waste is

generally more limited in rural areas than in urban areas. Therefore,

the potential impact of MACT regulations on small existing MWI may be

greater in rural than in urban areas. This concern was expressed in

many comments EPA received following proposal. As also discussed

earlier in Section II.B., section 129 of the Clean Air Act permits EPA

to subcategorize the MACT emission guidelines by class, consequently,

subcategorizing small existing MWI into rural and urban classes was

examined. In terms of the MACT floor emission limits, however,

subcategorizing small existing MWI into rural and urban classes made no

difference--the MACT floor emission limits are the same. As a result,

for purposes of the MACT floor, there is no merit to subcategorizing

small existing MWI into rural and urban classes.

Although subcategorizing based on location was rejected for

purposes of the MACT floor, it was considered again in identifying

regulatory options more stringent than the MACT floor. Thus, the

regulatory option of MACT emission guidelines for small existing MWI

based on the use of good combustion and low efficiency wet scrubbing

systems was subdivided to create two options. The first regulatory

option beyond the MACT floor is to base the MACT guidelines for small

existing MWI located in rural areas on good combustion only, as

required by the MACT floor, but to base MACT guidelines for small

existing MWI located in urban areas on good combustion and low

efficiency wet scrubbing systems. If this option were selected as the

basis for the final MACT emission guidelines, the emission limits for

small existing MWI located in rural areas would be different than the

emission limits for small existing MWI located in urban areas.

As discussed in Section II.B., location, by itself, is not a valid

criterion for subcategorization under the Clean Air Act. In addition,

use of location as surrogate measure of the availability of technology

may not be a valid criterion for subcategorization either. There may be

statutory limitations to this approach. As a result, the previous

discussion regarding differences in regulatory requirements based on

the location of an MWI may not be allowed under the Clean Air Act, and

EPA specifically requests comment on the validity of this approach. As

discussed later in Section V., one of the options EPA is considering

would reflect good combustion and wet scrubbers on all small existing

MWI except where an individual MWI could meet certain ``criteria,'' in

which case the individual MWI would be subject to emission limits based

on good combustion alone. Consequently, in addition to seeking comment

on the validity of identifying urban and rural MWI as separate

``classes,'' EPA also requests comment on other criteria that could be

used to make distinctions in regulatory requirements.

A third regulatory option is MACT emission guidelines for small

existing MWI located in both rural and urban areas based on good

combustion and low efficiency wet scrubbing systems. In other words, no

difference in the MACT emission limits between small existing MWI

located in rural or urban areas would exist. This third option would

achieve greater emission reductions than the second option.

Beyond these three regulatory options (i.e., the MACT floor option

and the two options more stringent than the floor), a review of the

performance capabilities of various emission control technologies

readily identifies a fourth regulatory option for small existing MWI.

This regulatory option is to base the MACT emission guidelines for

small existing MWI on the use of good combustion and moderate

efficiency wet scrubbing systems. This regulatory option would further

reduce PM emissions, however, it would not achieve further reductions

in emissions of other pollutants. As summarized earlier, moderate and

high efficiency wet scrubbing systems do not appear to achieve greater

emission reductions of dioxins, acid gases (e.g., HCl), or the metals

(i.e., Hg, Pb, or Cd) than low efficiency wet scrubbing systems.

[[Page 31756]]

Option 4 could also be subdivided into two options: (1) MACT

emission guidelines for small existing MWI in rural areas based on good

combustion and low efficiency wet scrubbing systems; and MACT

guidelines for small existing MWI in urban areas based on good

combustion and moderate efficiency wet scrubbing systems and (2) MACT

emission guidelines for small existing MWI in both rural and urban

areas based on good combustion and moderate efficiency wet scrubbing

systems. However, the cost difference between using a low efficiency

wet scrubbing system or a moderate efficiency wet scrubbing system is

not as great as that between using a low efficiency wet scrubbing

system or not using a wet scrubbing system at all. Consequently, at

this point, to limit the number of regulatory options under

consideration, the EPA has chosen not to further subdivide this

regulatory option.

Reviewing the performance capabilities of emission control

technologies identifies a fifth regulatory option for small existing

MWI. This option is to base the MACT emission guidelines for small

existing MWI on the use of good combustion and high efficiency wet

scrubbing systems. This would further reduce PM emissions, but as

outlined above, would not further reduce emissions of other air

pollutants such as dioxins, acid gases (e.g., HCl), or the metals

(i.e., Pb, Hg, Cd).

A sixth regulatory option for small existing MWI also is apparent.

This option is to base the MACT emission guidelines for small existing

MWI on the use of good combustion and dry scrubbing systems with

activated carbon injection. This possibility would further reduce

emissions of Pb, Cd, and dioxins, but would not further reduce

emissions of other air pollutants. Dry scrubbing systems, however,

generally cost about one and a half times what high-efficiency wet

scrubbing systems cost to operate annually, and the overall difference

in the emissions control performance between the two systems is

relatively small. Therefore, at this point, to limit the total number

of regulatory options under consideration, the EPA has chosen not to

include this sixth regulatory option for small existing MWI.

For medium existing MWI, as discussed earlier, the use of good

combustion and moderate efficiency wet scrubbing systems appears to be

necessary to meet the MACT floor emission limits. This option,

therefore, is the first regulatory option for medium existing MWI. The

second regulatory option is to base the emission guidelines on good

combustion and high efficiency wet scrubbing systems.

Finally, for large existing MWI, as discussed earlier, the use of

good combustion and high efficiency wet scrubbing systems appears to be

necessary to meet the MACT floor emission limits. Thus, the EPA is not

inclined at this point to consider other regulatory options for large

existing MWI.

As mentioned above, a review of the performance capabilities of

emission control technologies indicates that dry scrubbing systems can

reduce emissions of some pollutants (i.e., Pb, Cd, and dioxins) greater

than high-efficiency wet scrubbing systems. Additional regulatory

options for both medium and large existing MWI could be structured,

therefore, around the use of dry scrubbing systems. However, as also

mentioned above, the cost of these systems is much higher than that of

high-efficiency wet scrubbing systems and the overall difference in

emission control performance is relatively small. For existing MWI

already equipped with wet scrubbers, replacing a wet scrubber with a

dry scrubber would be exorbitantly expensive. As a result, at this

point, the EPA has chosen not to develop additional regulatory options

for medium and large existing MWI based on the use of dry scrubbing

systems to keep the total number of regulatory options under

consideration to a manageable number.

The regulatory options outlined above are compiled in Table 13.

This table summarizes the technology basis for the regulatory options

for the various MACT emission guidelines the EPA believes merit

consideration as MACT for existing MWI. This table is constructed only

to organize and structure an analysis of the cost, environmental, and

energy impacts associated with the various MACT emission guidelines in

order to consider these impacts in selecting MACT for existing MWI. In

reviewing this table, therefore, there are several important points to

keep in mind.

Table 13.--Level of Air Pollution Control Associated With Each Regulatory Option for Existing MWI

--------------------------------------------------------------------------------------------------------------------------------------------------------

Regulatory options

MWI size -----------------------------------------------------------------------------------------------------------------------

1 2 3 4 5 6

--------------------------------------------------------------------------------------------------------------------------------------------------------

Small 200 lb/hr...... Good combustion... Good combustion on Good combustion Good combustion Good combustion Good combustion

rural; Good and low and moderate and moderate and high

combustion and efficiency wet efficiency wet efficiency wet efficiency wet

low efficiency scrubber. scrubber. scrubber. scrubber.

wet scrubber on

urban.

Medium 201-500 lb/hr............ Good combustion Good combustion Good combustion Good combustion Good combustion Good combustion

and moderate and moderate and moderate and moderate and high and high

efficiency wet efficiency wet efficiency wet efficiency wet efficiency wet efficiency wet

scrubber. scrubber. scubber. scrubber. scrubber. scrubber.

Large 500 lb/hr................. Good combustion Good combustion Good combustion Good combustion Good combustion Good combustion

and high and high and high and high and high and high

efficiency wet efficiency wet efficiency wet efficiency wet efficiency wet efficiency wet

scrubber. scrubber. scubber. scrubber. scrubber. scrubber.

--------------------------------------------------------------------------------------------------------------------------------------------------------

First, the MACT emission guidelines for existing MWI will not

include requirements to use a specific emission control system or

technology; the MACT emission guidelines will only include emission

limits, which may be met by any means or by using any control system or

technology the owner or operator of the MWI decides to use to meet

these emission limits. Second, to the extent possible (i.e., within the

constraints imposed by Section 129 of the Clean Air Act), the EPA plans

to adopt emission limits in the MACT emission guidelines that can be

met through the use of several emission control systems or

technologies. Consequently, where not constrained by

[[Page 31757]]

the Clean Air Act, the actual emission limits associated with some of

the regulatory options shown in Table 13 have been selected at a level

designed to encourage or permit the use of both wet and dry scrubbing

control systems, as outlined below.

The emission limits associated with each of the regulatory options

for small, medium, and large existing MWI are presented in Table 14.

Table 14.--Emission Limitations Associated With Each Regulatory Option for Small, Medium, and Large Existing MWI

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Regulatory

Pollutant, units options Small MWI's Medium MWI's Large MWI's

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

1 2 (rural) 2 (urban)........ 3................ 4 and 5......... 6............... 1-4............. 5 and 6......... 1-6

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

PM, gr/dscf..................... 0.086 0.086 0.05............. 0.05............. 0.03............ 0.015........... 0.03............ 0.015........... 0.015.

CO, ppmdv....................... 40 40 40............... 40............... 40.............. 40.............. 40.............. 40.............. 40.

CDD/CDF, ng/dscm................ 800 800 125.............. 125.............. 125............. 125............. 125............. 125............. 125.

TEQ CDD/CDF, ng/dscm............ 15 15 2.3.............. 2.3.............. 2.3............. 2.3............. 2.3............. 2.3............. 2.3.

HCI, ppmdv...................... 3,100 3,100 100 or 93%....... 100 or 93%....... 100 or 93%...... 100 or 93%...... 100 or 93%...... 100 or 93%...... 100 or 93%.

SO2, ppmdv...................... 55 55 55............... 55............... 55.............. 55.............. 55.............. 55.............. 55.

NOx, ppmdv...................... 250 250 250.............. 250.............. 250............. 250............. 250............. 250............. 250.

Pb, mg/dscm..................... 10 10 1.2 or 70%....... 1.2 or 70%....... 1.2 or 70%...... 1.2 or 70%...... 1.2 or 70%...... 1.2 or 70%...... 1.2 or 70%.

Cd, mg/dscm..................... 4 4 0.16 or 65%...... 0.16 or 65%...... 0.16 or 65%..... 0.16 or 65%..... 0.16 or 65%..... 0.16 or 65%..... 0.16 or 65%.

HG, mg/dscm..................... 7.5 7.5 0.55 or 85%...... 0.55 or 85%...... 0.55 or 85%..... 0.55 or 85%..... 0.55 or 85%..... 0.55 or 85%..... 0.55 or 85%.

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Regulatory Option 1 in Table 14 reflects the performance of the

emission control system or technology needed to meet the MACT floor.

For small existing MWI, Regulatory Option 1 reflects emission limits

based on good combustion. For medium existing MWI, Regulatory Option 1

reflects emission limits based on good combustion and moderate

efficiency wet scrubbers, except for HCl (discussed below). For large

existing MWI, Regulatory Option 1 reflects emission limits based on

good combustion and high efficiency wet scrubbers, except for HCl

(discussed below).

Dry scrubbers with activated carbon injection can achieve the

emission limits associated with moderate or high efficiency wet

scrubbers, with the exception of HCl. While dry scrubbers cannot reduce

HCl emissions to the same levels as wet scrubbers, dry scrubbers can

achieve the MACT floor emission level for HCl. Consequently, Regulatory

Option 1 reflects the HCl emission limit achievable with a dry scrubber

for both medium and large existing MWI. Both technologies (wet or dry

scrubber) are capable of achieving the emission limits shown for

Regulatory Option 1.

Regulatory Option 2 is the same as Regulatory Option 1 for medium

and large existing MWI. Small existing MWI located in urban areas would

be required to meet emission limits associated with good combustion and

low efficiency wet scrubbers. Small existing MWI located in rural areas

would remain subject to the same emission limits as Regulatory Option 1

(based on good combustion). Regulatory Option 3 would establish

emission limits for all small existing MWI (urban and rural) based on

good combustion and low efficiency wet scrubbers. Regulatory Option 4

would establish emission limits for all small existing MWI based on

good combustion and moderate efficiency wet scrubbers. Requirements for

medium and large existing MWI would remain the same under Regulatory

Options 1, 2, 3, and 4. As discussed above, HCl emission limits in all

cases would allow the use of dry scrubbers.

Regulatory Option 5 would establish emission limits for small

existing MWI based on good combustion and moderate efficiency wet

scrubbers; medium existing MWI based on good combustion and high

efficiency wet scrubbers; and large existing MWI based on good

combustion and high efficiency wet scrubbers. The sixth and final

regulatory option would require all existing MWI to meet emission

limitations associated with good combustion and high efficiency wet

scrubbers. As discussed above, the HCl emission limit under Regulatory

Options 5 and 6 would allow the use of dry scrubbing systems.

B. National Environmental and Cost Impacts

This section presents a summary of the air, water, solid waste,

energy, and cost impacts of the six regulatory options described above

for existing MWI. Economic impacts are discussed in Section III.C. All

impacts are nationwide impacts resulting from the implementation of the

emission guidelines on existing MWI.

1. Analytical Approach

As discussed at proposal and within this notice, healthcare

facilities may choose from among a number of alternatives for treatment

and disposal of their medical wastes; however, these alternatives are

generally more limited for healthcare facilities located in rural areas

than for those in urban areas. In fact, as stated at proposal, most

estimates are that less than half of hospitals today currently operate

onsite medical waste incinerators. The clear trend over the past

several years has been for more and more hospitals to turn to the use

of alternative onsite medical waste treatment technologies or

commercial offsite treatment and disposal services. Consequently, even

fewer hospitals are now likely to operate onsite medical waste

incinerators.

More than half of existing hospitals today, therefore, have chosen

to use other means of treatment and disposal of their medical waste

than operation of an onsite incinerator. This is a clear

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indication that alternatives to the use of onsite incinerators exist

and that they are readily available in many cases. (Although as

mentioned above, these alternatives--particularly the availability and

competitive cost of offsite commercial treatment and disposal

services--tend to be more limited in rural areas than in urban areas).

For other healthcare facilities, such as nursing homes, outpatient

clinics, doctors and dentists offices, etc., only very few facilities

currently operate onsite medical waste incinerators. Therefore, for

these types of healthcare facilities, the percentage of such facilities

using alternative means of treatment and disposal of medical waste--

particularly commercial treatment and disposal services--is much

higher, probably higher than 95 percent. This high percentage is

further confirmation of the availability of alternatives to onsite

incinerators for the treatment and disposal of medical waste.

A very likely reaction and outcome associated with the adoption of

MACT emission guidelines for existing MWI, therefore, is an increase in

the use of these alternatives by healthcare facilities for treatment

and disposal of medical waste. The EPA's objective is not to encourage

the use of alternatives or to discourage the continued use of onsite

medical waste incinerators; the EPA's objective is to adopt MACT

emission guidelines for existing MWI that fulfill the requirements of

Section 129 of the Clean Air Act. In doing so, however, one outcome

associated with adoption of these MACT emission guidelines is likely to

be an increase in the use of alternatives and a decrease in the

continued use of onsite medical waste incinerators. Consequently, EPA

should acknowledge and incorporate this outcome into the analyses of

the cost, environmental, and energy impacts associated with the MACT

emission guidelines.

In these analyses of the cost, environmental, and energy impacts,

the selection of an alternative form of medical waste treatment and

disposal by a healthcare facility, rather than the operation of an

onsite medical waste incinerator and purchase the emission control

technology necessary to meet the MACT emission limits, is referred to

as ``switching''. Switching was incorporated in the analyses at

proposal and was the basis for the conclusion at proposal that adoption

of the proposed MACT emission guidelines could lead to as many as 80

percen

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Standards of Performance for New Stationary Sources and Emission Guidelines for Existing Sources: Medical Waste Incinerators · 61 FR 31736 | Frix