BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 762
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          Date of Hearing:   May 10, 2011

           ASSEMBLY COMMITTEE ON ENVIRONMENTAL SAFETY AND TOXIC MATERIALS
                                Bob Wieckowski, Chair
                  AB 762 (Smyth) - As Introduced:  February 17, 2011
                              As Proposed To Be Amended
           
          SUBJECT :   Medical waste.

           SUMMARY  :   Deletes the requirement in current law that, in order 
          for it to be consolidated into a common container, medical 
          waste, bio-hazardous waste, and sharps waste must be treated by 
          extremely high heat technology.  Authorizes the common 
          containers for these wastes to be reusable.  Authorizes the 
          Department of Public Health (DPH) to approve "INCINERATION" as 
          one of the words that may be used on the label of a common 
          container. 

           EXISTING LAW  :

          1)Establishes the Medical Waste Management Act (MWMA), 
            administered by the Department of Public Health (DPH), to 
            regulate the management and handling of medical waste.

          2)Establishes requirements for containing or storing medical 
            waste.  Authorizes medical waste, bio-hazardous waste, and 
            sharps waste to be consolidated into a common container, 
            provided that the consolidated waste is treated by extremely 
            high heat technology.

          3)Requires the common container to be labeled with the 
            bio-hazardous waste symbol and the words "HIGH HEAT ONLY," or 
            other label approved by DPH, on the lid and on the sides, to 
            ensure treatment of the bio-hazardous waste as required

           FISCAL EFFECT  :   Unknown.

           COMMENTS  :

           Need for the bill  :  SB 419 (Scott, Chapter 477, Statutes of 
          2004) amended the California Medical Waste Management Act (MWMA) 
          (Health and Safety Code Section 118275) to allow consolidation 
          of medical waste into a common container provided that the waste 
          is treated by an approved extreme high heat technology and that 
          the container is labeled as required by the bill.








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          According to the author's office, "Sewering, autoclave and 
          incineration treatments were recognized as acceptable treatment 
          methods at the time the ÝMWMA] was adopted and any other type of 
          treatment came to be known as alternative (to these recognized) 
          treatments.  SB 419 was adopted in anticipation that plasma arc 
          alternative treatment technology would soon be brought into 
          operation in California.  This and other forms of high heat 
          alternative treatment technologies have not developed due to 
          high development costs and the inability to operate them in a 
          cost-efficient manner.

          Over time and with no alternative high heat treatment being 
          introduced, some hospitals used the SB 419 provision incorrectly 
          to consolidate sharps and pharmaceutical wastes into a single 
          container and sending it for incineration.  Medical waste 
          incinerators typically operate at temperatures greater than 1300 
          degrees Fahrenheit.  Sharps wastes can be treated by 
          incineration and pharmaceutical wastes that do not fall under 
          the provisions of the federal Resource Conservation and Recovery 
          Act (RCRA) must be treated by medical waste incineration, if 
          they come under the provisions of the MWMA or may be incinerated 
          if they are ungoverned.  RCRA pharmaceutical wastes must be sent 
          to a federally licensed hazardous waste incinerator.  The 
          incorrect application of the SB 419 provision was that the 
          medical waste incinerators were not "alternative" treatment 
          technologies and a strict interpretation of the MWMA."
           
          Extremely high heat technology  :  According to legislative 
          analyses of SB 419, the author intended the bill to allow 
          hospitals that choose to use extremely high heat technologies to 
          combine wastes and create a more efficient on-site medical waste 
          disposal system.  The author pointed to the plasma arc treatment 
          process as an example of high heat technology that might be used 
          to treat medical waste.  According to a November 2000 paper of 
          the International Centre for Science and High Technology of the 
          United Nations Industrial Development Organization, in plasma 
          arc treatment, an electric current is directed through a 
          low-pressure gas stream, which creates a thermal plasma field.  
          These plasma arc fields can reach 5000 to 15000?C.  The intense 
          high temperature zone can be used to dissociate waste into its 
          atomic elements by injecting the waste into the plasma, or by 
          using the plasma arc as a heat source for combustion.  

          The sponsor of AB 762, the California Hospital Association 








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          (CHA), argues that SB 419 was adopted in anticipation that 
          plasma arc alternative treatment technology would soon be 
          brought into operation in California.  CHA notes that a plasma 
          arc technology company called InEntec had gained approval to 
          build a "Plasma Enhanced Melter" in Red Bluff, CA.  According to 
          the InEntec Website, this technology transforms municipal, 
          industrial, medical, and hazardous waste into clean energy 
          products for transportation fuels, electricity generation and, 
          industrial products.  CHA states that with the downturn of the 
          economy, the project was discontinued.

           Support  :  According to CHA, "One of the main threats to 
          California's streams and other waterways is contamination from 
          pharmaceuticals.  This occurs through leachate from landfills or 
          waste condensation from autoclaves.  Treating Ýmedical waste, 
          bio-hazardous waste and sharps wastes] in one common container 
          which may be reusable and incinerated is better for the 
          environment and for hospital workers.  The amount of time spent 
          deciding the appropriate segregation option at the point of 
          waste generation or the work site where care is rendered is also 
          reduced."  Kaiser Permanente argues, "This bill will encourage 
          health care organizations to put medical waste in reusable 
          containers and reduce health care worker confusion over how to 
          safely and legally dispose of medical waste."

           Double referral  :  This bill passed the Assembly Health Committee 
          on May 3, 2011, 18 - 0.

           REGISTERED SUPPORT / OPPOSITION  :

           Support

           California Hospital Association (sponsor)
          Association of California Health Care Districts
          Catholic Healthcare West 
          Kaiser Permanente

















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           Opposition 
           
          None received.
           

          Analysis Prepared by  :    Shannon McKinney / E.S. & T.M. / (916) 
          319-3965