Hospital Radwaste in the News - Additional Info & Clarification

["Richard, Mack L" <mrichar@iupui.edu>]

Dear Daren & Radsafers:

Daren Perrero raised some regulatory issues and requested clarification on
today's article in the Indianapolis Star regarding I-131 radwaste
originating in patients' homes.  I'll try to provide a little more
information.

You must first understand the players in this issue.  First, the city
incinerator is operated by a private firm - Ogden-Martin.  They are really
the crux of the problem because their approach is that if a load of waste
sets off their radiation monitor, they don't want it - it doesn't matter if
it's a thermonuclear device, a 100 Ci industrial radiography source, or a
contaminated kleenix from an I-131 patient - it's all the same to them.
After some repeated attempts to explain the difference in the above sources,
they do acknowledge that there are differences; however, they fall back on
the language on their incinerator permit (issued by the City of
Indianapolis) which states that they cannot incinerate radioactive materials
(yes, we pointed out that practically everything has radioactivity in it).
There is no requirement in their permit to monitor the waste coming into
their facility.  A few years ago, they apparently did receive and incinerate
some type of higher level source which ended up costing them a fair amount
of money to clean up their incinerator and dispose of the waste.  Thus, they
are simply trying to protect their facility from a similar incident.

Other players in this issue include the Indianapolis Department of Public
Works (IDPW) and the private waste haulers (e.g. BFI, et. al.).  When a
truck hauling municipal waste is rejected by Ogden-Martin, the waste hauler
is stuck with it.  Since the waste comes from multiple residences, there is
no way they can identify which residence it came from.  If the offending
radionuclide is I-131, the waste hauler has 2 options - either take the
truck out of service for about 80 days or dump the load onto the ground,
sift through it with a survey instrument, and remove the contaminated
material.  Taking the truck out of service for almost 3 months is not a
viable option from the cost standpoint, so the second option (known as
"dumpster diving") had to be implemented.  As I stated in my previous post,
sifting through municipal trash, particularly in the summer, is not
particularly appealing.  In fact, I would consider it pretty hazardous for
reasons other than the minute amount of radioactivity.

Early in 2000, IDPW requested a meeting with the RSOs from the local
hospitals, primarily to obtain information regarding the source of the I-131
in the municipal waste.  It was at this meeting, that IDPW proposed a
voluntary program whereby the hospital would fax them the address of any
patients treated with ~100 mCis of more of I-131 if the patient was to be
released from the hospital under the NRC regulations.  Due to patient
confidentiality, release of such information would require the written
consent of the patient.  During this first meeting, the RSOs from the larger
hospitals proposed some alternatives for Ogden-Martin (they had a
representative at the meeting), but they were not interested in deviating
from their current position or procedures.  Members of the state regulatory
agency were present at the meeting and agreed with the hospital RSOs that no
regulations were being violated; therefore, the hospitals were not obligated
to participate in the voluntary program.

As I stated in my previous post, the 3 largest hospitals in Indianapolis
decided against participating in this voluntary program; however, some of
the small hospitals are participating.  Today's article in the newspaper
implies that all hospitals are participating, which is simply not the case.

With respect to Daren Perrero's comments, I don't think the NRC considers
this stuff exempt due to the fact that it's patient excreta.  10 CFR 20
exempts excreta from patients for disposal via the sanitary sewer.  While it
would make sense to exempt patient excreta regardless of its ultimate fate,
I believe the NRC considers this a non-issue because the patient has been
released from the licensee's control.  It follows that if you release the
patient from licensee control, you are also releasing anything in the
patient (or that comes out of the patient) from the licensee's control.

Regarding the state regulators, the Radiological Control Section of the
Indiana State Department of Health (ISDH) responds to radiation incidents if
no other regulatory agencies (e.g., the NRC) do so.  I'm not sure under what
regulation, mandate, or internal policy this response activity falls under.

With respect to the DOT issue, I am aware that the state/ISDH has some type
of blanket exemption from DOT regulations should they need to transport
radioactive material to protect the citizens of Indiana. (e.g., transport an
orphaned source to a secure location).  Since the IDPW is a governmental
entity of the city, this exemption may have been extended to cover their
transport activities as well (this is purely conjecture on my part - I could
be wrong on that).

The other regulatory agency that no one has mentioned related to this issue
is the EPA.  It is my understanding that "orphaned sources" (i.e., lost,
abandoned, or stolen sources that cannot be tied to an NRC licensee) fall
under the jurisdiction of the EPA.  I'm not sure if this contaminated
municipal waste can be considered an "orphaned source".  I suppose someone
could ask the EPA (any volunteers?).  There might also be some EPA issues
for Ogden-Martin should they decide to incinerate this material.

Sorry for the length of this message - it's a complicated issue.

Regards,
Mack R.  

Mack L. Richard, M.S., C.H.P.
Radiation Safety Officer - IUPUI/Indiana Univ. Med. Cntr.
Phone #: (317) 274-0330   Fax #: (317) 274-2332
E-Mail Address:  mrichar@iupui.edu

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